The great majority of complaints from people are based on misunderstandings, medical illness, or mental illness. Some cases involve a combination of a genuine spiritual problem and medical or mental illness, and most genuine demonic cases have at least some disturbance in the emotions or thinking. Some cases are clearly a spiritual problem and there is little normal distress in the person or their lives, seen mostly in cases of full possession of a devout Catholic with a supportive family.
It is critical to first explore the hypothesis that the problem is medical or psychiatric in nature. This is statistically much more likely, and must be ruled out first. By jumping to the hypothesis that the problem is spiritual a person can leave untreated some progressive medical problem that needs to be addressed (like a brain tumor or the onset of mental illness).
While it is true that most requests for assistance are based on mundane problems there are genuine spiritually based cases. Schizophrenia doesn't make you suddenly fluent in ancient languages. Epilepsy doesn't make you suddenly know the details of the secret sins of the people in the room. A sleep disorder doesn't make you able to always identify the one blessed object in a set of objects.
Some of the common misunderstandings, medical illnesses and mental illnesses are:
- Sleep disorders. Sleep disorders account for most complaints of negative spiritual activity. Always be alert to problems that occur exclusively when tired, going to sleep or waking from sleep. When moving into or out of sleep people pass through a state of consciousness where they can dream while partly awake. They are not aware that they are dreaming and so these experiences seem real. These are called hypnopompic hallucinations when coming out of sleep, and hypnagogic hallucinations when going into sleep. Some people also have sleep paralysis, a malfunction of the natural immobilization of the body during sleep. This leads to the condition where the person is partly awake, paralyzed from the eyes down, and seeing things. It is a very fearful experience in which the person can look around but cannot scream or move their body.
- Schizophrenia: it is common for people with schizophrenia to interpret the voices they hear as being possessed. This is particularly true when they first have their psychotic break. It is important to work in concert with their family and treatment team to encourage them to cooperate with treatment (medication). Praying over someone with schizophrenia can reinforce the delusion that they are possessed and so cause harm. For this reason it is helpful to have some experience with mental illness when doing the intake interviews.
- Cervical dystonia, which can cause body contortions and grimaces of the facial muscles.
- Tourette’s disorder, which can cause loud verbal outbursts of profanity and intrusive thoughts of violent and disturbing actions.
- Epilepsy of various types, which can cause strange experiences and convulsions.
- Hysteria. Hysteria is fear accentuated by other people. With the popularity of paranormal television shows and movies it is not uncommon to find people that are hyper-sensitized to sounds or temperature changes due to a fear of ghosts. In some cases the parents can encourage this fear in their young children who then subconsciously go along with the idea to please their parents.
- Hormone issues. It is common that women in older age experience strange body sensations caused by hormone changes. These are often in the reproductive organs. When this is combined with early onset senility or general mental decline the person may become fixated on a demonic hypothesis to explain their experiences.
- Drug effects. There are many mental issues that can arise from the use of, or withdrawal from, legal and illegal drugs. It is also not uncommon for older people to make errors in taking their medications and have psychosis as a side effect of this. I have seen a number of cases where the modern synthetic drugs (K2, spice, etc.) can cause dramatic psychotic experiences that are interpreted as possession.
- Brain diseases of various types. There are many things that can affect the brain, causing psychotic experiences or a break with reality. A spiritual complaint could be based on the onset of schizophrenia, depression with psychotic symptoms, or manic depression with psychotic symptoms. There are a number of other brain based problems that can cause false experiences and paranoid fears.
- Head or spine injury. Some people that have had a head or spine injury attribute their pains, tingling, and other sensations to spiritual attacks. There can be a psychotic tinge to these cases where the person is very resistant to any other hypothesis about their symptoms, no matter how reasonable.
- Malingering. Malingering is when a person pretends to be in the sick role in order to get attention. Some people see the special attention people get on television shows and so use complaints about spirits to become the center of attention. This sometimes happens with young children also.
- Factitious disorder. Factitious disorder is when a person pretends to be in the sick role for a practical gain. These situations are rare. In one case the cover story of ghost molestations was used by a sex offender to cover up their crimes in the home. In another case a person wanted to use demonic infestation to avoid conviction for a gun crime.
- Vision misunderstandings. At the edge of the retina there is only black and white vision and little detail. Since the nervous system does not work perfectly at all times this leads to the occasional perception of a black and white vague shadow at the edge of vision. When the person turns to look at it, bringing the full detailed color vision of the middle of the retina to bear, it “disappears.”
- Hearing voices in white noise. It is not uncommon for mentally healthy people to hear voices or other meaningful sounds in white noise, the running of a vacuum for instance. People with some psychotic problems are more prone to this.
- Dementia: it is fairly common for people developing dementia to have delusions, hallucinations, and behavior disturbances. If they have a strong religious worldview this can be interpreted by them as a spiritual attack or possession.
People sometimes blame regular life problems or mental illness on curses or demonic activity. This externalizes problems for the person. They often read extensively on possession and exorcism, both online and in books, and self-diagnose their problems. These cases can take on a sad desperation where the person goes from diocese to diocese demanding that they have an exorcism based on their self-diagnosis, and refuse any other hypothesis.
Some complaints are genuine spiritual problems along with medical or mental issues. These problems can be unrelated or secondary to the spiritual problem. It is typical for people living in infested homes to get very little sleep and spend their time at home in great anxiety. This often leads to irritability and mild depression. It is also common that with oppression and possession people develop medical problems secondary to the spiritual affliction.
Every case is unique and there is no simple way to discern all of these possibilities. The medical and mental checkup is an essential step if there is any doubt. Leaving a medical or mental illness untreated because a person feels their issues are being addressed by the Church can be irresponsible and lead to harm through neglect. Having the person under some medical supervision while spiritual issues are addressed is the best course of action in cases of possession. In many house cases there is no obvious medical or mental problem and the complaints are resolved in one or two visits, so medical supervision is not needed.
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