12/10/2021
Exorcisms and Cultural Reactions to Mental Health
Tony Kail
There are a number of incidents occurring around the world where specific cultural practices are being used as forms of therapeutic solutions in combatting mental illness. One of the practices involves the use of exorcism to remove specific illnesses. Exorcism is described as “The driving away of spirits, such as demons, by chanting, praying, commanding, and other ritual means-occurs throughout the world and is invoked when an evil spirit has caused illness by entering a person’s body (Moro & Myers 2010). The belief in spirit possession can be found in a number of diverse religious faiths. Christian faiths speak of demons and the Devil as possessing individuals while Islamic faiths speak of the Djinn taking over the minds and hearts of men and women. In Tibetan Buddhism the spirits known as Angry Ghosts are believed to possess certain individuals. Various forms of exorcism are practiced by members of various cultural communities. Unfortunately, there are a growing number of cases where these cultural practices are taken to an extreme and have become replacements for scientifically proven medical and mental health solutions.
The sacred texts of various religions as well as additional classical commentaries of these faiths speak of several common symptoms that those who are believed to be possessed may exhibit. Victims of possession may exhibit such signs as speaking in unknown tongues, changes in personality, supernatural strength, blasphemous speech and erratic physical behaviors. Many of these symptoms are also found among patients with emotional disorders and mental illness. Early Greek cultures viewed disorders like Epilepsy as a visitation from the gods. Views like these spiritualize physiological disorders and create a need to spiritually combat these disorders. Many early exorcisms focused on victims who were suffering from mental illness.
Behaviors that include convulsions, compulsive obscenities and growling noises may be perceived as spiritual infestations but can also reflect the symptoms of various neurological disorders like Tourette’s Syndrome. Cases where individuals begin to have delusions and hallucinations can be interpreted as spiritual possession but they can also be documented symptoms of disorders such as schizophrenia. Patients suffering from schizophrenia can also exhibit several characteristics attributed to possession including catatonic states, hearing voices and lack of proper hygiene.
While I was in East Africa it was not uncommon to encounter victims of mental illness. In many communities’ victims would wander the streets and in many cases be treated as outcasts.
The World Health Organization states that in developing countries 85 percent of those suffering from mental illness never receive treatment. Reactions to the mentally ill range from social ostracizing to acts of abuse and violence. In 2005 the London Metropolitan Police established a special task force known as ‘Project Violet’. The task force focused on a growing number of cases involving child abuse and various spiritual therapies found in African communities. The task force found that there were several cases involving the abuse of children with disabilities and behavioral disorders done under the guide of exorcism.
Many of the exorcism techniques found in Africa communities include cultural practices involving chanting, prayer and singing. Various rituals performed by traditional healers include ceremonies, drumming and reading of spiritual texts. The majority of these techniques do not involve physical abuse or violence. However, there are a number of incidents where those perceived of being possessed by a spirit have been chained, beaten and cut in order to remove the perceived spiritual influence. Many of the same techniques that are used to drive away alleged ‘witches’ in African communities are being used against those that are perceived as being possessed.
There have been incidents where physical violence may not have occurred but the practice of unsafe spiritual treatments has resulted in harming victims. There have been cases where victims have been forced to fast without food or water for several hours thus diminishing physical health. There have been cases where victims were placed in confined spaces and have been subjected to smoke from burning incense and herbs creating possible threats to breathing.
There are incidents where the treatments become physical violent. An Associated Press reporter shared that a woman from Kenya suffering from schizophrenia was taken to a traditional healer for treatment. The woman was tied up for three months and was cut several times on her stomach by the healer in order to remove the spirit believed to be possessing her. There are documented cases where Africans have sought asylum in the United States as they were both accused of being witches because they suffered from schizophrenia and the other from Bi-Polar disorder.
There are a number of cases throughout the world where various forms of exorcism have been used to treat mental health issues. One of the earliest historical documents that was very instrumental in the European witch hunts was a book written in the 15th century known as the Malleus Maleficarum. Also known as the ‘Witches’ Hammer’ the book was used to diagnose the presence of malevolent spirits and the detection of witches. The book describes an individual that was believed to have been possessed by demons but could have also been exhibiting some behaviors attributed to a scientifically explained illness or disorder.
“In the time of Pope Pius II the following was the experience of us two inquisitors. A certain Bohemian brought his only son, a secular priest to Rome to be delivered because he was possessed. When he passed any church the devil made him thrust out his tongue and when he was asked whether he could not restrain himself from doing this, he answered “I cannot help myself at all for so he uses all my limbs and organs, my neck, my tongue, and my lungs, whenever he pleases causing me to speak or to cry out; and I hear the works as if they were spoken by myself, but I am altogether unable to restrain them; and when I try to engage in prayer he attacks me more violently, thrusting out my tongue.(Lawden 1986)”.
Recently a tremendous documentary produced by Netflix called 'Belief: The Possession of Janet Moses' told the true story of a Maori woman in New Zealand who struggled with mental health issues. The woman’s family decided to tackle these issues through the means of traditional rituals and the use of local healers. The dramatization of this woman’s daily life communicates many of the overt signs and symptoms she was experiencing. A four-day exorcism resulted in the death of the woman.
Stories like these present challenges to medical professionals. In many cases cultural approaches to dealing with mental health can be therapeutic when performed in a safe ethical manner. However, the need for medical and mental health professionals should not be ignored. The field of transcultural nursing can be helpful in addressing cultural issues. Dr. Joyceen S. Boyle of the Medical College of Georgia states that “Transcultural nursing is a body of knowledge that helps us provide culturally relevant care (Boyle 1999)”. Transcultural nursing practices take into consideration the culture of the patient being served. I have taught workshops for medical professionals regarding the practice of folk healing among Latin American cultures. In these classes I have shared about various models used in transcultural nursing that can be helpful in assessing a patient’s culture and worldview. This becomes particularly helpful when seeking information regarding the patient’s use of herbal remedies or cultural rituals to address sickness and disease. Some models include the use of Kleinman’s 8 questions regarding sickness, beliefs and treatment and the ETHNIC model.
Kleinman’s questions ask:
1. What do you think caused your problem?
2. Why do you think it started when you did?
3. What do you think your sickness does to you?
4. How severe is your sickness? Do you think it will last a long time or do you think it will it be better soon in your opinion?
5. What are the chief problems your sickness has caused for you?
6. What do you fear most about your sickness?
7. What kind of treatment do you think you should receive?
8. What are the most important results you hope to get from treatment?
(Taken from Namratha Kandula, MD. “The Patient Explanatory Model.” The HealthCare Blog, June 11, 2013)
The ETHNIC model stands for:
Explanation: How do you explain your illness?
Treatment: What treatment have you tried?
Healers: Have you sought any advice from folk healers?
Negotiate: Mutual accepted options
Intervention: Agree upon an intervention
Collaboration: Collaborate with patients, family and healers
(Taken from Levin SJ, Like RC, Gottlieb JE. ETHNIC: a framework for culturally competent clinical practice. In: Appendix: Useful clinical interviewing mnemonics. Patient Care 2000;34(9)188-9.)
In addition to assessing the patient’s cultural beliefs it is important to emphasize the need for medical treatment. Even if the patient decides to seek a spiritual treatment the treatment should be safe and humane. This can be a sensitive area for medical professionals to deal with as culture plays an important part of patient’s lives. Cultural competency and training in local cultural beliefs can be very helpful. Some healthcare organizations employee cultural brokers to provide insight into patient culture. The Epilepsy Foundation of Metropolitan New York shares that one of the challenges that cultural brokers assists with is in addressing cultural beliefs regarding epilepsy. The organization speaks of how in some Latin communities that epilepsy is viewed as a spirt and that some families believe that a convulsion is a sign of a spirit (Bronheim 2011).
Lastly, I believe that clergy and traditional healers should be educated to the dangers involved in dangerous behavior associated with spiritual expulsions. It would also be of tremendous help if they were also educated in a basic understanding of mental health issues and disorders. Patients and patient families that express the desire to seek out exorcisms or spiritual expulsions should be educated about the possible dangers and scientific explanations regarding their illness.
Works Cited
Boyle, J. S. (1999). Transcultural nursing at Y2K: Some thoughts and observations. Journal of Transcultural Nursing, 10(1), 8–8. https://doi.org/10.1177/104365969901000104
Bronheim, S. (2011). Promising practices: Cultural brokers help families and providers bridge the cultural gap. National Center for Cultural Competence, Georgetown University Center for Child and Human Development, Washington DC
Jumreornvong, Natty, Exorcism and Mental Illness Across Different Cultures, accessed at Huntington’s Outreach for Education At Stanford: https://hopes.stanford.edu/exorcism-and-mental-illness-across-different-cultures/
Kleinman, Arthur. (1978). Culture, illness, and care. Annals of Internal Medicine, 88(2), 251. https://doi.org/10.7326/0003-4819-88-2-251
Lawden, M. (1986). Gilles de la Tourette Syndrome: A Review. Journal of the Royal Society of Medicine, 79(5), 282–288. https://doi.org/10.1177/014107688607900508
Levin SJ, Like RC, Gottlieb JE. ETHNIC: a framework for culturally competent clinical practice. In: Appendix: Useful clinical interviewing mnemonics. Patient Care 2000;34(9)188-9.
Child abuse linked to faith or belief | metropolitan police. (n.d.). Retrieved October 8, 2021, from https://www.met.police.uk/advice/advice-and-information/caa/child-abuse/faith-based-abuse
Moro, Pamela A. and Myers, James E., 2010, Magic, Witchcraft, and Religion: A Reader in the Anthropology of Religion, McGraw Hill, NY
Namratha Kandula, MD. “The Patient Explanatory Model.” The HealthCare Blog, June 11, 2013
http://thehealthcareblog.com/blog/2013/06/11/the-patient-explanatory-model/
Pfeifer, S. (1994). Belief in demons and exorcism in psychiatric patients in Switzerland. British Journal of Medical Psychology, 67(3), 247–258. https://doi.org/10.1111/j.2044-8341.1994.tb01794.x
