An Indian man now in Britain explained his criminal behaviour as
episodic ghost possession.1 Traditional exorcisms failed to help.1
A ‘Western’ diagnosis of dissociative state or paranoid schizophrenia was made.1
Treatment commenced using trifluoperazine and clopenthixol.1 The
patient underwent remission during neuroleptic treatment, despite previous
evidence of genuine possession.1 Many cultures give rise to
apparently genuine cases of ghost possession.1 Neuroleptics may
relieve symptoms of exorcism-resistant possession.1
The nature of ghosts2
Although ghosts and apparitions have been reported for thousands of
years, surprisingly little information is available with regard to their nature
or essence. Ghosts are elusive and unpredictable, and the ways in which
they manifest are surprisingly diverse. Much of the available data is anecdotal
and is therefore prone to exaggeration, embellishment, and sometimes outright
Although studies suggest that approximately one in ten of us has the
ability to perceive ghosts, those of us who are actively looking for them
are apparently the least likely to have a ghostly experience. Children
seem more apt to experience manifestations, suggesting that adults develop some
kind of blocking mechanism as they mature. Women seem more attuned than
men, and it appears that the higher your intelligence quotient (IQ), the less
likely you are to experience ghostly phenomena.
There are five interesting theories to consider regarding the basics of
Theory one: Ghosts
are the earthbound souls of the deceased—This is the most common interpretation
when confronted with a visible apparition, and it certainly does fit many
haunting where the apparition is more or less recognizable as someone who is
deceased. For most of us, this theory is also comforting, as it hints at a
life after the physical body is gone. We know from science that everything
is composed of energy. The theory is that when the physical body dies,
this energy continues on in some form and can be tapped by living persons
sensitive enough to perceive it.
Theory two: Events
are somehow recorded in certain surroundings to be replayed over and over to
living people sensitive enough to discern them—This theory accounts for a lot
of our ghost legends and is likely the source for virtually all haunting that
repeat again and again, such as the many “lady in white” sightings and ghostly
battle reenactments. The catalyst that starts the recording is usually
very emotional or violent, such as a war or a mother losing a child. They
are reported as walking through walls or just disappearing into thin air, and
they do not appear to be conducive to photography, though electronic voice
phenomenon (EVP) recordings are occasionally successful. Although most concur
that these types of apparitions do appear to be “recorded” somehow in the
surroundings, there is disagreement on how exactly we as observers perceive
these recordings. One side postulates that it is something within the
observer that sets the recording in motion, and that the recording thus “plays
inside our heads.” The other side postulates that the recording is being
played externally for all to see, but that only those with the right “antenna”
can experience it.
Theory three: Apparitions
are created from some type of naturally-occurring electrical, magnetic, or
electromagnetic condition—Many serious paranormal researchers believe that
measurable properties such as electricity or magnetism play a part in why we
experience ghostly encounters. One of the few things we do know for sure is
that paranormal phenomena is more likely to be experienced at night, and sure
enough, there is an scientific explanation for why this may be. In short,
the earth is covered by a fluctuating membrane we all know as the atmosphere,
which is constantly being bombarded by a strong solar wind from the
sun. During the day, this membrane is at its thinnest and densest because
it is being directly hit by the solar wind. However, at night, when
sheltered from the sun, it expands much farther into space and has much less
resistance. This explains why television and radio stations come in better
at night, and why you can tune into stations much farther away than is possible
during the day. Therefore, the reason we see more paranormal activity at night
is because there is much less resistance to every kind of magnetic and
electrical current or force, making it easier for energy-based manifestations
Theory four: Ghosts
are actual beings living in one or more parallel dimensions—The concept of a
parallel universe is a fairly complex one. To put it simply, this theory
suggests that there are one or more (perhaps an infinite number) of complete
universes co-existing with us on a plane we are generally not aware of. Any
type of spectral appearance, sight, sound, or anomaly can fit into the theory
of parallel dimensions. Thus, when we see an apparition, especially one
seemingly from another time and place, it could be that we are getting a rare
glimpse into another dimension or reality and we are seeing events develop in
that plane of existence. Interestingly, it is also theorised that each of us
even have parallel selves living on different planes in different stages of
development and that we may be aware of them at times on a subconscious
level. Obviously, this theory is just that - a theory - but it is a
particularly tantalising one.
Theory five: Ghosts exist only as figments of our imaginations—This
theory can be made to apply to every kind of paranormal manifestation there is,
and in some cases, it is probably at least in part correct. Medical studies
have proven that when certain parts of the brain are stimulated, various
perceptions are disturbed, such as visual, auditory, and tactile
functions. Various external stimuli such as very low frequency sound waves
and high fields of electricity can cause hallucinatory experiences that for the
subject are indistinguishable from reality.
Indeed, schizophrenics often relate seeing, hearing, and even talking to
very real entities that nobody else can see or hear. Are they really
seeing things that nobody else can see or hear? The consensus seems to be
no - it is “all in their heads” due to “short circuit” in the make-up of their
brains. However, there are still a lot of questions left unanswered by
this theory, such as when more than one person sees the same phenomena.
Skeptics use the term “mass hysteria” for situations like this.
Ghosts: explained medical way3
Most ghostly encounters are not visual, but rather consist of noises,
smells, sensations, voices, cold spots, electrical disturbances such as lights
switching off or on, and displacement or movement of objects. Schizophrenic
patients are typically unable to filter sensory stimuli and may have enhanced
perceptions of sounds, colours, and other features of their environment.
“I couldn’t move and there was a disorientating continuous buzzing down
the side of my bed which I could not turn to look at because I couldn’t move, I
struggled, I was petrified, I thought I was dying. After this first one, I told
no one because I thought that there was some kind of demon that came to menace
me, or was it just sleep paralysis?”
In Nepal, people often believe it to occur due to covering of the body
by “khyaak” when they have similar experience of sleep paralysis. “Khyaak” is a
kind of ghost/demon that is believed to reside in the dark. Sleep paralysis is
something of different cultures has constantly reported about for thousands of
years. Different cultures at different parts of the world have different
figures associated with such kind of experience. But is sleep paralysis really
caused due to demon or is there some medical reason?
Medical concept: Medically, sleep paralysis is a flaccid paralysis at
sleep onset or on waking and in otherwise healthy person characterised by an
inability to ‘kick start’ the voluntary muscles, resulting in a transient
‘locked-in’ syndrome. It is associated with narcolepsy, Pickwick Ian syndrome,
sleep apnoea, cataplexy and hypnagogic hallucinations. Cases of reported alien
abduction are also commonly associated with this condition.
predormital sleep paralysis: It occurs while you are falling asleep and as
you fall asleep, your body slowly relaxes. Usually you become unaware of the
change but if you remain aware while falling asleep, your motion and speech is
postdormital sleep paralysis: It occurs when you are waking up. During
sleep, your body alternates between REM (rapid eye movement) and NREM
(non-rapid eye movement) sleep. During NREM sleep, your body relaxes and
restores itself. At the end of NREM, your sleep shifts to REM. Your eyes move
quickly and dreams occur, but the rest of your body remains very relaxed. Your
muscles are “turned off” during REM sleep. If you become aware before the REM
cycle has finished, you may notice that you cannot move or speak.
Hallucinations consist of strange electrical noise (sound), pressure on
chest, false sensation of someone standing by or moving, etc.
“Demonic possession” is often termed as the paranormal phenomenon
involving entrance of demon(s) inside a body (more commonly used for living
person) to possess control over it. If we describe it as portrayed in the
movie “The Exorcist”, it is characterised by erased personalities,
fainting, convulsions, knowledge of foreign languages, hidden secrets and
future, drastic changes in vocal intonation and facial structure, superhuman
strength, etc. which persists until the demon leaves or is forced to leave the
Religious concept: Different religions have different concepts on demonic possessions. They
suggest “exorcism” as the way to get rid of the possession though they are
performed differently in different religion (performed by priest in
Christianity and shamans in Hinduism). Prayers, sprinkling of holy water,
beating, etc. are some forms of exorcisms.
In the Middle Ages, people or animals were believed to be possessed if
they had any one of the following symptoms: ability to curse or speak in
unknown languages, ability to make abnormal physical efforts, ability to read
minds or predict future happenings, fear of holy objects like the sign of
cross, lacked the ability to say the word Christ, spitted or vomited
Medical concept: It
is considered to be one of the many forms of insanity in medicine (more
precisely psychiatry). There are many psychological ailments commonly
misunderstood as demonic possession. Some of them are hysteria, mania,
psychosis, schizophrenia, dissociative identity disorder (DID). Of these, most
commonly people misunderstand DID as demonic possession.
becomes equally important to discuss about those who accuse others of being
possessed. In that case we may be facing “collective hysteria (also called
mass hysteria)”. Collective or mass hysteria is the sociopsychological
phenomenon of the manifestation of the same or similar hysterical symptoms by
more than one person. A common manifestation of mass hysteria occurs when a
group of people believe they are suffering from a similar disease or ailment.
Between 1533 and 1697, many people lost their lives during exorcisms or similar
stuffs due to accusations made by children and teenagers. Many of them apologized
later due to remorse. This is a case of simulation. In Medicine, simulation is
defined as the conscious process of feigning illness in order to gain some
particular end. A person easy to influence can be convinced by others of
being demon-possessed. The number of “demon-possessed” people and accusers was
higher in women than in men because hysteria which is more common in women compared
to men is the first step to all other diseases mentioned above.
Accusations made about witchcraft (occurs mostly in villages): The accusations generally rise with
the reason for the illness of local people. Illiteracy is obviously the root
cause for this but there is much news about such accusations due to
superstitions, enmity against the victimised, and political interference. There
are no clear legal provisions and null professional commitment of the educated
sections of the society which makes the problem more severe.
Let’s analyse three local ghosts of Assam, India.
Setting: Men attending jaatraa party (a form of theatre), usually
at a distant place, along with use of alcohol
or other psychotropic substances,
return late at night either by walking or cycling. They sometimes complain of
seeing a group of children playing among themselves under groves of bamboo,
which is abundant along the village roadside in Assam. However, no harm is
complained of by these people but, they are frightened, chant some religious
songs and they reach home safe. Sometimes, some of these men are found
senseless in the roadside who later complain the apparition.
Interpretation: Sleep deprivation, possible electrolyte imbalance
following exertion along with substance use may be responsible for visual
hallucinations. Can jaaukaar paal be a local manifestation of
Lilliputian syndrome, and thus suggesting the possibility of short-term
delirious state due to exertion related or substance related
Setting: Jakhinis are supposed to steal fried fishes from the
kitchen while it is being kept aside during frying. The usual complaint is that
the cook finds the fried fishes missing. Usually it is found only after the
whole frying business is done. Sometimes, the cook also complaints seeing a
hairy hand stealing away the fishes through the wall, and hears sound of
Interpretation: In big joint families of Assam, the cooking for whole
family is done by the daughter-in-laws (as. n. buwaari) of the family.
However, the above phenomenon is found only when one person is working in the
kitchen. The young daughter-in-laws in the family are supposed to eat only
after the whole family takes food. Most of the time the bigger fishes, which
are supposed to be the tastiest, are given to male members in the family. Thus,
these daughter-in-laws usually do not get to eat these. So, the jakhini
phenomenon may be interpreted as a dissociative amnesia (DA), in which the
person consumes the delicacy by herself and the resulting guilt dissociates to
interpretation of a ghost.
Setting: A tall, well-built elderly man dressed in white, mostly helpful,
is met. He shows correct ways to lost one. At times thieves encounter him,
usually when the attempt is to steal from religious places like kirtan ghar.
The thief becomes unconscious seeing buraa daangoriyaa and reveals the
Interpretation: It may be the manifestation of the good unconscious.
Confession of the thief may dissipate the guilt feeling of stealing from
religious place, thus serving secondary gain. Encounter with buraa
daangoriyaa and subsequent unconsciousness is the primary gain. So can we
say it to be superego, and the phenomenon as another form of dissociative
Ghost and psychiatry
Possession is a common manifestation of distress in a multicultural
setting.6 It is increasingly likely to be encountered by mental
health professionals who may be unaware of the phenomenon.6 The case
of a 31-member family displaying mass hysteria in up to ten members at one time
is reported by Mattoo et al.7 The mass hysteria emerged in
the context of the strong religious and cultural beliefs held by this closely
knit family. The varied presentations included somatoform disorder, recurrent
vomiting, conversion, dissociative and possession attacks. Two members had
bipolar affective disorder that was recognised by the family as a ‘medical’
illness in contrast to other problems attributed to religiosity.
A study of possession was made on 1,029 inpatients (male 562, female
467) in Japanese mental hospitals.8 The results were: (1) The
incidence of delusion of possession in the sample was 20.7% for the sample as a
whole. (2) As to the contents of delusion of possession, possession by a god
was most common. In regard to the difference between the sexes, females were
significantly more likely to be possessed by a god than were males. (3) As to
the difference between the possession group and the non-possession group,
religion, fortuneteller contact, age and diagnosis were significant. (4) As to
the characteristics by district in regard to the incidence of delusion of
possession, cases of possession were very few in Tokyo and many in Okinawa.
It can be said that a definition of delusions requires the invocation of
cultural understandings, standards of acceptability, as well as conceptions of
reality and the forces that animate it.9 For these reasons, the
determination of delusional or normative ideation can only be effected properly
within particular cultural contexts.9 The cross-cultural record
suggests that it is difficult to separate the delusional from the cultural; a
belief that is patterned and culturally specific is, by definition a cultural,
not a delusional belief.9 One must rely upon particular, relevant
local cultural understandings to ascertain when the bounds of culture have been
transgressed and meaning has given way to unshareable nonsense.9
Cross-cultural concepts of reality are related to the development and
the threshold of hallucinations.10 Attitudes toward hallucinations
tend to affect the emotional reaction to, and the degree of control of, these experiences.10
Awareness of these attitudes may help the diagnostician to distinguish between
pathological and culturally sanctioned hallucinations.10 It is
important that therapists consider the functional significance and meaning of
hallucinations as well as the social context and the stimuli associated with
Approaches to trance and possession in anthropology have tended to use
outmoded models drawn from psychodynamic theory or treated such dissociative
phenomena as purely discursive processes of attributing action and experience
to agencies other than the self.11 Within psychology and psychiatry,
understanding of dissociative disorders has been hindered by polemical
“either/or” arguments: either dissociative disorders are real, spontaneous
alterations in brain states that reflect basic neurobiological phenomena, or
they are imaginary, socially constructed role performances dictated by
interpersonal expectations, power dynamics and cultural scripts.11
Integrative model, grounded in a cultural neuroscience, can advance
ethnographic studies of dissociation and inform clinical approaches to
dissociation through careful consideration of the impact of social context.11
Psychoanalytic theory appears flawed in its notions of universal oedipal
conflict and repression, and unsuitable for the study of pathological spirit
possession in South Asia.12 The biological theory of contemporary
psychiatry is no more effective in this analysis because mental illnesses are
constituted within culture-bound categories of experience.12
Dissociation theory offers a better theoretical tool for this type of research.12
Psychoanalytic theory appears flawed in the way it has been
traditionally applied in anthropological studies of
spirit possession in South Asia.13 It is suggested that
pathological spirit possession in South Asia has a similar a etiology
to multiple personality disorder in North America, which is caused by
spontaneous trance reactions to extreme situations in the environment,
particularly child abuse.13 Judging from the available
anthropological and psychiatric literature on spirit possession in South Asia,
it appears that if the possessing entity in not a supernatural being
(e.g. ghost, demon, god, etc.), but rather a human personality, then the
episode will be perceived as mental illness, and psychiatric treatment will be
Studies of psychiatric out-patients from India have found that diagnosis
of some of the subcategories of the dissociative and conversion disorders of
the World Health Organization’s International Statistical Classification of
Diseases and Related Health Problems (ICD) and American Psychiatric
Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM)
classificatory systems are rarely made in this setting.14 Moreover,
it was found that a significant percentage of patients seen in psychiatric
practice may not fit into the defined subcategories of dissociative
(conversion) disorders of these systems of classification.14 Spiegel
et al.15 make the following recommendations for DSM-5: 1.
Depersonalisation disorder should include derealisation symptoms as well.
2. Dissociative fugue should become a subtype of DA. 3. The
diagnostic criteria for DID should be changed to emphasise the disruptive
nature of the dissociation and amnesia for everyday as well as traumatic
events. The experience of possession should be included in the definition of
identity disruption. 4. Dissociative trance disorder should be
included in the unspecified dissociative disorder category. There is
a growing body of evidence linking the dissociative disorders to a trauma
history, and to specific neural mechanisms.15
Take home messages
Locally prevalent ghosts help understanding phenomenology which in turn
works in proper management. There is a need of central data collection unit
with reporting from multiple sites and their proper analysis.
In conclusion, quotation from an Elizabethan playwright is relevant to
the theme of this paper: ‘Beware you do not conjure up a spirit you cannot lay’
Ben Johnson, The New Inn (Act III, Scene ii).16
Pinninti NR. Exorcism-resistant ghost possession treated with clopenthixol. Br
J Psychiatry. 1994;165:386-8.
of Ghosts. Mystical Blaze [Internet]. [cited 21 Feb 2012]. Available from:
Explained Medical Way. Medchrome [Internet]. [cited 21 Feb 2012]. Available
Paralysis: Alien Abduction, Demon or Physiological? Medchrome [Internet].
[cited 21 Feb 2012]. Available from:
Possession: Medical Explanation. Medchrome [Internet]. [cited 21 Feb 2012].
Available from: http://medchrome.com/minor/psychiatry/demonic-possesion-explained-medical-concept/
Bhui K, Dein S. Making sense of ‘possession states’: psychopathology and
differential diagnosis. Br J Hosp Med. 1995,53:582-6.
Gupta N, Lobana A, Bedi B. Mass family hysteria: a report from India.
Psychiatry Clin Neurosci. 2002,56:643-6.
The current situation in regard to the delusion of possession in Japan. Jpn J
Psychiatry Neurol. 1989,43:19-27.
Culture-specific delusions. Sense and nonsense in cultural context. Psychiatr
Clin North Am. 1995,18:281-301.
The illusion of reality or the reality of illusion. Hallucinations and culture.
Br J Psychiatry. 1995;166:368-73.
R, Kirmayer LJ. Dissociative experience and cultural neuroscience: narrative,
metaphor and mechanism. Cult Med Psychiatry. 2008,32:31-64.
RJ. Spirit possession in South Asia, dissociation or hysteria? Part 1:
Theoretical background. Cult Med Psychiatry. 1994,18:1-21.
RJ. Spirit possession in South Asia, dissociation or hysteria? Part 2: Case
histories. Cult Med Psychiatry. 1994;18:141-62.
PJ, Joseph S, Das A. Limited utility of ICD-10 and DSM-IV classification of
dissociative and conversion disorders in India. Acta Psychiatr Scand. 1997;95:177-82.
Loewenstein RJ, Lewis-Fernández R, Sar V, Simeon D, Vermetten E, et al.
Dissociative disorders in DSM-5. Depress Anxiety. 2011;28:824-52.
Besieged by devils--thoughts on possession and possession states. Med Sci Law.