Classic case: Psychiatric treatment of ghost possession

flo_katie.jpg In 1994 a curious case-report was published in the British Journal of Psychiatry. It described a man who believed he was possessed by a spirit and was successfully treated by medication. Unusually however, the article mentioned that other people had seen the ghost.

Belief in possession is not uncommon in psychosis, the mental state that can sometimes accompany severe mental illness and typically involves delusions and hallucinations.

Psychiatry usually assumes all such experiences to be tricks of the mind, rather than the result of other-worldly powers.

The case-report by Anthony Hale and Narsimha Pinninti (summary) is almost unique however, in that it suggests that the authors are unsure whether the possession was mental illness or spiritual intervention.

As well as making for a gripping read, it reveals some of the assumptions and difficulties of contemporary psychiatry.

Hale and Pinninti entitled their article Exorcism-resistant ghost possession treated with Clopenthixol. It discusses the case of a 22-year old Hindu male who believed he had been possessed by the ghost of an old woman. The ghost reportedly forced him to do ‘wicked things’, including theft of a car, for which he was remanded in prison.

The patient experienced his body being taken over by her spirit and also heard the voice of the ghost commenting on his actions and commanding him to act. These are classic first rank symptoms, first listed by psychiatrist Kurt Schneider as being particularly distinctive of schizophrenia.

So this might be an otherwise unremarkable psychiatric case if it were not for the fact that the prison chaplain, and several of the patient’s cellmates, saw the spirit possess the patient as a ghostly mist. The chaplain was convinced this was a genuine case of possession, as had priests from several other faiths who had previously carried out exorcisms on the patient.

This begs the question, if the patient was treated for his belief in spirit possession and his apparent hallucinations as to the reality of the ghost, why were the chaplain and the others not considered to be ill ?

This article highlights the uncomfortable relationship between beliefs in the paranormal and the assumptions of psychiatry. The results of a recent gallup poll suggested that over 40% of Americans believe in possession by the devil and 15% believe spirits can ‘temporarily assume control of a human body’.

Although psychiatrists would argue that the content of a belief is not enough in itself to diagnose a delusion, the criteria for distinguishing between ‘healthy’ and ‘pathological’ beliefs are notoriously incoherent.

Psychiatrists might be forgiven for sticking to their guns, especially in Hale and Pinninti’s case, where the possession seemed to disappear when psychiatric medication was used. It is all the more surprising then, that the authors consider they may have had a genuine case of possession on their hands.

The article made little impact in the world of psychiatry, although it did generate a little discussion in the Lancet. One notable comment was from UK-based Indian psychiatrist Sushrut Jadhav who remarked on the relationship between the uneasy bedfellows of science and folk-belief:

By juxtaposing ghost possession and exorcism-resistance with clopenthixol, and by equating folk explanations with superstition, one comes face to face with questions that lie at the heart of culturally sensitive psychiatry and public health. Can exorcism and ghost possession be incorporated into the same paradigm of illness that clopenthixol claims to treat ?

The question remains as yet unanswered.

This is the full case report from Hale and Narsimha’s paper:

A 22-year old unemployed Hindu Indian male, in Britain with his family since the age of six, was interviewed while remanded for theft of a taxi, robbery, and kidnap of the driver. He was apprehensive about prison despite previous remands and one short custodial sentence. He admitted the charges, but claimed that his behaviour was under control of a ghost. Prison staff considered him to be malingering. He was admitted under Section 35 of the Mental Health Act 1983 for reports.

His history emerged from the patient himself, family members, the family doctor, and hospital and prison records. The patient said his problems began at a family gathering when he was aged 11. An aunt, jealous of the success of the patient’s family, fed him and his elder brother cursed sweet rice, rendering them susceptible to spirit possession. His brother was afflicted by years of physical weakness and impotence. The ghost of an old woman intermittently possessed the patient, taking control of his body and rendering him a powerless observer while she made him do wicked things.

Warning of imminent possession was a fog which the patient would see drifting towards him, settling initially on his chest and making him breathless, then entering his body through his nose and mouth, making him retch and wheeze as he resisted, and taking control of his whole body, including his voice. There was no hyperventilation or other features suggestive of a panic attack. There was no history of antecedent events, conflicts or stresses. While possessed, lasting from half an hour to several days, the patient was aware of his surroundings through all senses, although often blunted as though through a haze. He lost motor control, but retained awareness of emotions, remembering fear, anger and guilt. He would ‘struggle’ mentally to prevent his body’s actions, usually unsuccessfully. He experienced command hallucinations, and occasionally the ghost’s voice commented on his actions to unheard others. Even when not possessed, he thought the spirit could listen to his thoughts, punishing him if he told people about her. He remembered most events while possessed.

The ghost forced him into petty pilfering, truancy, shoplifting, car theft (to kidnap, to travel to a cemetery and look at her grave), and to jump from a bridge in front of a train (a punishment for struggling against the ghost’s will).

The patient was an intelligent, well educated and insightful young man, westernised in his appearance and apparent outlook. He said he gained nothing from his behaviour, deriving no excitement from his adventures while possessed and did not need the things he stole, receiving a generous allowance from his family who were financially comfortable professionals. He recognised the effects of his behaviour on the family, from which the jealous aunt took pleasure. Evidence of her continuing malign involvement were spells written on paper and charms of bird feathers scattered around the patient’s home. His parents initially would not listen, fearing stigma, but eventually consulted local religious leaders. They sent him to holy places in India where he was exorcised, by a Hindu priest and later a Moslem peer. Inpatient with the failure, which seemed to increase the ghost’s anger, he unsuccessfully consulted Christian priests.

During the period of remand, the patient displayed periods of nocturnal anxiety, withdrawal, depersonalisation and apparent response to hallucinations. Routine physical examination and blood chemistry, haematology and endocrinology were normal. The patient was apyretic, although complained of being hot. Blood and urine screens for illicit drugs were negative. EEG and computerised tomography scans were normal. Family relationships seemed comfortable and supportive.

We were disturbed by a telephone call from the prison chaplain who described seeing the ghost possess the patient in prison, seeing a descending cloud and an impression of a face alarmingly like a description of the dead woman given to us by the patient, of which the chaplain denied prior knowledge. Similar reports came from frightened cellmates. He and our hospital chaplain concurred on genuine possession. This is an acceptable belief within pastoral counselling (Issacs, 1987).

Western medical belief systems led us to a differential diagnosis of dissociative state or paranoid schizophrenia. However, we were conscious that the beliefs of at least four priests from three different religions cast doubt on the delusional nature of the phenomena.

Exorcism having failed, we prescribed trifluoperazine (4mg daily) producing apparent remission. Following return to remand prison, he was commenced on a depot neuroleptic, zuclopenthixol decanoate, remaing in remission 12 weeks later following hospital transfer.

12 thoughts on “Classic case: Psychiatric treatment of ghost possession”

  1. I believe the case of the 22 year-old Hindu male and his ‚Äúsupernatural possession by an old woman” is susceptible to several critiques. First, the roles cultural beliefs play on the psyche and secondly, the gullibility of an eleven-year-old child. An aunt feeding a child stories about the spiritual possession of his food is analogous to telling a child ‚Äúif I stick a pin in this doll, you will feel pain respectively.‚Äù Although there have been accounts of successful voodoo methodology when person and doll were separated by thousands of miles, I hold firmly that these coincidences are purely learned responses to conditioned stimuli. I believe the mind holds the power to control everything psychological as well as physiological within oneself. We don‚Äôt yet hold the key to consciously access many of those portals but unconsciously the capabilities are endless.

  2. It’s not clear to me why the cure of possession by the use of psychoactive drugs would seem unreasonable if, in fact, the vulnerability to this state had been induced by some ingested substance. I believe that practitioners of Voodoo, as well as shamans of numerous cultures, are reported to use ingested substances to facilitate their possession by discarnate entities. Many pharmaceuticals have an antidote which produces the opposite effect, and the anti-schizophrenia drug administered could well have brought about this effect, closing the open portal in the central nervous system of the patient.

  3. i need someone to tell me what to do, i went to chicago on with my mom and her friend last week and we they took me and my friend on a “ghost hunt” tour thing..i thought it was all just a big joke….she told us to talk to ghosts..gave us these tools..and so we did..we just messed around though and said dumb things to the “ghosts”
    now its been a while and ever since then i have not felt like im just myself, i came across this site looking up ways to possibly get this ghost out of me..after reading the symtoms of that guy i got some major goose bumps just reading the first symtoms he had, cause honest to god…im haveing those symtoms…i have all my feelings motor skills but every thing i see or hear is through a blunt a haze exactly, and i have a very very great feelign i am possessed by a really scared by this..i dont want to tell my family cause they will just think im crazy..i know im not..this hasnt happened since the chicago ghost hunt, now im getting those symtoms that man had everything i look at is hazy i feel as if im just high on drugs all the time i dont know how to rid it, i tried praying..nothing happened..i have a lack of faith in god..maybe thats why my body was vulnerable..i dont know..just someone please email me and help scared by this..everything is hazy

  4. I have seen possession. In a 40 year old woman that was on my mail route. She could speak in languages she never learned, she would be choked and pass out, etc. It was bizarre. Psychiatrists always try to put some natural diagnosis on possessions, they have no belief in the supernatural, the dummies. Oh well, they will really lose in the end when they meet God.

  5. someonehelpme, considering the story you’re commenting on, you might pursue less otherworldly solutions to your problems!

  6. thinking this all started when I lived in my previous house that was an old school house built in the 1800’s…I saw things,heard things,heck they even called mom to me and it was NONE of my children,my children have experienced things,other family members have also.Some people wouldnt even come to my house because they were scared.I was sleeping on the couch one night to keep the fire going because it was 8 degrees outside,well i was woken by noises and i saw a black apparation coming at me…NO LIE…I really believe it entered my body at that time and still here!!!! I started shaking real bad and was cold and confused…I ran into my room where my boyfriend was sleeping and i woke him and said something just entered my body!!! i layed in bed with him freaking out and he said i went to sleep and something white and flowing came from my side of the bed and disappearded into the wall…so many things have happened im lost and need help.i am a freak,i cant think clearly, i have headaches everyday,i get mad easily,making bad descions,everything seems cloudy,my eyesight and hearing are weird,I have a sense of smell like crazy and im a smoker!!! I am 35…what is goin on?

  7. Well I am not denying madical treatment to such ghost problems, as ghost is in body which responds to madicines and the thought process initiated by chemicals of the body, i mean when a ghost possess a body, then certainly two commands are working on the body and this mix up can lead to conclusion of bi polarism,I think I am possessed as the ghost when it talks to me through my body only, tells me about future event, but as soon as its effect is gone i forget the things which it tells and when such thing happens I recollect of what IT told.


  8. Well I must say that ghosts are fictional characters not because of my own perception but because I visited 12 such places which were reported but not a single clue.

  9. I am a resident of India, going to Med school, I reside in a Medical Hostel near my University. It was about three months ago that it started. Everything i saw, heard, smelled, touched or even tasted started feeling negative. I started getting these negative impressions on people, like if i saw them or heard them or touched them i think that i am influenced by negative things and gets stuck in my mind, and so now every single day after that, I kept having these thought every single minute of my day… I cannot do any normal thing like brushing teeth or taking a shower as a normal person, I consulted a psychiatrist and took all the Medical tests that is possible, everything was normal but these thoughts still remain. Now they are just taking me to another extent… It brought my whole family into continuous depression and everlasting sadness, now I am reading the Bible and giving my Fate to Lord Jesus. Please advice me what to do.

  10. My girlfriend was diagnosed with schizophrenia many years ago. Past relationships didn’t want anything to do with it, but I think there may be more going on and I want to help her. Last night, a voice that wasn’t quite hers was talking to me. The voice hissed its ‘S’s and claimed to not be her. I asked it over and over to leave, and when it did, she fell asleep. I woke her up and she claims to have no memory of the event. I trust her, and I want to know whether it really is just schizophrenia or if there could be a ghost inside of her, based on my conversation with the second entity. I want to help her, so if anyone knows what to do, please reply. I promised I’d protect her, but I really don’t know how.

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