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AMERICAN JOURNAL OF FORENSIC PSYCHIATRY VOL. VI, NUMBER 1, 1985. p. 46-56 THE POSSESSION SYNDROME ON TRIAL Ralph B. Allison, M.D. The concept of possession by disincarnate spirits as a cause of mental illness is as old as mankind itself. This belief is still extant in regions of the world where European and American psychiatric belief systems have not replaced older, ritualistic patterns of belief. Scientifically trained observers have reported such cases in the modern literature from exotic locations such as India (1), Egypt (2), New Guinea (3) and Ceylon (4). The most common explanation for such observations is that "spirit possession is a culturally sanctioned, heavily institutionalized and symbolically invested means of expression in action for various ego-dystonic impulses and thoughts."(5) Closer to home, similar cases of apparent possession have been reported in Latin American countries, such as Columbia. (6) Cases occurring in the United States (7) may be given the Greek label of "cacodemonomania," that is having the delusion of being possessed by demons. (8) The cases described by Schendel and Kourany (8) were of families involved in the charismatic branches of both the Protestant and Catholic religions, leaders of which believe that spirit possession is a major cause of all physical and mental diseases. In the last decade there has been a resurgence of interest in the emotional disorders characterized by the mental mechanism of dissociation, causative of such bewildering conditions as fugue states and multiple personality disorder (MPD). This area of mental illness has a long and controversial history ( 9), as it deals with that part of the mind which is both fascinating and terrifying to both the sufferer and observer. Therapists treating patients with clearly psychologically created entities, called alter-personalities, may also find themselves confronted with entities for which no internal cause can be discerned and which claim to be entities from outside the patient's mind. (10) Thus, a differential diagnosis becomes necessary for practical reasons, as an alter-personality must be dealt with psychotherapeutically, and an invading spirit must be dealt with by spiritual means. While dealing with patients who evidence both psychological dissociation and control by invading entities, the therapist becomes quite willing to accept the possibility that "real" possession can exist in vulnerable individuals, and MPD patients are extremely vulnerable, with hatred of their abusing relatives being one of the strongest magnets attracting the "evil entities" into their minds. The next step in differential diagnosis is between "real" possession and pseudo-possession. The latter condition is better called an "Atypical Dissociative Disorder" (the Possession Syndrome), DSM-III 300. 15. (11). A working definition of the Possession Syndrome would be "a dissociative disorder in which the patient unconsciously believes he is possessed by evil spirits who act out his forbidden wishes. The manifestation depends upon Ms view of what demonic spirits are like and how they should act." Thus, the clinical picture from one individual to another would have little in common, as each person's opinion of what possession is like would be very unique. This is still a mentally created disorder, but different in some of the dynamics from MPD and the other identified dissociative disorders in DSM-III. The problems in dealing with such a condition in clinical practice are massive enough, but when such a case arises in a forensic setting, the problems multiply. Than at least another differential diagnosis arises, that of playacting or malingering to avoid legal penalties. In addition, the belief systems of the members of the court system must be considered, as they are the ones to make the decisions after hearing the testimony of the witnesses. Such is the case presented below. The details of the case are real; only the names of the persons involved have been fictionalized. THE CASE OF LEROY JACKSON On April 11, 1981, police answered a domestic disturbance call from a motel. Upon their arrival, they encountered a short black man named Leroy Jackson who had been having an argument with his wife, Candy, in the presence of her four children by a prior marriage. No one complained of injuries, so the officers did not enter the motel room. Leroy promised to leave, so the police departed. The motel manager called police again an hour later and they arrested Leroy when they found his 10-year-old stepdaughter, Darnell Thomas, dead of multiple wounds sustained in a beating. Leroy started to run from the police but then turned and surrendered. The victim had been beaten with a board and with fists during a 22 -hour period. She had been choked with a dog chain, put in the attic in a duffel bag and twice had her head rammed into the wall. Leroy was charged with first degree murder with special circumstances and came to trial in early March of 1982. Just as there appeared to be no possible legal defense and the gas chamber loomed in the distance, his attorney heard testimony from Leroy's wife, Candy, that gave him hope. She testified that, for years, Leroy had spent many long hours talking to himself while alone in a field. He had also called himself "Michael, the Archangel," who had come to rescue this family from the urban ghetto. As Michael, he was most upset that they did not appreciate the sacrifices he had made for them. Candy also testified that Leroy had frequently called himself "Othello," claiming to be an ex-POW from Greece. As Othello, he forced the children to eat dog food and to drink their own urine. The attorney called me when he felt he had heard enough to interject an insanity plea in the middle of the ongoing trial. Prior to my arrival, he contracted with a local forensic psychologist to examine Leroy, which he did the day before I came to town. I met with the psychologist and the attorney. The psychologist reported that Leroy could well have MPD, as he had met "Othello Mulett Metheen," a possible alter-personality during the interview. While Leroy consistently claimed amnesia for the day of the crime plus the six days following, Othello readily admitted to having done the killing. I conducted my first interview with Leroy that evening, gathering all the history of dissociative episodes he could recall. The following day, Saturday, March 13, 1982, the attorney and I conducted a videotaped interview with Leroy in the attorney's office for the purpose of being able to safely present evidence of Leroy's mental state to the court. The taping before noon was a recap of what Leroy had told me the night before, focusing on the several episodes prior to his arrest for which he claimed amnesia. These included three suicide attempts and a tonsillectomy. I then asked him to prepare to let out Othello after lunch, and he agreed, having been aware of Othello for years by virtue of his long conversations with him in the fields. Leroy insisted on being handcuffed behind his back, for our safety. Two deputies were also stationed at the door and window to prevent Ws escape from the office. The afternoon taping was of Othello, who managed to twist his handcuffs under his buttocks and get his hands in front of him, where he banged the metal cuffs on the attorney's expensive table, trying to get them off. In a blustering, bragging fashion, he told of killing Darnell, though he would have preferred to have done in her mother, Candy, instead. He showed no remorse and indicated that Leroy had nothing to do with the crime, but he would kill him at a later date. After Othello's confession, I asked to talk to Michael, the Archangel, but this was unsuccessful. When I tried the procedure used to persuade multiples to switch to a non-dangerous personality, I only succeeded in getting Leroy back. We then showed the videotape to Leroy, as he claimed complete amnesia for that part of the session. The following Monday I testified that I could make only a provisional diagnosis of the MPD in this case, but I did consider him to be legally insane under current California law. I was unwilling to be definite in my diagnosis until I knew the origin of Othello. I felt that I needed to come back later for another series of interviews when I could pursue the questions that had been raised so far. During the following month, both sides called in their best forensic psychiatrists and psychologists, nine in all. When I returned five weeks later I was able to read all the reports and discovered that there was a split verdict. Four experts said that the defendant was a multiple; four said he was mentally ill but not a multiple; one said he was faking the whole thing. I was to be the last psychiatrist to testify for the defense prior to submission of the case to the jury. This trip I spent most of Saturday and Sunday (April 17-18, 1982) interviewing Leroy in the county jail. After meeting Leroy briefly I asked to talk to Othello, whom he promptly produced, as he had been produced for any examiner who had asked to talk to him. For the first time, Othello mentioned his son, Joe, so I asked to talk to him. When I met Joe I found an entity who claimed to be the same age as Leroy. He reported being the "snitch" who had told many of the previous examiners what had happened, while they thought they were talking to Leroy. He was willing to tell all about the events relating to the climes, as well as Leroy's prior experiences, as he had been the former assistant to Othello in doing Ws evil deeds. Joe claimed to be a spirit who had last had his own body as a boy in Auckland, New Zealand. He stated that he had fallen off a cliff at the age of 14 and died. He identified Othello as being Lucifer's agent and the one who had accepted the contract from the Council of 12 Archdemons to kill Leroy's wife, Candy. According to the Council, Candy had been backsliding in her participation in satanic worship services. After breakfast on the day of the crime, Othello took over the body from Leroy and began to threaten Candy by attacking her daughter. His message was, "Agree to be executed, or I'll kill Darnell, I'm knuckling under for nobody." His last threatening act toward Darnell was putting her in a duffel bag and then carrying her to the attic. When that failed to bring Candy around, Othello felt he had to kill somebody to fulfill the contract, so be bashed Darnell's head into the wall, finally killing her. When Darnell was pulled out of the attic, Joe lost awareness of what was happening. The next thing he remembered was hearing Othello's urgent instructions to run from the police, who had arrived for the second time. As he sprinted away, he looked over his shoulder and saw the glint of gunmetal in the officers' hands. Deciding he wanted to stay alive, he turned and surrendered and was then told that Darnell had died. Prior to that time, he thought she was still alive. Joe kept control of the body through the booking and initial questioning but relinquished it to Othello the following day. Othello held sway from the next six days, when Leroy came to being beaten by other inmates when they discovered he was a "baby killer." Joe explained the first appearance of Othello to Leroy, at age four. Leroy's divorced mother worked all day and left her children in the care of Jack, her brutal boyfriend. Jack locked Leroy in a closet while he sexually molested Leroy's sisters. Finally, neighbors called police, who removed the children from the home, but they missed Leroy in the closet. His mother came home to find her children gone, a note from the police on the kitchen table and Leroy still hiding in the closet under the clothes hems. As Joe said, "A person feels like he has been mistreated and thrown around, sexually assaulted. This builds up and makes a four-year-old turn away. They said there is a God. How come you don't do something? He doesn't understand. Here's a male doll in a dark closet. Used it for a type of voodoo. He took it, talked to it as a friend and wished. He talked to the doll. Why was Jack doing what he was doing? How could he get back? He felt lonely, not many playmates. Othello came in from the outside and gave orders. Son of fire, water and ice. " Joe explained that archdemons are strongest on Wednesdays and Saturdays. (The killing took place on a Saturday.) That is why I came to see him on a Sunday, which was the strongest day of the week for Michael, the Archangel. This time when I asked to talk to Michael, I was successful, in spite of interference from Othello. Here are his words: "I am Michael. I am a warrior. I've been with him five years now." I asked why. "For a young man who was born possessed with the evilness of Lucifer, for the life that was cast away, like the fire that burns away. Now the child is grown and the days are shorter. For then Othello exists. The battle continues till lives are taken. No more blood shall be stricken from the earth." I asked, "Why didn't you prevent the murder?" "You have twelve demons who exist. I don't win every battle that exists. " I asked, "Did Leroy make you?" "He didn't make me." I asked, "Where are you?" "Like an angel, as in the Bible, I am in that rank. The next day in court, Leroy was in legal chains and handcuffs since Othello was determined to come out and give a statement, invited or not. He did take over the body, as manifested with intense shuffling and muttering, in contrast to Leroy's usual quiet and passive behavior. In my testimony I concluded that Leroy Jackson did not fit the MPD but rather the Possession Syndrome, an Atypical Dissociative Disorder. My theory was that what we had observed was a creation of Leroy's unconscious mind and was simply a dramatic picture of what he wished to be and do but could not see as himself. Following my testimony, the jury found him guilty of first degree murder with special circumstances. During the penalty phase, Othello was allowed to testify. He told the all white "honky jury" that he didn't care what they said since Leroy was going to die by his, Othello's, hand that December on his twin son's birthday. Then he, Othello, would move on to another living body.. The jury found him sane and sentenced him to death. DISCUSSION In working out my final diagnostic formulation, I felt that there were four major differential diagnoses to consider in this case: malingering, MPD, "real" possession and the Possession Syndrome. None of these is easy to diagnose in and of itself, and differentiating them is even harder. The scientific literature offers the psychiatrist only scant guidelines. Varma, Bouri and Wig(12) noted only two out of five characteristics to distinguish their case of multiple personality from the "Hysterical Possession Syndrome " in their Indian cases. The hysterically possessed subject is aware of the abnormal personality while the multiple is not, and the entity is a deity, spirit or known person in the hysterically possessed patient, while the alter-personality is no known person and is the manifestation of conflict in the multiple. But I had to come to some logical conclusion from the data so far collected. Since there was data presented by witnesses that he had shown at least Othello and Michael on numerous occasions prior to the arrest, those entities had not been fabricated to provide him with a defense. There was also hard evidence, including police and hospital reports, to verify Joe's stories about conduct during Leroy's amnesic periods. Despite the efforts of the District Attorney to portray this odd behavior as nothing more than the play acting of an unsophisticated ghetto youth who was attempting to fool the experts, the evidence was there to show that the manifestations of this illness had existed for at least a decade. Several factors weighed against my picking MPD as the most likely diagnosis,--the subject's choice of victim was one important item. He had many times in the past indicated his fondness for the victim, to the point where her mother had become jealous of his attentions to Darnell. The defendant had tried Ms best to be the father none of these children had, in his persona of Leroy Jackson, and he really had no motive to kill this child, as she had not done anything to anger him so. There was, however, ample reason for him to hate Candy, but more than likely he repressed those urges, in order to continue to see himself as the devoted husband. Candy had a long documented history of beating all of her children. She had been threatened with arrest for this behavior in several states. Joe reported that most of the beating by hand that Darnell received immediately prior to her death was delivered by her mother, not by Leroy. Candy was Leroy's woman, and he was too nice a guy to hate her, as far as he was consciously aware. What lurked in his unconscious mind was another story. In my experience with bona fide MPD patients who did kill, the victim was a person the patient had personally hated and perceived as his persecutor. He did not displace his anger onto an innocent victim. Another important difference was the reported nature of the origin of the hostile entity, Othello. The description usually given by a multiple of the origin of the first hostile alter-personality usually relates to an attack by some adult he had trusted for care, a parent, for example. In this case the villain was Jack, mother's boyfriend. Jack was not described as one Leroy could or should trust, as he was assigned to care for all the children while Mother worked. I could perceive no positive affection on Leroy's part for Jack nor any expectation of his liking Jack at all. His total affect for Jack was, in fact, hatred. This hatred was then displaced onto a demon he made and named Othello, who could carry it for him. When a potential multiple is overwhelmingly abused by a parent he should love, he splits a part of himself off to become a non-personal entity who can then hate the parent of that other person who still loves the abusing adult. Leroy did not deny Othello's existence and carried on many long conversations with him over the years. This is something the multiple would not be expected to do, as he must deny this evil intent toward someone he believes he is expected to love. The multiple is unaware of the hostile entity he has created. Leroy was good friends with his own. Leroy used the mental mechanism of identification with the aggressor to design Othello, using Jack as his model. The types of abuse he described which Jack imposed on him and his sisters were exactly the same as Candy described Othello imposing on her children, namely eating dog food, drinking urine and being tied up with dog chains. While the same mechanism of defense may be used by a multiple in a later alter-personality creation, it is not likely to be used the first time. At that time, he is more likely to create an entity whom the abusing parent will like, one that can survive despite the abuse heaped upon him. This will most likely be a compliant entity rather than an angry and hostile one and is thus likely to invite more wrath from someone like Jack. Differentiating from "real" possession is even more difficult, since one has to assume that such a condition does exist. If it does, then it should follow rules which are common to all religions. In Leroy's case, there was a major flaw in the repeated insistence that God is strongest on Sundays and on Wednesdays and Saturdays the Archdemons are strongest. The Gregorian calendar was, after all, man-made, and I personally know of no religion that proclaims that God does more work on one day of the week than on another. Leroy's concept did not seem to me to be theologically sound. Another flaw was that Othello was so easy to reach and so ready to come out to have his say. If he really was an evil spirit, he had no need to restrict himself to Leroy's body and could have done all he wanted to upset the trial by non-physical means. I saw no rationale for an evil spirit emerging so baldly and identifying itself. It would seem to me more logical for him to do his dirty deeds without such advertisement of his existence. There was also evidence that Othello had engaged in pimping prostitutes, selling drugs, stealing explosives from National Guard armories and engaging in other unlawful activities, all of which were unknown to Leroy. All of these activities seemed more appropriate for an entity that expressed Leroy's hatred of the society he lived in rather than a demon spirit doing the work of Satan. POSTSCRIPT Two years after his conviction, on July 20, 1984, I conducted a four-hour interview with Leroy in a locked contact booth in the prison's visiting area. Leroy arrived, appealing cheerful, sporting a mustache and reading glasses. The interview lasted four hours. During this time I also reviewed matters with Othello and Joe, both of whom appeared with the cooperation of Leroy. No one knew what had happened to Archangel Michael, and he did not make an appearance at that time. Overall, there seemed to be no change in the balance of forces I had observed during the trial, since three of the entities were still in attendance and had been active during the previous years of incarceration. Leroy was very proud to report that he had learned to read, write and type in prison. His main accomplishment had been to secure official records through his sister, which proved to him that the District Attorney was completely wrong in asserting that he had lied about the incidents of child abuse in his past. Now that he could read the court testimony documents, he knew what facts he needed to prove to show he had been truthful in his statements to the psychiatrists, and he had secured court and police documents that verified his own memory. He had done this, not for the purpose of going back and re-trying his case but to be absolutely sure of his own roots and confident of his own recollections. Being called a liar by the District Attorney was something he could not let go unchallenged. The patient is getting along well with all staff and the civilized inmates, but some of the inmates do know him as Othello. He stays in his cell most of the time since he cannot risk letting Othello out among other inmates. He is still communicating with Othello regularly, but, as he says, "on my own terms." Leroy is still experiencing amnesic episodes. Othello did not execute him on his son's birthday in December, 1982, as threatened in court, however Leroy did awaken in his cell with multiple bleeding slash wounds of Ms right forearm on January 13, 1984 and required hospitalization. Leroy believes that Othello is trying to tear away at his body, bit by bit. He exhibited to me the 20 gash wound scars on his right inner forearm. Leroy made no requests for me to intervene in any way in his situation. He reiterated orally what he had earlier written to me: "I still have this problem and all I want is to die; then I won't have to live like this. " When I asked Leroy to let me talk to Othello, he reluctantly agreed but stalled as long as he could. Finally, his face became expressionless with his eyes wide open for a minute. Then, the voice I knew to be Othello's came forth, with its usual gutter language, in contrast to Leroy's polite English. Othello did not recognize me, since he had expected someone else, so I introduced myself to him. He referred to himself as the "King" and indicated a distinct pleasure in being in a prison where there were so many of his old gang buddies from the ghetto. He was apparently up to all of the old illegal tricks that he played outside prison and behaved like any convict who did all he could to de the authorities while in prison. He told me that Candy was in prison, while Leroy had no idea where she was now. It was apparent to me, now that Othello was out, that he would prefer to stay out, but that was not to my liking. I did not dare let him out into the visiting area where he could easily ruin Leroy's good reputation with the correctional officers. Also, I was locked into this steel and Plexiglas booth and had no way to leave if Othello should get angry with me. I asked him to let Joe come out for his turn, but he was not eager to give way to that traitor, and I had to devise a strategy to get him to leave on his own accord when I was done with him. Besides two chairs, the only items in the booth were an ashtray and a Bible. I picked up the Bible and leafed through it to get his attention. Then I casually brushed it against his left elbow. With that touch, he became testy but not hostile, He objected to my gesture but I also sensed that he feared it. Not long after my move, he quieted down, his face went blank and, with his eyes still open, he left, to be replaced by Joe, his former assistant assassin. With a sigh of relief, I held a long conversation with Joe about current events. His job is to protect the body from harm and to do all he can to get a better deal for Leroy. Although he has no hope that Leroy can be cured of his "cancer" of 28 years, he is the entity who meets with the defense attorneys to develop legal strategies for further hearings on Leroy's case. In Joe's opinion, if Leroy is executed by the State, Othello will simply go back to being a soul again and will join with someone else to continue his evil deeds. The next time it will take someone stronger than Michael to stop him from killing again. He asked to go when he had said enough and to let Leroy return. When Leroy awoke he wondered why he had not been wearing his glasses. (Neither Othello nor Joe needs glasses.) I briefly informed him of what had transpired, which did not seem to surprise him. A friendly correctional officer came by and, like friendly associates, they gleefully waved to each other. After locating an officer who would unlock the door, I said farewell and returned to the outside world. CONCLUSIONS Two years on Death Row has apparently not changed the essential psychodynamic picture of Leroy Jackson. Now in prison, while the angelic rescuer has disappeared from view, Leroy, Othello and Joe have split up the required roles of any long-term prison inmate. Leroy deals with the staff and the relatively civilized inmates, makes friends, follows the rules and is duly respected for his proper institutional behavior. He conducts research into his own personal past for the purpose of proving his memory correct and for disproving the prosecution's accusations that he lied in court. Othello, the antisocial entity, is playing life in prison by the inmate code; he will do anything he can get away with, He associates with the same people he did when he was in the ghetto and behaves in the same way as when he lived there. Joe, the advocate and rescuer, is working with the attorneys to obtain an appeal hearing and secure a legal basis for overturning the death sentence. In the meantime, he is doing what he can to keep Leroy safe from Othello's attempts to harm or kill the body they share. Such is the current state of affairs with this little band of entities that share Leroy Jackson's body and consciousness. I see no reason to alter my trial testimony; the psychological processes then described still go on, regardless of what those around him may believe. Those who work with Leroy Jackson in the areas mentioned will need all the skill, enlightenment and ingenuity they can assemble for the task. REFERENCES 1. Teja JS, Khanna BA, Subrahmanyam, TB: "Possession states" in Indian patients. Indian J Psychiatry 12:71-87, 1970 2. Nelson C: Spirit possession and world view: an illustration from Egypt. Int J Soc Psychiatry 17:194-209, 1971 3. Salisbury RF: Possession in the New Guinea highlands. Int J Soc Psychiatry 14:85:94, 1968 4. Obeysekere G: The idiom of demonic possession: a case study. Soc Sci & Med 4:97-111, 1970 5. Kiev A: Spirit possession in Haiti. Am J Psychiatry 118:133, 1961, Quoted by Teja (1970) 6. Leon CA: "El duende" and other incubi: suggestive interactions between culture, the devil, and the brain. Arch Gen Psychiatry 32:155-162, 1975 7. Ludwig AM: Witchcraft today. Dis Nerv Syst 26:288-291, 1965 8. Schendel E & Kourany RC: Cacodemonomania and exorcism in children. J Clin Psychiatry 41:119-123, 1980 9. Ellenberger HF: The Discovery of the Unconscious. The History and Evolution of Dynamic Psychiatry. New York: Jason Aronson, 1976 10. Allison RB & Schwarz T: Minds in Pieces. New York: Rawson Wade, 1980 11. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Washington, DC: APA, 1980 12. Varma VK, Bouri M, Wig NN: Multiple personality in India: comparison with hysterical possession state. Am J Psychother 25:113,120, 1981 About the Author Dr. Allison is a staff psychiatrist at California Men's Colony in San Luis Obispo. He maintains a private practice of psychiatry and is a court appointed alienist in San Luis Obispo, Santa Cruz and Yolo counties. Dr. Allison has written numerous articles on multiple personality disorders. This paper was first presented at the college's Second Annual Symposium in Psychiatry and Law held in Maui, Hawaii from April 25-28, 1984. 



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