Avahana Syndrome

Summary

Possession syndromes, where individuals appear invaded by a new personality, are common in the Indian subcontinent, especially among Hindu women with low education. These culturally sanctioned states can grant social status or healing abilities. The article proposes the term 'Indian Avahana Syndrome' for possession linked to the devotional practice of avahanam in bhakti yoga. It notes that 90% of 488 surveyed societies have institutionalized altered states, but systematic prevalence data are lacking. The phenomenon is more prevalent in India than in the West, where multiple personality disorder is more common.

Study at a glance

Abstract

INTRODUCTION Cultural factors and religious background influence the reporting of psychopathology in various psychiatric disorders. Like many psychiatric disorders, dissociative trance and possession states display cross-cultural variation. The Indian subcontinent with its bright history and different cultures has a prevalent history of trance and possession syndromes. Possession can be defined as “a state in which the organism appears to be invaded by a new personality and governed by a strange soul.” These disorders are seen more commonly in the Indian subcontinent countries like India, Bangladesh, Sri Lanka, and Pakistan. Possession can be beneficial to the individuals by giving them a special status in the society, as well as special abilities like healing or predicting the future, and this becomes a source of livelihood. These possession disorders and transient states can be considered culture-bound syndromes like “Suchibhai syndrome” an Obsessive-Compulsive Syndrome seen in Bengali widows and “Indian Dhat syndrome” seen in young males presenting with anxiety, depression and hypochondriacal preoccupation which is prominent in Indian subcontinent. Culture-bound syndromes were described by Kiev (1961) as a culturally sanctioned, heavily institutionalized, and symbolically invested means of expression in action for various ego dystonic impulses and thoughts. Culture-bound syndromes are a combination of psychological and somatic symptoms that are recognizable disorders seen only within a specific society with specific culture, folk that frame coherent meanings for certain repetitive, patterned, and troubling sets of experiences and observations. In most cases of possession, the possessing agent is unique and well known, whether it corresponds to a local entity belonging to the culture of the subject or to the universal figure of God or the devil. EPIDEMIOLOGY There are descriptions of possession states in various societies on the planet. Out of 488 societies surveyed worldwide, 437 (90%) had one or more institutionalized forms of altered states of consciousness that followed cultural patterns. Such experiences were attributed to possession in 252 societies.[1] There is a scarcity of systematic studies done on general and psychiatric populations, about lifetime and current prevalence rates of trance and possession disorders in non-Western or Western nations.[2] Therefore, the precise extent of the disorder is still unknown. PRESENTATION Deity or spirit possession must be viewed from within the cultural systems of which it is a part. Subjects with possessive disorders are often powerless members of their societies, often females, for whom the possessed deity or spirit provides an opportunity to express and act out socially unacceptable opinions and behaviors and achieves an improvement in their social status. The defining feature of possession to the observer is marked by psychological change that endears recognizable modifications in speech and behavior. This is accompanied by an observable shift from one internal focal context to another and from one presumed identity to another.[3] DISCUSSION The religious background and practices can color the reporting of psychopathology. Studies in patients with delusions from the West have shown that the delusional themes of the patients are usually based on myths according to the ancient culture. An interesting aspect of neurosis in India is its higher prevalence of hysterical fits, trance and possessive states compared to the West. On the other hand, multiple personality disorders, a common problem in the West, are rarely seen in Indian patients.[4] Patients with trance and possession disorders behaved like they have been possessed by God-behaving, demanding, and fulfilling wishes (desires). Possession syndrome has a widespread familiarity in this culture. The observed phenomenology is specific to the Indian subculture. This phenomenon is most commonly reported in Hindus. It was observed that people from Indian subculture perform prayer, meditation (Japa), spiritual practices to God/Goddess to attain godliness by allocating various parts (Karanyasa and Anganyasa) to the formless God (higher being). Nyasa is closely associated with dhyanam (meditation). Dhyanam arises spontaneously and lasts for a while when the previous state of dharana (concentration) on one object is reached and maintained. Mantras are forms or words that are sacred words, syllables, phrases, or sentences that are necessary to enter the state of dharana. A mantra is applied to certain body parts. Following the completion of the nyasa, those body parts receive the power of the mantra’s letter, which is governed by a specific deity.[5] CONCLUSION The belief in the presence of the possession phenomenon may explain the increased prevalence rate of possession syndrome seen in these patients. The assumption that God is helpful to everyone leads to further instances of possession by a God. Female sex, young age, and a poor education all predispose an individual to be possessed. The prevalence of this syndrome is more common in the Indian subcontinent due to the belief in this disorder as well as the help received from others and the respect the person is usually offered. Possession syndrome tends to be a socioculturally mediated condition that is used by some to become healers and by others to portray the sick role and seek help. Some people fail and suffer as a result. This specific culture-bound syndrome in which individuals (commonly women) tend to influence with the concept of avahanam which is widely practiced in bhakti yoga, a common form of devotional prayer in India [Table 1]. This will assist in the possession process (Avahanam) in the Indian subcontinent and could be classed as the “INDIAN AVAHANA SYNDROME.”Table 1: Karanyasa and Anganyasa for Gayatri MantraFUTURE DIRECTIONS We psychiatrists of India should put our efforts in Indianisation of psychiatry utilizing Indian mental health concepts. This disorder is unique to the Indian subcontinent and is more prevalent among Hindu women within this region. Researchers working within these areas could conduct more studies and research on the subject, so that we can obtain a greater awareness of this concept. This may be potentially useful to explore more treatment options and other interventional approaches.

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