Project

Qualitative analysis of phenomena and symptoms associated with possession

Goal: The main objective of this project is to analyse and produce a systematic description of phenomena and symptoms accompanying possession, compare different clinical presentations of possession against diagnostic criteria of various disorders, analyse alterations in consciousness and behaviour in terms of memory, sense of control, accompanying affects and other clinically significant symptoms, and explore how people make meaning of their experiences and seek help.
‘Possession’ relates to change in behaviour and sense of identity, attributed to supernatural forces. The ‘possessed’ often seek help from priests, hoping that exorcisms will help them restore a sense of control over their body, speech or mind. There are Christian communities in Poland where individual and group exorcisms are held regularly. Studies show that people with ‘possession’ have often had traumatic experiences, including emotional, physical or sexual abuse, but they rarely linked these events with possession. Focusing on possession and exorcisms can delay treatment, divert attention from problems in the family, and also have potentially re-traumatising effects in the case of people with trauma history. Although ‘possession’ evokes the interest of many anthropologists, very few psychological studies have been carried out, even though symptoms relating to possession are described in psychiatric manuals. There have been no studies applying comprehensive clinical examinations to diagnose the possessed and understand their symptoms dynamics.

Project website: http://badaniepsyche.pl/projekt/opetanie

Methods: Interpretative Phenomenological Analysis

Date: 1 January 2016

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Project log

Igor Pietkiewicz
added a research item
Few studies on Possession Trance Disorder (PTD) describe diagnostic and research procedures in detail. This case study presents the clinical picture of a Caucasian Roman-Catholic woman who had been subjected to exorcisms because of her problems with affect regulation, lack of control over unaccepted sexual impulses, and somatoform symptoms accompanied by alterations in consciousness. It uses interpretative phenomenological analysis to explore meaning attributed by her to ‘possession’ as a folk category and a medical diagnosis; how this affected her help-seeking was also explored. This study shows that receiving a PTD diagnosis can reinforce patients’ beliefs about supernatural causation of symptoms and discourage professional treatment. Dilemmas and uncertainties about the diagnostic criteria and validity of this disorder are discussed.
Igor Pietkiewicz
added 3 research items
In many cultures, people use the concept of spirit possession to explain abrupt changes in behavior and identity or problems with affect regulation. High incidence of traumatic experiences are also found among “possession” victims but there are few studies exploring in detail their clinical presentations. This study reports the symptoms of two women with a history of sexual abuse, labeled in their religious communities as possessed, and subjected to exorcisms. Following a thorough clinical assessment, interpretative phenomenological analysis was used to explore their meaning-making and help-seeking behavior. Accepting the demonic reappraisal of trauma-related symptoms and interventions offered by clergy contributed to receiving social support but discouraged them from seeking diagnostic consultations and trauma-focused therapy, leading to their continued symptoms. This justifies the need for educating religious leaders in recognizing and understanding basic psychopathological symptoms.
Igor Pietkiewicz
added a research item
The notion of evil spirits influencing human behaviour or mental processes is used in many cultures to justify various symptoms or experiences. It is also expressed in psychotic delusions of possession, but there is limited research in this area. This study explores how patients with schizophrenia came to the conclusion that they were possessed, and how this affected help-seeking. Interviews with two men and two women about their experiences and meaning-making were subjected to interpretative phenomenological analysis. Three main themes were identified: 1) Links between traumatic experiences and psychotic symptoms, 2) The emergence of religious themes in delusional contents, and 3) Reluctance to use medical treatment and instead to seek exorcism. In each case, attributing problems to possession was supported by the local environment and media, led to seeking spiritual help, and delayed diagnostic assessment and treatment. However, using religious coping contributed to the sense of predictability and social support. Clinicians are encouraged to explore the experiences and conflicts expressed by the symptoms which people ascribe to possession and to negotiate alternative explanatory models with their patients.
Igor Pietkiewicz
added a research item
There is a gap in research exploring the experiences and explanatory models of people labelled in local communities as possessed. While previous accounts often focused on the links between possession and dissociative disorders or psychosis, the current study elaborates on problems attributed to possession in women with features of personality disorders. Participants were eight Polish Roman Catholic women who had frequented deliverance ministries or individual exorcisms because they were perceived as suffering from malignant possession. Following clinical assessment, video-recorded in-depth interviews about possession experiences were transcribed and subjected to interpretative phenomenological analysis. Participants talked about: 1) Difficulties with expressing emotions and needs; 2) Aversion to the church and its people; 3) Casting spirits out; and 4) Negotiating explanatory models and seeking help. Data shows that the notion of possession can justify unaccepted conflicts and impulses associated with anger, sexuality, and attachment needs in women with personality disorders. Endorsement of, and identification with this belief can prevent people from taking ownership of emotions and using professional treatment. Alongside spiritual counselling, priests involved should have a basic understanding of mental disorders and encourage the use of clinical consultations.
Igor Pietkiewicz
added a research item
Endorsement of and identification with cultural beliefs about spirit possession can affect clinical presentations and explanatory models associated with sudden, uncontrollable behaviour. Although literature shows links between possession-form presentations and dissociative disorders, which is also a focus of this paper, few studies explore in detail the experiences, meaning-making, and coping strategies of people with such presentations. This study is an interpretative phenomenological analysis of changes in behaviour and identity reported by an elderly, Catholic Mauritian woman of a Tamil background during in-depth interviews. The participant shared her personal experiences in relation to acquired beliefs about the influence of the supranatural world. In this study, such explanations – whether they have a dissociative base or not – are regarded as cultural metaphors to rationalise her conflicting impulses and actions. We suggest that possession-form presentations may involve various diagnoses and psychological strategies. The need for further research into possession-form presentations using detailed clinical diagnostic assessment is emphasised. This study also questions the link between possession-form presentations and complex dissociative disorders.
Igor Pietkiewicz
added 2 research items
Childhood trauma can have a lasting effect on personality and daily functioning, leading to dissociative changes in behaviour and identity. How these are interpreted and handled usually depends on local culture and beliefs. This paper presents the case of a Mauritian woman with a history of childhood abuse who was exorcised to 'dispel an evil spirit'. An in-depth interview exploring her experiences and meaning-making was transcribed and subjected to interpretative phenomenological analysis. This paper discusses possession as a culturally accepted metaphor for incomprehensible behaviours. It shows that help-seeking pathways are determined by symptom interpretation models which are reinforced by the local environment. It also demonstrates that exorcisms are potentially retraumatising, by the enactment of painful memories and emotions during this ritual. The authors stipulate that exorcism seekers could benefit from additional clinical assessment by professionals experienced in the dissociation field.
Phenomenological Analysis (IPA) has become a popular methodological framework in qualitative psychology. Studies based in IPA focus on examining how individuals make meaning of their life experiences. A detailed analysis of personal accounts followed by presenting and discussing the generic experiential themes is typically paired with the researcher's own interpretation, which is an expression of double hermeneutics in practice. IPA draws upon phenomenology, hermeneutics, and idiography. This paper presents fundamental principles behind IPA and offers guidelines for doing a study based on this framework. For many decades, the mainstream experimental psy-chology relied on quantitative methodology based on a model which involved testing theories by deriving hypotheses from them, which could then be checked in practice via an experiment or observation. The researcher looked for disconfirmation (falsification) of theory and, by eliminating claims which were not true, he or she was believed to move closer to the truth. In contrast to this approach, we have observed a growing development of qualitative research methodologies.
Igor Pietkiewicz
added an update
A pilot study has been carried out and a grant proposal has recently been submitted to the National Science Centre. We are hoping to find budget to continue our exploration of the phenomena and symptoms associated with possession. This will be the starting point for developing treatment guidelines for clinicians working with people experiencing changes in behaviour and consciousness, which are commonly attributed to supernatural forces.
 
Igor Pietkiewicz
added a project goal
The main objective of this project is to analyse and produce a systematic description of phenomena and symptoms accompanying possession, compare different clinical presentations of possession against diagnostic criteria of various disorders, analyse alterations in consciousness and behaviour in terms of memory, sense of control, accompanying affects and other clinically significant symptoms, and explore how people make meaning of their experiences and seek help.
‘Possession’ relates to change in behaviour and sense of identity, attributed to supernatural forces. The ‘possessed’ often seek help from priests, hoping that exorcisms will help them restore a sense of control over their body, speech or mind. There are Christian communities in Poland where individual and group exorcisms are held regularly. Studies show that people with ‘possession’ have often had traumatic experiences, including emotional, physical or sexual abuse, but they rarely linked these events with possession. Focusing on possession and exorcisms can delay treatment, divert attention from problems in the family, and also have potentially re-traumatising effects in the case of people with trauma history. Although ‘possession’ evokes the interest of many anthropologists, very few psychological studies have been carried out, even though symptoms relating to possession are described in psychiatric manuals. There have been no studies applying comprehensive clinical examinations to diagnose the possessed and understand their symptoms dynamics.