CU:\ICAL A:\D SPIRITUL EFFECTS OF LXORCIS)I 1:\ FlITEE:\ PATIE:\TS \11TH )ICLTIPLE PERSO:\.-\lJH DISORDER
Elilabelh S. BO\l111an. \I.D.. S.T.\!.
EIi ...abcth S. Bowman, M.D., ST.M., is Associate Professor of about abuse, to identification with abusive parents (Bowman, Ps),chiau), at the Indiana University School of Medicine in Coons,Jones, & Oldstrom, 1987 Putnam, 1989;Sperry, 1990), Indianapolis, Indiana. and to abusive experiences in which suggestions ofdemon possession were given (Friesen, 1991). In addition, subjec For reprints write Elizabeth S. Bowman, M.D., Indiana tive experiences ofalters who identify with the devil 01' spir Uni\'crsity School of Medicine, 541 Clinical Drive, Room it-likc internal self-helpcrs can cOll\;nce patients that they 291, Indianapolis, Indiana 46202. are possessed (PuUlam, 1989; Bloch, 1991). Most ~IPD experts beliC\'c that demon alters arc cul ABSTRACT turallyshaped psychological constructswhosefunctionsshould be understood (Pumam, 1989; Ross, 1989). Ross cautions Fift~/tmak multiplepn-sonality dis
222 D1SS0Cl\llO\. \01.11. t Dtrrnbtr 199:1 I BOWMAJ~
of MI'J) patients was Fraser's (1991) description of scven emotional reactionsofhostsandalters to these experiences, paricntswho reported priorexperiencesofexorcisms. Fraser the details of exorcism experiences, and the clinical, emo concluded that exorcisms of MPD patients call create new tional, and spiritual sequelae ofexorcism. ego states, cause ego states to belic\'c !.hey arc demons, con Questions were worded in a neutral manner and sign egos to an intcmal hell, causesuicide aucmptsand hos inquircdabout both positive and nL'g'ltivcoutcomes. Subjects pitalizations, and result in curtailment of religious fervor described their emotional rcactions and classified them as and/or participation. Fraser recommended that would-be very positive. somewhat positive, neUlral. somewhat nega exorcists be familiar Wilh ego states and have knowledge tive, or\'cry negative. Mixed reaclionswere also nOled. Positi\'e able therapistsrule outdissociati\'edisordersand PTSD before reactionsweredefinedas pleaSiultfcelings (e.g., peace. relief) altCmptillg exorcisms. In the popular press, an ~IPD palielll or reduction of unpleasant experiences or symptoms. all a recent television talk show reported that an unwanted Negativc reactionswere defined as unpleasantemotions (e.g., exorcism had caused most of her alters to withdraw from fear, anger, shame) or worsening ofsymptoms. therapy. This exorcism led to a lawsuit againsllhe minister Subjects were asked about current and past religious exorcist Uournal Graphics, 1992). experiences and abuse involving religious groups, authori Inlight ofthe recentinterestin exorcisrTIsofMPD patients ties, or doctrines. A brief immediate post-interview inquiry and the dearth ofdata on the outcome, I decided to study assessed the emotional impactofthe interview. Despite free a series ofMI'D patients to determine the clinical and spiri dom 10 c1iscoIllinue the interview at any time, all subjects lUal sequelae ofexorcism. This paper reports the results of completed it. mat study. No attempt \','as made to verify the accuracy of patient reports. Collateral informationand clinical obsen'ationscon METHOD AND STUDY firmed the occurrence ofexorcism in two subjecLS and the diagnosis of MPD in thirtecn subjects. I recruited subjects by conrncting all local therapists known 10 treal MPD patientsand asking Lhem LO conlaCl for RESULTS merorcurrent MPD patientswho metinclusion criteria. Some subjc<:tswere recruitedwhen these therapists contactedother Demographic and Qinirol OIaradt'riltics colleagueswho treat MPD. Inclusion criLCriaforsubjectswere: All subjects were female with a mean age of39.5 )'cars (median 49, range 23-54). Fort}"'SC\'en percentwere emplo)'ed. 1. At least 18 years ofage. Marilal status was: 27% single, 27% married, 20% divorced, 13% separated, 7% widowed. and 7% unknown. Rounding 2. DSM-/II-Rdiagnosis ofmultiple personalil)'disorder. off the percentages leads to the total of 101%. Two (13%) were inpatients and the remainder were outpatients. Their 3. Having had one or more of the following experi mean duration oftherapy for MI)I) was 43.5 months (medi ences: an 36, range 5-88). ll1ree had been treated for less than one a. Feeling they might be possessed by cvil spirits; year but nearly all had good awareness of their alters. In b. Bcing told by others they were possessed; 80%, the personality who initially gave information was the c, Being told they needed exorcism or actually host, solely or in co-consciousness with an alter. Ten sub undergoing an exorcism. jects switched executive control of personalities during the interview, most frequently when discussing the alters' reac 4. Judged by therapist as clinically stable enough to tions LO exorcisms, Four of fivc who did not switch report cngage in the interview. ed data internally from alters,
Sixtcen subjects living in rural and urban areas in sev· Religious Background and Religious AbllSe eral midwestern stales were contacted. One who had under Of the fourteen subjects (93%) with childhood reli gone exorcisms as part of her psychotherapy declined 10 gious affiliations, IWO were Catholic, and twelve Protestant participate. Subjccts consisted of the first fifteen patients (six mainline. four charismatic. and two non-mainline). who gave infonned conselll LO be illlcrviewed. No tvtO sub Currently. only seven (47%) remain religiously affiliated, jects were being treated by the same lheragist. but onc does not participate. Current affiliations are four I interviewed eachsubject.all MI'I) paticnts, forapprox mainline ProtestantandoneeachCatholic, charismatic.and imately 90 minutes using a scmi-structured inten.iew. the non-mainline Protestant. Most cited the negative impaCl of Exorcism Experiences Questiunnairt, presented as an appendix exorcisms orchildhood religious abuse as the cause ofceas to this article. EIC\'en subjects were interviewed in person ingadult religious affiliations. Twelve subjects (80%) repon and four b)' tclephone_ The intervie\\' consisted of screen some kind ofcurrent spiritual beliefs or practices. ing questions about suspicions ofpossession and the occur Nine subjects (60%) report<.'Bible to tionShip to being diagnosed with MPD, the past and current justify or enforce obedience to parelllal abuse or 1.0 label
223 .. D]li50Cl\TIO\. \01 \ 1.1. Dmll!ll.'r I!l!IJ ------EXORCISM I;\, 15 ~IPD PATIE;\,TS
TABLE I Reactions to Suggestions of Possession
Suggestion of Possession (N:::14) Overall Reaction (N)
VP SP Ncu SN VN Mixed Unk/Um
Initial Reaction 2 0 1 9 0
Current Reaction o 1 0 II 0
Specific Reaction Initially Currently
fear 7 0 Agreement/belief 7 I' Feeling evil/worthless 7 0 Disagreement!disbelief 4 II Angry 3 9 Suicidal 2 0 Relief 2 0 Withdrawal from church 2 0 Chagrin/beU"a)'al/used I 2 Dissociated to religious aJter 1 0 Neutral/understands motivation 0 4 Sad/hurt 0 3 Desire lO self~mutilate 0 1
VP - Vt'I)' Positive SP - Somewhat Positive Neu - Neu/ral SN - Somewhat Negative VN - Very Negative Unk/Uns - Unknown or Unsure *Subjrct wonders at times ifshe is posst.5sed.
the child as evil. Nine (60%) reported abuse b}' religious selves andothersabom the realit)' ofMPD were causati\'e fac leaders. some ofwhom were relatives in lay leadership. tors. Fourteen (93%) subjects reported that others had told Possession Belitfs and Suggestions tlIem the,' were possessed. The first suggestions usually Thirteen (87%) subjects had thought alsomc timcthal occurred in adulthood (N:::9). Most subjects reported mul tJleywere possessed b)'demonsorevil spirits. The first occur tiple suggestions ofpossession. 111irteen subjects had been rence of this was e\'enly distributed from childhood to age laid they were possessed before their MPD was diagnosed fort}'. These thoughts began before the diagnosis ofMPD in and five afterward. Suggestions ofexorcism were most com all thirteen, but seven also wondered about possession after monly made by clergy (N:::9), but also came from church diagnosis. Reasons for feeling possessed included dissocia mcmbers (7). family members (6), pastoral counselors (2), tive symptoms such as amnesia, destructive behaviors, pas othcr religious officials (2), and others (2). Twelve subjccts sive influence experiences and hearing voices (N:::9), per reportcd suggestions orpossession rrom more than one type sonalorfamily religious beliefs (8), thesuggestions offamily ofsource. or friends (6), and having studied or participated in occult Table 1 sho,",,'S the reactions ofsubjects to suggestions activities (4). When subjects continued towonderabout pos that the)' were possessed. Ten of fourteen (71%) inilially session after their diagnosis, personal religious beliefs, the reacted negati\'e1)' to this suggestion. but two (14%) felt suggestions of religious persons, and the doubts of them- reliC\W. Emotional reactions remained quite stable overtime,
224 TABLE 2 General Reactions to Suggestions and Experiences of Exorcisms
Event N Overall Reaction (N)
VP SP Neu SN VN Mixed Unk/Uns
Suggestion of Exorcism 14
Initial reaction 0 0 0 10 1 2 Current reaction 0 0 I 10 0 2
Exorcism (Initial Rxn.) 14
Host reaction* 2 0 2 0 11 1 0 Alter reaction 45*· 4 0 0 2 35 3 I
Exorcism (Current Rxn.) 14
Host reaction 2 0 I 2 8 0 2 AJter reaction 45 3 0 7 7 -"9" 1 2 *TUJQ hosts "fJOrtm. diffl'mll nacti(ms to difftTt'rl1 aorcism ~mm. "''''This is the number ofdiscrete alttTs or a/ler groups (stich as children) who rtf>orted reatliollS. \lP _ Vt:ry Positive SP - Somewhat Positive Neu _ Neutral SN - Somewhat Negative VN - Vt7), Negative UnJi./Um - Unk'lOwn or Un.rure
bUl all subjects whose reactions changed reported fl.'eling authorit},. Four considered it more than oncc. Se\'en con more Ileg-dtively. Initial positive reactions involved hope or sidered it before MPD was diagnosed and two considered it relief that a sollllion to long-sr.anding problems had been aflerwards, but no one considered it both times. Seven of found. Half ofsubjecLS initially agreed they were possessed these niIle went to speak with someone about exorcism. because they trusted the authority of those who suggested Table 2 presents the reactions offourtecn subjectswho it, because possession provided an explanation for puzzling rcported that others had suggested they undergo exorcism. dissociative symptoms, and because possession was conso Thcse suggestions ,,'cre generally made during adulthood nant with their beliefS)'slem. Many ofthose who agreed they (N=I2), occurred nearly equally before (10) and after (8) were possessed also reported feelingC\-il, frightened, or sui their MPD diagnosis, and often were made more than once cidal as a resull. The other common initial reaction pattern (6). Eleven responded by discussing exorcism with some included rage, disagreemelll, and distancing from those who onc, but onc of these was an adolescent who had no choicc. made the suggestion. Ten subjects reponed feclingcoerced or pressured by those With the passage of time, subjecLS rFpol'ted two basic who suggested or performed exorcisms. All ten reported outcomes to feelings about thesuggestion ofpossession.Anger bcingverballyurged to undergo exorcism.Six were told the)' eitherremained orgrew. and they experiencedspiritual dis would go to hell iftheydedined. Two who had been minors illusionment and hurt. Othersgained perspecti\"eon thesit~ were ph}'Sically restrained and exorcised without their per uation and realized their friends meant well but were igno mission. One adult fled from the room to avoid an exor rant of MI'D. The major cause of remaining hurt aboUlthc cism. suggeslion was post-exorcism rejection by religious friends At the time exorcism was suggested, mostsubjects react who viewed them as evil or spiritually tainted. ed ncgativelyin ways similar to their reactions to suggestions that they were possessed. Negative reactions included fear Suggestio".s ofExorcism (N=4), diminished self-esteem (4), hurt or anger (2), dis. On their 0\\11, in adolescenceand adulthood, ninesub sociation or creation of new alters to comply (2), and with jects had considered discussing exorcism with a religious drawal from religious activities (I). Se\'eral subjects repon-
225 D1SS()( mlO\ \01 \1 I. D!'Cf'IIlbrr I9!tJ
" EXORCISM IN 15 MPD PATIENTS
exorcised bya parent who used exorcism as a vehicle ofabuse TABLE 3 to punish the child's -evil~ .....ays. Three subjects reported Characteristics of Exorcism Riluals their families look them as children to be exorcised. Eleven exorcisms (79%) were performed by groups of persons. usually three to eight lay persons in a private set ting. Four subjects who reported being exorcised in front Number ofcongregationsofup to 400 persons perceived publicexor ofSubjects cisms as implicitl), pressuring them lO comply with group Characteristic expectations or as humiliating experiences which stigma La}i.ng on of hands/tollching 13 ti7..ed them religiousl)'. Three subjects were exorcised by sin gle individuals - a friend. a counseling pastor. and a non Prayer offered II treating therapist_ No correlation was seen between spirirual Speaking in tongues 7 orpsychological sequelaeand thesizeoftheexorcisinggroup. Yelling or shouting 6 The exorcism rituals contained some common char acteristics presented in Table 3. J\bnysubjects were shocked Use ofreligious paraphernalia 6 by unexpected ph)'SicaI touch. Religious paraphernaliaused Anointed with oil or water 6 in exorcisms included crosses, rosaries, Liturgical books. and Physical restraints used 6 Bibles. A sizeable number oftile exorcisms appeared chaot icasgroupsofeXOrcislS)'elledat tile demons,spoke in tongues, Jerked/shaken/hit by exorcists 5 chanted. jerked, or shook the subjecr's head or bod)' (at Duration more ilian one hour 5 times \iolently), or held the struggling subject down. One subject reported a minor neck injury from the exorcism. Threats or ,;olence toward exorcists 4 Some subjects described ....Tithing, shaking. or slithering on Exorcist perceived as abush"c 4 the floor. Nearly all subjects wenl into rrances or S\\itched Exorcism attempted in series ofsessions 3 personalities at least once during the exorcisms. Some switched to altcrs who produced the desired beha\iors in Exorcists nurtured subject 2 order to terminate the ritual. Omers switched to calm alters (Total subjects exorcised was 14.) who could remain quiet until an escape was possible. Some S\\itched to assertivc alters who were able to escape or end the ritual. The altersoffoursubjects became threateningor terminated the exorcism in violence toward me exorcists. cd positive or neutral emotionsSlIch as hope orrelief (N=2) In two ofthese. animal alters carried out the violence. or a desire to be helped (3). Psychological Sequelae ofExorcism Exorcism Experiences Table 2 shows the reactions of fourteen subjects who Fourteen subjects underwent exorcism. Six reported undern'cnt cxorcism. Each subject was asked the reaction one exorcism, five reponed two, and three subjects report ohhe host and known alters orgroups ofalters (such as pro ed six or more. The mean duration since the most recent tectors or children) now and at the time ofthe exorcism. At exorcismwas6.3years (range 0.5- 20years, median 4.5years). me time of the exorcism. 82% ofthe alters whose reaction Two persons had been exorcised in the pastyear. Seven sub was known and 79% ofthe hosts experienced negath'e feel jects were exorcised only before their diagnosis, four only ings, nearl)' always very strong ones. Fourteen percent of afterwards, and three bOlh beforeand after. Implicitorexplic hosts and 9% ofalters viewed the exorcism positi\·ely. These it permission was given by cleven subjects (79%) but four tended to be religious alters who agreed with the exorcism reported that at least one cxorcism occurred withom their or sadistic alters who enjoyed the terror ofother alters. permission. Manysubjecls had liule explanation ofwhat the At time ohhe inte....iew. 71 % ofhosts and 71 %ofalters exorcistintendedandwere taken bysurprise. Some had under still felt negatively about the exorcism. Feelings remained slood they were going to receive prayer for their healing. quite heated for a numberofsubjects who dissociated at this Others felt coerced by public pressure when exorcisms were point in the interview to express their outrage or fear. Still. performed in fronl ofcongregationsofdozens 10 hundreds. the general illlcnsit), of feelings had faded somewhat m'er Several subjects reported being ....·ell-informed. approached time. resulting in more neutral responses. Positive respons gently. and feeling carcd for. es were stahle. persisting in 14% ofhosts and 7% ofalters. Exorcisms nearly alw3)1; occurred in homes or church Table 4 presents the clinical sequelae of exorcism in sanctuaries, butfive subjects were exorcised in me offices of these fourteen subjects. The most common sequela was d)'S minislers who were counselling them, and one was exor phonc feelings ofrage. fear. anxiety. agitation, humiliation. cised on a pS)'chiauic "''ard, Clergy were in\'Oh'ed about half despair over lack ofefficacy. suicidality. and vie....ing them the time; male and female lay personswere in\'ol\'l~d in eleven selves as C\;I. Specific exorcism-related fears occurred in half exorcisms. Se\'eral health ormental health professionalswere the subjects. usuall)' fearofbeing in church ornearreligious in\'Oln~d in la)' religious roles. One subject was repeatedly people.These fears remained forweeks to months in all sub-
226
D1 ....owno\. \01.. \1.1. Dm.IIrr]!!] BOW!l1A.~
TABLE 4 Ps)'chological Sequelae ofExorcism
Clinical Sequelae N % Comments
Painful or Bad Feeling/Experience 13 93 Needed More Thernpy 11' 78 Exorcism Still Affecting Subject 10* 71 Hospilal Admission 9 84 15 admissions for 9 subj. Prolonged Phobia/Specific Fear 8 57 6 had fear ofchurch worship Alters or Inner World Changed 8* 57 Alters Hid Mterwards 7 50 Duration: Hours to 4 }'ean Self-mutilation 6- 43 New Alters Formed 6- 43 6 subj. formed 7 new alters Suicidal Ideation 6- 43 Suicide Attempt(s) 5 36 5 subj. rcported 6 attempts Alters Disappeared 4* 28 Duralion: Months to 12 years Symptom Relief (Tcmportl.ry) 4 28 Duration: Up La 2 months Onset ofRapid Switching 4 28 Alters Newly Discovered 3* 21 Entered Psychotherapy 3 21 Left Psychotherapy 0 0 One subj. changed therapists Needed Less Therapy 0 0 Hospital Discharge/Decreased Sta}' 0 0
·O'lt' otJu:r subject was unsure. ·Two other subjects VJe'ft unsurt.
jectsand becamechronicadaptations[orsomesubjects, who ofinternal safety. still cannot enter a church or sit through an entire service. Half of subjects reported alterations of the autohyp Se1.'cn subjects reponed numerous sequelae amount notic images ofalters orthe internal world. Changesin alters ing to general clinical chaos. The Olher se\'en reponed less included growing bigger to provide protection, regressing pervasive effects. The clinical symptoms related to the exor in size and age, becoming angry and vindictive, temporari cism resulted in at least one hospitalization for over halfthe ly or pennanently disappearing, or surfacing for the first subjccts. One subject was admiued fi\'e times in six months, time during orjust after the exorcism. Those who fonncd which encompassedtwo exorcisms. First onsotor recurrence newalters reportcd creatingaggressh'c alters to protcctthcm ofself-mutilation, onsct ofrapid switching. suicidal ideation or stop the ritual, or religious alters who satisfied the exor or auempts were common causes of hospitalization. cists' expectations. A few subjects described massivcchangcs Dissociati\'e sequelac includcd amncsia for part oCthe in their internal worlds. For exampic, onc subject reponed cxorcism or aftClWards. One subject rcported continuous the collapse of the house in which her alters resided, the amnesia for the next six months. Halfofsubjects reported discovery of another layer of alters, and the breakdown of that alters (usually child alters) fled La safe places inside the internal amnestic barriers that protectcd alters from each internal world to hide. Theygenerally hid for hours to weeks, Olher'semotionsalld thoughts. Thisled to cessation ofinter butduring the interview one patientdiscover<.-d an alter who nal communication as altcrs auemptcd 10 avoid eacholher's had been in hiding for four years. In more cooperativeorga mentalcontents. O\'crfour)'ears latcr, thissubject described ni.led s)·stcms, protectorsoftenescortedchildalters La places the currentclTecLofthe exorcism: "There has becn noorder
227 EXORCISl\I IN 15l\1PD PATIENTS I
TABLE 5 SpiriLUallReligious Sequelae of Exorcism
General Sequelae N % Comments
Ever Had Positive Spir./ReJ. Effect I 7 One subject reported Evcr had Negative Spir./Rel. Effect 13 93 positive, then negative effeCls; onesubj. unsure Current Positive Spir./Rei. Effecl 7 Two subj. unsure about currenl effects. Current Negative Spir./Rel. Effect 10 71 No Current Spir./Rel. Effect I 7
Specific Sequelae N % Comments
Relat. ""ith God Worsened/Destro)'cd II 78 Unable to Go to Church 10 71 Duration: Weeks to 19 )'ears Doubted or Lost Faith 8 57 Uncomfortable in Worship 8 57 Distrust/Doubt ofChurch or Members 7 5(] Feeling ofBeing Bad or £\;1 6 43 Increased Lopury to Salan 1 7 Motivated to Work on Spiro Growth 1 7
inside since that time. It has been a zoo." The spirilual and religious effects of these exorcisms Exorcisms caused some to ellter psychotherapy but no were overu.'helmingly negative, lasted longer, and wcre far one ceased therapy as a result. Some therapies were longer morc distressing than lhe psychological effects, Thc nega assubjecLS devoted time to dealingwith trdumalic exorcisms. tive cffects fall into three calegories: faith. religious panici Some subjccLS reported positive cfTeeLS from the exorcisms. pation, and self-view. The impacton subjects' personal faith Initially, some felt hope, relief, and spiritual ,,·ell-being. \\-'as SC\'ere. When no demons left or subjects felt humilial Temporary symptom relief ill\'olved remissions of depres cd or subsequently ostracized by church members, a gen sion, allgeroutbursts. behavioral changes, or hearing illler eral death ofnai\'ete about religion and the onset ofserious nal \'oices. but the symptom relief was nC\'er pennanent. religious questioning occurred. God .....as hated, doubled. One subject reported positive emotional changes from per \icwed as haling failed, as no longer good. or as not PO"'· ~nal rituals to renounce the power ofeli!, but these were etful enough to stop the mistaken and unintentionallyabu not really exorcisms. si\'eexorcists,Assubjects re-examined who the')' thoughtGod was, somefelt frigh tened orguiltyabout theiT response. Some Spiritualj&ligious Sequelae ifExcrcism who retained a beliefin a dcil)'gavc up beliefin a traditional Table 5 shows the spiritual and religious sequelae of Cod. TIlOsewhoarecurrentlyrehabilitatingtheiT God image exorcisms. One subject reported an initial positiw effect have done so because ofthe persistent efforts ofclergy and (hope and being closer to God) from exorcisms she sought church members in groupswhich do not advocate exorcism, \·oluntarily. but these benefits faded and she now describes The prayer Iifeofmanysubjects hasbeendestroyed orsevere severely negative sequelae (inability to beliew in God or go ly curtailed. to church, difficulty being around religious people). One One subject who experienced exploitalion by a reli subject who was unsure about the spiritual effects of tllC gious therapist. as well as t\\·o unwanted exorcisms by lay reli· exorcism has sLrong religious beliefs in demon possession gious persons four years previously. described the spiritual and deliverance rituals. impact: ~I feci spiritually deplclcd. Between (the pastoral
228 Dl~~O(l\TJO\ \ot \I I. Drtmber 19!U BOWMAN
counselor) and lhe exorcism, someone has stotcn Illy soul. expressed the confusion which exorcism can engender: "I I used to be dose to Christ and used prayer a 101. and expe fcel violated and 1 feel abused, abused in the name of rienced God. I don't experience itiUlymore and feel dead. Christianity. in the name ofChrist. It's very confusing." She \Vc were almost tOl.ally destroyed by the event. ~ This subject responded to herexorcism andsubsequent rejection bychurch reported 40 years ofaclivc church life prior to these events. members by forming a new alter from a religious alter and The effccl ofexorcism on al1iliation with religious peo an angry anti-religious alter. The new alter embodied her ple or attendance of public worship was also severely ncga righteous anger and used a biblical namc for God. Live. Post-exorcism responses La worship orcharismatic prac tices (laying on of hands. raising hands, anointing. lalking Impact ofthe Exorcism Interview about demons) include mnning Qul ofservices, becoming At the cnd of the internew subjects .....ere askcd about phobic about attending worship or being in church sanc the emotional impact of the interview. Three subjects had tuaries, having nashbacks of exorcisms, or upsetting ahers felt very upset, seven felt somewhat upset. one reported lit \\'ho remain angry about the exorcism. Dislrusl ofreligious tle emoLional impact, two felt somewhat positive and three people and/or ministers was rampant. Lay persons engen felt very positive. Four felt they had learned about them dered lasting mistrust and hurt by treating subjects as mint selves, and tWO felt they had learned about their past. Two ed or spiritually defective after the exorcisms failed to cur ofthe subjects who reponed feeling very upset also felt they Lailtheir symptOllls. Some subjccts were openly shunned had learned something or felt it was also a positive experi told 10 Slay away from the exorcists and their families. ence. Positivc effects included gratification at helping oth Foursubjects reported that exorcisms led to increased ers avoid similarexperiences, reliefO\'er beingable to speak religious part..icipat..ion. Two increased church attendance oftheexorcism,gaining new insigh ts in 10 lheir history,dynam and personal worship in ordcr to purge thcmselves of the ics and alters. and recO\·cring exorcism-related memories. cvil ....'hich the exorcism failed to remove. Two others were One subject discovered twO previously unknown alters dur motivated to participate to help olhers a\'oid being hurt as ing the internew. Painful effects included visible emotion they were. al upsct, dissociating to upset alters, and requiring breaks One subject who was shunned after se\'eral exorcism before continuing. Onesubject wrote to me within six weeks attcmptsdescribed the aftermath: "I putalotoflrustin these and reported lhatthe interview triggered feelings in an altcr people. I think thc one thing it did the most - it's made it who tried La derail therapy. This led to a hospitalization for harder for me La trust people, to confront religious issues suicidality and self-harm. This patient had prepared for the in therapy. ~ After her exorcisms, an angry altcr became so interview by arr,mging social support, taking extra medica st..irred up by worship attendancc that he publicly spoke out tion, and reading her old journals. It is not clear what fac during sermons to tell Lhe minister Lo "shut up." She ran tors led to this negative outcome. from numerousserncesin humiliat..ion or to avoid the inter nal chaos. Seven years after the exorcism, she still cannot DISCUSSION consistently sit through an entire .....orship service. Despite being in a supportive congregation, she remains very dis While unverified clinical reports should always be trustful of church members. Continued participat..ion has approached with some caution, these data shed some light bcen possible only because of intentional congregational on the social, religious. and psychodynamic context ofexor support, extensive pastoral counseling, and psychotherapy. cisms of MPD patients. These exorcisms occurred because The impact of exorcisms on religious self-image was offourfactors, the most powerful ofwhich was the exorcist's less severe. Subjects who initially viewed the exorcism as a needs and beliefs. These subjects described exorcists and success feh better abom their spirituallh'es ulllil symptoms others with similar beliefs urging the subjects toward exor returned. Then self-esteem plunged as they concluded that cism to relie\'e their own anxiety about evil. out ofgenuine ifcven an exorcism didn't help them, they mUSt be spiritu concern. and, for some, to fill a need to act as powerful spir ally reprehensiblc. The most common change in religious itual conquerors. Second,thesubjects' religious beliefs, their self \;ew was belief that a failed exorcism confinned their wish to deny the ~lPD, and simple desperation in lhe face of evil nature. Subjects mentioned feelings ofshame, guilt, dis prolonged suffcring pla)'cd a role in them enteringthe exor gUSt, dirtiness. unworthincss. and belief that they were not cism situation. Persons with less devout beliefs would be less "good"Christians.Thiswas amplified attimesby the changed likely to see exorcism as a possible cure. Third, cultural sug aniludes of olhers and shame over a failed cxorcism per gestion played a role. Several patientsmentioned bcingexor formed in public. Those who feltangryat God for "not being cised shortly after the movie, The Exorcist, was released. Last, thcrc"tended to avoid self-loathing, butstruggled with guilt in addition to ha\~ngconsiderablereligiousexperience,these and fear of hell because lhey were angry with God. subjects reponed a high rate ofchildhood religious abuse. One subjectexpressed fear tllat ifshe told me the exor I feel these two factors rcndered them more susceptible to cism had not relievcd any symptoms she would go to hell religious re-\~ctimization in adultllOod. ill much the same for speaking against God. Another subject felt that because way that other child abuse victims arc vulnerable to adult God was '"not there"during lheexorcism,she must be unwor hood trauma. th)'. Consequently, for SC\'en )'ears she has been unable to The psychological and spiritual sequelae ofthese sub pray for herself, bl..ll will ask God to help others. She jects'exorcisl1lsarestrikinglysimilarto I.hoscofFraser·s (1991)
229 DMOUHIO\. \/ll \J ~ Dt('t.'lnber 1m EXORCISM I;.,' I5l\lPD PATIE~TS
patients. For both groups, the exorcisms ser"ed as traumas the spiritual damage. This approach ....'as successful for sev which resulted in rearrangements ofdissociated Slates and eral ofthe subjects. negati\'c psychological and spirhua} effects. The negative These data carry many implications for therapists who sequelae oftelling a person she is possessed are less severe consider performingexorcisms on theirMPD patients.These than those ofexorcism, but still show that suggestions that patients were all exorcised outside of psychotherapy prop an MPD patient is possessed are quite unwise, even if the er, so their experiences may be different from those exor patient appears to be in agreement. cised by therapists who ask conscnt and approach the topic Several factors conlributed to these exorcisms being gently. Ncvertheless, the negative sequelae ofthe exorcisms traumatic. First, they were often done ""ithoUL consent or described here.alongwith the lack offollow-up dalaon exor explanation, so l.hey functioned as physical, emotional, and cisms performed in tllerapy lead me to recommend thera spiritual "sneak atlacks." This eroded the subjeclS' sense of pists neverinvolve themselvesin exorcismsofpatients. Anyone personal safety and control. This was especially true when consideringexorcism oftheir patient should ask themselves counselingministersabrupdybegan exorcisms. Second.many about the motivations which may underlie their conscious of the exorcisms ....·cre loud, violent. and chaotic. Shouting. religiousrationale. Isuggestfirst as.king oneself"Whose needs un....'aIlted physical touch, and restraint reminded subjects am I meeting. my o .....n or the patielll's?" Feeling that one ofchildhood abuse. thus retraumatizing them. The few sub has.o\'erpo",·ered the forces ofC\il isgratif)ing, butthe patient jectswhoexperiencedquiet, non-coercive encounten>reJX>rt may pay a high price for the therapist's narcissistic gratifi ed being less frightcned by them and did not report flash cation. backs or phobic avoidance as a result. Therapists who perfonn exorcisms cite the disappear As with other traumas, these subjects responded with ance of \'Dices. physical pain, or other symptoms as. proof symptoms ofpost-traumatic stress disorder (PTSD) and dis that demons ha\'e left. The descriptions of these subjects, sociation. Many of the severe religious consequences were however. show that internal autohypnotic rearrangements PTSD symptoms such as flashbacks ofcxorcisms during wor ofdissociated egoSll1.lcturesaccounl for the"disappearance" ship. anger at religion, avoidance of religious activity. and ofalters. and the temporary cessation ofsymptoms. Visual, phobiasofwon>hip. ministers, and religious persons. Numbing auditory. and sensual autohypnotic experiences can seem and amnesia during long exorcisms also occurred. very, very real and can lead the eager exorcist and hopeful Two types ofdissociative responses occurred. FiI"St, new patient to believe demons have departed. Symptom relief rcligious or aggressive aheI"S were fonned to cope with the can last monthsand patientscan feel reluctant todisappoinl immediate traumaand intolerableaffect. Second,exorcisms their exorcists ....ith reports offailure. uiggered considerable rearrangements of internal auto Child abuse\ictims....i th dissociativedisordeI"S are often hypnotic images and strucmres. A1teI"S changed as they eagerto pleaseauthority figures and aresuggestible enough absorbed new affect or took on new roles. Massive lowering that they can easily produce the desired outcome. Group of dissociati\'e barrieI"S to traumatic memories occurred as pressure and expectationswere dearl}' perceived by my sub well. Both dissociative responses led to negative psycholog jects. Itwould be naive to think thatsuch expectations .....ould ical sequelae, but the internal rearrangements resulted in be absent in the office ofa therapisl-exorcisL These subjects the most severe psychological sequelae (self-mutilation, sui produced religious alters who fell down, raised hands, and cide, and rapid S\\'itching) and some PTSD symptoms. declared themselvesdelivered, andsincerel)' believed it Jwd hafr The negative sequelae of these exorcisms were severe pnud. Some alters retreated into internal hells, believing and long-lasting. Despite an average ofsix years passingsincc theywere demons. Therapistswho performexorcismsshould these subjects' most recent exorcisms. the pain generated beaware that what theysceis nOI necessarilywhal really hap by these events remained powerful. Those who had come pened. to terms with the exorcism had worked long and hard to The fear generaled by these exorcists virtually guar achieve this. Even those who continued to see it positively anteed that ahcI"S would nOI teU exorcists the true results of expressed disappointment and doubts. the exorcism. Therapists .....ho claim Ihal good results come The mostsuiking finding"''aS that the spiriru.al and reli from exorcising spirits who have been distinguished from gious damage was much more severe and lasting than psy a1teI"S need to conduct scientificall}' rigorous follo.....-upstud chological damage. The \igneues presented in this paper ies to see ifthese kinds ofexorcisms differ from those ofmy do nOI begin to convey the depth ofspiritual pain poured studies. Therapists who do exorcisms and wish to conduct out in these inteniC\',·s. These were somc ofthe most painful follow-up need to wail a considerable period of time (10 inteniews I have C'o'er conducted. Perhaps spiritual hcaling allow for return of symptoms) and ha\'e someone else do is a more lengthy process. It is also possible that spiritual thc follow-up. Patients who ha\'e been damaged wOllld not healing had not occurred because psychotherapy had likelybecandid with their fornlerexorcists. Doingexorcisms addrcssed problems which seemed more pressing. because is legally risky. Several persons have initiated lawsuits against therapists had nOI assessed the spiritual damage. or because tlleir exorcists, and others had strongly considered it. Fully they felt inadequate to address it. It is also possible that the infonnedconsentis mandatory. butmay not protect abrainst spiritual damage lasted longer because psychological heal litigation. ing needed tooccur bcforespirimal healingcould take place. These data point [0 a need to educate the consen'ative I recommend finding trusted clergy to help patients repair Christian community about the reality of MPD and how it
23ll > ~ BOWMAN
call resemble their conceptualization ofdemon possession. Unlil such education occurs, therapists can expect to face fo,lPD patients who need considerable psychological and spir inml repair after exorcisms.•
REFERENCFS
Allison, R.. & Schwa'-l, T. (1980). Minds ill man, pi«ts. New York: Rawson. Wade Publisher.
Bloch,J.P. (1991). AsJtssmt'lll and trM/lflnlt ofmulliflupnwnalilJ and dmooatiwdiJordc-s. SarnSOla, f-lorida: Prof~iollal Resollrc~ P~.
Boor. M.F. (198"1). The mulliple personality epidemic.journal of Sm'Olis and Mt1lUl/l>iJMJ,. 170,302-304. lkmman, E.5., Coons. I'.M.. Jones. R.s., & Oldsrrom, M. (1987). Religious psychodynamics in multiple personalities: Suggestions lor treatmcnL I\mnironjoumal ofPsy(holJIt~mpy.61. 542-554.
Bo...,nan, E.S. (1992). 800k rC\;cw: Unco\'cring the m)'stcI'yofMPD. Journal ofPsychology and TMology. 20, 326-327.
Coous. P.M. (1980). Multiple personalit}~ Diagnostic considerd. lions. Journal ofOiniral 1'JJchialT)" 41, 330-336.
Coons. P.M. (1984). TI,e differential diagnosis of multiple per sonality. A compn:hensi\'e re\;ew. Ps)'rliialrirOinic:s ofNorlh Amnim, i. 51~7.
FI-a.ser. G.A. (1991). Clinical effects on multiple personalities exposed to exorcism rites. In B.G. Braun & E.B. Carlson (Eds.), LJi.lwrinlilledisordm: 1991. I'rocNdillgs oflheBlh !llternationalConfrmla! on Mu/tiP/1' !'I'7'Mma/it)'jlJissool1ti",Stall'<;; Chicago: Rush-Presbyterian Sl. Luke's Medical Center, p. 186.
Friesen.J.G. (1991). Uncow:ri'lg 11u mJ-llery' ofMl'D. San Bernadino, California: Herc's Life Publishers. juhnstoll,j. (1989). The edge of roil: The rise of SalOl/ism in Nor/h Ammca. Dallas: Word Publishing.
Journal Gmphics, Inc. Tmmcripi #1006 (1992). Thcy told IIlC I have the devil inside me. S'lllyjcssy Raphael Show,july 14, 1992. Denver, CO,
Oesterreich.T.!\.. (1974). PO$$tMioll a/l(lrxorrism. NewYork: C..wscway Hooks.
Putnam. F.W. (1989). lJiag'lOJis (/lid tnalmnll ofInultipk /J"solla/ity di.'l(mfn-. New York: Guilford Press.
Ross, CA (1989). MultipkpmollallIJdisordn'. New York:john Wilt:), & Sons.
Sperry, L (1990). Dissociation, multiple personality, and the phe lIOlTIenon of e\11. journal ofPasloml Counsding, 25, 90-100.
Stem,G.R. (1984).Thectiologyofllluitiplepcrsonalities. Psychmtric QmiC3 ofNorth tlmt'Ti(o. 7. 149-159.
231 DI'\.~Q(l\TlO\ ,01. \l. l. ~ IIJ!l EXORCISM EXPERIENCES QUESTIONNAIRE FOR MPD PATIENTS
Elizabeth Bowman, M.D., S.T.M. Indiana Univel"Sity School of Medicine Indianapolis, Indiana
BACKGROUND DATA
Date oflntervie\\': Patient StalllS: Inpatient Outpatient Day Treaunent Sex: Female Male Age: Marital Status: Single Married Separated Divorced Widowed Approximate date ofdiagnosis ofMPD: Personality present at beginning ofintervie\\': Host Alter Unknown Ifalter, describe alter's function:
(NOTE: Indicate in margin ifpersonality switches occur during tM intnvitw.)
EXORCISM INTERVIEW
I. At any time in }'our life, did you wonder or think that you might be possessed by demons or elil spirits? Yes No At what age(s): Wh}' did you think or wonder that? Was that before or after your MPD '....as diagnosed? Before After Both How long before or after the MPD diagnosis?
2. At any time in your life. did otherJNoplewonder or think lhal you might be possessed by demons or evil spirits? Yes No At whal age(s)? Who? Clergy/Spiritual Director/Chaplain/Pastoral Counselor/Religious Therapisl/ Other lherapist ([\'10 PHD MA Psycho!. Social Worker Family Therapist. R.t~, etc. Circle as many as apply.) Family members friends Other persons (specify) What was the faith group of the person(s) who suggested you might be possessed? Whal did thal person tell you about why you were suspected to be possessed?
(Question.. 3-4 are only for thO!IC "'ho answered \'es to Question 2.)
3. At that time "'hal was your reaction to someone sa}ing }'ou might.be possessed? Would you consider )'our reaction then as: strongly positive, somewhat positive, neutral, somewhat negative. strongly negati\'e? (KOTE: A pasitiw rroclilm is agr-tfflInlt, fal;ng of rdi~J, pkasu", hopt, orfttling bdLtr in any UJa)'. •"- nq:atiw rrodion is anp, faling offmMd, anxious, orfalinguJOfSi! in an] WOJ. Nole ifdifJrmll rttlction.s OClUmd at difJtrmt times, and if~ach time was lxfOJ? or afttr MPD was diagnOMd.}
232 D1~\TlO\. \al \l to OrmAn l!m 4. As you remember the time rnat someone suggested you might be possessed, how do you feel now about that person suggesting that to }'ou?
Would you consider your reaction now as: sLrongly positive, somewhat positive, neutral, somewhat negative. strongly negative?
5. I-lave }'OU ever decided 011 youroum to talk to someone about being exorcised? (This docs not include doing so at the suggestion ofSOlUcone else who thought }'OU were possessed.) Yes No
At what age(s)? Why did }'OU de<:ide to do this? Did you go to someone to talk about it? No lfres, who? Was that before or after }'our ~IPD ....'aS diagnosed? Before Aftcr Both How long before or aflCr diagnosis?
6. Has ollJolleelstcvcr suggestcd that you talk to someonc about being exorcised? Yes No
At what age(s)? Who suggestcd this? Clergy/Spiritual Director/Chaplain/Pastoral Counselor/ReligiousTherapist/Other therapist (MD PHD M..o\ l)sychol. Social Worker family Therapist, Ri\l, etc. Circle as many as apply.) Family members Friends Other persons (specify)
What waS Lhe faith group of the person (s) who suggestcd you should talk to someonc about exorcism?
Was thaL before or aftcr your MPD was diagnosed? No I-low long before or after diagnosis? Did you go LO talk to somconc about it? Yes No If yes, who?
(Questiom 7-10 are only for those to whom a suggestion of exorcism waS made.)
7. How strongly were you urged to consKler exorcism? Describe:
Did the person who suggested exorcism use any verbal, spiritual, religious, or any psychological pressure to get you to comply with this suggcstion? Yes No Describe:
Was that before or after your MPD was diagnosed? Before After Bo'h How long before or after tJle MPD diagnosis?
233 EXORCISM IN 15 MPD PATIENTS
8. What was your reaction to the suggestion ofexorcism at tIlL time it was suggMUtP. Describe;
Would you consider }"Our reaction then as: strongly positive. somewhat positive. neutral, somewhat negative, strongly negative?
(Note ifdiffuenl reacticm.s occurnd at diff"mt timt:S, and how long each li1M was bt/on or aft" MPD diagnosis.)
9. As )'Oll look back on the suggestion mal )Ull be exorcised, what is )'our reaction to that now~
Would )'0" consider )'our reaction now as: strongly positive. somewhat positi\·e. neutral, somewhat negative, strongly negative?
(Nok ifdifferent readion.s oa:UrTM at diffmnt times, and how long roch lilM was btJort or afln" MPD diagnosis.)
10. Were )'OU e\'er abused by a person who suggested exorcism to you? Yes No Jfyes, who? Describe what happened.
11. Has anyone ever altempted to exorcise }Ull or do a ritual for deliverance from demons or c\;) spirits? Yes (Go 10 Qyestion 12.) No (Go to Question 29.)
(Questions 12-28 arc onlv for those who answer ves \0 Question I I.)
12. How many times?
13. For each time: Was lhe exorcism done with your permission? How long was il before or after MPD was diagnosed?
Exorcism Permi. 1>< Ves No Before After How Long? 2nd Ves No Before After How Long? 3,d Ves No Before After How Long? 4th+ Ves No Before Afler How Long? 14. Who attempted the exorcism and where was it done? Exorcist(s) and Failh Group Place and Description of Exorcism 1st: 2nd: 3rd: 4lh+: 234 D1'i\OCl\l10\. \ol. \l t. Drl:"""" 1"3 15. Describe the reaction of the host personality at that time to each exorcism: Would you considcr the host's reaction then as: strongly positi"e, somewhat positive, neutral, somewhat negativc, strongly negative? 16. Dcscribe the reactions orthc host personality now to each exorcism: Would )"OU consider thc hosl's rcaction now as: strongly positivc. somcwhat positivc, neutral, somewhat negative. strongly negath'c? 1i. At tM tilm ofthe exorcism, how did four alter personalities rcact to the exorcism(s)? (Nok: RLacfiolls may ~ describtd for single alUn orfor groups ofall~.) A Alter's Name or Function: Reaction: very positive. somewhat positr..e. neutral, somewhat negativc. vcry negative Describe: B. Alter's Name or Function: Reaction: vcry positive. somewhat positive, ncutral, somewhat negativc, vcry negative Describe: C. Alter's Name or Function: Reaction: vcry positivc. somewhat positivc, neutral, somcwhat ncgativc, vcry negativc Describe: D. Altcr's Name or Function: Rcaction: very positive, somewhat positive, neutral, somcwhat ncgative, very negativc Describe: 18. Describe the reaction of the alter personalities now to the cxorcism(s): A. Altcr's Name or Function: Reaction: vcry positive. somewhat positive, ncutral, somewhat negativc, very negative Describe: B. Alter's Name or Function: Reaction: very positive, somewhat positive, neutral, somewhatncg-ative, very negative Describe: C. Alter's Namc or Function: Reaction: very positi,'c, somewhat positive, neutral, somewhat n("~rative, vcry neg-dtive Describe: 235 DlSSOWnO\. \01. \1. t I>«mbrf 1"3 EXORCISM IN 15 MPD PATIENTS D. Alter's Name or Function: Reaction: \'ery positive. somewhat positive, neutral, somewhat negath'c, vcry negative Describe: 19. Did the exorcism relieve all)' emotional or ph}'Sical pain, discomfort. or symptoms? Yes No (Specif}'which exorcisms: 1st 2nd 3rd 4th+) Ifyes, whal? What personality had the problem? Did that problem ever return? Yes No U}'es, how long after the exorcism? What happened? 20. Did the exorcism result in anything painful or bad for any personality? Yes No Unsure If}'e5, whal? 21. Did an)' personalities Rdisappear~? Yes No Unsure rf)'es, who? What happened to lhem? (Record duration ofabsence ofpersonalities who later reappeared.) 22. Did any personalilies Rappear~ then? Yes No Unsure Jryes, who were they and what were/are they like? 23. Were any personalities or their experiences of the inside world changed in any way? Yes No Unsure lfyes, who and how? 24. Is the exorcism affecting you in any way today? Yes No Ullsure lfyes, how? 25. Did the exorcism result in rou: Entering the hospital? Y., No Leaving the hospital? Yes No Entering psychotherapy? Y., No Leaving pS)'chotherapy? Ye, No Needing less therapy? Y., No Needing more therapy to help }1)U deal with the effects of this exorcism? No 236 DIS.SOCI.\T10\. \ol \1. t Ilm-*r 1!1!3 I BO~ REUGJOUS AND SPLRlTUAL EFFEcrs OF EXORCISM 26. Did the exorcism ever arreci your religious or spiritual life in any way? Yes No Unsure Ifyes, how? Is your spiritual/religious life loday affected in any way by the exorcism? Yes No Unsure If )'CS, how? 28. Were you e\'er abused b}' any of)'our exorcists? Yes No Ifyes. who? Describe: OPTIONAL REUGIOUS BACKGROUND QUESTIONS 29. In whal religion. ifany. were you raised? 30. What other religious orientations or experiences ha\'c yOli had? At whal age and for how long? Age Duration Experience 31. Do you currenlly consider yourself to belong to any religious group? Yes No Ifyes, what? How active arc you in tbis group? 32. Evell ifyou currently do not belong to a religious group, do you consider yourself religious or do you have spiritual practices or belicfs? Yes No Unsure Ifycs, what are they? 33. Do you consider yourself lO have been abused during any religious rile? Yes No Unsure Would you classify lhe rile as: Convcntional religion Religious cull. not Satanic Sar.anic cult Olher (specify) 34. Were religious ideas or scriptures evcr quoted or used during any ofyour abuse experiences? Yes No Unsure If yes. what ....'as s.1.id and by whom? 237 mssoo.mo\. \ 01. \l. t ~ I"' EXORCIS:l1 I~ 15 :lIPD PATIE:\TTS 35. AsidLfrom ~cism ~n1us. were )'OU C'ier abused by a member ofthe clergy or other religious official? Yes No Unsure Iryes, who? OPTIONAL POST-INTERVIEW QUESTIONS 1. Orner than the personality who began this intcn;e\\'. has any other personality or pan ofyou helped provide answers? Yes No Unsure rryes, would you be \\'illing to say what part or parts helped? (Circle applicable response.) A. Patient declined to say who helped. B. Answers provided by hosts and altcrs (specify alters' roles): C. Answers provided by a combination ofalters (specify alters' roles): 2. Did any switches occur during the inteniew? Yes No (lnteniewer. Did }'OU detect all)' switches? Yes No Unsure) Ifswitches occurred during me interview, note where they occurred so the source ofinformation can be noted. 3. How has answering the questions in this interview affected you? Circle; Very upset, Somewhat upset. NOl much emotional effect. Somewhat positi,'e, Very positi"e emotionally. Learned something about myself Learned something about my past. Other: 238 D1W)(L\TIO\ \01 n U.ltmllbrt' 11ll1}