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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.

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... People labelled or identifying themselves as possessed and using religious coping strategies may represent a heterogeneous group of diagnostic categories, including: schizophrenia, dissociative disorders, and also personality disorders. However, possession experiences have been insufficiently explored in the last category (Pietkiewicz & Lecoq-Bamboche, 2017;Pietkiewicz, Lecoq-Bamboche et al., 2019;Van der Hart et al., 1996). There also may be individuals without a psychiatric diagnosis who simply express their conflicts and needs in a culturally legitimate way (Pietkiewicz, 2008). ...
... Experiences attributed to spirit possession, ways of reporting them, and accompanying symptoms have never been clinically analysed in detail, although existing research has compared possession narratives with local categories and phenomena described in psychiatric manuals (Somer, 2004;Van der Hart et al., 1996;Van Duijl, Kleijn, & De Jong, 2013). Pietkiewicz, Pietkiewicz, Lecoq-Bamboche, and Van der Hart (2019) stress the need for more qualitative studies in which individuals labelled as possessed, while using religious methods would be subjected to thorough clinical assessment. ...
... For example, people who ascribe their symptoms to demonic influence may be more inclined to use religious coping instead of clinical assessment and treatment (Pietkiewicz, 2008). Individuals may also feel confused and distressed when they hold different and conflicting EMs simultaneously, or when their EMs are not supported by the environment -for example, when they attribute current problems to possession but their priest refutes this theory and refers them to a psychiatrist, or when family and friends try to persuade someone that he or she is possessed (Pietkiewicz & Lecoq-Bamboche, 2017;Pietkiewicz, Lecoq-Bamboche et al., 2019). ...
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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.
... It is frequently associated with possession-form presentations, marked by: talking in a different voice, sensation of paralysis, shaking, glossolalia or making animal sounds, or "night dances" (2). Members of different religious groups also explain possession as incomprehensible somatic symptoms, difficulties in spiritual practice or even problems in relationships (3)(4)(5)(6)(7)(8)(9)(10)(11). Furthermore, people in many groups perceive exposure to inappropriate music or films, using substances, masturbation, homosexuality or extra-marital sex as spiritual threats or indicators of being possessed per se (12,13). ...
... In contrast to that, possession-form presentations in PTD comprise some dissociative symptoms not matching criteria for complex dissociative disorders. Other patients with possession-form presentations are better described in terms of personality disorders, marked by problems with attachment, affect regulation, and internal conflicts associated with aggressive or sexual impulses which they can express in a culturallylegitimate manner (4,11,13,23,24). These people can be encouraged by community members to attribute unacceptable or shameful impulses to demonic influence. ...
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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.
... Understanding a student's level of discipline requires detailed background information (Bellinger et al., 2016). This includes the geographic and economic factors of the area and the family conditions for the student, such as whether it owns or rents a home, whether parents or grandparents live with the student, whether another family lives with them, the economic situation of the family, and the family's income (Pietkiewicz, Lecoq-Bamboche & Hart (2019). Solutions for addressing disciplinary deficits (Bellinger et al., 2016;Solikhah & Budiharso, 2020;Tamang & Shrestha, 2021) include accommodating and listening to complaints, creating a safer school environment, challenging students to practice self-discipline and find solutions for themselves, and collaborating to transform negative aspects of the student by turning negative thinking into positive thinking (Warman, 2021). ...
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A discipline of worship and seems to be associated with the fact that students who apply discipline in worship should demonstrate more autonomy in school. This research used a case study design with a qualitative approach to data analysis. Participants in this study included four sixth-grade students, two teachers, and one principal from Tulungagung, East Java, Indonesia. The data for this study were gathered through direct observation and an in-depth interview. Direct observation was used to immerse students in how they perform their worship and Islamic beliefs at home and at school in order for them to be aware of their faith, worship, and application in their daily lives, and thus disciplines at schools, motivation to learn, and efforts to increase academic attainments are identified. Throughout the study, in-depth interviews with teachers, principals, and parents were conducted three times, and all were registered verbatim. To describe both numeric data and themes, data was analyzed using content analysis. The findings indicate that worships contribute significantly to internal and practical discipline efforts and behaviors. Students' future and proper insight into education opportunities and their future of existence are threatened by their knowledge of worship. Psychologically, students do well in terms of motivation and academic achievement. After receiving teaching worship, self-confidence, trust, spirit, belief, and self-efficacy all improve.
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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.
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Although clinical reports on MPD [Multiple Personality Disorder] and other dissociative disorders began to appear in the Dutch literature, there is still much controversy as to whether MPD can be considered as a valid diagnosis. Boon & Van der Hart (1988, 1991)—based on their clinical experience with MPD patients—suggested that MPD probably is underdiagnosed in the Netherlands due to lack of knowledge and inexperience of clinicians with the phenomenology of the disorder. Within the context of the ongoing debate on the 'reality' of MPD, the central question of our studies was whether MPD is indeed a distinct diagnostic condition (as we believed it to be), that can be reliably diagnosed in the Netherlands and distinguished from personality disorders such as borderline or histrionic personality disorder, and from psychotic disorders. In order to answer this question a first step had to be the validation of a diagnostic instrument to assess dissociative disorders. In this book we report on several studies conducted with the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D) (Steinberg, Rounsaville & Cicchetti, 1990) to improve the ability of detecting and diagnosing multiple personality disorder and other dissociative disorders in the Netherlands. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This handbook examines cultural psychiatry, a special field of psychiatry primarily concerned with the cultural aspects of human behavior, mental health, psychopathology, and treatment. The cultural focus is beyond any particular ethnic group and includes many majority and minority communities from around the world so that "cultural issues" are addressed in the broadest sense. The handbook begins with the cultural aspects of human behavior within the framework of the human life cycle. It moves to the cultural influences on stress and illness behavior, which provide the basic sociocultural knowledge needed by clinicians. The focus then turns toward the impact of culture on various psychopathologies, clinical assessment and practice, and psychological therapy. Culturally relevant therapies for various subpopulations and special social phenomena relevant to clinical work are then presented. The book ends with the issues of research and theoretical elaboration. An appendix of books organized by subject is provided for the convenience of the reader. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
In this paper Reactive Dissociative Psychosis (RDP) is seen as a post-traumatic stress response and as a subcategory of Brief Reactive Psychosis (BRP). A review of the literature and the evolution of RDP from Hysteria and Hysterical Psychosis are given. Issue is taken with defining the duration of BRP as Brief. The authors argue that long-standing psychotic symptoms may be traumatically induced. The dissociative aspects of RDP as its key feature and the concomitant implications for accurate diagnosis are proposed. The usefulness of applying hypnosis in RDP treatment is summarized in a case study from Janet and detailed in a case from the authors' practice.
Diagnostic and statistical manual of mental disorders
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, Fifth edition (DSM-5). Arlington, VA: American Psychiatric Publishing.
Préface. La possession de Jeanne Fery, religieuse professe du Couvent des Soeurs Noires de la ville de Mons (pp. i-v)
  • D.-M Bourneville
Bourneville, D.-M. (1886). Préface. La possession de Jeanne Fery, religieuse professe du Couvent des Soeurs Noires de la ville de Mons (pp. i-v). Paris, FR: Progrès Médical, A. Delahaye et Lecrosnier.
Spirit Possession in the Nepal Himalayas
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Hitchcock, J. T., & John, R. L. (1976). Spirit Possession in the Nepal Himalayas. Warminster, UK: Aris & Phillips.
Un cas de possession et l'exorcisme moderne
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Janet, P. (1898). Un cas de possession et l'exorcisme moderne. In P. Janet (Ed.), Ne´vroses et ide´es fixes, Vol. 1 (pp. 375-406). Paris, FR: Fé lix Alcan.
Djinnati, a possession state in Baloochistan
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Kianpoor, M., & Rhoades Jr, G. F. (2006). Djinnati, a possession state in Baloochistan, Iran. Journal of Trauma Practice, 4(1-2), 147-155. doi:10.1300/J189v04n01_10
The trinity of trauma: Ignorance, fragility, and control, Volume I. The evolving concept of trauma
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Nijenhuis, E. R. S. (2015). The trinity of trauma: Ignorance, fragility, and control, Volume I. The evolving concept of trauma. Gö ttingen/Bristol, CT: Vandenhoeck and Ruprecht.
Treating trauma-related dissociation. A practical, integrative approach
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Steele, K., Boon, S., & Van der Hart, O. (2017). Treating trauma-related dissociation. A practical, integrative approach. New York: Norton.
  • Uganda
Uganda. International Journal of Mental Health Systems, 8, 24. doi:10.1186/1752-4458-8-24