PARANORMAL AND
DISSOCIATIVE
EXPERIENCES IN
MIDDLE-EASTERN JEWS
IN ISRAEL: DIAGNOSTIC
AND TREATMENT
DILEMMAS
Eli Somer, Ph.D.
Eli Somer, Ph.D., is Director of tlle Israel Institute for
Treatment and Prevention of SU'ess and a Senior Lecturer
at the School ofSocial Work at the niversity of Haifa, both
in Haifa, Israel
For reprints write to Eli Somer, Ph.D., School ofSocial Work,
University of Haifa, Mt. Carmel, Haifa 31905, Israel
ABSTRACT
Four Israelijewish persons ofMiddle Eastern cultural heritage pre-
sentedfor consultationfollowing unsuccessful helpingattlmlpts deliv-
ered by variousfolk and spiritual healers. Thefour patients suffered
from the following DSM-IV defined problems: Post-traumatic Stress
Disorder, DissociativeDisordernot Othe>wise Specified, Schizophrenia
- paranoid type, and Histrionic Personality Disorder coupled with
a Conversion Disorder with Seizures. The patients construed their
suffering in cultural idioms implicating supernatural experiences.
Many of their symptoms "esembled dissociative clinical pictures.
However, unlike many dissociative disorde>'patients described in the
Western scientific literature, these persons refused to accept any of
thei,' possession-like experiences as possible manifestations of their
own dissociated egl>-states. The paper desClibes the struggle to find
common wound on which significant cross-cultural help could be
offered to indigenouspeople manifestingdissociative and othersymp-
tomatology.
Anthropologist Erika Bourguignon argued that spirit
possession was a universal phenomenon, insofar as all known
religions contained such types of experience, regardless of
how they were defined (1976). Hers is a non-etiological per-
spective on the nature of spirit possession. She viewed the
phenomenon mostly as a culturally shaped altered state of
consciousness influenced by social programming and uni-
versal human cognitive features. Another theoretical per-
spective in the anthropology of spirit possession stems from
Freud's psychoanalytic theory and views spirit possession as
culturally shaped hysteria, viewed as an irrational, emotion-
al state, caused by repressed oedipal desires in the uncon-
scious (Freud, 1962). Another influential perspective on tlle
phenomenon is based on Pierre janet's dissociation tlleory
and views possession as culturally shaped divided con-
sciousness Ganet, 1889). Several interesting parallels exist
between possession and dissociative phenomena. They both
174
involve involuntary behavior or influences by forces that are
not considered part ofthe self. Persons manifesting both phe-
nomena are usually good hypnotic subjects (Ackstein, 1982;
Putnam, 1989); amnesia is a central element in both cases
(Ellenberger, 1970), and these two types of experience can
be reproduced expel;mentally in hypnosis (Putnam, 1986;
Richeport, 1992).
Castillo (1994) reported that it appears that there are
two factors determining how a particular episode of posses-
sion will be perceived in the South Asian (Indian and Sri
Lankan) cultural context. First, if the possessing entity is a
human personality, the episode will be perceived as a rare
mental illness, and psychiau'ic treaunent will be sought. In
most possession cases in South Asia, the possessing agent is
manifested as a ghost, a demon, or a god. In the case ofbene-
volen t possession by a god or a goddess, treatmen t is usual-
Iy not sought and the experience is regarded as a gift. In cases
of malevolent possessions, traditional folk healers are usu-
ally approached for help (Amarasingham, 1980; Kahar,
1982). A reanalysis of previously published case histories of
spirit possession illnesses in South Asia from the perspective
of dissociation theory suggested that, like dissociative disor-
ders in North America, these pathologies might also be reac-
tions to extreme situations in the environment (Castillo,
1994) .
Many Hispanics in Latin America and in the United
States have been reported to hold beliefsystems ofEspil;tismo
and Santeria, in which spirits are thought to have both the
ability to make people physically and emotionally ill and the
power to cure them (Berthold, 1989). Several articles about
Hispanic patients' perception of their illness through a cul-
tural perspective have been published (Comaz-Diaz, 1981;
Ruiz & Langford, 1976, 1982). The database on articles writ-
ten about Hispanics and dissociation is growing (Alonso &
Jeffrey, 1988; Martinez-Taboas, 1989; Ronquillo, 1991) with
some papers warning that dissociative phenomena may be
misdiagnosed as schizophrenia in this ethnic group (Rendon,
1974; Steinberg, 1990).
Another culturally condoned expression of distress fre-
quently seen among Hispanic women is ataque de nemios.
Descriptions of this clinical presentation include dissociation
(Lewis-Fernandes, 1994), seizure-like responses (Guarnacia,
Canino, Rubio-Stipee, & Bravo, 1993), and panic-like respons-
DlSsoamo;.;. 1'01. X. ;';0. 3. September 1997
es (Liebowitz, et al., 1994). The phenomenon is seen more
frequently among women and is rcg:uded as a permissible
1\<1y for woman to express rage (Oquendo, 1994). Elsewhere
in L.·uin America, in Brazil, spontaneous riuml trances are
Icry common in everyday life and spiritist medicine is
becoming professionalized. For example. psychiatrist Eliezer
.\Iendes ran a clinic in which he tried to unify the personal-
it\' stnlClurc of multiples using mediums (Mendes. 1976).
In Ital)' a natiol\\lide sur..ey of belief in demons and in
magic re\'caled that 46% ofthe respondents belic\'ed in the
dcvil and that respondent.'; with !>lIch beliefs tcnd 10 experi-
ence a higher incidence of paranormal phenomenona
(Marra. 1990). Carena and Cipolla (1993) reponcd dinical
()l,sc["vations on dell10nic posscssion in certain gcographi-
c,l area!> in Italy. Another Italian sludy (Ferracali. Sacco, &
Lazzari, 1996) looked at the psychological test resulL" of ten
persons undergoing exorcisms for dellolllic trance posscs-
"ion states. The investigators found that these persons had
many traits in common with dissociative identity disorder
IMticlltS.
A cross<ullural slUd)" of problems that invoh'ed altered
!>tates ofconsciousness within Balinese culture was published
bl Luh KetutSurgani and GordonJensen (1993). In this work.
the amhors esplain that spirits are seen in B..lli as a normal
part of life. beginning\,ith the manifestation at binh offour
~piritllal forces that ilHeract to fonn a person's personality.
rhe\' noted the significance of their research for ps)"-
chotherap}': ~Clinical implications are that II'hen the patient
believes in thc spiriUlal essence of his condition, the clini-
cian II1I1St have a broad pcrspecli"e to accept the spiriLUal
factor and communicate with the patielll in his or her own
terms as well as in psychological terms- (Surg::mi &.Iensen.
199~, p. 128).
Possession statcs have been docu111entcd in Jewish
suurces from the sixtecnth ccnllu)'. ~""nyofthc traditional
folk talcs invoke the term "dybbuk possession." In Hebrew
the noun d)'bbuk designates an cslemal agent cleaving or
clinging 10 a person. Dybbuk possession invoh'ed the spiritS
of the dead as posscssing agentS. The concept is deri"ed from
Jewish m)'stical philosophy, the Kabhala. Thc kabbalistic doc-
trine of transmigration of souls first appeared in the Sefer
Iia-Bahir published in the late twelfth century (Abrahms.
199-1). !\Iost of the early kabbalistS saw tr:msmigration as retri-
hmiOll for offenscs against procreation and sesual trans-
Kressions. II was seen as a \'el"}' harsh punishment for the soul
Ih.u must undergo it (Scholem, 197Ia). Ibbur. another fOlln
of spirit possession, was described in the kabbalist book the
Zohar in the second halfofthe thirteenth centul"}' (Goldstein,
1989). Ibbllr in Hebrew means impregnalion and connotes
the enu)'ofanolhersoul into a person nOI during pregnanq'
or at birth but during his life. The purpose of Ibbur was to
allow the soul ofa righl-eoUS person who did not have lhe
opponllnity t,o fulfill all of the 613 Jewish commandments
to temporarily reincarnate in a person who does have the
opporllmity to fulfill them. This is an act of divine Illere,
llleant nOt only to purify the sinner's spirit, but also for the
benefit of a lIni\·ersc. The ibbur of a wicked man into the
soul of another was called d}'bbuk. This kind ofspirit peru....
tJ<Hed humans to lind refuge frOIll Ix:rsecutioll. These spir-
itS of sinners were doomed to remain in limbo, esposed to
rmhless persecution by angelic and demonic beings (Nigal.
1980). The term d)"bbuk was employed 1Il0stl)' by Ashkena7i
(Eastern European) Jews. ScphardicJe\\'s, who li\'ed mostly
\\'ithin the Muslim orbil ofpo\\'er (the Middle East), adhered
to the tcrminolob'}'oftlle e.u·lyk'lbbalistic liter-Hure in which
the possessing agent \\~",s named ;Ill "evil spirit~ (Bilu, 1980).
Hundreds of thousands of Sephardic Jewish refugees wcre
absorbed into the Israeli socictyduring 1950s. Howevcr, many
ol'tlle (ulturallyconslituted sctofconceptS imponed to Israel
by these WilVCS of immigration had to be pcrmitted or dis-
carded in order to achicve social aC(ultur,ltioll (Palgi, 1963).
Man)' culture-specific l>l'T1dromes arc rapidl), dis.'lppearing in
ISr<ld; thc \\'eslem-oriented '~lluesespressedby the modern
slate are perceived as rcprescntingan enlightened prefel'rc.:d
ideal for man)' former inunigmntS and their offspring.
Nevertheless, ethnic traditions hal'e made a strong comcback
in Israel and are fealUred f{,:gularl)' in contempordfyfolk alld
rock. music as well as in the local film indusll"}'. In Illy 0\\11
practice. I have noted Ihat some ofm}' Middle EasternJc\\'ish
pmienu have seemed inclined to usc spiritist folklorc.....bascd
idioms in theirauempts tocxprcssand esplain theirsuffcring
to me. A currem renewed imerest in cuhure-spccific issucs
in ps)'chotherap)' in Israel is '11so reflected in published arti-
cles on topics related to ps)'chopatholof,'1' and reli&rlous 1ll)'S-
ticism (e.g., Greenberg. Witttum. & Buchbinder, 1992;
WitzlUm, Greenberg, & Buchbinder, 1990); the belief in
tr,lnsmigr:nion of souls as reflected in PS)'cholherapy (Daie,
Witl.lurll, r-.<fark. & RabinowiTZ. 1992) and exorcism in ps)'-
chOlherapy (Somer, 1993).
Arguing from a Westem perspective, Fraser (1993)
raised the concern that negative eflects may result when dis-
sociative states are misinterpreted as poSSt:ssion states. He
suggested that patient.'; preseming with recollcctions of
Satanic rimal abuse rna)' comain dissociated ego slates with
delusional demonic idcntities. Coons (1993) argued t11aldis-
sociative disorders are fundamcnmll)' different from trance
possession states in that the lauer. unlike the former, are nOt
\iewed as illnesses, nor arc cur:lli,'cs sought. In a paper on
pr:lctices in Brazilian spiritism. Krippner (1987) differenti·
ated between the incorporation of benign spirits (mediu·
mistic possession) and involuntary possession, which he So'lli'
as resembling di.ssociatil'C ps)'chopatholog}'. This paper will
describe different dinic<ll presentations b)' Israeli Je\\'s of
!\liddle Eastem origin involving distrcssful intcractions I\ilh
wltal were perceh·ed as spiritist emities. These possession
cases were concei\'ed of b), me as idioms for articulating and
structuring ego-d)'SLOnic experiences. following Obe)'esckerc
(1970), Crapanzano (1977) and Bilu (1985). Bilu, an Israeli
175
•• ..J L _
PARANORMAL EXPERIENCES IN MIDDLE EASTERN JEWS
anthropologist and psychologist, suggested that spirits are
vehicles for articulating unacceptable conflict-precipitating
desires and demands. Since among some Israeli ethnic
groups the idiom ofspirits and possession are culturally con-
stituted, this articulation might be used by them because of
the relief these cultural constructions can offer for their pro-
tagonists. They do not seem to suffer the stigmatic conse-
quences of expressing these cultural idioms as much as
Western mental health patients do. In a culturally changing
society, which Israel is, people afflicted with certain maladies
may be confused as to what conceptual framework might bet-
ter explain their pain: the culture-bound one or the more
stigmatic psychiatric one. The four cases described below illus-
trate this dilemma as faced by both patient and therapist. All
four patients had visited either traditional healers or rabbis
before they sought psychological help. In the first two cases,
bridging the cultural perspective gap was less successful than
in the latter two.
ILLUSTRATIONS
Case One: A Man Persecuted By a Ghost
Boaz was a 35-year-old man who had immigrated to Israel
from Tunisia at the age offive. Married and a father of three,
he was a military payrOll non-commissioned officer in charge
of an electrical repair team in a divisional vehicle main te-
nance workshop. Eightyears prior to his referral, the patient
discovered the bleeding, disfigured body of a soldier who
had blown himself up with a hand grenade in one of the
armored vehicles he worked on. Boaz, who ran to seek help,
collapsed on the ground near the base commander's office.
He was weeping and trembling, and felt dazed as he became
aware of the base commander himselfstanding next to him,
seemingly amused by his agony. Boaz remembered feeling
deeply humiliated and helpless. He proceeded to develop a
sense of dazed detachment which evolved into severe dere-
alization. In the few days following the incident his anxiety
symptoms mounted and he began to experience flashbacks
and depressive guilt about the soldier's suicide, which he felt
he could have prevented. Nevertheless he received no psy-
chological help. The only attention he received from the sys-
tem was a prolonged and detailed interrogation by the
MiIitaryPolice, who suspected foul play. The patient, a proud,
masculine man, had become increasingly embarrassed by his
mounting distress and by his incapacitating fears. His shame
was fueled by recurrent and intrusive recollections of the
mocking he felt he had been subjected to. He developed a
substantial distrust of people, which he associated with the
deep disappointment at the emotional abandonment and
perceived abuse he had experienced following the trauma.
Consequently, he gradually neglected mostofhis other social
ties. AltllOugh he had never been accused for any wrong
doing, Boaz felt he should have somehow prevented the sui-
cide. Not atypically, he also developed considerable depres-
176
sive guilt.
By the time I first saw him Boaz had developed a full-
blown post-traumatic stress disorder which he inexplicably
managed to conceal for years from his commanders, col-
leagues, and family alike. Prominent among his symptoms
were nictophobia (fear of night/darkness) and agorapho-
bia. Boaz refused to leave home unaccompanied to any des-
tination other than work. He also had a very low tolerance
for being left alone at home, particularly at night. Despite
his formidable distress he was not willing to confide in any-
one - even in his loving wife - fearing potential mockery.
Boaz reported to me that he first consulted a kabbalist rabbi
who not only blessed him but also gave him a talisman to
protect him from evil spirits. The patient said he chose to
pursue this avenue for healing first because he did not see
his most distressing and unrelenting problem as a mental
health matter. Boaz had believed he was haunted by the
deceased's soldier's spirit. The patient, who possessed oth-
envise intact thought processes, was convinced tl1ere was a
constant "presence" around him. Vigilantly attentive, he unre-
lentingly monitored what he perceived as the strange sounds
the haunting spirit had been making at night. Even soft
sounds such as the rustle ofthe leaves on his front lawn, the
movement of branches in his backyard tree, or the running
electrical motor of his refrigerator, would startle the patient
and cause him to lock himself in the safety of his bedroom.
Boaz was com~nced he was being punished for his wrongful
negligence and constantly expected to be expo ed to a sur-
prise attack by the spirit. The patient had interpreted all of
his symptoms within this paradigm, rendering them com-
pletely un treatable within an in trapsychic conceptual model.
He rejected any information or interpretation of his symp-
toms as othenvise plausible, but irrelevant to his own par-
ticular case. Symptoms such as depersonalization and his fre-
quent mid-sleep awakenings were experienced as the spirit's
attempts to gain possession over his body. This chronic
patient did not respond to minor or major tranquilizers, and
several anti-depressant trials yielded no positive effect eitl1er.
The patient responded only to a regimen ofcognitive behav-
ioral counseling that mildly improved his coping capacity.
An attempt to employ a culture-sensitive approach and to
influence the haunting spirit in some way failed as well. Boaz
was too phobic to allow any such direct approach.
Case Two: Woman Possessed by Her Dead Mother's Dybbuk
Maya was a 61-year-old female who had immigrated to
Israel from Egypt in the mid-1950s. She was a divorced moth-
er of two and had three grandchildren. The patient was her
parents' only child and had been sadistically abused by her
mother in childhood, mostly by arbitrary and unusually harsh
punishments. On one occasion Maya, then a child, had
noticed creases in the blouse she was wearing. She asked her
mother to iron the blouse for her and was subsequently
burned ,vith the hot iron as her mother ironed the blouse
DISSOCIATJOIi. 1'01. X.lio. 3. September 199i
while il was still on hel" IXKI}'. ~Iapi married in her mid-twen-
lic~ and emigr.ucd 10 Europe 'lith her husb.."1nd. She led a
<;()("ially isolaled blll functional life, and raised IWO psych!?
logically health)' daugillcrs. She ne\'cr saw her mother again
.u1d fell mildl}' guih), al>OlII il. Two )'eal"S before I firSI saw
Ma)"1 her widowed mother died. Ma)'a al1cnded the fllner-
.11 and flew back home innnediatel)' .. fter il. A few days 101-
lowing the shiv(/ (the seven days ofJewish ritual mourning)
~hc became aware of a voice speaking to her ill her head.
She recognized it as that of her mOlher, ,,'ho proceeded to
1tI10rm Maya thai she had been reincarnated into her bod),.
,lIld IIml Maya had to die because lhe mother "'<IS to live 011
Idthin her. The mother's dybbuk imposed a variely ofS<lJlc-
tiolls on the n:sisting dallgiller, who refused to giw up either
Ilt'r bod)' or her life. Maya sought the help of bolh it rdbbi
,lIld a psychic in Israel. The lalter, who e\elllually made the
t('ferrallo the ther.lpisl. allempl,ed 10 exorcise the transmi-
j{r.lted mother's soul, She used special incantations and
hurned pieces of blue linen on which sacred formulae were
inscribed, J\'lara was also fumigaled wilh evil spirit repellent
illt'ensc 10 choke the evil mother's soul away aft.er it had Ilot
responded 10 milder methods, including aCli\'e coaxing. At
tile end of the exorcist rilllal Mara was ceremoniouslr noti-
0('(1 that her mother's lransmigraled solll had left the I>ody.
onl\' 10 discover minutes later that the mocking \'oice oflhe
rossessingagentlingercdon. Thc psychic healer insisted lhal
tht· exorcism had been successful and lhal because of an
un\...nown psychologic.'ll malad)' the spirit's voice COIHinued
10 contaminate ~fa)'ll'smind, and so, proceeded to refer lhe
pillictH to me. Thc palicllI was told lhat I would be able to
('''pel the spiril's remaining \'oice fl"om her head.
Ilypnosis was not necessary to contact the mother's
~\oice~ in consultation. The ,'oice M insisted that she, the
mother, had ncver left and would notlca\'c beforc i\-Jap was
dead or gave in completely. The pll1-ient was not. willing to
atcept <In)' psychological formulation lor her predicament,
<lnd tenninaled the consuhalion process whell she realized
thai I ",ould not condllCI the ,'oice expclling M rimal reo
commended b), thc psychic.
This patient mel both Bourguignon's (1979) criteria 1'01"
~Possession Trance"and J)S.\I·1\'cntClia foreidlcr Dissocialh'e
Di'lOrder NOS. or Dissociative Trance Disorder (oro), a cal-
l"!<on prol>oscd for furdler study in lhc DiagnfJSlic ami
Stat/sliml .\lallual oj Mmtal Di.mml'n 41h cd. (DS,H-/I')
(American Psychiatric Association, 199·1).
Case 17Jree; A Womall willi a Tmpped Muzik,
Treateclwitll Haldol
Til-la \\'as referred 10 me by her "channeling" Illedinlll.
Shl' Ilad seen hcr lor tllC fi\'C 1l10nths that preceded her con-
~ult'llion wilh mc. Til¥la was a 23-year-<lld single female, of
\('menite descent. an aCCOlllHant by profcssion. She soughl
tht· lll)'Slic's assistance as part ofher quesl for spiritual growth
and enlightenment. Tirlll ",<IS a religious woman, well vel"St.-d
in Jewish teaching". She knew Ihat Israel's oOidal religion
COlHrasts sharply with New Age lllediumship and channel-
ing. These praclices were prohibited in Ihe Hible. She went
to consult a mcdium, knowing vcry well thai she would be
\'iolat-ing an imponant command from lhe lkK>k of the
Covenanl: "YOll shall not tolenlt.e a s()rccress~ (Ex. 22:7 [Eng.
22:18]; cf. DeU!. 18: 1(}"12) .
Tir-DI w;lllted to ha\'e a "spirit guidc" ofhcr own. "A spir-
it guide, M she explained LO lIIe ~is a spirit teacher and
guardian, who works with tbe medium tbroughom her life. ~
The patient dc~ired 10 be endowed with the gift of tiled i-
umship, so she could hcrselfbeCOlllc a channel for a spirit
communicator. Tirlil "'<IS I<tughl 'iClf-hypnosis by her men-
tor so she could achieve trance mediulllship. She was lold
to CXpe<:tlo be controlled by a kind and wise guide and that
she should stri\'c for maximulll cooperation with lhe spiril.
TIle paticlltrcspondl.·d inlensel)'lo herfirsl twosessionswilh
herspiritual consultant. Howc\'er, aflCr her third session she
felt possessed by a rather rnalt:\'o1cnt spirit. She complained
that thc cntity was emharrassing her by forcing her LO express
fOlll and blasphemolls language. The patiellt felt distressed
and ashamed, and finally referred herself to me for bell'.
Despite Iler fears thall might see hcras psychotic,she .lllolI'cd
access to her possessing agenl ;uUllhus demonstrdted some
level ofcontrol o\'er the phenomenon, The possessing agent
presented ilSClfasa Ma7ik. This kind ofspiril was mentioned
in the kabbalist book ofZohar and was thought 10 be a spir-
il ofa deceased e\il man. During dlt: brief episodes in which
Til-La allowed the J\la7ik to interaci 'lith me, she displayed
an incoherenl and loose thought process; inappropriate. sill)'
alIecl; and disorg;miled beha\'ior marked b)' str:mge ann
mo\'ements, The Mposscssing agenl~ was mostly disll'ilughl
ahout h,wing forgotten how to lea\'e a medium's body. It
showed anxious and desperale affect, mixed with silly satis-
IllCt.ion assoc;,ned Wilh Tirza's sllO·cring. It was not possible
to establish :Iny meaningful pS)'cholherapcutic discourse.
The patient wasdeeplyefllbarr.lssed al>OlIt heraffiiclion
and insisted lhal somelhing had gone terribly wrong in the
channeling process itself, but lhat lhal had nothing to do
with her history or current personalilY d)"llamio, She
adamantly and angrily refused an\' fonn of psrchother.ap)'.
and provided no helpful anamneSlic infonnation. The only
Ihingshe expected wasa rapid release from the Mazik'scon-
u·ol. Tirt.;l was consl:lnlly worried Ihal I was queslioning the
authenticil}' of her experience and that I WdS construing it
,IS a psychotic episode ratherthanlhe dislressful spiritist phe-
nomcnon she believed she was experiencing. In a daring
attempt to meet this woman on her conceptual groullds, I
suggested to her the Mazik's exil mighl be facilitated ",ith
the aid of medication. The patiellt accepted the plausibility
of the idea and \',<IS refened lor a psychiatric c\'<llulltioll ",ith
a prmisional DSJI-Il' diagnosis of schi70phrenia-paranoid
Iype. Thisdiagnosis wasendorscd b)' the physician and Tirla
",<IS prescribed Iialopcridol I mg. lwice daily.
Iii
----------------------------
PARANORMAL EXPERIENCES IN MIDDLE EASTERN JEWS
The symptoms diminished quickly. On a follow-up visit
after six weeks, she happily reported that the "Mazik" was
increasingly weakened by the medication and that one
morning four weeks after she commenced her psychotro-
pic regimen, she awoke and the possessing spirit was no
longer within her. Her psychiatrist continued to follow her
up for three more months, and reported she was well on a
maintenance dose of medication.
Case Four: Demonic Possession in a Woman
Treated with Exorcism
Leah was a 19-year-oldJewish orthodox young woman,
born in Israel to Moroccan immigrants. At the time of refer-
ral she lived in a neighborhood inhabited mostly by Middle
Eastern immigrant families.
She was referred by her teachers' college counselor
because of frequent fainting spells associated with exami-
nations and with chaperoned male visits. The patient will-
ingly confided with the therapist that a few months prior to
the referral she had started to notice a foreign presence in
her body. She claimed to have been possessed by a small black
demon which now resided in her abdomen. Leah had no
explanation as to how and why the demon had penetrated
her, nor was she terribly alarmed by this unusual paranor-
mal phenomenon. The patient proved to be an excellent
hypnotic subject and entered very readily into trance with
almost no formal induction. Although the demon never
gained full active control over her body, communicating with
it was made possible with the hypnotized patient reporting
to me the demon's replies and messages.
In response to her questions the demon explained that
his role was to protect her undue distress by causing intense
stomach pain that typically ended in a loss ofconsciousness.
This patient met both Bourguignon's (1979) criteria for "non-
possession trance" as well as DSM-N criteria for Conversion
Disorder with Seizures and Histrionic Personality Disorder.
Although no clinical evidence in regard to a possible histo-
ry of incest was available, intense unresolved oedipal con-
flicts were still active in Leah's family. The oldest child, and
sibling to a 15-year-old sister and a ten-year-old brother, Leah
had been a close ally of her father and his favored child. She
was openly hostile to her restrictive mother, who frequent-
ly clashed with the father on issues related to Leah's upbring-
ing.
Attempting to understand this patient through the the-
oretical schemata I was most familiar with, I first regarded
the demon as a fragmented personality alter, and thus con-
ceptualized the psychotherapeutic effort as requiring an inte-
grationalist approach. Although this patient was cooperative
and displayed genuine curiosity in exploring her possession
state, the demon refused to engage with the therapist direct-
ly, and communication with itwas relayed through Leah. The
demon seemed to be threatened by the positive transference
the patient developed, and proceeded to threaten the
178
patient and to demand that she discontinue both college and
therapy. The demon's unheeded threats were followed by
frequent severe fainting spells that completely paralyzed
Leah's social and academic lives. In one of the sessions dur-
ing this critical period, Leah implored me to exorcise the
demon despite her painful ambivalence about it. Although
we carefully explored the possible function of the phe-
nomenon, the demon refused any cooperation, demanded
sole protective control over the patient. Leah became
increasingly adamant about ridding herself of the menace.
The "exorcism" process was both planned and carried
out in conjunction with the patient. The process was suc-
cessfully completed during one single session. The patient
was asked to describe the visualized and mutually constructed
procedure. The ritual was an adaptation of an old ]ewish-
Morrocan exorcism rite described by Bilu (1980).
Mter a strenuous and painful half-hour labor process,
the demon was delivered through her abdomen. While still
in the exorcism trance, Leah reported a sad sense of empti-
ness and loss. She asked for my help in finding an alterna-
tive for the missed protective agent. Although she was posi-
tive about her decision to rid herself from the demon, she
asked me ifl would help her correct the internal deficit. Leah
indicated she believed the demon consumed part of her mah
and that she had desired that her neshamahexpanded. These
kabbalistic terms are known as two of the three faculties or
dispositions ofthe unified human soul that form a sequence
from lower to higher. Nefeshis the source of man 's/woman's
animal vitality and the totality ofhis/her psychophysical func-
tion, and is present from birth. Ruah, or anima, is aroused
when a person succeeds in rising above his/her purely vital-
istic side and represents the power to distinguish between
good and evil. The neshamah, or spiritus, is aroused when
the person occupies himself/herselfwith the Torah and re-
presents the virtue ofbeing "a part of Cod above" (Scholem,
1971b).
I suggested to Leah to visualize her neshama. She
described an ethereal presence in her chest. When I inquired
as to how the neshama could be strengthened, she respond-
ed with a silent prayer as tears rolled down her cheeks. Out
of trance, Leah said that she had experienced an unusual
spiritual experience in which she visualized a ray of golden
light descending from Heaven and connecting with her
expanding neshama. The demon disappeared immediately
following that session and so did her fainting spells. The
patient remained in psychotherapy for six months more. She
learned to own her own drives and feelings, to resolve her
conflicts through enhanced personal skills, and also to bet-
ter manage her own stress. At the same time she intensified
her Torah studies. Leah was well and symptom-free at six,
twelve, and twenty-four months' follow-ups.
DISSOCIATlO1'>, Vol. x, 1'>0. 3, September 1997
DISCUSSION
This paper described four clinical cases of ~Iiddle
EasterllJt:ws in Israel who prcsclllcd with I)aranormal expe-
riences imoh-ing variOliS forms of possession phenomena.
lkh't7 canstnlcd his ps)'choph)'siological arousal reactions in
concepts Ihal reflected not only his deep sense ofguih blll
al'iU his cuhllr-tl beliefs about the menacing influences of
angry ghosts. Boaz's peritraumauc dissociative reactions pre-
\cnted adcqw:\tc mCL.1.bolizing oflhe shocking siglll he had
lx:cll exposed 1.0. This ps)'chopalhogenic event was exaccr-
h~.'cd by lhe hUI'ulIl lack of support he was subjected to by
his superior. Respecl for authority ligures ,\'as a basic Icnanl
ofHoa,-'s traditional Nonll-African.Jcwisll upbringing. In his
posnrau11'l,l1ic hypnotic condition, lhe p:llienl probably
.H:cepted his commander's implicit suggestion that he did
nol deserve 10 be supported for wilrlessing the catastrophe
hl' ilT'llionall)' felt he himself should have pre\'emed. BaaL
';(:emed to have externaliZl'd thc plilliti\'e aspect of his guilt
•lIId framed it in concepl.'; that precluded an)' meaningful
pwchotherapeutic interventions. Ilis paranoid vigilance
.md arous-'\! did not yield to folk-healing methods. However.
he was also unable to accept my own \\'e'ltern medical expla-
nations for his condition. He appeared to ha\'c condemned
himself 10 a state of eternal penance.
~tara \\~.lS referred to me as a failed C<bC of exorcism in
.1 dissociative disorderp:uient.Ik>\\1nan (1993) reponed that
among 15 female multiple personalitydisorder patients who
had undergone exorcism, initial reactions were negative in
aboul 80% of hosts and allers and positive in 14% of hosts
;md 9% ofallers. Bowman cautioned against exorcism in dis-
sociative disorder patients bccallscshe fmlnd lhat these prac-
lin:'! fuuctioned as psychologically damaging traumas, par-
rinllarl)' in Sill lations in which counseling minislersalmlptly
began exorcisllis Ihat in\'olved shullting:, tlllWlllllt;d ph),sical
tollch, alld n'straint lhal reminded slll~jects of childhood
,Ihll'le, In tI:la)'a 's case there was no e\'idence that tmurna was
ilwolved in the folk-healing procedllre she wa.s subjeCled to.
Ilers was a consenlltal, quiet, and gentle process managed
b\ <I gr.:mdmOlherly female healer. Nevcnheless, I fell that
\lava's conceptual fmmework lor tile undcn.mnding of her
al11iction was incompatible wilh convcntional psychothera-
pt.·utic principles. Even the botched exorcismjob pelformed
b\ the folk·healer was integratc.:d inlo her reinc.tnIationist
beliefs\'stem. The patient was led to bclic\'c that she was not
being referred to <I psychotherapist but to an expen in the
art of completion ofexorcism rilllais gone asu-a.y. Although
the patiem c1c:lI'ly suffered from :1 diagnos."lblc dissociative
disorder hcr misinterpretation of lhc nmlcvolent dissociat-
ed m<lternal inu'oject was reinforced by lhe healer, who
l'ncoumgcd her 10 regard it as proof of possession.
Fnlser (1993) cautions that exorcism should -never be
cOllsidered unless a dissociative disorder sllch as i\H'D Tis]
lir" ruled 0111 b), a knowledgeable Ihentpist well versed with
SOMER
the current Iiterdture, theo!")', and therap}'ofdissociative dis-
orders- (p. 293). This guideline \\.\5 ob\;ousl)' 1I0t heeded
ill ~Iaya's case, rcsulting in a lasting damage. This unsuc-
cessful outcome points to a need to communicate with tra-
ditional and religious he.tlers in an allempt to educate them
about dissociative disorders and how those can resemble their
concepluali/.ations ofpossession S\"lldromes. Such a dialogue
mal' result in producti\'c cooperations between traditional
he:tlers, who ma)'conlillue to help theirclients in non-malig-
nanl cases. and psycholhcr.:lpists.
The next two examples demonstrated attempts tu bridge
the gap belween the empiricist cult lire of professional c1in-
ie'll psycholob,)' and folklore-rehlled syndromes.
In lhe third case the patient was olTered a "\Vestern"
biOlnedieallreatmenlfrall1cd ill Ilerown explanatory model.
Tirla \\~\sobviollsly ambivalent and confused aooul the appro-
priale help she felt she needed. I believe she \\';IS aware of
her psychotic condition when she SOUghl me. I also belie\'e
she bec;llne frightened by the psychotic breakdown lhat
dc..'veloped while she was ilwolving herself with the occult.
Iler ambivalence was renectcd in the fact tll<lt she insisted
on adherence to her cultul..,.I·bound concept of the illness
while seeking the assistance of a mainslrcam psychologist.
Interestingly, her ambi\'alencc and confusion manifested
themseh-es in the spiritU:11 blunder she created. On the one
hand, as an onhodox Jew she \\'<I.S prohibited from engag-
ing in Msorcery.- On tllC other, she was drawn to U1C \\'orld
of -New Age- cuhure. She apparenu)' -resoh'ed· the guih-
pronc incompatibilif)' of these lWO beliefsrstems with a psy·
dIOtic cont<lmination.
The fourth case presented in this p<lpt:r demonstrates a
rcluclamly performed. but successful exorcism ritual deli\,·
el'ed within cullUre-sensiti\'e pSrchOllu,r'apy. Bowman (1993)
srudied 15 multiple personality disorder patients who had
fell or been told they were possessed. and had undergone
exorcism. Although most of those patienls werc harmed by
the procedure, a few relxll'ted positi\'e effects. Some initial-
ly fclt hope and rcliefand subsequentl),expcrienced :lllcast
temporary symptom relief. Leah's C:ISC did not involve <I dis-
sociativedisordcr, asyndrome lhat t)'picall)'stems from child-
hood abuse. Such association within possession has not been
established (Cardena, 1988; Surgani & Jensen, 1993), It is
thus conceivable that in somc cases the phenomenological
di:lgnosis of possession c:tn be made by a pS)'chotllerapist
\\;thout taking an ontologiol1 stance. In <It IC-dSt (WO of the
cases presentt.'<I in this art ide this diagnosis was the onl)'one
Ihat could prO\;de a workable basis for the professiomll
encoumer. In tlle case of Leah, where no <lpp<lrent child-
hood u....lllma was irn'olvcd, lher.:lp)' was sllccessfull)' carried
OUI utili"ling lhc possession/exorcism melaphor.
Aoout halfoflsracl's Jx>pulal,iOlI arc Middle EasternJe"'S.
This group proudly preserves the Strong Anbic cultural influ-
ence on il~ music, dance, cuisine, accent, and customs. It
would be wrong to ignore t.he llniqlle properties of the Anlb
179
DISSOCL-\TJO'-;. \01. X. \0, 3, Sl'pI('lI1beJ 199;
IPARANORMAL EXPERIENCES IN MIDDLE EASTERN JEWS
I
tradition and its influence on personal characteristics on
Middle EasternJews.
Survival of the individual in the Arabic society is con-
tingent upon his/her relationship with the family. The fam-
ily is a source of vital support for the individual. However,
such support is conditional. The individual will face rejec-
tion and punishment if traditional norms are disobeyed
(Dwairy, 1993). M a result, individuals learn to detach them-
selves from their true emotions and desires and adapt by
developing a group and family-oriented conforming self
rather than an individual authentic self. Dwairy and Van
Sickle (1996) claim that repression is an inevitable conse-
quence oftraditionalArabic society, in which members learn
to practice Musayara, concealing one's true feelings and
behaving only in a socially sanctioned manner (Griefat &
Katriel, 1989). The Middle Eastern individual experiences
control as external. Family, God, and the spirits are thought
to exertvarious influences on individuals, who develop a col-
lective and a rather undifferentiated personality. Therefore,
instead of offering personal, intrapsychic explanations for
one's distress, Middle Eastern people often tend to provide
religious, social, and cultural explanations to their experi-
ences.
One of the reasons as to why dissociative disorders are
still relatively unknown in the Middle East could be that per-
sons afflicted with these problems are not construing them
as intrapsychic, but rather perceive them as manifestations
ofexternal spiritist agents. Passive acceptance of patriarchal
authority, strict prohibitions on manifestations offemale sex-
uality and the moral punishments often imposed on women
who are thought to have shamed their families due to sus-
pected improprieties can all contribute to the development
of spiritist formulations of dissociative syndromes, particu-
larly of those associated with incest and child abuse.
This paper underscores the need to examine ethno-cul-
tural variables and how these features can inpact on the man-
ifestation ofpsychopathology. This work specifically address-
es syndromes that phenomenologically implicate paranormal
experiences resembling dissociative phenomena. The clin-
ical data presented here point to the need for further stud-
ies of cases where culture-specific idioms and technique are
the only acceptable common grounds on which an empiri-
cally-oriented therapist and patient can meet.
Further psycho-anthropological research is needed in
order to identity the prevalence and features of cuiturally-
shaped dissociative disorders in indigenous populations.
Findings from such research may also support changes in
the dissociative disorder section in future DSMs.•
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