Don't let them call it madness: spirit possession and mental health

I had been hearing voices – rather I felt something compelling me to commit suicide. The lake running through the university became alluring. I would also bang my head against the walls (breeze blocks we used to call them) in my hall whilst trying to perform basic tasks like showering. Before my brother and sister came I had sought refuge off campus with a Trinidadian woman – a Christian I’d met a few months previously. She prayed that I would find strength to fight the negative spirits enticing me to kill myself.

I finally attempted to write part of the story from which the above extract was taken. It’s a life writing piece that didn’t win the competition for which I composed it. The experience it relates happened in 1997. I knew it would have to be told some time but why now?

Aside from the idea that everything is a matter of ‘divine order’ and ‘timing’ as my mum always reminds me, it has to be told now because it’s the hour of awakening when I try to connect all the forces that have shaped me to be the person I am.

I have wanted to attend one of the conferences put on by The Ethnic Health Initiative (EHI) for a number of years. I could never afford it. The one I scraped funds to go to on Monday 9th March would have set me back £175. I was excited by the theme of this conference - “Spirit Possession and Mental Health until I remembered how much they usually cost. Here’s a bit of the email I wrote to the organisers:

I am an independent scholar, previously worked at London Metropolitan University. My research is in the very topic of spirit possession. I am also a practitioner of spirituality in which spirit possession features. I have also experienced what might be termed mental breakdown/schizophrenia and was nearly institutionalised. It was this latter experience that drove me to do a PhD on spirituality.

I am also in contact with several healers and practitioners… is it [the conference] centrally an academic exercise aimed at intellectualising the experiences? I would love the opportunity to contribute to this very important debate, especially since it impacts a number of Africans who are often left out of the debate. Kindly advise how I can attend with some concession?

They conceded £40 off the ticket. I was grateful and went, half expecting it to be as I’d imagined – an overly intellectualising affair. This is not the first time this conference theme was put on by EHI – I saw one in 2009; the contributors then were: Professor Sashi Sashidharan, Dr. Simon Dein, Dr. Antti Pakaslahti, Dr. Tim Hardie and Dr. Najat Khalifa (co-presenting a paper), Bettina Schmidt (her paper was titled Spirit Possession in the Caribbean Diaspora today: A Hermeneutic Challenge), Dr. Andrew Powell. The focus then, as it was at the 2015 conference was predominantly on the Muslim perspective. For this conference contributors were: Professor Sashi Sashidharan, Dr. Simon Dein, Dr. Najat Khalifa, Dr Mohammed Aboueslleil Rashed and Dr Terence Palmer. I left Dr Palmer til last deliberately. He was an English man. Six years has lapsed since I noticed the first conference on spirit possession, I was just about to complete my PhD then and really wanted to attend, but couldn’t. I am struck here by the fact that the same professors, bar two were re-invited to present with the focus again on these issues as it affects Muslims. I smell closed shop.

The perspective of spirit possession the conference focused on was in terms of negative entities overwhelming their victims causing them to either harm themselves or put themselves in harm’s way. The psychiatric response would be remedial, restoring the patient to well-being. After all, no one should strip themselves naked and prance through the streets shouting, cursing and basically ‘getting on mad’ – unless, as Trinis might say it’s in the name of Carnival! Ordinarily this behaviour clearly points to some psychic disturbance. The bulk of the presentations illustrated that belief in Jinns as part of Islam takes precedence over the diagnosis of mental illness when such behaviour is presented.

Spirit possession was defined as when ‘a person feels as if their normal identity has been pushed aside by a spirit, who takes control of their body and typically communicates with other people.’ Usually after the ‘possession episode’ the person has amnesia. Often spirit possession is diagnosed as schizophrenia, which according to Professor Shahshidharan was a recognizably distinct phenomenon and that the misdiagnosis meant long term psychiatric treatment. In other words, if the diagnosis was spirit possession other suitable interventions would be sought in place of those associated with the equally critical psychiatric disorder of schizophrenia. Importantly, it was clear in all the presentations that spirit possession was a real phenomenon. However, this didn’t mean all cases pertained to spirit possession but point to other psychological conditions.

...Maybe it was the morning I pulled out my locks, or one of the days she returned from classes to find me still in pyjamas, or when I started pressing a large knife against my wrist that she decided we needed to call my family.

Somehow I didn’t believe it was obeah. I didn’t see why anyone would do this and who it could be. My brother insisted it was and I guess my sister thought I was having a mental breakdown…

Part of the experience of spirit possession is ‘dissociation’ which was described as the ‘process where the person feels disconnected and loses touch with normal reality.’ A psychiatric evaluation would equate the dissociation with trauma; as an aspect of Post-Traumatic Stress Disorder. It was difficult hearing the clinical assessment of what would have been my experience. After I ‘recovered’ I had wondered whether it was stress induced, and over the years have been convinced it wasn’t but how could I be sure? When it happened I was in the penultimate semester at University (for my undergrad), so there was pressure or stress which we know can manifest or hide. Either way it impacts behaviour psychologically and often negatively.

It was supposed to be a 5000 word English essay on Charles Dickens’ Great Expectations. I don’t know how or why this book became so terrifying to me but each time I attempted to read it in preparation for the paper I suffered a kind of sea sickness and had to stop reading. This went on for several days – perhaps over a week. I had felt a similar sensation with Joseph Conrad’s Heart of Darkness.

Both texts were part of the English with Commonwealth Literature course I was near completing (only one more semester) at Stirling University. I didn’t find the books difficult because of their themes. But there was a strange abjection, a feeling of suffocation – something so familiar it gave me jitters when I tried reading them. There was some sort of spiritual proximity – with Conrad’s book particularly, it was as though reading it meant discovering that I was its subject.

It was agreed thankfully that responding to forms of spirit possession was culture specific. Although in the Western world dissociation would be considered a mental problem for which medical intervention was the go-to remedy it was acknowledged that in some societies other forms of ‘treatment’ were used in cases where the possessing spirits were negatively impacting the lives of patient/victims. Ritual, for example was used as a form of healing in some societies to determine the cause of the possession episode, who the spirit/s might be, why they were possessing a particular individual and how to exorcise or appease them.

Dr Terence Palmer introduced himself as a hypnotherapist and declared that he had only ever treated clients who were ‘British/white.’ Prior to this it was almost being suggested that spirit possession and the belief in spirits was something remote, belonging to Africa or Asia but not to the white Western World. He said that for him the phenomenon was universal. He had an idea which he shared with the conference and which formed the longest title amongst the papers: ‘A Pragmatic Approach To The Integration Of Education, Research and Clinical Practice In the Treatment of Spirit Possession.’ How wonderful! The other papers, seemingly presented by the ‘real experts’ were much shorter – ‘Spirit Possession and Mental Health,’ ‘Jinn Possession and Psychiatry,’ ‘Spirit Possession and Recovery in Psychosis,’ ‘Anthropology and Spirit Possession.’ Truth be told I thought Dr Palmer’s presentation, simple as it was despite the long title, shone through; for a few reasons.

Firstly, he assessed who was in the room by asking a series of questions that could allow him and us to know who were there. He then wanted to know if any of the 10 or so organisations that were involved in the Department of Education’s Commision of Enquiry into the Victoria Climbié case were present. Someone from AFRUCA was present, but no others. As you will recall Victoria Climbié was the tragic victim of murder and child cruelty. Her death was mostly responsible for the introduction of the children’s Act 2004. Dr Palmer expected Helena Stobbart, employed by the DoE to be there along with others from: The Churches Child Protection Advisory Services, Churches together for England, Children and Families Across Borders, London Safeguarding, etc. He hoped that he could communicate the need for integrating all these organisations and others as a practical response to dealing with instances not so much of child abuse but in the treatment of spirit possession. The increasing and cruel act of child witch hunt would form part of the body of research he was proposing.

Secondly, Dr Palmer asked the vital question of whether anyone in the audience had experienced spirit possession, few hands went up. He was aiming to see what the numbers of practitioners, researchers and those who had experienced possession were in the audience. There weren’t too many. Later it became clear that most of the attendees were from the NHS whose work overlapped in the area. The point he was making was that there was a need to bring together therapy, Education and training and research so that the ‘aetiology of symptoms’ could be catalogued as the first pragmatic research of its kind in the UK. He noted that countries like Brazil were years ahead in this approach to the treatment of spirit possession. I know that in Holland medical practitioners refer patients to traditional healers for remedial treatments as standard, where, for example, symptoms relate to spiritual matters.

Dr Palmer makes a good point, I know of no such practice (pragmatic approach) in the UK. This is surprising, given the existence of organisations like EHI, whose work is aimed at ‘promoting a better understanding of BME psychological health and well-being.’ Dr Palmer therefore appealed to the EHI organisers to take up the proposal to generate accurate data about the phenomenon of spirit possession. This, he felt could contribute enormously to new discoveries and lead to better training, education and treatment of related symptoms. But more than these it is surprising that there is no such practical integrative approach in the UK given the disproportionate numbers of minority ethnics, and specifically Africans/African Caribbean in the mental health system. If the EHI’s central remit, as it seemed to me, focusses on the Muslim perspective, I wondered what work was being done to assess the connection between spirit possession and mental health amongst other minority ethnic communities. Researching this area, with a practical emphasis of training and education would go some way in tackling the despicable practices of child cruelty, as one example, whereby children are being killed because their parents/guardians believe they are possessed by demons; there is also the practice of executing albinos for the same reasons. Better awareness of symptoms like hearing voices, as an example (which is quite common) could alleviate the need for long term psychiatric treatment or medication.

Thirdly, Dr Palmer shared that he had experienced spirit possession. I was hooked but know some were now thinking whoa can we really trust this guy? The PhD, the research, the training and practice, the second edition of his book The Science of Spirit Possession obviously bellowed some credentials, but how so big and broad, in public and I should add without a public school accent could he come out with his tales about being possessed by spirits? And still expect the now cautious audience to trust what he was saying? One particular experience he shared he said took him 20 years to write about. After his presentation in the brief Q & A I thanked him – no really - I hope I held it down but thought what he had to say refreshing. So I said how glad I was that he began by saying that spirit possession was universal, that I had written as part of my PhD a novella in which an English man, married to a Guyanese woman experiences trance. I wanted to put this into the narrative to illustrate the importance of cultural understanding/awareness and the universality of spiritual matters. In my story the English man becomes possessed by an Amerindian. His manifestation is wrongly interpreted by the Mother Leader (organising a ritual ceremony held to appease the ancestors of the African family the English man is married into). In Comfa, my research study, manifestations can take the form of seven ethnic spirits: African, Amerindian, Chinese, Dutch, East Indian, English (white) and Spanish, as pertains to the groups of people who make up the country or had historical links with it. A taster from the novella might better illustrate:

Joseph Ambrose was exhausted. It was two o’clock in the morning of what seemed to him like an interminably long day and the drums, the tambourines were yet pounding and clashing in his head…

He heard himself muttering as his head nodded from the weight of sleeplessness. He was still lagging, this he knew.

‘She was my daughter,’ he was saying as his head flopped and flailed. No one seemed to hear him.

‘Why am I here? Why am I here’? He felt himself stiffen and thought of his great uncle Joseph who at all times held a straight posture as befitted a royal soldier. The drumming now seemed to be thundering in his blood and heart.

‘My daughter... My daughter is dead. Oh Loise, Loise is dead. Why, why, why?’ Joseph repeated the words over and over as if compelling the drummers to make from them his sound. And it seemed in truth that a new tune had been made from his words which carried him in its peculiar pull and tugging. He began to clap his hands. Slowly, he clapped his hands as the Chief leapt from his roots and limbered towards him.

‘Titty, look your husband.’

‘Stop him, somebody, he ain know what he doing. Stop he. Look T husband.’ said Euna, anxiously.

‘Leave him. Leave him.’ No one owned the voice and command. Joseph Ambrose was left alone to dance his dance.

His feet began to shuffle. Suddenly, he was tossed to the ground by a force no one, not even the seeing one could see. He wriggled slowly, as if he was in a straightjacket from which he was trying futilely to remove himself. His head swirled around his body. Slowly he raised himself from the ground and reached for Festus’ walking stick which he saw in his own rhythm and light. His head jutted forward. His back arched straight, he held the stick of his light and vision across his chest and slow marched around the table. Somewhere behind his now closed eyes he could see his uncle Joseph. He was no longer wearing the uniform of a soldier but was topped and tailed in white. Joseph could barely see a young woman standing beside him but she seemed to be crying. His uncle began to cry too. Joseph noticed he was holding a young child’s hand in his. ’Eloise, Eloise’ Joseph cried. But his cries could not be heard for they were entombed in his private womb of memories.

I deliberately have the Mother Leader misinterpret his manifestation - ‘Congo, Congo, Congo,’ Ms Somner shouted. I wanted to show a cultural coming together of ethnicities, as facilitated by spirit possession. The Amerindian Chief, one of the spiritual narrators in the text, possesses the English man but the African Guyanese practitioner interprets the entity/spirit as ‘Congo.’ It would be another Shout to go into this intricately, as I’d like, but in the narrative, the Chief pulls away from the English man, vexed at the failure to recognise who he was. I played here too on the invisibility (in political, social, cultural affairs) and marginalisation of Amerindians in the wider Guyanese society. In my novella, however, the Amerindian Chief is an important liminal figure (spirit) trying to guide the lives of the African family, along with their ancestral spirits.

At the conference I initiated a question that alluded to the more positive nature of spirit possession, where it was actually being celebrated as part of a cultural practice and ritual. The presenters accepted this but returned that their concern was with the negative aspects. Dr Dein, who seemed to be a celebrity in the field, shared a case study about a Trinidadian woman whom he was invited to treat/diagnose at Guys hospital. There was a number of African Caribbean people during his time there presenting symptoms that were linked to spirit possession or mental health at the hospital. As background, he told us that the Trinidadian lady had jilted her lover to travel to England. The lover apparently cast a spell on her, putting the spirit of a rat inside her tummy. She stopped eating and was in a terrible condition when she ended up at the hospital. Dr Dein was called in on the anthropological side as compared to colleagues who were psychiatrists. The latter thought she had serious mental problems and needed medicating. At first Dr Dein tried to go with her notions of being consumed by the spirit of a rat, if I recall he called in someone from a church who agreed with the psychiatrist that the lady had mental issues. The audience were invited to say what we would have done in Dr Dein’s position, or rather (for show of hands) how many of us believed she was mad. Most hands stayed down, but an African woman, proudly raised hers and said she thought the woman was paranoid. She believed this to be so because from the description forwarded about the woman, because she hadn’t eaten and basically sick. One response was to assess whether she really needed and then to give the lady Spiritual Release Therapy, there were a few people there who did this work in the audience. Anyway, it seemed Dr Dein had no choice but to medicate the woman, to at least calm her down, after which time she returned to Trinidad. I got the feeling that he remained troubled that the woman herself never stopped believing there was a spirit of a rat inside of her, even after being administered with the drug that restored her to relative normal life.

My director of studies called it an “illness.” I asked the counsellor if she believed in God. “No,” she said simply. What a lovely freedom to be so sure, some part of my wavering consciousness must have thought. “Then you can’t help me,” I told her - leaving the dreary room with its false promises of healing.

My brother prayed for a rainbow to appear so he could wish for my mental recovery. This would be the first of many appearances of the rainbow that would become a permanent sign in my spiritual life. For there it was like a brazen truth arching across the morning sky, one end touching Dumyat Hill. He later baptised me on this hill, part of the Ochils of Scotland surrounding the University Campus; into no particular faith but I imagined I could be Rasta like him. The night before, when he and my sister arrived in Scotland my brother said what was happening to me was Obeah.

They mentioned the importance of patient explanatory models in the diagnosis of symptoms – that is what the patient thinks/believes is happening to them. This didn’t mean that the patient would know what treatment they needed but I think the idea is to explore possibilities, begin by closely listening to the patient. Too often, I think intervention is taken without consideration of the source – the person who is going through the experience. During my own experience, I felt at times that I was being lucid, other times it would be clear that it was less so, at least from my family’s perspective. I recall particularly knowing that my behaviour could land me in a mental institution. That was because this experience for African people was imprinted on my psyche. So during serious outbursts when it seemed inevitable I implored my family not to take me to hospital. They never did, not because they didn’t want to but my will was pretty fierce then – and there was sometimes this clarity which meant they probably couldn’t be sure that I was really mad. I used to ‘reason’ (particularly about spiritual things) with all of them; I know my diction changed (returned to heavy Guyanese accent that I’d lost). Fear, confusion, embarrassment, I think would all have played on their nerves; remedy, uncertain; but my mum realised the holy water thing she was doing wasn’t working!

The pastor they brought to do some kind of exorcism or maybe pray for me couldn’t match the biblical lyrics I was coming out with and left, bible between his sorry legs. The spiritualist church I went to which asked its victims to attend every night and spit into a bucket and pray aloud for redemption realised that I caught on quickly to their scam: during one of the collective writhing and spitting and praying episodes I realised that I wasn’t mad, and didn’t belong there. No one did. I saw an image of a man in my mind’s eye, whom I believe was Selassie glowing before me (perhaps it was because this version of a Christ figure had replaced the white one. As a first act of my ‘break with reality’ I tore down every one of those white Jesus images from the house; paradoxically this would have led my family/mum to conclude that the ‘possession’ was demonic, hence the need for holy water). When the pastor and his helpers were yelling ‘come out, come out’ allegedly to possessing spirits, I said to one of them very clearly and firmly – ‘I am out.’ I’ll never forget the look of terror on their face. I never returned. They were taking all this money – since every day you went you had to give tithes – from poor unsuspecting souls, some who were genuinely in need of help – whether spiritual or mental.

This very point was being made at the conference. In the case of Muslim belief in Jinns families were being exploited by so called practitioners who claimed they could exorcise spirits. But often they just robbed families without any change in the family member’s condition. It was noted that the traditional belief in ancestral spirits, who were venerated was eroding in favour of deepening reference to every ailment or complaint as the possession by or cause of jinns. A point was well made that in Africa (she was speaking specifically about Sudan) mental breakdown as a diagnosis is considered a long time after every other traditional approach has been explored – medical intervention is the very last resort. They would try to understand what was happening from the spiritual perspective of a tribe or family first. It wouldn’t always be thought negative, either.

The delusions, hallucinations, outbursts of violence and break with reality point to schizophrenia which would have led to sectioning. But spiritual and cultural associations are left out of this convenient diagnosis. Malodoma Somé, a Shaman of Burkino Faso would regard my “psychological crisis” as an “intense interaction with the Other World.” It makes the person experiencing the crisis “think and act crazily.” It is a calling - for release, an unlocking (or break) so the person could reveal their “gifts” to the community – gifts, he says, that are “won through the person’s intense dealings with Spirit.”

My self- explanatory model has led me over the years to recognise what happened to me was initiated by a mental break with reality but which was necessary for me to walk the myriad ways of spirit. I have never forgotten that my family’s first response was to believe what was happening to me was negative. It seems easier to call the devil's name than the divine's. I chose the latter, believing, feeling that what was happening to me was powerful and frightening but not necessarily negative. The 'voices' changed. I now felt that I was in some mediation with the spirit of my maternal grandparents. I allowed myself to speak in the non-lexical language during prayer - didn't fight the force, though this was very real. My family and it would be the same for others didn't really know what to think or do. And that's understandable given how far removed Africans have been shoved from their ancestral traditions and spiritual practice or really our worldview. It was clear at the conference that it was not always possible to be ‘sure’ of the diagnosis. But it was important to work with the person experiencing/presenting symptoms and in some ways try to bridge their interpretation with a professional assessment and I would add that of reputable spiritual practitioners. For the families of anyone experiencing/displaying symptoms of mental break down, I would say be vigilant about the person’s actions - if these are indeed harmful to themselves and others then the experience is unlikely to be positive and they will need professional care. Never abandon them, out of hand because your support, unless it becomes critical you cannot help them is vital. Whether the conference was worth the £135 I paid is one of those niggling, meddlesome questions – the kind that makes one sit uncomfortably on a shabby fence. However, I know I needed to go and am glad that it at least gave me the confidence to share this.