Pathological spirit possession as a cultural interpretation of trauma-related symptoms.

In the Eastern Democratic Republic of the Congo, pathological spirit possession is a common explanation for unexplainable mental and physical health problems, especially among people affected by war. Among 73 formerly possessed individuals, mostly women, the most frequent explanation was that a family member or neighbor sent the spirit out of jealousy or conflict. Lifetime spirit possession was linked to more severe PTSD symptoms, depression, shame, guilt, psychotic symptoms, and physical complaints. Possession in the prior four weeks was linked to PTSD, impaired functioning, and psychotic symptoms. The findings suggest pathological spirit possession serves as a broad cultural framework for distress, including but not limited to trauma-related disorders.

Study at a glance

Abstract

Spirit possession is a phenomenon frequently occurring in war-torn countries. It has been shown to be an idiom of distress entailing dissociative symptoms. However, its association with trauma exposure and trauma-related disorders remains unclear. This study aimed to explore subjective disease models and the relationship between pathological spirit possession and trauma-related disorders in the Eastern Democratic Republic of the Congo. Seventy-three (formerly) possessed persons (74% female, mean age = 34 years), referred by traditional and spiritual healers, were interviewed about their experiences of pathological spirit possession, trauma exposure, posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, shame and guilt, psychotic symptoms, somatic complaints, and the impairment of psychosocial functioning. The most common disease model for pathological spirit possession was another person having sent the spirit, mostly a family member or a neighbor, out of jealousy or conflict over resources. Significant correlations were found between spirit possession over lifetime and PTSD symptom severity, feelings of shame and guilt, depressive symptoms, somatic complaints, and psychotic symptoms. Spirit possession during the preceding 4 weeks was associated with PTSD symptom severity, impairment of psychosocial functioning, and psychotic symptom severity. The results of this study indicate that pathological spirit possession is a broad explanatory framework for various subjectively unexplainable mental and physical health problems, including but not limited to trauma-related disorders. Understanding pathological spirit possession as a subjective disease model for various mental and physical health problems may help researchers and clinicians to develop culturally sensitive treatment approaches for affected individuals. (PsycINFO Database Record