Falling out/Blacking out among Afro-Carribbeans and Black Americans

Falling out and blacking out occur primarily in southern U.S. and in Caribbean groups.  The disorder is described as a sudden collapse and fainting of the body usually occurring without warning. Symptoms can usually be described as an inability to move, inability to see with eyes open, dizziness, and sudden weakness of the body.

It is stated that falling out usually happens in context of intense anger, rage, or fear. Specifically, it is an accepted response when attending funerals, receiving shocking news, hot weather, and in stressful school situations. It is a coping mechanism for some as it prevents certain situations to escalate or produce an undesirable conclusion. Falling out can be chronic because of it’s use as a coping mechanism, and thus debilitating because it can affect everyday life. Studies do not suggest that it is a biological or genetic illness, but more of an environmental trigger that can cause it.

This disorder can also be found among Afro-Caribbeans in which symptoms are similarly described with episodes of a loss of consciousness. In the Bahamas, it shows that falling out happens to 23% of the population. In Haiti, it is referred to as “Indisposition.” The article states that most Haitians have known someone who has fallen out. Outside of that, not much else is known about the illness in the Caribbean region. It is not known why this illness occurs among African Americans (based on 1970’s data), but a hypothesis shows that falling out is more prevalent among people of African descent living in the U.S. than any other ethnic group.

It seems to be that falling out and blacking out are due to high levels of stress in an individual’s surrounding environment. The article states that the stress-induced illness has many roots in inner-city life because of the overcrowding, high levels of violence, safety issues, and financial concerns.

It was very difficult to find a written article about the treatment process in falling out because it generally tends to happen as an unexpected one time occurrence. In general, it is suggested that when a person looses consciousness that you check their pulse, and make sure that oxygen is somehow reaching the brain. If the person does not regain consciousness, then a medical professional should immediately be seeked out. As a long-term treatment, falling out can be cured by preventing environmental stressors. Definitely an easier statement said than done. However, due to the fact that it is an environmentally triggered illness, the only treatment process would be to seek out a different surrounding or find a different coping mechanism.


Jackson, Yo. “Culture-Bound Syndromes: Falling Out, Blacking Out.” Multicultural Psychology. 2006 :136-137. Web. 20 July 2012.


Okpaku, M.D., Ph.D., Samuel O.. “Somatization and Psychologization.” Clinical Methods in Transcultural Psychiatry. 1998: 238. Web. 20 July 2012.


4 thoughts on “Falling out/Blacking out among Afro-Carribbeans and Black Americans

  1. I do not think I would consider falling out or blacking out to be a culture bound syndrome. To me it sounds like fainting and I would think that happens in most every culture considering it is a physiological response to lack of oxygen. It was said that falling out occurs in “context of intense anger rage or fear” and it’s common enough to be an “accepted response when attending funerals receiving shocking news, hot weather, and in stressful school situations”. It called it a coping mechanism which I guess it could be. But one of the common causes of fainting is the vasovagal reflex which leads to less blood getting to the brain and is caused by stress, pain, fear, as well as other things. That fits the causes of “falling out” pretty well. I think it is interesting that it is an illness when it is usually a “unexpected one time occurrence”. I would see it more as a symptom of an illness if it occurs on a regular basis. I could see how it might affect some people more that others if they have a lot of stress in their life, but I don’t think it can be bound to a certain culture.

    I could see a culture believing the cause of falling out to be something of a spiritual nature. Like a temporary spirit possession or something where they lost control of their body and fell down and they wake up and they are all disoriented.

  2. Personally, I would not consider falling out or blacking out to be a culturally bound syndrome. Although it might occur readily in cultures such as Afro-Carribbeans and Black Americans, I would not consider this syndrome to be specifically bound to these cultures. Although it can happen during intense anger, rage, or fear, it is primarily the result of lack of oxygen to the brain, which can (and does) occur throughout many cultures. Studies suggest that environmental factors trigger falling/blacking out rather than biological or genetic illness, but I feel that this does not prove that it is the result of cultural practice. I disagree with the other commenter that to call this an illness would be incorrect. I feel that because it is environmental and situational—occurring during funerals, when hearing shocking news, or in other stressful times—it is both a psychological and social phenomenon, therefore it is an illness. I believe in a different ethnomedical system this condition would be described considerably differently. For example, instead of focusing on the biological effects of environmental factors that cause blacking out or falling out, there could be a focus on the spiritual and mental cause of the condition. Spirits could be taking over the bodies of afflicted individuals, causing them stress and loss of control. However, in the biomedical system this is merely considered passing out.

  3. I’m having trouble deciding whether “falling out” is a culture bound syndrome, because it sounds very similar to someone who just passes out which can be found in many cultures. People pass out for many different reasons including when the brain is deprived of blood, oxygen, or glucose. This is why people with low blood sugar are more likely to faint than people who do not. I think this could be related to the nocebo effect, which is due to someone’s belief and expectation that this “falling out” will happen. It sounds to me like it could be culture based because with the idea of the nocebo effect, if someone lives in a culture who truly believes that certain things can trigger the “falling out” it is much more likely that it will happen. Just hearing something can happen could actually be a trigger itself for that thing to happen. I remember learning in one of my classes that over seventy percent of people threw up after drinking a liquid they were told would make them throw up, but it was really only sugar water. So to conclude, I really don’t think I’m able to decide if it is a culture bound syndrome or not because it’s similar to fainting, but could also be part of the nocebo effect within a whole culture.

  4. I would not consider falling out/blacking out a cultural bound syndrome. I came across it as I was doing research for my own article and decided to pass it up merely because I could not place it into that category. I think it is such an encompassing term (blacking out) and happens across a number of cultures. Just because it does not occur frequently and does not have obvious biological causes, the environmental trigger is what separates it from CBS’s. The body has strange ways of handling stress, and so I see it as a natural coping mechanism. Perhaps the only part about the disorder that makes it ‘culturally bound’ is the specifics of what happens when one experiences it, like how long they are unconscious, how they react emotionally to it, etc. On the other hand, I am not sure that I could come up with a reason as to why some cultures experience it more or less than others. By not categorizing it as a CBS, perhaps it would help to decrease the number of cases in specific culture groups. I am a strong believer that many things are just in our heads, that we convince ourselves that we are sick and so our body takes on that expectation. So without the expectation of “falling out” simply because it runs in the culture may help to keep people from experiencing it and contribute to the possibility of other coping mechanisms.
    If looked at from a distinct biological perspective, then I think the diagnosis would be similar to my own opinion of it. The body is just reacting to a quick onset of stress, avoiding confrontation with the stressors.

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