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).
