Havana Syndrome Demonstrates the Power of Suggestion
(Bloomberg Opinion) -- It started in November of 2016, with a young U.S. undercover agent in Havana hearing a piercing noise, then realizing that his ears wouldn’t stop ringing and that he’d lost some of his hearing. He told colleagues who remembered hearing weird noises, too. Soon, more than a dozen American diplomats and intelligence agents were reporting distressing symptoms — difficulty concentrating, headaches, insomnia, dizziness. Some heard weird noises, some didn’t.
For months, the Central Intelligence Agency and many media outlets thought the culprit was some sort of exotic microwave weapon, possibly wielded by Russian agents. But now, amid alarming reports of similar maladies affecting at least 200 people in foreign service posts from China to London to Colombia, scientists are starting to consider something more mundane — psychosomatic illness.
That’s the explanation favored by a prestigious panel called Jason, commissioned by the State Department and reported to the public in September. The finding doesn’t mean psychology explains all cases, or that anyone should dismiss the problem, which afflicts Americans and some Canadians who work in intelligence or diplomacy — including two aides traveling in India with CIA Director William Burns.
Psychosomatic illness is widely misunderstood. Its origins are psychological but its symptoms are physical. It’s not imaginary and victims aren’t fakers.
“In the practice of neurology, we see people with profound comas, profound paralysis, very severe symptoms are often a manifestation of psychosomatic symptoms,” said Suzanne O’Sullivan, a neurologist at the National Hospital for Neurology and Neurosurgery in Ireland.
She considers psychogenic illness to be a problem with the way the mind and body interact, and she’s concerned that people are using it to minimize the suffering of Havana Syndrome victims.
“If people were able to understand that what's happening to them is disabling and terrifying and real and outside of their control, then it would be a lot easier for them and the doctors caring for them to accept that this could have a psychosomatic cause,” she said.
Listen to an interview with Dr. Suzanne O’Sullivan in an episode of Faye Flam’s podcast, Follow the Science, which covers how we can distinguish scientific ideas from chatter, speculation, sanctimony, hype and noise.
Psychology alone might not account for all the cases — especially the first ones, before the power of suggestion could be a factor. And in those, there’s nothing far-fetched about the notion that loud sounds could cause distress, or in one case hearing loss and tinnitus. Such things can happen by accident, so it’s a big leap to attribute them to a new kind of weapon.
A detailed account from ProPublica says that the Federal Bureau of Investigation eventually discarded the sonic-weapon hypothesis. There’s no known device that can target sound so precisely that it can damage one person’s hearing and not even register with others.
As the number of victims grew to more than 20, the symptoms became more diverse, as did the description of the sounds. Over the next few months, those reporting symptoms or weird sounds were sent to the University of Pennsylvania where neurologists tested their balance, cognitive function, hearing and vision, and conducted MRI scans of their brains. Those results, published in the Journal of the American Medical Association, were inconclusive.
Later, the Penn researchers would use a more fine-grained MRI technique to uncover a subtle difference between the victims and a control group, though other neurologists pointed out that this was likely to be a statistical fluke due to natural variation between peoples’ brains.
By 2018, another theory gathered favor — that someone, possibly Russian agents, was beaming microwaves at U.S. agents’ heads. The microwave theory rose to prominence after it was deemed the most plausible explanation by a panel assembled the by the National Academies of Sciences, Engineering and Medicine.
According to the report, microwaves can cause people to hear a sound through something called the Frey effect. But the NAS panel was heavy on doctors and light on physicists. In 2018, I talked with Ken Foster, a Penn bioengineer who, back in the 1970s, figured out how the Frey effect worked. To create more than a faint click, he said, you’d have to use enough microwaves to cook people’s brains. It’s never been clear how the theory ever got put on the table, he said, and when contacted for this column, he said he hasn’t changed his mind.
The Jason panel, founded in 1960 to advise the government and others about such matters as detection of nuclear tests or the safety of nuclear stockpiles, listened for its September report to recordings that some of the Havana patients made — ones who heard not a single loud noise but something more persistent. It determined that it came from crickets or cicadas, and that the most likely cause of Havana Syndrome was mass psychogenic illness. In the popular press it’s often referred to as mass hysteria, but that carries a stigma that isn’t fair or accurate.
O’Sullivan, the Irish neurologist, said it doesn’t mean these people are crazy or that they’ve imagined their symptoms. Consider the placebo effect, she said. Experiencing it is normal and common. Psychogenic illness is related to a harmful counterpart called the nocebo effect.
“If you give somebody something or do something to somebody and say this has the potential to be harmful, then a percentage of people can suffer physical symptoms,” she told me. The symptoms may be new, or might be existing symptoms that a person hadn’t paid as much attention to previously. In some circumstances, it can be disabling.
In the case of Havana Syndrome, she said, the nocebo effect could be reinforced by doctors, since many were convinced there had been an attack. As described in The New Yorker, a foreign service agent who went by the pseudonym Audrey Lee submitted to an exam, not initially convinced she had “the Thing,” which is how the Havana Syndrome was labeled early on. The doctors replied, “Oh, it’s definitely the Thing.” She was left convinced that she suffered from the syndrome.
O’Sullivan said she looked at all the MRI scans and found no evidence of physical abnormalities. Which doesn’t mean the problem isn’t real. “The symptoms are arising because our brains are flawed at dealing with information and they make mistakes,” she said.
And often, when there’s a mass psychogenic illness, the first case does have a more physical origin. And this is where a sound-related incident might still be worth considering. The first person to record symptoms — not just noises — was described in ProPublica as an athletic-looking man in his 30s who worked undercover for the CIA. It was late fall, and the weather was nice so it was common for people to leave their windows open.
The man reported something loud and piercing — not persistent — around his house. Did anyone else hear it? It’s not really clear, and long after the fact, people not adversely affected might not remember it.
I come to this story with a bias, personal familiarity with sonic injuries. It’s nothing remotely weird. I have moderate age-related hearing loss, which is probably genetic. In February, 2020, on a road trip, I stopped in a rest stop in Connecticut, where someone was testing a fire alarm. It went off right near my head. My ears rang after that, loudly. The interior alarm hasn’t let up and probably never will.
The ringing comes from a malfunction in the brain; chronic tinnitus is a brain disorder triggered by ear damage. At first, I felt horrible. Gradually, I got used to the ringing enough to sleep. I know from experience and research that it doesn’t take a fancy sonic weapon to damage the brain. Some people are more vulnerable than others, so a sound that causes permanent hearing loss and tinnitus in one person might leave others unscathed.
So it makes sense to take the idea of mass psychogenic illness seriously as a cause of Havana Syndrome, and also to take the illness and its investigation seriously. There’s much that could be learned whatever the cause — if it’s psychogenic, it might help reveal more about the way the mind and body are connected.
And if sound is involved in any cases, even if just one, it could raise awareness of the dangers of extremely loud noises. A sonic weapon would be as cruel as a blinding weapon. And loud noises that might be seen as a prank or nuisance could emerge as a cause of irreparable harm.
This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
Faye Flam is a Bloomberg Opinion columnist and host of the podcast "Follow the Science." She has written for the Economist, the New York Times, the Washington Post, Psychology Today, Science and other publications.
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