Issue 13: Are you possessed by demons or are you actually sick?
When we mistake mental illness for jinn, espíritu and other nonhuman beings
Foreign Bodies is a mental well-being newsletter for immigrants and refugees with a mission to de-stigmatize vulnerability through storytelling. This is our final issue available to the public for free. In 2020, our work will be fully funded by readers like you. We need your support to do this.
Once upon a time in medieval Arabia, shape-shifting creatures made of smokeless fire were born.
These invisible beings—called jinn, djinn or genies—are believed to possess nonhuman powers. In many Muslim cultures, they’re blamed for all kinds of misfortune.
Though jinn were around long before the creation of Islam, the creatures, which may appear in animal or human form, are actually mentioned in verses of the Quran as one of three types of beings: humans (made of earth), angels (made of light), and jinn (made of smokeless fire).
Like humans, jinn are neither inherently good nor bad. But more often than not, the ever-changing folklore that’s passed down from generation to generation casts the creatures as cunning and malevolent—interpretations that definitely make for some solid horror-tainment.
In fact, a couple of years ago, See Something Say Something podcast host Ahmed Ali Akbar rounded up some user-submitted spooky jinn stories for a Halloween special. In one, a listener recalled a crying jinni dressed as an old woman who would regularly appear in her childhood bedroom at 3 a.m.
Another said his Indian family always reserved a corner of the courtyard for the jinn to rest through the night. If someone disturbed the space, “strange things happened.”
There are several other stories describing pointy-fingered beings and humanlike creatures with hooves for feet, but much of modern lore suggests jinn usually have an invisible, ghost-like presence; they are entities with the ability to overpower the human brain.
In Islamic writings, jinn often tempt and seduce humans to stray from Allah (God)—and the devil (or shaytan) is thought to be from their world. True jinn possession, some believe, can cause a person to have seizures and to speak in an incomprehensible language.
It’s easy to see how these beliefs can lead to various manifestations related to mental illness—manifestations that aren’t exactly amenable to medical treatment, researchers Amin A. Muhammad Gadit and T.S. Callanan wrote in a 2006 opinion piece for the Journal of the Pakistan Medical Association.
Gadit mentioned a Pakistani patient he met who was booked on charges of blasphemy and under trial. Though this woman had been diagnosed with schizophrenia years before, her relatives dismissed the diagnosis and insisted on the phenomenon of jinni possession.
Symptoms commonly associated with demonic or spiritual or jinni possession—convulsions, hysteria, or erased memories—can mimic symptoms of conditions like epilepsy and schizophrenia.
The case resembled U.K.-based social worker Aisha’s experience, too. When her brother began having schizophrenic episodes and her sister was diagnosed with bipolar disorder, Aisha was instructed by family to keep her distance, lest the evil reach her. She told Metro reporter Faima Bakar that her mother was convinced that jinn—not biology—were behind it all.
A 25-year-old married woman in Pakistan, when asked by psychiatrists with the Aga Khan University’s Department of Psychiatry and Behavioral Sciences to describe the visual and auditory hallucinations she’d been experiencing, completely denied having them. “I am possessed by jinn, I don’t need any medication,” she said. The psychiatrists suspected bipolar disorder and prescribed appropriate medication. They also recommended admission to a psychiatric unit or further workups. The patient never followed up.
In northern Lebanon, one mother said her son, Hussein, was struggling to sleep, could barely recognize his surroundings or his loved ones and would often run away from home. Thinking he must be cursed, she took Hussein to various sheikhs to try and remove the jinn from his body.
“This is usually done in one of three ways—remembrance of God and recitation of the Qur'an (dhikr); blowing into the person's mouth, cursing and commanding the jinn to leave; and seeking refuge with Allah by calling upon Allah, remembering him, and addressing his creatures (ruqyah),” according to a 2005 study published in the Journal of the Royal Society of Medicine.
The understanding is that a person is made more vulnerable to possession if they fail to secure protection through prayer and other forms of worship.
But in some cases, faith leaders might also strike the possessed individual, claiming the harm they inflict is hurting the jinni and not the person.
This practice, researchers noted, is considered deplorable by Muslim scholars and “far from the principles of Islam and the instructions of the Prophet.”
Nonetheless, Hussein’s mother told Médecins Sans Frontières that during these rituals, the sheikhs they met with did just that. They’d try and beat the jinn out of Hussein’s body. It didn’t work.
That’s when she decided to make the 40-hour trek from their small town of Wadi Khaled to Tripoli to see a psychiatrist, where Hussein was officially diagnosed with schizophrenia.
Unlike Gadit’s patient, Hussein has been seeing a mental health counselor and receiving treatment since the diagnosis. And that’s primarily because MSF clinicians opened up a free mental health clinic in their town. Otherwise, there was no way Hussein’s family could afford the transport and treatment costs in Tripoli.
In almost all of the stories I’ve read on the subject, individuals viewed as being possessed by jinn—many of whom experience common psychotic symptoms—are made to feel there’s no help or medical treatment out there.
Instead, they and their loved ones wind up feeling helpless under the control of a more powerful being. This helplessness and submission to jinni power, research shows, actually contributes to additional suffering.
I grew up in a Shia Muslim household that rarely, if ever, mentioned jinn. I didn’t even know what these creatures were until I went to college and met people who were much more in touch with their religions or cultures.
When I started working on this issue, I asked my mom if Nani had ever used the word around her when she was growing up in Pakistan. Was this something she believed, too?
“I remember Nani asking things like, ‘Bhoot bhar gaya kya?’ or ‘Is the ghost in you?’” my mom told me. Colloquially, at least in her upbringing, “jinn” was used sparingly and jokingly. She recalls one specific situation when her mom used the phrase; she and her sisters were teenagers, giggling about boys.
But jinni possession was definitely an accepted belief around town, particularly if there was a mention of any kind of mental imbalance, my mom said. And exorcisms were quite common, too. Sometimes the rituals would involve locking up afflicted individuals in a room, an attempt to starve the jinn and force it to leave the body. My mom had also heard of beatings, of tying individuals down, of holy water prescriptions.
“What would people say if the exorcisms didn’t…work?” I asked.
“Simple,” my mom said. “They’d say this jinni is just too strong to overcome.” But a lot of the times, the ritual itself would scare the individual into having some control over his actions in fear of having to suffer through another exorcism—reinforcing the belief that there was a jinni that needed removing in the first place, she said.
So what exactly does it mean to say that someone is behaving a certain way because they’re possessed by a spirit?
Scientists have, in the past, approached an understanding of spirit intrusion by viewing it as a form of pathogenic possession, similar to a virus or carcinogen.
In fact, according to some researchers, even some religious healers might “employ a representation of human biology of various degrees of sophistication to argue that spirits achieve their effects by directly targeting the bodily organ or centre responsible for that effect.”
Typically, pathogenic possession involves the spirit “making” its host behave bizarrely, with some kind of goal in mind, similar to an act of sorcery.
Executive possession, on the other hand, involves displacement—the belief that an individual’s identity and agency can be totally eclipsed by a spirit or demon. This is where the science seems to get…complicated.
“To be driven against one's rational judgement is a few steps removed from being driven against one's conscious will,” writes London philosopher and researcher Mohammed Abouelleil Rashed.¹
The ubiquity of spirit possession
For centuries, before the birth of modern disciplines like psychoanalysis and psychopathology, “the social institution of spirit possession had been preserving the intentionality of socially inappropriate and un-understandable behaviour” all over the world and across numerous cultures, according to Rashed.
The Hindu Vedas refer to supernatural beings known as asuras that “challenge the gods and sabotage human affairs.”
Woo-Woo ghosts haunt some Chinese communities “to the point where if someone fell down or cut their finger, it was blamed on a nasty spirit—“Aiya! Get the Polysporin! But make sure there are no ghosts in the fucking medicine cabinet!” Lindsay Wong, author of the memoir The Woo-Woo, wrote for Vice. According to Wong, Woo-Woo ghosts are ancestors who have the ability to occupy any individual at any time.
For the ancient Greeks, too, “demon-like creatures lurked on the shadowy fringes of the human world,” The Atlantic’s Mike Mariani reported last year.
In some Jewish folklore, demonic spirits are called dybbuks. According to the Jewish Chronicle, these spirits “came from the domain of evil. The person could not be cured until they were exorcised, sent back to where they had come from… the domain of evil is called in kabbalistic terminology the Sitra Ahra, the ‘Other Side.’”
Most modern research cites this major cross-cultural study from anthropologist Erika Bourguignon, who found the presence of institutionalized possession in nearly all regions of the world, but especially so in Sub-Saharan Africa and the Circum-Mediterranean.
You may have heard of the zār or sar, a type of spirit associated with dissociative episodes such as sudden changes in consciousness or identity that often lead individuals to being apathetic, withdrawn and unable to accomplish daily tasks. Zār is most common among Islamic and minority Christian communities throughout the Middle East and Africa.²
Various Latino communities are likely to attribute unidentified voices to their hallucinations “to the realm of unidentified spirits, or forces which at times serve as protections or provide ominous warnings.”
In Britain, Asian immigrants—particularly Pakistani immigrants—also commonly ascribe their psychological ailments to a religious cause (like jinn).
According to recent Gallup polls, roughly half of Americans today believe in spirit possession, too.
In these societies, the spirits don’t just explain illness; they inform one’s understanding of themselves and others—their “agency, responsibility, identity, normality, and morality.”
As our world becomes more globalized, as more and more people move (willingly or not) from rural areas and small cities to larger cities, from low- and middle-income countries to high-income countries, it’s essential for mental health clinicians and leaders alike to understand their changing communities and familiarize themselves with culture-bound syndromes and histories.
A look at the zār across multiple cultures:
According to a well-known Ethiopian story, Adam and Eve had thirty children and to protect the most beautiful ones from the Divine envy, Eve tried to hide fifteen of them in the Garden of Eden, out of God’s sight. God, who was all-seeing, got angry with Eve and declared that those children would remain invisible for eternity. The fifteen invisible children became the ancestors of resentful and unpredictable spirits like zārs, and the other fifteen became the ancestors of humanity. In Ethiopia, if a zār chooses a person, then that person would be a member of the zār cult.²
In Sudan, the Hofriyati community believe that the zayran (types of zār) never abandon their hosts’ body. A person who is possessed will always be possessed and can be affected by her spirit(s) at any time, according to ethnographers. These spirits also tend to afflict a specific demographic: married women.
But in Iran, “the poor and deprived people (such as fishermen) seem to be the most common victims.” According to the Encyclopædia Iranica, most (but not all!) sheikhs or cult leaders in Iran—called Bābā or Māmā zārs—believe patients should only join the zār rituals when their doctors cannot treat them.
Here’s a very detailed (and very long) description of one Iranian zār ritual:
Photo: Zār ceremony in Hormuz Island/CC BY-SA 4.0
When Bābā or Māmā zār chooses someone to heal, the patient will stay in the Bābā or Māmā zār’s home for up to seven days.
During this separation phase, only Bābā zār or Māmā zār can visit the patient; moreover, the patient’s body is washed with seawater and every night Bābā zār or Māmā zār rubs a combination of aromatic herbs and spices on the patient’s body.
In the last day of the separation phase, when the patient’s body is cleaned and washed to be prepared for the incorporation phase, one of the cult members, who is usually the one who has formerly been possessed by zār, informs everyone about the upcoming zār ceremony.
Ahl-e-Hava (Eve’s family), who are people who have already been possessed by the zār and have been treated at least once, have to attend every zār ritual. In addition, other people of the cult, who may or may not be possessed, also participate as it is considered a sin not to attend a zār ritual.
Depending on how big the Bābā or Māmā zār’s home is, the ritual can be inside or outside the house. Participants gather in a U-shaped open area—Maidān—with a patient sitting in the center. A piece of tablecloth including eggs, confetti, dates, and aromatic herbs is placed on the floor in the center of Maidān.
After Bābā or Māmā zār covers the patient’s head with a piece of white cloth, a big tray holding aromatic herbs on burning charcoal is passed around and the patient and all participants are frequently incensed with the smoke from the mixture.
The zār leader—Bābā or Māmā zār—leads the music, which involves local drums played by musicians and which is followed by others who are present at the ceremony. The leader is someone who knows the name of the zārs and its related music (the specific beat of drums). The leaders also sing and the participants respond to them. Songs of the incantations can be in a different language or just melodic sounds without lyrics. During the singing, when the zār hears its related music, it makes itself known through the body of the patient, who feels a strong inner urge to move.
Every spirit has its own piece of music and some members of the cult, mainly Ahl-e-Hava, may start moving and shaking with every piece of the music, as they are supposed to be the eternal hosts of the zār. The leader cannot identify the zār until the patient reacts to the music, so musicians change the tune until the zār takes over the afflicted; the signs of this occurrence appear when the upper body and the head swing and the shoulders shake.
When the zār is identified, Bābā or Māmā zār starts to communicate with the zār in a language that is ordinarily unfamiliar to themselves and the patient. This language is a combination of Persian, Arabic, Swahili, and Indian. Through this communication with the zār, the healer tries to find out the reasons behind the affliction and what the spirit wants in exchange for leaving the patient alone.
Through the afflicted, the zār names its demands, which vary from simple things, such as a few prayers or a piece of bamboo (ḵeyzārān), to something more considerable, such as a sacrifice. Bābā/Māmā zār assures the zār that its demands will be met by tying a piece of cloth around the patient’s arm. It is believed that if the zār’s wishes are not granted, the zār will return and make more trouble for the patient.²
If you’re experiencing mild panic attacks or depression, most clinicians would probably initially recommend talk therapy over medication, Swaran Singh, head of the Mental Health and Wellbeing division at Warwick Medical School told BBC. “In some cultures this means talking to a healer, so it may work.”
Problems tend to arise when it becomes an alternative to medical care—when “instead of taking medication, they rely exclusively on religious ceremony or religious procedure. That's not going to treat the condition, so faith may offer comfort but it doesn't offer a cure for illness.”
In addition to patients completely opting out of medical care, related factors that commonly compromise psychiatric treatment include: Lack of clinical knowledge about jinn or other spirits as a cultural explanation for serious psychiatric illnesses; limited awareness among the public about psychiatric illnesses in general; poor access to health care; low socioeconomic status and education levels; stigma attached to mental health conditions; wide availability of and belief in spiritual healers; lack of insight by the afflicted person.⁵
In several cases, patients who attributed their symptoms to spirits actually showcased additional signs of distress. Some examples I came across:
According to this study of patients with a Muslim background in the Netherlands, patients often showed “signs of fear and depression while talking about jinn and suffered considerably from the prospect of the consequences that might have.”³
Another report noted ample support for a strong relationship between traumatic experiences and pathological possession states.
Singh told BBC of a Sikh patient who went undiagnosed and untreated for his psychiatric ailments for 13 years. By then, too much damage had been done, he said. Without treatment, individuals with mental illness are known to face recurring symptoms, hospitalization, substance abuse, damaged relationships, and much more.
I’d also be remiss not to mention the potential for exploitation.
CW: Some disturbing examples
Using beliefs to explain away crimes: In 2012, four members of the same family were found guilty of murdering 21-year-old British Muslim Naila Mumtaz, who was pregnant at the time of her death. Her in-laws, her husband and her brother-in-law were convicted of her killing. During the trial, the family members claimed she was possessed by jinn.
Using beliefs to silence victims of abuse: “If somebody was saying I was being abused, or I'm living in horrific conditions, they would automatically silence them by saying ‘she’s possessed,’” U.K. teacher Yasmin Ishaq told BBC. “I'm talking from personal experiences - family members, neighbours, community members - where women were beaten on the premise that they were possessed when really it was just violence against women.” Fed up with beliefs’ being exploited, Ishaq became a healer herself.
And remember, if you’re looking for a faith-based therapist in America, Psychology Today’s Find A Therapist search tool offers options to filter for therapists versed in the following religions: Buddhism, Christianity, Hinduism, Islam, Judaism, Mormonism and “Other Spiritual or Religious Affiliations.”
For current or aspiring clinicians and researchers
When seeking help, an individual who believes they’ve been possessed may limit their explanation to the mysterious work of an otherworldly power. Some resources and tips to approach spirit possession in clinical settings with understanding:
See what research is already out there. Here’s one: This paper on Zār spirit possession in Iran and African countries may help clinicians adopt a “sociocultural and historical understanding of zār spirit possession that will help them identify this condition in clinical settings in order to avoid misinterpreting it as a psychosis and/or dissociative identity disorder and to increase intervention efficiency.”²
In general, consider consulting a faith counselor. “When medicine invites conflict with culture and religion, the therapeutic alliance suffers. Most people are content to utilize biomedical treatments without giving up traditional explanations of illness; therefore there may be a strong case for involving an Imam or religious leader in the management of these cases.”⁴
Refresh your memory on the cultural variants researchers have already identified, including the (admittedly limited) list of culture-bound syndromes included in the DSM-5.
Take note of Mentalhealth4muslims.com’s Dr. Nafisa Sekandari, whose center offers a “multimodal approach” where patients can get the psychological support they need and still incorporate faith as part of their treatment.
For community leaders
Community leaders and clinicians alike may want to consider collaborating with spiritual healers and incorporating them into the treatment plan “by inviting them for talks and educational sessions in mosques, community centers, schools, and madrassas (religious schools).”⁵
I Grew Up with Parents Who Didn’t Understand Mental Illness (Lindsay Wong, VICE): Lindsay Wong, author of The Woo-Woo, penned a fascinating essay about growing up in her deeply superstitious Chinese American household. Read here.
Will My Mom’s History of Mental Illness Repeat Itself in My Kids? (Kristina Wright, Healthline): Kristina Wright’s mother claimed to hear voices and see demons, Wright wrote for Healthline. “A minor infraction, like walking on a freshly mopped floor, would result in screaming and crying… She would take to her bed, or the couch, for two or three days at a time, sleeping or staring listlessly at the television.” Their relationship grew dysfunctional, worsened by her mother’s refusal to seek treatment. Eventually, Kristina cut her out of her life. Read here.
When Mental Illness Is Mistaken for Demonic Possession (Emily Korstanje, VICE): Around her 18th birthday, Nadia (name changed for story), would often feel worthless; she suffered from anxiety and depression and at times could barely get out of bed. She turned to her parents for support, and they took her to a faith healer who determined evil spirits entered her because of a lack of faith. “He made me drink something strange, recited the Quran and then choked me with two of his fingers until I passed out,” Nadia said. Read here.
As a psychiatrist, I diagnose mental illness. Also, I help spot demonic possession. (Richard Gallagher, Washington Post): “Is it possible to be a sophisticated psychiatrist and believe that evil spirits are, however seldom, assailing humans?” Meet Richard Gallagher, who says he may have seen more cases of possession than any other physician in the world. Read here.
American Exorcism (Mike Mariani, The Atlantic): More and more Americans are seeking priests for help with demonic possession. “Why, in our modern age, are so many people turning to the Church for help in banishing incorporeal fiends from their body? And what does this resurgent interest tell us about the figurative demons tormenting contemporary society?” Read here.
That’s all, folks. Wishing you all a very, very Happy New Year. Here’s to more highs than lows, more reflection, more books, more therapy, more dogs, more travel, more of whatever else makes you smile. Thank you from the bottom of my heart for supporting Foreign Bodies. I don’t know what the future holds for this newsletter, but it’s been a lovely ride so far.
Rashed, Mohammed. (2018). More Things in Heaven and Earth: Spirit Possession, Mental Disorder, and Intentionality. DOI: 10.1007/s10912-018-9519-z
Mianji F, et al. (2015). Zār Spirit Possession in Iran and African Countries: Group Distress, Culture-Bound Syndrome or Cultural Concept of Distress? PMID: 27006667; PMCID: PMC4801492
Lim A, et al. (2018). The Attribution of Mental Health Problems to Jinn: An Explorative Study in a Transcultural Psychiatric Outpatient Clinic. DOI: 10.3389/fpsyt.2018.00089
Khalifa N, et al. (2005). Possession and Jinn. DOI: 10.1258/jrsm.98.8.351
Khan Q, et al. (2016). “Jinn Possession” and Delirious Mania in
a Pakistani Woman. DOI: 10.1176/appi.ajp.2015.15030281
Foreign Bodies is an email newsletter centering immigrant and refugee experiences with a mission to de-stigmatize mental illness through storytelling. It’s written and curated by Atlanta-based writer Fiza Pirani with copyediting and fact-checking help from Boston-based journalist Hanaa’ Tameez and traveling journalist Farahnaz Mohammed. Want to contribute your time or share your own #ForeignBodies story? Fill out this form and be sure to say hi on Twitter @4nbodies or Facebook. Special shout-out to Carter Fellow and friend Rory Linnane for the adorable animated logo and Marissa Evans for Issue 13’s art!