Even today, many cultures still believe that unusual behaviour that may be symptomatic of mental health problems is caused by spirit possession – especially in some less developed areas of the world where such beliefs are still important features of the local culture. Interestingly, beliefs about spirit possession are not simply used to try and explain the effects of psychopathology-related experiences, but are also regularly used to control and coerce individuals.

An interesting study by Neuner, Pfeiffer, Schauer-Kaiser, Odenwald et al. (2012) investigated the prevalence of cen, a local variant of spirit possession, in youths aged between 12 and 25 years in war-affected regions of Northern Uganda. They compared youths who had been abducted and forced to fight as child soldiers in the so-called Lord’s Resistance Army – a group that has waged a long and brutal campaign to overthrow the government of Uganda – with youths who had never been abducted.

Cen is a form of spirit possession where the “ghost of a deceased person visits the affected individual and replaces his or her identity”, and Neuner et al. reported that spirit possession was significantly higher in former abducted child soldiers than in non-abductees. They also found that reports of spirit possession were related to trauma exposure (such as sexual assault and being forced to kill), to psychological distress, and to higher rates of suicide and post-traumatic stress disorder.

Neuner et al. conclude that in many of the areas of the world where beliefs about spirit possession are widely held, such beliefs are a standard consequence of psychological trauma and may be a way of explaining the dissociative symptoms that often accompany intense traumatic experiences. These beliefs about spirit possession can then be used by various local agencies to manipulate the behaviour of individuals – even to the extent of coercing them into acts of extreme brutality. Explanations of mental health problems in terms of “possession” have taken many forms over the course of history, and it is a form of explanation that has meant that many who have been suffering debilitating and distressing psychological problems have been persecuted and physically abused rather than offered the support and treatment they need. Many ancient civilizations, such as those in Egypt, China, Babylon and Greece believed that those exhibiting symptoms of psychopathology were possessed by bad spirits (this is known as demonology), and the only way to exorcise these bad spirits was with elaborate ritualised ceremonies that frequently involved direct physical attacks on the sufferer’s body in an attempt to force out the demons (e.g. through torture, flogging or starvation). Not surprisingly, such actions usually had the effect of increasing the distress and suffering of the victim.

In Western societies demonology survived as an explanation of mental health problems right up until the eighteenth century, when witchcraft and demonic possession were common explanations for psychopathology. Nevertheless, as I have described above, demonic or spirit possession is still a common explanation for mental health problems in some less developed areas of the world – especially where witchcraft and voodoo are still important features of the local culture such as Haiti and some areas of Western Africa (Desrosiers & Fleurose, 2002). The continued adoption of demonic possession as an explanation of mental health problems (especially in relation to psychotic symptoms) is often linked to local religious beliefs (Ng, 2007; Hanwella, de Silva, Yoosuf, Karunaratne & de Silva, 2012), and may often be accompanied by exorcism as an attempted treatment – even in individuals with a known history of diagnosed psychotic symptoms (e.g. Tajima-Pozo, Zambrano-Enriquez, de Anta, Moron et al., 2011).

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