The Influence of "Espiritismo" Onacaseof Multiple Personality Disorder

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The Influence of - THE INFLUENCE OF "ESPIRITISMO" ONACASEOF MULTIPLE PERSONALITY DISORDER Edison B. Ronquillo,Jr., A.C.S.\\'., Edison B. Ronquillo,Jr., A.C.S.W., is a clinical social work­ designed as: eratKingsboroPsychiatric Center,WilliamsburgOut-Patient Unit, and a graduate student studying for his doctorate in The core ofthe beliefsystem lies in the assumption New York City. that spirits are able to influence and affect the lives of people in the material world, that is while on For reprints write Edison B. Ronquillo,Jr., A.C.S.W., 83-40 earth. Spiritists believe that spirits have both the Austin Street, Apt. 1U, Kew Gardens, New York 11415. ability to make people physically and emotionally ill and the power to cure them. (Ruiz & Langrod, ABSTRACT 1982, p. 36) MultiplePersonality DIsorder (MPD) has been studied through indi­ In this case the belief systems of Espiritismo impacted vidual case studies and large scale clinical studies. The author, in on how the patient and family perceived the condition of presenting a Hispanic case ofMPD, cites needed attention forfur­ MPD. They often used the word possession; this term can be ther research into ethno-cultural phenomena which can interplay defined in relation to multiple personality as follows: with the phenomenology and dynamics ofMPD. The articlefocuses on the relationship ofa beliefsystem practiced or believed l7y many ...a clear differentiated alternate identity, whether Hispanics which is ''Espiritismo'' (spiritualism) and the syndrome human or otherwise, that seems to take over the ofMPD. Etiological and belief system factors are ~lucidated in the person... However, the proposed analogybetween case study. Assessment and treatment considerations that empha­ possession and multiple personality (Kenny, 1981), size cultural sensitivity are highlighted. is limited, not onlyby the exclusionwithin the mul­ tiple personality literature of the transcendent INTRODUCTION form of possession...but also by other important differences. For instance, the etiology of multiple Multiple personality disorder is distinguished from the personality overwhelmingly involves childhood other dissociative disorders in that alter personalities take abuse; such association within possession has not executive controloverthe personanddisplaydifferentbehav­ been established: (Cardena, 1988, p. 11) . ior patterns. Challenges to the rarity or implied non-exis­ tence ofmultiplepersonalitydisorderarebeingprofessionally Ethno-culturalvariablesare ofincreasinginterestin research; disputed (Putnam, 1989). DSM-IIIprovided MPDwith its own this article attempts to contribute to this area ofconcern. diagnostic category in 1980. Research on this syndrome has "The data on ethnic and socioeconomic status are proliferated since then. Scientific attention to MPD is gain­ scanty, butsufficientto allowone to conclude thatMPD occurs ing momentum. Relatively large scale clinical studies have across all major racial groups and socioeconomic settings. been done (Putnam, Guroff, Silberman, Barban, & Post, Although most cases involve whites, black (Ludwig, 1972; 1986), and the future for continued research in this area Solomon, 1983; Stern, 1984; Coons & Sterne 1986) and appears promising. Hispanic (Allison, 1978, Solomon, 1983) MPD victims have MPD has its own unique historydating back to the 1700s. been described" (Putnam, 1989, p. 57). Phenomena such as demonic possession, spirit possession, The relevance of ethno-cultural variables in research mediumships, automatic writing, and hypnosis have all at are imperative (RogIer, 1989). The study ofMPD needs to one time been discussed in connection with the syndrome. incorporate a sensitivity to ethno-cultural influences upon In most recent years there has been growing attention to the disorder. I am specifically referring to ethnic groups, the influence of cults and their impact on MPD (Van their cultural contexts, belief systems and in what manner Benschoten, 1990). these variables influence the etiology and outcome ofMPD. This present article will emphasize in what manner The traditional Hispanic religious-cultural beliefs espiritismo (spiritualism) shapedthe phenomenologyofthe addressed in this article are practicedworldwidewith a heavy MPD suffered by a Hispanic female. The origin ofspiritual­ concentration in Latin America and the United States. The ism can be tracedback to the 19thcenturyspiritistwhowrote two major belief systems practiced are Espiritismo and under the pseudonymofAllan Kardec. Spiritualismhasbeen Santeria, which is also a spiritist tradition. Espiritismo devel- 39 DISSOCIATIO:\, Vol. IV. No. 1, ~Iarch 1991 THE INFLUENCE OF "ESPIRITISMO" oped in the 1870s from Europe and its beliefsystem entails sociative disorderssuchas MPD in Hispanics, Rendon (1974) spirits being reincarnated several times. Santeria is the wor­ andSteinberg (1990) warn thatdissociative phenomenamay ship of saints. It originated in Nigeria and w~s br?ught to also bemisdiagnosedas schizophreniain this groupofpatients. Hispanola during the slave trade. The syncretIc mIxture ?f Santeria involves the Mrican Yorba religion and its Cathohc METHOD Saints (Berthold, 1989). The concept ofillness and health have different m~an­ The data base obtained on the case to be presented was ings to diverse cultures. The traditional belief systems Just from case notes, collateral, and family sessions. A sodium described will influence Hispanic patients' perception ofan amytal interview (Marcos & Trujillo, 1978), was done with illness and their usage of treatment centers. "Several stud­ the consent of this patient and was written up with transla­ ies have expressed concern with the paucity ofappropriate tion into English. Therewas also a consultationmeetingwith mental health services to the Hispanic, and in particular to a spiritualist. Puerto Rican communities, (LatinoTaskForceonCommunity Limitations ofthe material are that data were obtained Mental Health Training, 1974; Miranda, 1976; Padilla, E.R., from one case (N = 1), with various facets of the study rely­ & Padilla, A.M., 1978) clinicians providing services may not ingon the memoryofthepatient, family, andcollateral sources. be culturally attuned to the clients whom they are serving. There were idiosyncratic aspects in the life of this patient This results in underutilization of available services as well and thus one must be cautious with generalizations. as a less than optimal treatmentresponse." (Ruiz &Langrod, Furthermore, the material was reviewed retrospectively. 1982, p. 35; See also Abad, Ramos, & Boyce, 1974; Ghali, 1977; Minzio, 1974) CASE DATA Spiritism and multiple personalityhave begun to be stud­ ied cross-culturally (Krippner, 1987). In the article "Cross­ Identifying Infonnation and History Cultural Approaches to Multiple Personality Disorder: The patient under consideration is a Spanish-speaking Practices in Brazilian Spiritism," there is mention that not Hispanic female who was 48 years ofage at the start oftreat­ much analogy can be found between mediumistic posses­ ment. She had resided in the United States for twenty-five sion (the incorporation ofbenign spirits) and MPD, but that years, and during those years she made periodic trips back there appears to be a closer resemblance to the "involun­ to her country of origin. The patient was under treatment tary possession" ofindividuals and MPD. Anotherstudyfrom with the author for an eighteen-month period during 1987 a different part of the world, but still relevant, was an arti­ and 1988. Initially she was treated intensely for two months cle presenting an MPD case in India and comparing this with during a psychiatric hospitalization. She was then followed hysterical possession state (Varma, Bouri, & Wig, 1981). In as an outpatient once a week with the possibility of being Indiathe possession statewas more common, andwas attribut­ seen more frequently when in crisis. ed to be related to the religious beliefs of polytheism and Dolores (a pseudonym) informed the author that she reincarnation. was unemployed and her parents were deceased. In the past Cultural beliefsystems can also impacton the treatment she had worked as a seamstress. She had presently separat­ practices. There canbeexorcisms, healingsessions, andmedi­ edfrom herspouse ofelevenyears. The husbandwas a believ­ umisticseances. Krippnerreports, "Mostspiritistpractitioners erand practitionerofEspiritismo. The patient admitted hav­ (and their clients) have never heard of MPD, as such, and ing beliefs in Espiritismo, but felt this was in conflict with treat people with dissociative reactions with the same ritu­ her religious (Christian) beliefs. The patientin the past had als amulets and brews that have been used for centuries" consulted with espiritistas (spiritist mediums). (&-ippner, 1987, p. 276). These herbsand devotional objects Dolores was born in a politically unstable Latin coun­ can be found throughout stores often referred to as botani­ try. Her parents were first cousins, and they were economi­ cas (Schwartz, 1988). cally disadvantaged. She was raised in rural sections of the In the literature one can find articles pertinent to the country. Her parents had eleven children. Dolores and her treatment of Hispanics (RogIer, Malgady, Costantino, & fraternal twin were born afterfive othersiblings. The patient Blumenthal, 1987) and writings on spiritualism often asso­ described her family as quite religious, but knew her father ciated with Allan Kardec (Kardec, 1857). also was a believer in Espiritismo. The patient was told
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