A Journal of Rhetoric, Writing, and Culture

Complex Rhetorical Contagion: A Case Study of Mass Hysteria

Julie D. Nelson, University of Tampa

(Published April 19, 2019)

“The hysteric unties familiar bonds, introduces disorder into the well-regulated unfolding of everyday life, gives rise to magic in ostensible reason.”

–Hélène Cixous and Catherine Clément 

In October 2011, a high school cheerleader in­­ upstate New York woke up from a nap with a stutter. Before long, Thera Sanchez’s stutter escalated into Tourette-like symptoms; twitches, jerks, and vocal outbursts became so disruptive that Thera stopped going to school. In the following weeks, eleven more girls at Le Roy High School presented similar symptoms, and parents became frantic as the school district rushed to determine the cause of the illness. The New York State Department of Health began an investigation but concluded no environmental or infectious causes could be found. By the spring of 2012, twenty-four people in the area had developed the same debilitating symptoms, and the national news media began reporting on the case, calling it a “mystery illness.”[1]

Several of the girls appeared on the Today Show, CNN, and Dr. Drew. Through stutters, jerks, and snorts, the girls pleaded for answers to their “mystery” symptoms. Shortly after the case gained national attention, several experts and physicians came forward to declare the illness was not mysterious at all: it was a case of mass hysteria or mass psychogenic illness (MPI). However, parental denial of the diagnosis, exploitative news media reports, growing community fear of environmental contamination, and rampant conspiracy theories convinced many of the girls and their families to reject the diagnosis. Susan Sontag’s words in Illness as Metaphor rang true: “Any disease that is treated as a mystery and acutely enough feared will be felt to be morally, if not literally contagious” (6). Because, as Sontag suggests, learning one’s diagnosis can be “demoralizing” (7), many of the girls and their families embraced alternative theories about the cause of the symptoms, believing the HPV vaccine, a toxic chemical spill, or an autoimmune infection was to blame. Any explanation was more appealing than mass hysteria.

As Cixous and Clément describe in the epigraph, hysteria unties, disorders, and threatens reason. Psychologists and neurologists have made great advances in understanding hysteria, yet culturally, we still can’t seem to process the “out of control” female body.[2] Since first documented in ancient Egypt, hysteria has marked the line between appropriate and pathological behavior. Despite being removed from the DSM in 1952 and replaced with “conversion disorder,” hysteria is often still condemned as a fake or exaggerated syndrome. “A lot of people say we are faking it,” reported Traci Leunbar of Le Roy, “I’d like to see anyone do what we do 24 hours a day and try to fake that. If I could stop I would. I would love to” (Samson). In many ways, Le Roy is a classic case of mass hysteria or MPI; however, several of the girls’ symptoms arose or intensified only after media exposure, making this the first documented case of hysteria emerging as a networked digital phenomenon. While news and social media allowed the girls to have some unprecedented control of their stories, they also produced representations of hysteria that spread rapidly through our networked culture and contributed to the spread of symptoms (Bartholomew, Wessely, and Rubin). Contemporary examples of MPI encompass a complex and layered virality.

For rhetorical studies, the Le Roy case illustrates the elaborate interplay between viral rhetorics that are seemingly external to the illness (discourses from physicians, scientists, reporters, community members, etc.) and viral rhetorics of the illness itself (girls’ bodily/affective expressions, interviews, social media posts, etc.). When videos of the girls’ “mystery” symptoms went internationally viral, so did discourses of hysteria, affective responses, and bodily mimesis. This article considers the Le Roy case as a rhetorical event, using scholarship on virality (Nahon and Hemsley; Sampson), rhetorical ecologies and circulation (Edbauer Rice; Gries; Seas), and affective contagion (Dean; Gibbs; Chaput) to analyze the emergence and progression of the illness. I assert that in addition to existing rhetoric scholarship, complex contagion theories expand our approaches to studying complicated rhetorical events, especially as rhetorical contagions manifest in bodies, affects, and media. Given that complex contagion research is interdisciplinary, it theorizes the contagion of pathogens, ideas, emotions, and behaviors. Thus, this research is especially well suited for examining the virality of symptoms and discourses. In the following section, I review relevant rhetoric scholarship and introduce complex contagion theories to supplement epidemiological studies of rhetoric. The next section analyzes the Le Roy case, specifically the intersecting rhetorical ecologies (e.g., historical mythologies of hysteria, debates about diagnosis, girls’ posts on social media, news media exploitation) that sustained the somatic disorder. Finally, I consider what a theory of complex rhetorical contagion offers our field, asserting that it extends current epidemiological approaches, explicates multiple and intersecting viralities, and assists in rhetorical invention.


Viral and Contagious Rhetorics

Across disciplines, scholars use theories of virality to analyze a range of social and media trends—capturing what is deemed significant in a particular moment and place. Rhetoric scholars have integrated virality into the field, inspiring recent epidemiological approaches and coinciding with interests in ecologies, circulations, bodies, and feelings. With advances in technology, digital virality has emerged as a primary mode of rhetorical contagion. A viral trend has many qualities, Karine Nahon and Jeff Hemsley assert, but perhaps the most important is that it is “remarkable.” Whether it be the emotions it incites, the context it responds to, or its quality, a viral trend captures people’s interest and attention, so much so that viral events “reproduce and transform norms, rules, practices, and arrangements that regulate our behavior” (Nahon and Hemsley 104). Because virality works on us in many ways simultaneously, Tony Sampson asserts viral discourse is “intimately interwoven with a prediscursive flow of contagious affect, feelings, and emotions” (3). We consume more than the content or information of viral media; Sampson contends we also consume the affects attached to or incited by them. Thus, virality moves via somatic, social, and affective means, and it produces somatic, social, and affective changes.

Affective networks and contagions not only inspire viral digital rhetorics but also attract and absorb users. Because social media draws us in through affective stimulus (precognitive feelings and bodily intensities), Jodi Dean theorizes that social networks and platforms “produce and circulate affect as a binding technique,” making the experience itself enjoyable (21). Drawing on Lacan’s concept “jouissance,” she asserts that behavior like commenting, adding links, and reposting offer “a nugget of enjoyment.” While these “affective networks” and “loops” give us a sense of community, Dean argues they also “capture” and “ensnare” us (42). Our drive for engagement powers digital networks, allowing contagious affects to travel great geographical distances. Affect contagion, Anna Gibbs describes, is “the bioneurological means by which particular affects are transmitted from body to body” (191). Bodily mimesis reflects these transmissions of affect, traditionally through facial expressions, voice, bodily movements, or smell. However, with digital media’s capacity to capture these expressions (at least partially), affect contagion travels from body to body digitally. Mediated affects can change our biochemistry and neurology, even if only momentarily or in small ways (Brennan 71). Viral affects, then, alter one’s capacity to move or be moved, or as Catherine Chaput (following Spinoza and Massumi) suggests, they open and close rhetorical opportunities (15). Affective networks shape our moods, foster conditions for virality, and drive us to transmit contagions.    

Within rhetorical studies, ecological approaches provide avenues for analyzing the layered, intersecting viralities of complex events. Unlike traditional notions of the rhetorical situation, rhetorical ecologies, Jenny Edbauer Rice claims, emphasize the process of rhetoric as “distributed emergence and as an ongoing circulation process” (“Unframing” 13). Because rhetorical ecologies reposition rhetors and audiences not as stable bodies but as always moving, changing, and sensing (Hawhee; Holding; Albrecht-Crane; Edbauer Rice “New”), bodies, discourses, affects, objects, etc. emerge and adapt with, against, and among any number of human and nonhuman entities, including other ecologies. Rhetorical contagion, then, moves among overlapping and merging ecologies, often facilitated by digital technologies. Viral rhetorics gain varying significance and impact within ecologies. For example, a viral video of girls’ symptoms alters the national discussion of MPI diagnosis, binds social media users together through similar responses, and ignites the onset of symptoms in a susceptible body. Laurie Gries asserts, “rhetoric, especially in a digitally mediated environment, is more like an unfolding event—a distributed, material process of becomings in which divergent consequences are actualized with time and space” (7). In these unfolding events, rhetorical agency is dispersed among all human and nonhuman participants, yet virality isn’t random but reflects something significant about a culture. An illness contained to a few cases in a small town unfolded into an international news sensation because of what it represented and meant to people. More than indicating what we find remarkable, viral rhetorics unearth overlooked problems in a society or what Christopher Gilbert calls a “magnification of cultural disturbances” (110). He suggests viral trends expose an imbalance and will “fester” until a remedy surfaces. Thus, contagions emerge almost as a correction to cultural discord, drawing our attention to the health of the collective. Building on Sampson, Gries asserts, “Things are especially contagious, when they propagate affective desires that induce unconscious collective identifications and unconscious imitative feelings, thoughts, and behaviors” (87). There is a collective, binding quality to a successful contagion.

In addition to affect, virality, and rhetorical ecologies studies, epidemiology similarly advances concepts and frameworks to better understand rhetorical contagion. In her theory of “rhetorical epidemics,” Kristen Seas uses Malcom Gladwell’s epidemiological framework in The Tipping Point, employing the concepts “virus,” “host,” “environment,” and “time” to describe how the surrounding conditions make rhetoric successful—not just the rhetor’s own abilities. Because the virus (e.g., idea, text, trend) relies on the rest of the ecology to become an epidemic, she suggests rhetors focus on “cultivating the whole system” to produce more contagious rhetorics (63). Seas argues, “epidemiology provides a means of explaining nonlinear success in a complex ecology beyond the biological. With some modification, this model of contagion can explain the spread of ideas and behaviors” (53). Since Seas made this argument, an influx of scholarship on complex contagion and large-scale viral events builds a bridge from contagious pathogens to ideas and behaviors. Because complex contagion models are based on empirical studies of virality, they describe the material and mediated variables necessary for fostering contagions.

Originally used in epidemiology to predict incidence of biological contagion, complex contagion models are now used across disciplines to theorize how infections, behaviors, and ideas spread and flourish—making it ideal for analyzing how rhetorical contagions travel among biological, mediated, and affective ecologies. Unlike simple contagion, in which an infection is spread through one-to-one contact, models of complex contagion illustrate how multiple exposures increase the likelihood of infection. Scholars in the social sciences have used models to measure the adoption of particular behaviors or ideas, in face-to-face interactions and through media (Guilbeault, Becker, and Centola). The more exposures one has to an infection or behavior, the more likely she is to be infected or adopt the behavior (Monsted, Sapiezynski, Ferrara, and Lehmann). However, a contagion’s reach isn’t limitless and often requires additional variables (biological, psychological, cultural, etc.) to catch on. In this case, the infected group is called a “cluster.” In addition to supplying concepts and frameworks to explicate viral rhetorics, the results of complex contagion studies provide predictors for and qualities of viral events.

Media theories of complex contagion reveal how digital social network contagion shapes our feelings, moods, and outlooks, as users digest the content and emotions in their social media networks. These emotions don’t dissipate in the user but go on to shape how she interacts with her social network. For example, one Facebook study concluded that when positive posts were reduced in newsfeeds, users posted fewer positive posts, and vice versa (Kramer et al.). Similar studies of Twitter suggest that emotionally-charged messages seem to travel faster and farther (Stieglitz and Dang-Xuan) and positive emotions are more contagious than negative emotions (Ferrara and Yang). While this area of research is in its early stages, complex contagion in social media reveals how even quick log-ins can influence mood, as we are persuaded emotionally or affectively. In addition to existing scholarship on rhetorical, affective, and media virality, complex contagion theories assist in identifying the various, layered contagions in the Le Roy case. Reflecting the methodologies detailed in this section, the following section will not—could not—be a linear or comprehensive examination of the Le Roy event. Rather, I identify some notable examples of contagion to further consider the usefulness of epidemiology theories in our field.

A Contemporary Case of Mass Hysteria

To begin studying a case like the one in Le Roy, it’s useful to conceptualize the rhetoric involved in terms of ecologies and unfolding events (Edbauer Rice; Gries). Emergence in ecologies describes how a symptom arose from a confluence of variables like personal history, psychological susceptibility, exposure, and affective contagion or how a viral media event arose from interviews with “out of control” bodies, social media, news reporting, and affective networks. As an unfolding event, we can trace the progression and overlap of various ecologies; for example, a symptom is expressed in a digitally mediated environment, it is recognized as “hysteria,” representations of hysteria are circulated broadly, and symptoms emerge in more girls. This, in turn, attracts other bodies and ecologies (e.g., local officials, physicians, conspiracy theorists, the general public). As the event goes viral, more people are pulled in through “collective identification” and “imitative feelings, thoughts, and behaviors” (Gries 87). This section identifies some key influences and ecologies that drove the progression of MPI: 1) an omnipresence of hysteria’s mythologies, 2) public mediated debate about diagnosis, 3) girls’ social media accounts of their stories, and 4) news media coverage and exploitation. Each of these contributed to a new emergence of MPI: contagious rhetorics became part of the epidemiology and girls’ symptoms ceased only after disengaging from the news and social media that were vectors of contagion.

Ecologies grow out of contexts and histories. Thus, hysteria’s mythos is always more or less present in the Le Roy event and must be considered an influential body or force. Because hysteria is almost exclusive to females, who Elaine Showalter asserts, “are typically situated on the side of irrationality, silence, nature,” it has always been used to reprimand (supposedly) inappropriate behavior (3-4). “Don’t be hysterical”—both an accusation and dismissal launched at girls and women for millennia—censures emotional and somatic expressions. For centuries, physicians in ancient Egypt and Greece believed that women’s wombs could wander around their bodies, inciting all kinds of hysterical symptoms (Adair; Faraone). Freud, of course, re-popularized hysteria’s connection to sexuality with his assertion that its cause was childhood sexual trauma. When high school girls in Le Roy started showing “mysterious” symptoms, many were quick to blame Gardisil (the HPV vaccine), reflecting not only fear of vaccines but also the historical tendency to associate female bodies and sexuality with susceptibility to illness.

Just like historical cases of hysteria, public debate over the diagnosis of symptoms was central to driving its virality. After neurologists Jennifer McVige and Laszlo Mechtler, who treated most of the girls at the DENT Neurological Institute, confirmed to media outlets that the case was MPI, national news outlets continued to feature and promote conspiracy theorists who asserted the cause was environmental contagion or another medical disorder. [3] Many parents believed there was an environmental cause—a theory that was buttressed in part by Erin Brockovich, who insisted the symptoms were a result of a train that derailed in the ‘70s, spilling thousands of gallons of cyanide and trichloroethylene only three miles away from Le Roy High School. Brockovich was a regular guest on several national newscasts that covered the “mystery,” diverting attention from the real diagnosis for weeks. Tosha Brownell, a mother of one of the girls, claimed, “It was completely out of this world to me that they would say this was a psychiatric issue for her . . . when a doctor says its conversion disorder, you know, I really feel like saying to them, stop lying to me and just tell me you don’t know what the hell is going on” (Town). Along with Brockovich, Dr. Rosario Trifiletti was a major voice supporting alternative theories featured in national news media. Dr. Trifiletti publicly declared the symptoms were evidence of PANDAS, an autoimmune disorder, and a group of families eager for a diagnosis other than hysteria stopped receiving treatment for conversion disorder at DENT and started seeing Dr. Trifiletti, who prescribed antibiotics. Following this division, the girls who left DENT bullied those who decided to stay on social media. The girls in the Trifiletti camp implied that if the girls who remained at DENT were getting better without medication, they must have been faking symptoms all along (Dominus). Social media was an avenue to maintain and regulate the symptoms (affective mimesis) within the group, as the girls themselves contributed to the viral debate about diagnosis.

Negative responses to the MPI diagnosis, situated in a historical (mis)understanding of hysteria, spread among parents and reinforced the illness. One of the girl’s guardians lamented, “It’s a very hard pill for me to swallow—what are we, living in the 1600s?” (qtd. in Dominus). Many of the parents’ first association with hysteria was the Salem Witch Trials—an association they felt was ridiculous, if not insulting. Parents like Heather Parker simply dismissed the diagnosis: “That mass psychogenic illness—that’s just a bunch of hoggy” (qtd. in Dominus). Images of hysterics as wild, unseeing, and possessed loomed large in collective understandings of the disorder. Christopher Bollas explains, “When we think of hysteria we think of people who are troubled by their body’s sexual demands and repress sexual ideas; who are indifferent to conversion; who are overidentified with the other; who express themselves in a theatrical manner; who daydream existence rather than engage it; and who prefer the illusion of childlike innocence to the worldliness of adulthood” (1). These longstanding notions of hysteria were often more persuasive than the opinions of physicians at the DENT. Like many cases across history, growing skepticism prevented swift treatment and recovery. If parents, girls, and local residents had accepted the diagnosis, this case could have slowly come to an end. But when parents, who have been described by anthropologist Ryan Cook as “concerned but poorly informed” (3), decided to create a support group and turn to the national news media, reporters continued to swarm the town, fear in the community escalated, symptoms worsened, and the number of afflicted doubled to twenty-four. Multiple ecologies (parents, news media, girls) intersected and complex contagions (somatic, social, affective) merged to sustain the viral event.

Within the town, affective contagions—anger, disgust, and fear—were “interwoven” in community members’ discourses with physicians and experts (Sampson 4). At a Le Roy community meeting where Dr. Gregory Young reported the results from the New York State Department of Health investigation, residents expressed great frustration. A student named Jessica confronted Dr. Young: “You’re not telling us the truth because you don’t really know what’s going on” (Owens). Young, citing HIPPA, couldn’t reveal the individual diagnoses of the patients but assured the community there were no environmental or infectious origins. Following the meeting, Jim Dupont reported, “Well in my opinion we’ve only just begun. If you haven’t found anything then we have to turn some more stones and we need to have another investigation that is not government related” (Chung). With more and more exposure to intensifying reactions, many parents became a part of, or were pulled into, the “affective networks” of media contagion (Dean). Public debate about the illness increased media attention, parental concern, and intensity of symptoms for a period of weeks.

Amid the media scrutiny, several of the girls took control of their own stories. They posted videos of themselves exhibiting symptoms on YouTube and Facebook and asking for help with diagnosis and treatment. Personal cell phones and social media were outlets for the girls; this was, as Robert Bartholomew et al. suggest, “the first case in which, to our knowledge, those affected have been able to ‘put their case’ directly to the wider public” (511). While the girls tried to reposition themselves as sincere and innocent, as more videos were posted, doctors treating the girls noticed those who had no physical contact with each other started to exhibit symptoms featured in the videos. A few new cases emerged and some symptoms worsened after digital exposure—an affective complex contagion and mimesis—as a cluster of girls formed. Attempts to rearticulate the rhetorics associated with their bodies not only went viral among the general public but also reached local girls who had a susceptibility to develop the featured symptoms.

Because of the emotional potency of videos featuring the girls (Stieglitz and Dang-Xuan), they quickly went viral in mass media. News media reports revolutionized how viewers around the world saw what has always fascinated people about hysteria: the “out of control” female body. With the international broadcasting of the case in Le Roy, the network of onlookers grew exponentially so that anyone with internet or TV access could be pulled into the affective drive to engage with the story (Dean). In addition to regularly featuring the girls in live interviews, news and talk shows included pre-recorded clips and cell phone videos taken by the girls that showed the worst of their symptoms (Cook 4). The visual spectacle—pretty young white girls yelling and flailing uncontrollably—transfixed many viewers, especially when presented through the veil of mystery. Exposés in the New York Times and Slate delved into the girls’ lives, using strategies just short of Aristotelian tragedy: “language embellished with each kind of artistic ornament . . .  through pity and fear effecting the proper purgation of these emotions” (bk. VI). And given the mass international interest in the story, these strategies seemed to work. Susan Dominus’ exposé in The New York Times Magazine portrays a sad, if not depressing, scene: “Parents wept as their daughters stuttered at the dinner table. Teachers shut their classroom doors when they heard a din of outbursts, one cry triggering another, sending the increasingly familiar sounds ricocheting through the halls.” Many reports and interviews continued to use fear to emphasize the mystery, for example, in headlines like “Corinth Girl’s Tics Are a Medical Mystery”; “Mysterious Illness At Le Roy High School”; “Le Roy Student Speaks out about Illness, Lack of Answers”; “Facial Tics, Verbal Outbursts Perplex Community”; “The Mystery of 18 Twitching Teenagers in Le Roy New York”; and “Mystery Malady; No known Cause.”[4] There was indeed something “remarkable” about this story and it “festered” until the girls and families stopped engaging with the news media (Nahon and Hemsley; Gilbert).

External media ecologies entered the girls’ own affective ecologies, encouraging somatic responses. The girls were pushed to “prove” that their symptoms were real and not exaggerated. In a Today Show interview with two of the girls and their mothers, a visual disparity in the girls’ symptoms is clear. While Thera’s answers to questions are continually interrupted with shouts, head twitches, and arm flails, Katie seems almost asymptomatic as she answers questions without interruption. In response, Ann Curry says to Katie, “You’re just shaking a little bit here and there but it’s not as pronounced as Thera’s. Yours aren’t really as bad” (“School”). Katie explains, “Mine is more advanced because I’ve had it longer but mine has definitely gotten better”; earlier she says, “My days are all different . . . some days I won’t stop twitching for ten … fifteen minutes” (“School”). Hysteria’s symptoms are notoriously adaptive, mimicking what is acceptable and visible in a particular time period (Maines 8), yet many of the hosts and reporters tracking the case verbally evaluated the girls in their reports. Media outlets wanted to see physical symptoms, which encouraged collective identification and mimesis among the girls. The most extensive coverage (and arguably most sensational) came from Dr. Drew Pinksy who, as Cook describes, “enthusiastically positioned himself as [the girls’] advocate” (3). On his talk show, Pinsky had an almost daily report on the girls for several weeks, frequently featuring videos or interviews with the girls as they exhibited very debilitating symptoms. This consistent tracking of the girls clearly affected how they believed they were perceived and the rhetorical opportunities available to them (Chaput). Lori Brownell, one of the girls, describes, “people are just judging on how I’m doing but what they don’t know is what I feel on the inside . . . all the head aches, the flu like feeling that I get every day, the exhaustion, all the joint and muscle pain that I get, no one sees that” (Town). The pressure to make visible the severity of the illness weighed heavily on the girls.

The unfolding event in Le Roy illustrates a 21st-century reemergence of MPI from its supposed disappearance in the 20th century (Scull; Shorter). As Juliet Mitchell claims, “Hysteria may have been divided into other illnesses or apparently [has] lost its appeal on being comprehended, but, endlessly imitative, it has also vanished and reappeared with fashion in an unconscious game of hide and seek” (116). Some physicians have suggested that PTSD, chronic fatigue syndrome, and borderline personality disorder may be new manifestations of hysteria. If images of Salem’s burning witches and glamorous Victorian hysterics are the first to come to mind when we think of hysteria, our cultural understanding is seriously lacking. Ironically, as much as parents wanted to distance themselves from hysteria’s negative mythology, they perpetuated it through their suspicion and denial. Ruth Graham of Slate notes, “As archetypes go, the Salem events hold up quite well, even from a distance of 320 years.” Just as in Salem, the community’s fear and doubt contributed to the progression of the illness, yet complex digital contagions made this case “a milestone in the history of MPI where the primary agent of spread will be the Internet and social media networks” (Bartholomew et al. 511). As a complex contagion, the more social and news media exposure the girls had, the more likely they were to develop symptoms (Monsted, Sapiezynski, Ferrara, and Lehmann). One of the girls’ primary physicians, Dr. Mechtler, asserts, “The mass hysteria was really fueled by the national media, social media—all this promoted the worsening of symptoms by putting these people at the national forefront” (Gulley). However, the cluster was contained to Le Roy and a few surrounding towns, suggesting some additional variables influenced who developed the disorder, including a psychological susceptibility. The day-to-day experience of living in Le Roy and participation in the national news media were additional variables that may have made girls more likely to develop the disorder. Successful treatment and recovery for the girls required that they stop giving interviews, watching media coverage, and using social media—disengaging with the vectors that propelled it. As hysteria reemerges again, we must remain vigilant about how “hysteria” (by any of its cultural or medical definitions) is used to reprimand and marginalize. We can do this, in part, through studies of rhetorical contagion, since circulating hysterical rhetorics become part of MPI itself.

Hysteria and Complex Rhetorical Contagion

Like so many complex rhetorical events, the case in Le Roy illustrates intersections among bodily, mediated, historical, and affective rhetorics across many people and ecologies. Digital networks became vectors of contagion, spreading videos of affective/somatic expressions and discourses about the “mystery illness.” With increased exposure, the girls’ illness and the news media storm progressed, influencing collective understandings of hysteria and pursuit of medical treatment. Hysteria has long been rhetoricized to support social and cultural ideals, and to appropriately study new manifestations of MPI, we must consider how external ecologies transmit affective and somatic mimesis. Complex contagion scholarship reveals some of the variables that made the Le Roy case go viral and offers clues for how we can “cultivat[e] the whole system” for creating and sustaining viral rhetorics (Seas). This final section considers some of the optimal conditions for complex contagions and how they could be harnessed in rhetorical studies. Because scholarship on complex contagion spans biological, social, and behavioral contagion, it is useful in studying rhetorical events that have multiple, overlapping, and intersecting contagions.

The size of networks, connections, kinds of contagion, and content all contribute to the longevity of a virus or viral trend. For maximum transmission, networks need to be expansive, to transgress personal social circles; as Douglas Guilbeault et al. assert, contagion is more pervasive if spread among “long connections,” “weak ties,” or “casual acquaintances” (3). In Le Roy, this kind of transmission occurred through social and news media networks that transmitted the videos, interviews, and debates about diagnosis that ultimately caused the illness to grow. Complex contagion models suggest that content like videos and political hashtags are the most contagious in digital networks (Guilbeault et al. 12), so it should be no surprise how quickly videos of the girls’ symptoms went internationally viral. Though expansive networks are productive for viral content, when a contagion requires the adoption of an idea or behavior, studies suggest there is an optimal social network size. According to Bogdan State and Lada Adamic, those most likely to adopt a behavior have similarly sized social networks of 400 connections (cited in Guilbeault et al. 26). Balance between “homophily” and “diversity” in networks is necessary for ideas, behaviors, or movements to catch on. Once networks get too diverse, the pressure to change one’s behavior becomes more dispersed. In Le Roy, girls’ and parents’ changes in opinion and behavior (e.g., rejecting a diagnosis, deciding on treatment, accepting invitations from the national news media) determined the longevity of the illness. More studies of behavioral complex contagions could shed light on the process of changing beliefs or decisions during pivotal points in medical and rhetorical epidemics.

With the potential to predict the climax and longevity of viral trends, complex contagion models gauge the impact and reach of contagions. Daniel Sprague and Thomas House’s study of the ALS Icebucket Challenge, for example, successfully predicted the climax and length of the social media campaign using complex contagion models. For digital rhetors, these models offer insight into launching and sustaining digital campaigns. However, for widespread, layered contagions like those in Le Roy, these models could assist in earlier medical diagnosis and intervention, recognizing how news and social media have become part of contemporary MPI. The Le Roy case makes visible the affective and somatic contagions that accompany viral digital content. While social media campaigns may seem innocuous, they transmit affective and somatic contagions that work to shape users’ moods, behaviors, and health. Social media connections need not be human to transmit contagions. For example, Pizzagate, the conspiracy theory that Hillary Clinton was running a child-sex ring in the basement of a D.C. pizza parlor, was driven mostly by bots and Twitter users in the Czech Republic, Cyprus, and Vietnam (Fisher, et al.). Taking advantage of complex contagions to saturate social networking platforms, an influx of international users and bots influence local concerns and debates.

The predictive aspect of complex contagion provides strategies for invention of viral rhetorics. In digital environments, this means taking into account how variables like medium, platform, network size, and hashtags affect if, and for how long, a rhetorical trend is “infectious.” Based on just the few studies mentioned in this article, a rhetor hoping to incite or contribute to a social movement could produce a social media post that includes a video, invokes positive yet powerful emotions, and uses a political hashtag. If after taking advantage of the “long connections” in her social networks, the post goes viral, with a predictive model, she might have an idea of when the trend is peaking and when to queue another post. While the instigation of complex contagion is undoubtedly more complicated than this because it depends on many other contextual variables (e.g., trending topics, current events, network connections, connection usage), it is at least a starting point for rhetors and rhetoricians wanting to take advantage of the latest research on digital contagion. The Le Roy case exemplifies that contagion is multifaceted and expansive, as ecologies and contagions intersect and overlap. Intentionally produced or not, affective, behavioral, and somatic contagions move through our personal technologies, social networks, and mass media in ways we’ve only begun to consider.

Many thanks to Laurie Gries and four anonymous reviewers for invaluable feedback on this piece. Thanks also to Dennis Lynch and Kara van de Graaf for guidance on earlier versions. 

1 Reports suggested the final count may have even been higher. In addition to the girls in Le Roy, several other people reported symptoms in the neighboring Town Cornith, NY, including a 36-year-old woman and a boy.

2 New cases of mass hysteria are reported monthly. Some of the most publicized cases include over 300 students in Portuguese schools who suffered symptoms of rashes, difficulty breathing, and dizziness (2006); female students at a Catholic School in Mexico City who had difficulty walking, fever, and nausea (2007); and students at an all-girls school in Brunei who suffered from screaming, crying, and shaking (2010).

3 While there’s no definitive assessment to determine cases of conversion disorder, the total recovery of the girls treated at DENT Neurological Institute for conversion disorder supports the diagnosis, which has been supported by other experts in the field (Pollak; Goldstein and Hall).

4 Headlines are from WNYT 13, WKBW, WGRZ, USA Today, The New York Times Magazine, Nightline ABC.

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