What fear daemons

Society & Religion - When the demon makes the psyche sick

Samuel Pfeifer, 30 years ago you worked in the emergency department of a hospital in Israel, where many Palestinians were being treated. What did you experience there?

Samuel Pfeifer: When a patient had a psychological or a physical problem, people would say: “This is a 'Djinn!'” That is what invisible, demon-like beings are called in Islamic countries. I remember a young woman who came to the hospital in an apparently unconscious state. My Arab colleague said it wasn't really unconsciousness. He was right: she was not yet married, was disadvantaged in her family, abused as a maid.

When she was brought here, the young woman was hardly responsive and had a completely fixed elbow. She was in a kind of trance. I was told that she was "madschnun", that is, possessed by a "jinn". When we gave her Valium, the arm was completely free to move again.

She has not let go of this topic since then. You recently attended a conference in London on the subject of “Spirit Possession and Mental Health”. It was also about obsession with ghosts in the Muslim communities in Europe.

Many Islamic ethnic groups from Asia, Pakistan and Bangladesh live in London. There are traditional healers in their quarters, and some of them are also imams. Many believers with physical as well as psychological problems turn to this first. Often the explanation is that it is a question of "jinn possession".

What kind of therapies do these healers use?

The healers, for example, write a verse from the Koran on a small piece of paper, stow it in a capsule, and the patients should then wear this capsule as an amulet on their bodies. Or they recommend sacrificing a chicken or a sheep, with particularly stubborn spirits, a sum of money is sometimes asked for.

The anthropologist and psychiatrist Simon Dein, who presented this research, also spoke of healers who take advantage of people's emergency situation and demand a relatively large amount of money. So there is a subculture there too, in which money and spirit mix.

Don't these people go to doctors?

Often they go to their family doctor. But our western model, our understanding of illness and medicine, makes people from these cultures rather suspicious. You can't believe that all of your problems are simply due to stress or a genetic predisposition to a particular disease.

They are often convinced that there is a force behind them that is causing their problems. In addition, people from completely different cultures often fear that the Western-oriented doctor does not understand them and considers them backward when they say that they suspect a spiritual power behind their problems.

That is why they do not tell the doctor that they feel possessed by a "jinn", for example. Or they go two ways: the doctor gives them painkillers or tablets for depression, but so as not to miss anything they also go to the local healer.

How do you rate such practices?

As a psychiatrist, I have strong reservations. It may be that in lighter cases there is some subcultural consolation. But unfortunately that is not enough for severe mental illnesses.

In 2010 in Bali I saw that schizophrenic patients were so feared that they were chained in a backyard. The animistic-Hindu culture there is well aware of obsession and trance rituals by healers. But these rituals are of little use in severe conditions.

I met an impressive psychiatrist in Bali, Luh Ketut Suryani. In remote villages on the island she came across severely mentally disturbed people who were kept in cages or chains by their relatives for years.

I've seen people chained in the back yard myself. The relatives are afraid they might attack the people in the village. Often the rituals of healers have not made progress and there is not enough money for treatment.

The psychiatrist brings these patients neuroleptics, i.e. drugs against psychoses. She and her helpers regularly administer depot injections with these drugs to the patients. Many of them today can live without chains thanks to the treatment.

How do these experiences flow into your everyday psychiatric routine?

Before traveling to the Middle East, all I knew was the Christian view of exorcism and obsession. I was fascinated that this phenomenon also existed in other cultures. It can be said that almost every culture summarizes the ultimate evil, the incomprehensible, in a concept of personalized power. A force that you may then have to drive out, or limit, soothe. That seems to be a basic pattern across the different cultures.

Is modern psychiatry equipped to deal with these cultures?

One signal of hope is that the German Society of Psychiatry, Psychotherapy and Neurology has reacted: It has founded a specialist lecture on "Religiosity and Spirituality". There, spiritual explanatory models for mental illnesses can be discussed in a factual and perhaps also ethnologically sensitive manner.

To person

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Samuel Pfeifer is the senior doctor at the Sonnenhalde Clinic in Riehen, which is based on basic Christian values. He is interested in phenomena of possession and the connection between psychiatry, spirituality and ethics.

Trance and obsession

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The WHO defines “trance and obsession” as “disorders in which a temporary loss of personal identity and complete awareness of the environment occurs”. In some cases a person behaves "as if he is ruled by another personality, a spirit, a deity or a" force "".

Luh Ketut Suryani

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Luh Ketut Suryani is the head of the psychiatric faculty at Udayana University in Denpasar (Bali). She has won various awards in Europe for her commitment to the mentally ill. Her work was documented in the film "Bali’s Shame". (Watch the film on Youtube).