THE POSSESSION SYNDROME MYTH, MAGIC AND MULTIPLICITY by Ralph B. Allison, M.D. May, 1980 Presented at Second Pacific Congress of Psychiatry Manila, Philippines May 12-16, 1980 In the world of psychological sciences, it is considered a mark of progress to have passed beyond a belief in witchcraft and spirit possession as a cause of mental illness. The awareness of the way the mind can split itself into several parts, as in multiple personality, has more current acceptance than the ancient, supernatural beliefs. This seems in contrast, however, to the common, lay opinion of many cultures that black magic and evil spirits are more acceptable explanations for certain odd behaviors than dissociated parts of one person's mind alternately taking over that person's body. In this paper, I would like to propose that this problem is not an "either/or" situation, but that all of these current and ancient ideas may have merit. I would like to suggest that the concept of a possession syndrome, whereby a person's mind is controlled by an agency acting contrary to his own best interests, can be viewed as a spectrum. This spectrum rates the forces involved on a scale from totally self-generated to those which seem totally externally-generated. I will illustrate each of the five points on the spectrum of the possession syndrome with a clinical example from my own practice. I fully realize that other interpretations of the clinical data may be made, but we must first start with a description of the clinical information from which all theories evolve. Grade I Possession is control by an idea, an obsession, or by an involuntary act, a compulsion, or by addiction to alcohol or drugs. A lady with an obsessive-compulsive neurosis came to me for years for depression and a hand-washing compulsion. Many years ago water had splashed from a public toilet into one eye, causing a conjunctivitis. Ever since then she had to avoid public toilets, due to her persistent thought that she would go blind if such an event should ever happen again. Certainly, her fixed idea about public toilets being so dangerous greatly hampered her social life, since she could only stay out in public for a limited time before having to go home and use her own toilet. She could not work at her former job as a legal secretary and she could not take advantage of any of the cultural events in town. We have all seen such patients who seem controlled by such mistaken ideas, compulsions or addictions. In some cases where physical damage occurs from the compulsive act, these persons harm themselves severely, sometimes to the point of death. Grade II Possession is due to the influence of a negative alter-personality developed by a person with an hysterical personality structure. One young man created an imaginary friend at the age of nine, while hiding under the bed to escape another of his mother's angry tirades. This dissociated mental creation evolved into an alter-personality who hated all women, considered them only good for sex and eventually raped and killed six young women in two states. All this happened while the young man, in his primary personality, was holding down a responsible job, living with a girlfriend with whom sex was wonderful, and was helping raise their young son. When he weakened in any way, the alter-personality came out and killed another young lady. The primary personality was totally amnesic for all these episodes until psychiatric investigation under hypnosis was conducted. He was found to be a modern Dr. Jekyll and Mr. Hyde, with absolutely no recollection of the periods of murderous activity. In many cultures, the alter-personality would be considered the prime example of an evil spirit, invading the body of this decent young man. However, deep hypnosis showed very clearly the psychosocial roots of his mental splitting. The way this alter-personality was able to handle the repressed aggression against his mother was clearly demonstrated. With adequate information from his unconscious storehouse of data, there is no need to invoke supernatural explanations, at least in this particular case. Grade III Possession is when the controlling influence seems to be the mind of another living human being. Here is where witchcraft commonly becomes involved, in order to accomplish this end. A very Americanized Mexican lady, who did not believe in witchcraft, came to my office complaining of a year of depression and physical weakness. These symptoms had started just after her nephew had been killed in an automobile accident the night before his wedding was scheduled. The young man's mother (my patient's sister) blamed the patient for his death, since my patient had refused to try to talk the young man out of the desire to wed his girlfriend. The sister and their mother then visited a local black witch and had been observed by other family members performing black magic rituals aimed at harming my patient. In hypnosis, I asked to find out the cause of the problem and a voice came forth, identified itself as the sister of my patient and explained why she hated my patient. She admitted to having caused all of the suffering my patient had endured over the past year. After I told her to go back into her own body and leave the patient alone, the patient awoke with total amnesia for the hypnotic session and relief of her symptoms. I had no follow-up on this case, so I do not know the patient's mind well at all. But the facts were that she considered witchcraft pure superstition and acted the role of the typical sophisticated American housewife. Both her sister and mother were still very superstitious and fully believed in native Mexican folk beliefs of witchcraft, bought black candles and other paraphernalia from a local witch and performed rituals in front of a nephew. They fully believed that one mind could adversely affect another from a distance. The voice told me she was the sister, by name, and hated my patient because she, the patient, was so well-liked by everyone, and the sister was despised by most who. knew her. This was the sister's way of punishing the patient for being so popular. I had no evidence at all that the patient was suppressing her hostilities and created this entity, which had not caused blackouts, hallucinations or any other symptoms of dissociation. Only generalized, unexplained aches and pains, depression and malaise had been present for the previous year. I would like to think some other explanation would be more likely than the obvious one, but I can think of none which is supported by the data I had. Grade IV Possession is control by the spirit of a once alive human being. Although there is doubt in European and American circles as to the continued existence of the human spirit, it is an accepted belief of the majority-of the earth's inhabitants. one young lady, who also had multiple personalities, found herself compelled to walk from her home to the local harbor without knowing why. When she finally regained consciousness and control of her body, she went to a phone and called a friend to come and get her. I saw her at home shortly after that, induced hypnosis and asked to learn what was responsible for this odd behavior. A voice came forth which claimed to be the spirit of the woman who had drowned herself in the surf of the Atlantic Ocean while looking in the boats at the harbor for her husband and children, who had deserted her. She stated that she had taken over this patient's body to continue the search, but she was now on the Pacific Coast instead. After she agreed to leave the patient, the patient ceased to be interested in walking in the water. This patient was well-known to me and I was well-acquainted with all of her alter-personalities from therapy. She had often been "taken over" by entities which claimed to be either good or evil spirits, and which were identified as such by one or another of the wise, informative helper alter-personalities she had. This particular spirit-fitted the role of one which had died but had not completed a necessary function at the time of her demise--namely, finding her family. So, she did not accept the reality of having died, and had to take over the body of a susceptible person and one which lived near a harbor. My patient fit both of those criteria. Grade V Possession is the control by a spirit which has never had its own life history and identifies itself as an agent of evil. I once saw a young man who had been injured at work when a piece of machinery fell on his head. He had had several subsequent convulsive seizures but neurological evaluations did not show injury sufficient to explain the seizures. He also began hearing a voice telling him he was going to die shortly. Under hypnosis, I asked to learn the reason for these symptoms. A voice came forth, claiming to be the Devil. This Devil claimed to have entered the man several years before, when he was in Japan in the U.S. Army. The man had run into a burning house to rescue a Japanese occupant and, when he did, an explosion blew him out of the house. The man was hospitalized for many months and was very unhappy about the poor quality of his medical care. This Devil claimed he went into the man at the time of the fire and was responsible for the object falling on his head. He also claimed responsibility for all subsequent physical and mental symptoms. I secured a consultation with a local priest, who also met this same Devil, just by reciting certain rituals. The priest expressed an opinion that this was really not the Devil, as known in theology, but that he was an evil spirit who was so stupid he actually thought he was the Devil. When the man was relieved of this particular burden by the priest, he began to express the very strong repressed hostility he had toward his father from childhood, and about the male doctors who had treated him in Japan. As far as I know from subsequent correspondence, the symptoms of the voice and seizures did not continue after he left the priest. DISCUSSION: It is an axiom in parapsychological research that it is impossible to accurately differentiate, when a strange voice emanates from a person who is capable of deep hypnosis and dissociation, from play-acting, dissociation of that person's mind, or an outside entity which has entered sometime before. All we have for data is the self-definition of that voice and, if it is presumed to be an evil entity, there is reason to think it would lie to the examiner. There is no reason to think that a negative alter-personality would-not also lie and claim to be an evil spirit. Therefore, self-definition is an inadequate criteria for identification of the entity. Only by repeated exposure to such entities can an examiner arrive at his own most logical conclusions. In this talk, I cannot go into all the other experiences. I have had that led me to feel the entities I describe were what I think they were. Only by following a series of cases can any physician come to know what presenting symptoms usually indicate in regard to the underlying pathology. One thing is sure about the human mind--it is capable of doing anything. The only limitation is. our own perception of what we think is possible or impossible for it to do. Personally, I am all in favor of intrapsychic explanations for the symptoms I have noted in these patients. I have no doubt that, even if one accepts possession by an outside agent as possible, there has to be something about the patient's mind which makes it fertile ground for such entities to grow. This is usually found to be repressed negative feelings from their own past history, feelings which have never been dealt with and resolved by needed psychotherapy. These feelings act as a magnet for the outside force, since they are of the same nature, but internally-generated. Any healer of any culture soon comes to recognize this process and has learned to deal with it in a way compatible to the ways of the culture and the client. CONCLUSION: In conclusion, I would like to suggest that we not so lightly brush off explanations based on experience of many cultures over centuries of time, with many bright, insightful healers. The purely intrapsychic view of mental illness may not hold all the answers, especially when one gets a glimpse of what is deeply buried in the unconscious mind.. When one digs deep enough and the exposure is wide enough, strange entities may come forth from the depths. Only with careful analysis and correct identification of these entities can an effective approach be planned and curative maneuvers be successfully undertaken. 

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