The Piper's Dance: A Paradigm of the Collective Response to Epidemic Disease

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Abstract
A content analysis of the literature on epidemics, with particular reference to the American experience with AIDS, reveals the natural history of the response of endangered populations to epidemics. The paradigm contains four sequential phases: discernment, in which the threatened society becomes cognizant of the presence of a spreading lethal infection; a collective trauma with symptoms similar to other natural and man-made disasters and attended by denial, epidemic phobia, scapegoating and retribution guilt; avoidance behavior ruled by rational attempts to lessen the risk of contagion; and recovery, in which survivors enabled by biological immunity or medical technology witness the abatement of the epidemic. Though they have distinctive traits, epidemics illustrate the essential dynamics that mark natural and technological disasters.

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