Exorcism As Psychotherapy: A Clinical Psychologist Examines So-Called Demonic Possession

Exorcism as Psychotherapy: A Clinical Psychologist Examines
So-Called Demonic Possession

Is there a difference between demonic possession and mental disorders?
Published on February 5, 2011 by Stephen A. Diamond, Ph.D. in Evil Deeds
The Rite (2011), starring Sir Anthony Hopkins as a Jesuit priest and professional exorcist somewhat
reminiscent of Father Marin (Max von Sydow) in The Exorcist, was recently released to tepid if not
terrible reviews. Nonetheless, the topic of exorcism and demonic possession still touches a nerve in
the movie-going audience, perhaps especially in horror fans, true believers and so-called recovering
Catholics still not sure what to believe about such matters. Evidently, the movie makes reference to
the reported growing demand for exorcisms and the need to train more priests to perform
this religious ritual. Films such as this and previous others about possession and exorcism, like, for
example, last year's The Last Exorcism(2010) (see my prior post), strive in part to convince their
audience of the objective existence of the Devil, and, in turn, of God. But in dogmatically pursuing
this fundamentalist agenda, the filmmakers are missing a golden opportunity to examine and explore
the many important parallels between exorcism and modern psychotherapy, and to possibly reach
and educate a far wider secular, spiritual and psychologically sophisticated segment of the public
about this fascinating treatment for what I call the "possession syndrome."
Exorcism can be said to be the prototypical form of psychotherapy. Despite the secular scientific
persona of most mental health professionals today, simply scratching the surface of rationality and
objectivity reveals a secret exorcist: Like exorcists, psychotherapists speak in the name of a "higher
being," be it medical science or some psychological, metaphysical or spiritual belief system. They
firmly (and, in the case of biologicalpsychiatry in particular) literally believe in the physical reality of
the pathological problem manifested in the patient's symptoms and suffering, and
dispense drugs and/or encouragement while joining with the patient in a sacred "therapeutic
alliance" against the wicked and debilitating forces bedeviling them. Notwithstanding today's
economically-driven, simplistic trend toward brief psychotherapies such as CBT and myriad
psychopharmacological treatments, sooner or later one inevitably is confronted in clinical practice
with strikingly similar phenomena and principles to those educed by traditional exorcists:
Psychotherapy, like exorcism, commonly consists of a prolonged, pitched, demanding, soul-
wrenching, sometimes tedious bitter battle royale with the patient's diabolically obdurate emotional
"demons," at times waged over the course of years or even decades rather than weeks or months,
and not necessarily always with consummate success. (See my prior post.) And there is now
growing recognition--not only by psychoanalytic practitioners--of the very real risks and dangers
of psychic infectioninherent also in the practice of psychotherapy. Counter-transference is what we
technically call this treacherous psychological phenomenon, which can cause the psychotherapist to
suffer disturbing, subjective symptoms during the treatment process--sometimes even as the patient
progresses! Hence the ever-present importance for psychotherapists, like exorcists, to perform their
sacred work within a formally ritualized structure, making full use of collegial
support, cooperation and consultation, and to maintain inviolable personal boundaries. To
paraphrase Sigmund Freud, no one wrestles with the emotional demons of others all day without
themselves being affected.
Of course, the main difference between psychotherapy and exorcism is that psychotherapy is
typically a secular treatment for figurative, metaphorical "demons"--mental, emotional or
psychological traumas,memories or "complexes,"-- whereas exorcism takes the existence of demons
quite literally. Doing so can have certain advantages in treating patients who believe in the Devil,
demons and exorcism, if for no other reason than the extremely impressive power of suggestion.
Someone in the midst of an acute psychotic episode, for example, is confused, disoriented and
hypersuggestible. They desperately seek some meaning to hang on to. Unless we can offer a more
or at least equally satisfying explanation of the patient's disturbing experience, it is, as clinicians well
know from working with delusional patients, exceedingly difficult if not impossible to rationally
dissuade someone of his or her fervent conviction that they are victims of demonic possession.
Sometimes the best approach can be to go with where they are and use the patient's belief system
to the treatment's advantage. Psychiatrist M. Scott Peck correctly pointed out that, unlike
psychotherapy, exorcism makes more use of power in waging war against the patient's sickness,
and is usually conducted by a team of exorcists who attempt to overpower the patient's efforts to
resist treatment. He further notes that, unlike time-limited psychotherapy sessions, exorcisms can
extend far beyond forty-five minutes, and often involve forcible physical restraint of the patient during
these intense and typically angry confrontations. In religious exorcism, as opposed to psychotherapy,
the team invokes the healing power of God via prayer and ritual, and attributes any success directly
to God rather than themselves or the exorcism process itself, as with psychotherapy. Exorcism is
based on a theological, spiritual or metaphysical model, unlike psychotherapy, which is generally
rooted in a psychiatrically-based biopsychosocial paradigm. But both methods address similar
symptoms or syndromes, especially as seen in the most severely disturbed patients. The Catholic
Church is careful today to rule out malingering or demonstrable mental illness when considering
candidates for exorcism, using medical doctors and mental health professionals to help distinguish
between so-called genuine possession and pseudo-possession. But can such a distinction truly be
drawn? And, if so, on what basis?
The Roman Catholic Church's official diagnostic criteria for discerning genuine demonic possession
includes speaking in tongues or languages formerly unfamiliar to the possessed
person, supernatural physical strength, and visibly negative reactions of the victim to prayers, holy
water, priests, etc. But for the modern Church, physical and/or psychiatric disorders must first be
ruled out. From a psychiatric perspective, the problem with such criteria is that these phenomena
can be found in manymental disorders, including dissociative and psychotic disorders of various
sorts. According to Dr. Peck (1983), the distinction between "human evil" and "demonic evil" is
crucial: He distinguished "satanic possession" from mental illness, stating that though in such cases
some emotional problem predisposes the patient to satanic or demonic possession, "the proper
question to pose diagnostically would be: ‘Is the patient just mentally ill or is he or she mentally ill
and possessed?' " This is a clearly religious conceptualization. But another way of looking at this
same possession syndrome is that in such cases what we are seeing are the most extreme and
treatment resistant states of mind manifested in patients who may truly believe themselves to be
demonically possessed. The pertinent question then is how best to treat such severely disturbed and
deeply suffering individuals? It seems that at least some familiarity with their religious beliefs and
meaningful integration of these beliefs into their psychotherapy is essential. These patients have
usually tried traditional psychiatric treatment, with its neurobiological bias, to no avail. Providing
some way to help such patients make sense of their frightening and bewildering subjective
experiences and integrate them meaningfully into a deeper psychological and
spiritual understanding of themselves and the world is what real psychotherapy should, at its best,
strive toward. Without such a meaning-centered, spiritually sensitive secular psychotherapy (see
my prior post), exorcism is seen to be their only hope.

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