Possession trance
is characterized by a transient alteration in identity whereby one's
normal identity is temporarily replaced (possessed) by a spirit, ghost,
deity, or other person. The experience of being "possessed"
by another entity, such as a person, god, demon, animal, or inanimate
object, holds different meanings in different cultures and therefore
the diagnosis for this disorder may be culturally bound. While possession
is a common experience in many cultures, in Western industrialized
cultures, such experiences are not the norm.
Associated
Features:
Subjects often
complained of a variety of associated symptoms:
Loss of control
over one's actions.
Behavior change or acting differently.
Loss of awareness of surroundings.
Loss of personal identity.
Difficulty distinguishing reality from fantasy at the time of the
possession.
Change in tone of voice.
Wandering attention.
Trouble concentrating.
Loss of sense of time.
Loss of memory.
Belief that one's body changed in appearance.
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore, in
his diagnostic attempt, has to differentiate against the following
disorders which need to be ruled out to establish a precise diagnosis.
Currently 'trance and possession' disorders under the general rubric
of dissociative disorder (ICD-10) implying a psychological causation
of symptoms. However, there is evidence that brain damage is also
a causal factor.
Dementia.
Delirium which involve cognitive
impairments.
Major Depression.
Post Trumatic Stress
Disorder
Head
Trauma. - temporal and frontal lobe lesions .
Schizophrenia
Alcoholism
associated with memory loss.
Epilepsy.
Dissociative Amnesia.
Tourette Syndrome.
Malingering.
Cause:
This condition
is multifactorial, in which spiritual, social, psychological and physical
factors may all play an aetioIogical role. It is also commonly accepted
that dissociative identity disorder have their aetiology in an early
history of repeated trauma and abuse, often to horrific degrees. However,
as yet, there are no biological theories concerning the origin of
these disorders. Therefore, besides screening for common medical and
psychiatric conditions, the clinician should also examine the particular
cultural context in which the patient presents.
Treatment:
A consideration in the treatment
of Trance and Possession Disorder is
determining whether the person is in the midst of an episode of mental
disorder or having a spiritual problem. Therefore treatment currently
revoles around assistance to cope with the physical aspects of possession.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Supportive therapy
and psychotherapy may be helpful in certain situations. Family therapy
is often helpful to assist relatives in coping with the affected individual.
Behavioral techniques used in a therapeutic setting, or in the home
can help a person learn behaviors that will lead to social acceptance.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
Typically the
treatment of this pstychosis is similar to that of Schizophrenia and
therefroe the following may be used:
Antipsychotics
(typical).
Chlorpromazine (Thorazine).
Thioridazine (Mellaril).
Trifluoperazine (Stelazine).
Thiothixene (Navane).
Fluphenazine (Prolixin).
Haloperidol (Haldol).
Antipsychotics
(atypical).
Risperidone (Risperdal).
Olanzapine (Zyprexa).
Clozapine (Clozaril).
