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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.