The presentation of mental illness and understanding of the patient’s experience with regard to psychopathology is quite unique and cannot be generalized due to the diverse etiological factors. In understanding and managing psychopathology, cultural knowledge plays a vital role. It has been seen that most of the interventions, in a similar fashion, need an understanding of historical roots in the specific cultural background and they also shape the psychotherapy models. The current case shows us the development of psychopathology with regard to cultural belief as well as discerning the symptom profile associated with it. Mr X, a 41-year-old gentleman from a rural area of Assam, presented with complaints about a “living thing” inhabiting his abdomen for the last 2 years and has been growing ever since. He claims that an enraged faith healer with incredible powers had done so to him. He was diagnosed with persistent delusional disorder at LGBRIMH and was managed with both pharmacological and nonpharmacological interventions. In nonpharmacological interventions, coping strategies and insight-oriented psychotherapy in context to his cultural beliefs were given. Significant improvement was seen after 2 months and at 3 months his socio-occupational functioning improved as well.