As far as many doctors and psychiatrists are concerned, the diagnosis of demonic possession is one that reeks of medieval superstition and ignorance, and the symptoms that lead to it are subject either to a wide range of medical and psychiatric interpretations or to being dismissed as misperceptions or hallucinations.
Other medical and psychological conditions likely to produce symptoms confused with those of possession are epilepsy, hysteria, and multiple personality. During a convulsive seizure, a person with epilepsy can experience extreme muscular rigidity and foam at the mouth and is sometimes subject to rapid back-and- forth head movements. The face may be distorted, and strange, guttural noises may be produced by a spasm of the throat muscles. During the period immediately before a seizure, the patient may experience auditory and visual hallucinations and various sensory distortions. Most seizures last no more than five minutes.
All these symptoms may also be present in a person diagnosed by the church as suffering from possession. But there are distinguishing characteristics. The first of these is that a demonic attack can continue for many hours. Extreme liveliness, rather than rigidity, is characteristic and muscular reflexes tend to be strong.
According to the Roman Ritual, other signs of possession include “the ability to speak with some familiarity in a strange tongue or to understand it when spoken by another; the faculty of divulging future and hidden events; and the display of powers which are beyond the subject's age and natural condition.”
Hysteria also produces many of the symptoms of possession. The following description of a female hysteric was recorded at the turn of the century by Prof. Paul Richter, a doctor at La Salpetriere, a famous hospital in Paris for mental disturbances:
Suddenly, we heard loud cries and shouting. Her body, which went through a series of elaborate motions, was either in the throes of wild gyrations or catatonically motionless. Her legs became entangled, then disentangled, her arms twisted and disjointed, her wrists bent. Some of her fingers were stretched out straight, while others were twisted. The body was either bent in a semicircle or loose-limbed. Her
head was at times thrown to the right or left or, when thrown backward with vehemence, seemed to emerge from a bloated neck. The face alternately mirrored horror, anger, and sometimes fury; it was bloated and showed shades of violet in its coloration....
One of the most striking details in this description is that of the body “bent in a semicircle.” This is also known as the hysterical arch and is frequently seen in cases of possession. All the other symptoms described above have been observed by exorcists. In addition, the appearance of livid marks on the skin — sometimes resembling bites, letters, or graphic symbols — are also known to be produced by hysterics. Given this partial duplication of symptoms, how does the church distinguish between hysteria and possession? The determining factor is the context in which the symptoms occur. If they arise in relationship with a hatred of religious objects, and if they are accompanied by paranormal phenomena (the ability to detect religious objects that have been hidden, to understand languages never learned, to levitate, and so on), the church is likely to consider them manifestations of the Devil.
As mysterious as hysteria, and as likely to be confused with possession, is the multiple personality, in which the patient may at different times manifest one, two, three, or even more different personalities — each with its own goals, likes, dislikes, speech patterns, and memories. Each personality may be indifferent or opposed to the others, or ignorant of them. If one or more should have a diabolic cast, the church has no means of determining whether to treat the case as possession other than the criteria it applies to distinguish hysteria from possession.
Those criteria are the hatred of religious objects and the paranormal phenomena referred to earlier, and they are precisely the phenomena that many doctors and psychiatrists are likely to reject as misperceptions or hallucinations on the part of witnesses. Those less skeptical, on the other hand, are likely to view such things as para psychological but not as the work of demons. Again, the church’s test is likely to be whether or not the paranormal manifestations occur in the context of a general hatred of religion.
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