Possession Syndrome Occurring in a Family: A Case Report

INTRODUCTION

When someone believes that an evil spirit has invaded their body and could potentially take control of them, they are said to be in a “possession state.” It is a dissociative disorder and has huge cultural and religious ramifications. The disorder is more prevalent in religious and God-believing persons and may occur under conditions of extreme stress. The condition can also manifest in someone who believes in black magic and thinks that someone has cursed or wronged them. Possession syndrome can also occur in conjunction with a delusion when a person believes they have been taken over by a witch or other evil force, and it can also occur in conjunction with other types of delusions, such as schizophrenia. Patients with the syndrome may also have depression, anxiety, and other psychiatric disorders as a comorbidity.^1,2 The role of the family is very important in such cases, and they need to be psycho-educated about the condition. Many times the patient may be taken to a dargah or temple for exorcism rather than being provided the correct psychological treatment.^3,4 Sometimes more than one family member may be affected by the disorder and a family history of dissociative disorder and anxiety has been noted in the condition.⁵

We describe herewith a case of possession seen in one member of the family which later then led to other family members getting affected. Such cases may be seen in clinical practice and warrant clinical discussion to help us understand these cases better.

CASE DESCRIPTION

A 45-year-old male, resident of Vani town, Dindori Taluka, Nashik district, studied up to class 4th, working as tempo driver with a factory, married with 2 male children (20 years, 14 years) and 1 daughter (18 years) presented to our outpatient clinic. The patient lives in Nashik with his family for work but had gone to his native place 1 week back, where without any precipitating event that patient he started feeling that everyone in the village was looking at him differently. That used to make him angry, and he would have frequent quarrels with the villagers. Subsequently he came back to Nashik and started having a feeling that someone was there in the house even though other family members denied its presence. The patient became convinced that there was some spirit and hence lost sleep due to the fear. The next day he claims that he suddenly felt a weird sensation and had goose bumps after that he started behaving abnormally. The patient doesn’t have much recollection of the event. Multiple similar events with increasing intensity followed in the next two days-during day and night.

The wife mentioned that after coming back from the native village, the patient was quite fearful and refused to go to work. He would keep sitting at home not wanting to interact with others. No sleep. The patient developed 1st episode of possession and started shouting and screaming before 4 days. He kept saying “I will not leave you” and his voice sounded different. All the children were in the house at that time and were terrified during this episode. Eventually, the father became quiet and slept. When he developed a similar episode again the eldest son also started showing bizarre behavior as though trying to stop that spirit from harming his father and then he started acting possessed-shouting and screaming exactly like the father. This time the daughter also followed the son and started behaving abnormally, letting her hair loose and shouting. This was disturbing for the youngest son who started having giddiness and fell to the ground. The father or the children have no recollection of these episodes of possession, just saying “I don’t know what happened to me” None of the family members would sleep well and the moment the father would become fearful and start screaming, it was followed by similar reaction in his children.

It became difficult for them to stay in the city and for the mother to manage things alone, so they went back to their village and were brought to the Out Patient Department (OPD) from there. All the family members including the children had come for consultation for being fearful, developing episodes of possession, and loss of sleep. He has three children, eldest son (diploma in engineering) 20 years, daughter (12th std pass) 18 years, and youngest son (9th std) 14 years.

All the children were also interviewed and said that once the father is possessed, they also develop similar feelings and behave abnormally. They can’t sleep soundly as even they believe that the spirit might possess their father at any time of the night and then even, they may become possessed. There was no history of similar episodes in any of the patients or their family members in the past. The patient did not have any history of substance use. General and systematic examination revealed no abnormality in any family member.

DISCUSSION

From the above case, we can see that the father (primary partner) developed Possession syndrome. The secondary partners (the three children) do not have any history of possession, but they may have genetic and cultural predispositions owing to the father and also share the same environment. Possession has been known to run in families.⁵ There was no sharing of a common thought process which was fixed and hence the diagnosis of shared delusional disorder was ruled out. Possession is a cultural phenomenon and a dissociative mechanism that may develop in response to trauma or fear or stress as in our case.

In cases of possession, the dominant partner typically exerts significant control over the family by weakening the other family members’ defenses and imposing their bizarre views on them. In the beginning, the other family members do not develop the disorder but because of the father’s influence, the children get influenced and develop a similar disorder. Similar is the situation in our case where the father is in a dominant position over the kids, who had a close and dependent relationship with the father since they were young, too for a long time. This again is a case of the nuclear family. In their clinical work, clinicians need to be aware of this uncommon but serious illness. Possession disorder may also occur in families. Possession is a dissociative method, where dissociation is used as a defense mechanism and is an unconscious process. The dynamics stem from a defense mechanism to deal with problems at a subconscious/unconscious level. The children also develop the same because they have a possession model at home which they emulate under anxiety, though this may also happen at a subconscious level.⁶ This case is an important case as it is one where a person develops possession symptoms under stress and his children develop the same after him. Clinicians must be aware that this phenomenon of family members having possession together and one after the other can exist in practice.

REFERENCES

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