Two cases

Spirit Possession: Two Cases from West Africa Adapted from DSM Casebook

Background

Individual or mass dissociative phenomena is quite common in Africa. The cases you are about to read reflect news of a spirit-possession movement in the Guinea-Bissau region of West Africa. This movement was initially noted among a group of barren young women, but later spread to include over a thousand young men and women who reported to have been "called by their highest being".

The belief system of the movement is a blending of traditional African, Christian and Islamic ideas. The "calling" that the participants participate in consists of two phases. During the first "trance" phase, members of the movement run about exhibiting bizarre behaviors until they have established contact with one of the leaders. They then reveal their personal problems to the leader while digging for roots in a trance-like state. During the second phase, members report that voices inside their heads transmit orders and messages from God.

Case One: The Leader of the Movement

The leader is a thirty-five-year old woman who lives in a small village in Guinea-Bissau. The following is a synopsis of her report to a psychiatrist interested in the movement.

During the rice planting season, I became very ill. I saw several diviners but was unable to discover the cause of my illness. A year after this, I lost my first child. A month later, I felt pain all over my body. I jumped up from my stool, ran around and did not know what was happening to me. My head was shaking, and my body was thrown to all sides. During this time, our God opened my mouth and made me announce that he was calling me. I had dreams, too. In one, a white man with long white hair, dressed in a white robe visited me. He handed me a book and a pen and taught me how to write.

It became clear to me that my strange sickness came from our highest being and that I should follow God. God guided me, gave me orders and forced me to speak through my mouth. He told me our people should get rid of their ancestor spirits and shrines. The people were not to hold big mourning feasts and slaughter whole herds of cattle anymore. I was told to tell my people that they were to refrain from witchcraft, not to eat pork or drink alcohol, not to steal and to work hard.

About once or twice a day, God forced me to rush around and then kneel in a clearing he pointed out to me. He guided my hand and made me dig a hole. There I found a healing root and God explained its properties to me. He gave me orders through a voice that I knew was my father's dead brother. Once I heard the voice of one of my aunts. Sometimes God entered my body. Then my body would get hot and I would have visions. The visions were like a dream or gong to the cinema. These colored moving pictures show God's way. These visions were more important that the voices. If I don't accept them, my body hurts, and I feel as though I might die. I can't ever see God's face, only his long white robe.

The people here around me all here things but with some of them, it is not true. Then God’s voice will tell me which person is clairvoyant or nor or if they are a witch. I also can smell a witch. This is the most important weapon against witchcraft.

Case Two: International Spirit

A twenty-year-old man from Guinea-Bissau named N'Daffa is admitted to the hospital. He left his village the day before, swam across a turbulent bay, and then walked naked to the center of the city. When he was stopped by a policeman, he bit the policeman and then ran to the house of a doctor he knew. With the help of seven strong men, he was subdued so that he could be injected with a tranquilizer by a nurse. He was then taken to the hospital and his family was called.

The patient was dressed by a nurse and was interviewed while lying tied to the hospital bed. He tells the doctor that hundreds of people are going to die and that he can kill people by pointing at them with his forefinger. He will only allow the doctor to give him water and food. He trusts no one else.

The family wants to take N'Daffa to the woman leader of the movement, but the police refuse and insist that he be taken to a mental health clinic. During the night, the man develops a high fever, his lungs appear congested and he is given an antibiotic in addition to the antipsychotic medication already administered by the hospital. The next morning N'Daffa is carried to the mental health clinic in a comatose state.

N'Daffa's brother gives his history. He says N'Daffa is the third child of a peasant family consisting of his father, his father’s two wives, four sons and three daughters. His father died when he was ten-years-old. N'Daffa took part in the funeral rites without difficulty.

The brother says N'Daffa had a calm and cheerful character which made him popular with others. He was not interested in decorating his body with painting or beads, as is the custom and he did not seem interested in participating in competitive games with his peers.

N'Daffa's trouble began two days before he was admitted to the hospital. He awoke during the night to urinate and started seeing strange things. H went back to bed, woke later and felt better after he woke. The next evening, he felt worse and swam across the bay to find a healer (normally no one would swim across the bay like this). He was unable to find a healer in the city and eventually was taken to the hospital after his encounter with the policeman.

At the mental health center, N'Daffa is interviewed and gives answers that make no sense. He says he saw a spirit that looked like a white woman with long hair. He talks to himself and utters unintelligible phrases. He tells the people in the room that they are "international spirits". He claims he can kill other people by pointing at them and that he is going to be a "scientist".

After three days in the mental health center, N'Daffa is back to his usual self. A normal conversation is possible; the "spirit" has gone. He no longer has strange ideas. His temperature has dropped, and his lungs are clear. The psychiatrist is skeptical about his total recovery from the effects of his experiences with the "movement". He nevertheless reduces the amount of antipsychotic medication N'Daffa is receiving and the symptoms immediately return. The dosage is increased again in response to this and, by the end of the fifth day, N'Daffa is again his old self. Both his brother and other visiting relatives ask for his release from the center. They still want to participate with him in a ceremony with one of the women in the "movement".

N'Daffa leaves the center and participates in a "movement" ceremony on the way home. The woman leader of the movement concludes that N'Daffa's disease is an appeal by God for him to become a healer in the new movement.

N'Daffa stops taking his antipsychotic medication within two weeks of leaving the mental health center. Three months later, he says that he is immortal, that he speaks all languages and that he can kill people with his finger. Three months after that time (six months after leaving the clinic) N'Daffa is back to normal, working in the fields and behaving as he always has. He says that he will soon be initiated as a healer in the "movement".