True or False Possession?


The question about the devil was put to me directly by a patient who had come to see me for treatment  of depression and recovery from a serious drug addiction. As a physician, he had gained access to the intravenous anesthetic drug propofol and had self-administered it in order to escape from refractory insomnia and unrelenting depression. Without  carefully titrated dosing, gleaned from his medical knowledge, this patient would surely have overdosed long ago. Indeed, it was something of a miracle that he was still alive.

During an interview, he suddenly interrupted the narrative of his psychiatric history, paused, and looked me directly in the eye. With a sober seriousness, and without a trace of hysterics or dramatization, he asked simply, “Do you believe in the Devil?”

I stared back. “Yes. I do.” “Me too,” he said.

Then after a pause, I inquired: “Why do you ask?”

“When I was injecting the propofol I felt something . . . enter into me. It was not the drug, but something else. The drug was just the gateway. It was . . . something . . . foreign.”

At no point in his treatment did I suspect this patient to be possessed, in the strict sense of the term. Yet, neither did I doubt the reality of a malevolent influence on him that exceeded in power and scope the physiological effects of the anesthetic he was abusing. He later related to me how this evil spirit would mock and taunt him as he slipped deeper into the hell of drug addiction.

Most of my colleagues in psychiatry probably would have regarded this exchange between doctor and patient  as rather puzzling, even ludicrous. They would likewise regard a book like the one here as an oddity. A work purporting to distinguish between cases of true and false possession will seem to many a throwback to a bygone age of religious superstition. Yet a modern psychiatrist cannot help but be impressed by the author’s perspicuous medical and psychological analysis of each case he examines in these pages. This is not the work of a pre-modern credulous dupe, but the work of a skilled and experienced neurologist, who knows his trade and sees his way clearly into the tangled workings of the human mind and heart.

The  author,  a physician and  not  a theologian,  skillfully navigates the Scylla of credulity and the Charybdis of relentless skepticism. Inclined  by training  and clinical experience to search first for naturalistic medical or psychiatric explanations for the phenomena  in question, he nevertheless leaves open the possibility of explanations that go beyond what science or medicine can assess, as well as the possibility that any given manifestation  may have elements of both  the  natural and preternatural. Originally published over fifty years ago, the author’s medical judgments and observations still hold true. While some clinical terminology may have changed in the interim, little could be brought to bear from modern neurology or psychiatry that would contradict his findings or conclusions. The clinical histories, fascinating in their own right aside from the author’s clinical assessment, are presented with sober clarity and reserve.

Believers have sometimes made the mistake of finding supernatural possession where there was only a pathological personality, given to the  grossest hysterics and deceptions. This book provides fascinating accounts of false-possession cases, for example, those of Marie-Thérèse Noblet and Sr. Jeanne of the Angels. Here the author astutely notes that the repeated misapplication of the Rite of Exorcism may have exacerbated the behavioral disorder, in this case, hysterical (what we now call conversion) symptoms that  were encouraged by the excessive attention received from the exorcist and by the public or overly dramatized way in which the exorcist misapplied the rite, in defiance of the prescriptions of the Roman Ritual. The curious onlookers fell prey to the colorful and dramatic, while the sick individual was motivated by receiving such attention.  The author observes: “Well known, too, were all the criteria which the Church holds to be decisive of genuine possession, but they were scarcely heeded” in such cases. The cautionary note here comes not from a belief that the rite or the prayers themselves would be harmful, but rather from a desire to avoid an overly theatrical application of a sacramental in situations where the hysterical person was taking on the sick role precisely in order to draw attention  to herself. The author discerns that it was the excessive attention,  not the prayers of the rite itself, that could have exacerbated the behavioral symptoms.

In a similar vein, the author then recounts well-documented historical cases of mass hysteria and pseudoseizures, which often become “contagious” among those living in close quarters through suggestion and mimesis. Such phenomena could be accounted for by psychological observations known as early as the sixteenth century and given more definitive form in the work of the great French neurologist Charcot in the nineteenth century. Today, one could add a wider knowledge of culture-bound syndromes worldwide, with characteristically wild behavioral, dissociative, and somatic manifestations — such as the clinical syndrome Amok found among the Malaysians. In such cases, as the author concludes, “the influence of the demon is to be sought in vain.” Yet he also notes correctly that hysteria is not playacting and that those who manifested this behavioral disorder were not consciously feigning their symptoms or deliberately trying to deceive: “Hysterical patients, like all other sick people, deserve our understanding and our charity.”

With astute medical insight, the author describes a case of postpartum depression with psychotic features, including homicidal command-type auditory hallucinations: “One of my patients, for example, during a state of depression heard the devil in the middle of the night speaking to her and bidding her kill her child, then a few months old.” After acting on this impulse and tragically tossing the poor child out the window (fortunately the baby was only bruised), she received medical treatment and made a good recovery: “As for the mother, when she had been given electric shock treatment, she was not long in recovering her mental equilibrium.” Naturalistic explanations for such evil sensory perceptions and violent acts can often be found within the realm of well-described mental illnesses.

In  light  of such  cases, a  skeptical reader might  wonder whether the Latin Rite of Major Exorcism should now be tossed into the dustbin? Is it the product of a bygone era, now known to be defunct and discredited by the  findings of modern science and medicine? Have psychoanalytic concepts, or modern materialistic theories of the mind sufficiently disabused us of the need for supernatural explanations, for recourse to angels and demons? As our author poses the question, “If there can be no doubt of the existence of non-genuine possessions, are we in a position to distinguish them from the genuine?”

We still face this question: How do we account for the manifestations documented  in  many cases that  were thoroughly examined  by competent  psychiatrists, cases still seen today that evade the explanations of skilled physicians? Can modern psychiatry or neurology give an account of all such things — of preternatural knowledge, of superhuman strength, of xenoglossia, of inexplicable rage toward sacred objects — or will science ever discover a naturalistic cause here? I have observed first- hand several of these demonic manifestations during an exorcism, manifestations for which I can find no explanation within the realm of natural science.

This book needs to be framed in the context  of profound cultural shifts that  have occurred since it was first published in 1956, most notably the rise of a widespread philosophy of materialism that turns appreciation for science into an ideological scientism. Such secularizing cultural changes surely influence the book’s readership. When the author wrote it, he could assume that  most Catholic  readers would, by and large, take for granted the necessity of exorcism in certain cases and not doubt its efficacy in instances of true possession. He was writing therefore with the prudent intent to avoid overzealous applications of the rite in cases that  had not been sufficiently medically examined. But the background cultural assumptions today are radically different, even among many Catholics, including many clergy. Today the  default assumption for many readers would be that naturalistic or medical explanations can always be found and can be taken  as fully explanatory. The  danger today is therefore precisely the opposite, namely, that the rite may now be under-applied rather  than  overused. Indeed, in many dioceses in the United States there is no available trained exorcist to deal with such cases, and afflicted individuals there- fore suffer without recourse.

This author  knows the  permanent  limitations  of his science: this book does not attempt to detail cases of what may be considered true possession, for these by their nature would lie outside the scope of the author’s explanatory powers or clini- cal expertise. That  task is best left to the trained and experienced exorcist and to the theologian. Where the physician has reached the limits of his methods, where medical or psychological explanations simply cannot  account for the phenomena, then the doctor must recognize the boundaries of his own craft and remain silent before the mystery of iniquity — the mystery of a real and effective evil personality that in rare cases may oppress and torment some few unfortunate souls.

In such cases the physician and the priest need to collaborate responsibly, and with respect for the insights of both science and theology. Fr. Gary Thomas, who is the subject of journalist Matt Baglio’s book, The Rite: The Making of a Modern Exorcist, recently recounted to me severe cases of demonic possession with extraordinary manifestations. Some of these I have since witnessed during an exorcism and can attest that such “symptoms” lie outside the scope of anything listed in the psychiatrist’s  Diagnostic and Statistical Manual of Mental Disorders. Fr. Gary also gave me an invaluable insight into his work when he explained that an exorcism is always an act of healing. And so, of course, the Church recognizes the urgent need for competent neurologists and psychiatrists to work with exorcist in the process of discernment, diagnostics, treatment, and healing. But such collaboration presumes that each person — both the medical doctor and the priest exorcist — have something indispensable to contribute  to this work of discernment  and healing. This is a work of mercy, patterned after our Lord’s own acts of casting out demons and curing disease.

This was excerpted from the Introduction to True or False Possession by Jean Lhermitte, which is available from Sophia Institute Press 

image: facade of the Cathedral, Orvieto, Italy via Shutterstock




Avatar photo


Aaron Kheriaty is an Associate Professor of Psychiatry and Director of the Program in Medical Ethics at the University of California Irvine School of Medicine. He serves as chairman of the clinical ethics committee at UCI Medical Center. Dr. Kheriaty graduated from the University of Notre Dame in philosophy and pre-medical sciences, and earned his MD degree from Georgetown University. He is the author of several books and articles for professional and lay audiences, and he lectures regularly on topics related to psychiatry, social science, bioethics, and spirituality. Dr. Kheriaty lives in San Juan Capistrano, California, with his wife and five sons.

Subscribe to CE
(It's free)

Go to Catholic Exchange homepage