Richard E. Gallagher, M.D., is a board-certified psychiatrist in private practice in Hawthorne, New York, and Associate Professor of Clinical Psychiatry at New York Medical College. He is also on the faculties of the Columbia University Psychoanalytic Institute and a Roman Catholic seminary. He is a Phi Beta Kappa graduate of Princeton University, magna cum laude in Classics, and trained in Psychiatry at the Yale University School of Medicine. Dr. Gallagher is the only American psychiatrist to have been a consistent U.S. delegate to the International Association of Exorcists, and has addressed its plenary session.

Amid widespread confusion and skepticism about the subject, the chief goal of this article is to document a contemporary and clear-cut case of demonic possession. Even those who doubt such a phenomenon exists may find the following example rather persuasive. For clergy, or indeed anyone involved in the spiritual or psychological care of others, it is equally critical, however, to recognize the many and infinitely more common "counterfeits" (i.e., false assignations) of demonic influence or attack as well.

Demonic Possession
©New Oxford Review


This need for caution and precision is especially important at a time when untrained laymen or, worse, public ministries may unfortunately mislead or even exploit the faithful in this area. One has only to turn on a television to witness obvious abuses -- for instance, tele­vangelists' dunning their audience for cash as they conduct exhibitionist ceremonies before large assemblies of the overly credulous. Sharp distinctions -- long known to traditional theologians, but now often ignored -- need to be drawn.

Possession is only one and not the most common type of demonic attack. Possession is very rare, though not as exceedingly so as many imagine. So-called "oppression," or "infestation," is less rare, though hardly frequent either, and sometimes more difficult to discern accurately.1 For our purposes here, a truly "possessed" individual exhibits so massive and unequivocal an assault that we will use it as the paradigmatic example of a genuine demonic attack. This case will be contrasted not to the many lesser degrees of demonic assault, but rather to the varied kinds of purported demonic involvement -- often psychotic conditions -- that turn out to have a purely natural explanation.2 These states should be more widely recognized as such by religious practitioners. This need is especially great among the many laymen now in deliverance ministries, a rapidly growing worldwide phenomenon.3

The Case of a Modern-Day Demoniac

To show, first, that the devil, however rarely, may indeed "attack" by possessing an individual, I present here a detailed summary of a present-day demonic possession. It is truly an obvious example of a genuine attack, at least to an objective observer.

Each case of possession (as well as oppression) is, in one sense, unique. What makes this example especially singular -- but also particularly and powerfully convincing -- is that the woman involved not only exhibited, in a highly dramatic fashion, the classic signs of possession but, having been an avowed and prominent Satanist in her life, also seemed to display "special occult powers" even outside her trance states, not infrequently in a quite open manner to anyone who came in close contact with her.

All the facts presented here are true and verifiable by the multiple and highly credible individuals involved in her care. For reasons of confidentiality, we will identify our subject with a pseudonym (she agreed to have her story published if she were not identified), and little incidental material is included.

"Julia" is a middle-aged, self-supporting Caucasian woman who lives in the U.S. She first approached her local clergy on her own, and was soon referred to an official priest-exorcist (who collaborated on this article) to explore getting help. She herself was quite convinced from the start that she was being "attacked" in some way by a demon or Satan. During the course of her lengthy and thorough evaluation, she was eventually seen by this writer, a board-certified academic psychiatrist, who was asked to provide a medical and psychiatric opinion.

Julia revealed a long, disturbing history of involvement with explicitly Satanic groups (an obvious, historical antecedent to her then-present condition and to her accompanying "psychic" abilities, as they might be characterized). Though raised a Catholic, she no longer practiced the Faith. But, with considerable ambivalence, she stated she might need the Catholic Rite of Exorcism.

Julia was not the typical type of individual who frequently importunes the Church for help but who is really in need of psychiatric or other medical intervention. She was in no way psychotic; in fact, she was consistently logical, highly intelligent, and even quite engaging at times, despite her obvious turmoil.

Periodically, in our presence, Julia would go into a trance state of a recurring nature. Mentally troubled individuals often "dissociate,"4 but Julia's trances were accompanied by an unusual phenomenon: Out of her mouth would come various threats, taunts, and scatological language, phrases like "Leave her alone, you idiot," "She's ours," "Leave, you imbecile priest," or just "Leave." The tone of this voice differed markedly from Julia's own, and it varied, sometimes sounding guttural and vaguely masculine, at other points high pitched. Most of her comments during these "trances," or at the subsequent exorcisms, displayed a marked contempt for anything religious or sacred.

When Julia came out of these trances, she strongly professed no recollection of these remarks or of having said anything at all. An experienced psychiatrist might well conclude that we were probably, therefore, dealing with a dissociated personality or, more precisely, even Dissociative Identity Disorder (elaborated on later). What quickly made this understandable hypothesis implausible, however, were several other peculiar though obviously related phenomena, but a sampling of which is covered here.

Because of the complexity of this case, we assembled a team to assist. At varying points, this group comprised several qualified mental-health personnel, at least four Catholic priests, a deacon and his wife, two nuns (both nurses, one psychiatric), and several lay volunteers. We made a number of phone calls to arrange gathering together to help Julia. Julia herself was not in on these phone discussions; she was far from the area at the time. Astonishingly, Julia's "other" voice -- again sometimes deep, sometimes high pitched -- would actually interrupt the telephone conversations and somehow come in over the phone line! The voice(s) would espouse the same messages: "Leave her alone," "Leave, you idiots," "Get away from her," "She's ours." Julia, again, said later that she was unaware of any such conversation. And yet this speech was heard distinctly by several of the team on a number of occasions.

As mentioned, even outside her trances, Julia unmistakably displayed "psychic" abilities; put another way, her presence was clearly associated with paranormal events. Sometimes objects around her would fly off the shelves, the rare phenomenon of psychokinesis known to parapsychologists. Julia was also in possession of knowledge of facts and occurrences beyond any possibility of their natural acquisition. She commonly reported information about the relatives, household composition, family deaths and illnesses, etc., of members of our team, without ever having observed or been informed about them. As an example, she knew the personality and precise manner of death (i.e., the exact type of cancer) of a relative of a team member that no one could conceivably have guessed. She once spoke about the strange behavior of some inexplicably frenzied animals beyond her direct observation: Though residing in another city, she commented, "So those cats really went berserk last night, didn't they?" the morning after two cats in a team member's house uncharacteristically had violently attacked each other at about 2 AM.

As another example, Julia once described not only the actual surroundings (including the décor of his room) but the exact state of mind (skeptical and dismissive) of a priest peripherally involved, whom she had never met. The facts were subsequently precisely confirmed. Julia could also consistently depict, from afar and with amazing detail, the activity of one of the principal priests involved. She would repeatedly report, from her distant vantage, whether and when he was in pain (he suffered from a recurring illness), often where he was (e.g., walking on a beach), and remarkably, even what he was wearing at the time (e.g., a windbreaker).

Rounding out the picture of this case, finally, were the happenings during the lengthy exorcism rituals, that Julia herself requested. There were two series of such sessions separated by a period of time. (Ultimately, due to her hesitations, these efforts were interrupted and may or may not be resumed. Exorcism per se, a worthy and complex topic in itself, is not the focus here. This article looks rather to the reality of the subject of possession and its counterfeits.)

The exorcism began on a warm day in June. Despite the weather, the room where the rite was being conducted grew distinctly cold. Later, however, as the entity in Julia began to spout vitriol and make strange noises, members of the team felt themselves profusely sweating due to a stifling emanation of heat. The participants all said they found the heat unbearable.

Julia at first had gone into a quiet trance-like state. After the prayers and invocations of the Roman Ritual had been going on for a while, however, multiple voices and sounds came out of her. One set consisted of loud growls and animal-like noises, which seemed to the group impossible for any human to mimic. At one point, the voices spoke in foreign languages, including recognizable Latin and Spanish. (Julia herself only speaks English, as she later verified to us.)

The voices were noticeably attacking in nature, and often insolent, blasphemous, and highly scatological. They cursed and insulted the participants in the crudest way. They were frequently threatening -- trying, it appeared, to fight back -- "Leave her alone," "Stop, you whores" (to the nuns), "You'll be sorry," and the like.

Julia also exhibited enormous strength. Despite the religious sisters and three others holding her down with all their might, they struggled to restrain her. Remarkably, for about 30 minutes, she actually levitated about half a foot in the air.5

The presumptive target of the exorcism, the entity (or entities) that was possessing Julia, could also distinguish between holy water and regular water. She would scream in pain when the blessed water was sprinkled upon her, but have no reaction to clandestine use of unblessed water. During the ceremonies, she also, as previously, revealed hidden or past events in the lives of the various attendees, including information about deceased relatives completely unknown to her.

While many other details could be added, the above sufficiently convey the general picture. As noted, the exorcisms were seen as helpful, but have not yet resolved the matter of the possession. It should again be noted that Julia herself had no recollection at all of what occurred during the ceremonies.

Summary of the Case

The case of Julia illustrates a number of the classic signs of possession. The venerable Roman Ritual (Rituale Romanum of Pope Paul IV, 1614) lists as strongly suggestive signs, prominent among others, hidden knowledge, the ability to speak an unknown language, and abnormal physical strength. Other elements traditionally associated with possession were evident as well, including, invariably, expressions of hatred of the sacred, blasphemous and vituperative language, the ability to discern (and recoil from) blessed objects, the phenomenon of levitation, and, most importantly, a trance-like state interrupted by the presence of what appears as an independent, intelligent entity (or entities), and the expressed desire of this intelligence not to leave the afflicted.

Many of these individual features, let alone the full constellation of this overall "syndrome," are, to state the obvious, simply inexplicable on psychiatric or medical grounds. From a psychiatric point of view, two major features distinguish this and other such cases from a mental disorder: (A) the clear presence of paranormal phenomena, and (B) an overall pattern of presentation that, while it may overlap with certain psychiatric symptoms, nevertheless constitutes a truly sui generis, distinct group of features. Therefore, we clearly felt, in this instance, that we were indeed dealing with a genuinely possessed individual, albeit one complicated even further by her Satanist history and "psychic" abilities presumed consequent to her cultic involvement and/or her possessed state.

The Medical/Psychiatric Perspective

Several principles of the relevant discernment and diagnosis require emphasis. First, it needs to be acknowledged that medical input (which, given the highly bizarre nature of these cases, for practical purposes in today's world almost invariably entails an appropriate psychiatric consultation), while indispensable, is not without its own risk. Unsurprisingly, physicians, and perhaps even more so psychiatrists as a group, are generally not very open to, or knowledgeable about, the possibility of demonic possession. They have been trained (and rightly so) to be skeptical and to base their diagnoses and interventions on more standard criteria of modern scientific canons of judgment -- e.g., typical symptom clusters, the ability to replicate data, lab results, blind clinical trials, etc.6 These criteria cannot apply to historical singularities, of course. In any case, physicians should not be expected to make discernments in matters of this sort -- it is not their trained task or area of expertise -- and more properly is the professional responsibility (one hopes with due caution, sobriety, and openness to medical consultation) of a suitable and knowledgeable member of the clergy.

What the physician/psychiatrist can properly offer, however, is certainly indispensable in its own right: the professional expertise to determine whether the case in question fits a medically recognizable, exclusionary syndrome. This critical role can save all parties an enormous amount of time and effort. The vast majority of such "cases," which could easily be misconstrued as possible attacks by a demon or the like, indeed turn out to have an obvious psychiatric explanation, or less often a neurological or other medical explanation.

Another important orienting perspective is, unfortunately, often not well understood by many non-medically trained people, lay and clerical alike. Lack of experience in medical pathology can serve as a great source of confusion in certain religious circles. Surprisingly to many people, psychiatrists are in the frequent habit of encountering and diagnosing an assortment of patients who claim to be experiencing demonic or occult attacks in some way or, conversely, who report conversations with God, mystical visions, etc. The typical psychiatrist, or other mental-health practitioner for that matter, commonly meets patients who claim all sorts of contact or special visitations from "God," the "devil," a "spirit," etc. Patients may complain on a regular basis that demons are harassing or berating them; telling them to perform shameful, grandiose, or destructive acts; even touching them (via tactile hallucinations). It is easy, therefore, for such professionals to draw the nearly obvious corollary that all such cases purporting to have a diabolic or occult aspect are simply a reflection of psychiatric pathology or the patient's imagination. Many doctors thus regard all talk of demonic possession as hopelessly ignorant and out of date, "medieval," superstitious, even psychotic per se.

The obvious danger is that such an opinion gets generalized to all cases indiscriminately, even those highly rare ones with manifestly inexplicable or preternatural features as well, such as a possibly genuine demonic possession or oppression. For this reason, the astute student of demonology and official exorcist of Paris from 1924-1962, Joseph de Tonquédec, S.J., wrote back in 1923 that the skepticism of physicians arises from "an unwarranted generalization of what they observe in mental institutions or in private practice" (Introduction à l'étude du merveilleux et du miracle). Sadly, this reflection is probably even truer today, when even fewer doctors have any sound, sophisticated theological knowledge.

While it is unfortunate, though understandable, that such a lack of discernment exists among most (but by no means all) members of the medical profession, the far more common danger is exactly the reverse. Clergy or laymen may be drawn, as noted, to the opposite reasoning and suspect demonic activity when no such conclusion is warranted. Again, de Tonquédec noted this problem early in the last century: "some of the faithful and certain priests" -- I would say more commonly today fundamentalist ministers or laymen in quasi-clerical or other helping roles -- "take the opposite stand and also end in error, because of their ignorance of mental and nervous pathology and their failure to follow the guidelines given by the Church. As a result, they attribute to the devil certain disturbances that are purely natural in origin" (ibid.). By contrast, the Roman Ritual stipulates recourse to medical expertise and the need for prudent caution before ruling out the naturalistic. St. Thomas Aquinas in the 13th century similarly warned clerics not to jump to a supernatural explanation when a purely natural one sufficed. Much harm can result from misdiagnosis either way.

Psychiatric Counterfeits of Possession

There are some common psychiatric conditions that are apt to mislead the clergy or an overly credulous public in this regard. I pinpoint "psychiatric" even though there are other medical conditions that may potentially confuse laymen. For instance, neurological and in particular seizure disorders of a complex nature come to mind. These disorders may well have prompted many in past eras to suspect wrongly a diabolic etiology. With the growth of medical knowledge and increased public sophistication about medical matters in recent centuries, however, it has become undoubtedly much less common to ascribe these neurological diseases to the actions of the devil. The most commonly confusing disorders, in my professional experience, are almost always psychiatric or quasi-psychiatric in nature.

In general, three broad types of psychiatric disorders seem especially apt to confuse observers and the suffering patients themselves.

(1) Various medical conditions, generally psychiatrically based and less often metabolic, substance-abuse related, or neurological in nature, present with hallucinations, most commonly auditory, and also visual, tactile, or even gustatory. These conditions are frequently associated with delusional material, often paranoid in nature. Taken at face value, these hallucinations or delusions, which often involve the idea that the devil, demons, angels, God, or other "spirits" are actively communicating with the patient in question, can certainly and quite naturally confuse the patient and other interested parties into believing that the patient is under some kind of demonic assault or other supernatural influence, when nothing of the sort is going on. The patient may say quite openly, "The devil is bothering me" or "The devil told me such-and-such." These symptoms are characteristic of such chronic psychotic diagnoses as schizophrenia and bipolar disorder (or manic depression), as well as of various brief psychotic conditions or episodes caused by other medical etiologies, such as neurological impairments or drug/alcohol abuse and withdrawal states.

(2) Another common group of psychological impairments apt to mislead are the so-called personality or character disorders. Typical of these conditions are a struggle with deep-seated feelings of rage, low self-esteem, a need for attention, a strong sense of victimization or, as is most relevant here, a strong sense of inner "evil." Psychiatrists commonly encounter such troubled patients, paradigmatically as "borderlines" (who may also become briefly psychotic). These individuals often feel that their powerful inner feelings of being "bad" are due to some tenuously experienced "foreign" entity inside themselves. This entity is at times explicitly self-described as a "monster" inside, or an "evil presence," or even a "devil" or "evil spirit" per se. This strong sense of an internal "foreign body" seems generally a thinly veiled projection of one's own inner sense of badness that is felt to be outside one's control while still somehow contained "within" the personality. I have actually even heard such patients spontaneously describe their inner states precisely as dominated by a sort of "writhing serpent" or a "dark spirit" inside themselves, without any indication whatsoever of true diabolic involvement.

(3) A final category of patients who are frequently misunderstood, by themselves at least, as suffering from demonic attacks are the severely histrionic and/or dissociated individuals (again a spectrum of types being implied, not a single diagnosis). This class of patients, which may well overlap with the second category, typically displays highly overactive imaginations and strikingly poor insight or self-awareness. These individuals desperately seek the love and attention that they otherwise miss in their often unhappy lives. To come to believe that they are being attacked by unseen forces may give them a sense of excitement or self-importance that they otherwise lack. One such patient we saw, an emotionally disturbed woman of around 20, would actually slither like a snake on the floor of the church, and even claimed to experience a serpent's touch. She sought our help, but our eventual diagnosis was a classic case of histrionic personality disorder, a finding ultimately agreed upon by both the priest involved and the patient herself. This individual had sought repeatedly to enter a religious order, any religious order, but was wisely never allowed to do so, given her disturbed emotional condition.

Patients in this final class of cases frequently have some proclivity to dissociate. In the more severe variants of this group, these individuals (who have often been abused) may even manufacture or "elaborate" -- unwittingly or not -- separate "personalities" or "ego states" in what was originally called "multiple personality disorder," but which is now more properly known in psychiatric circles as "Dissociative Identity Disorder" or D.I.D. (DSM-IV). This disorder may well present one of the personalities (sometimes known as an "alter") as a "devilish," often seductive type, or even as a "demon" per se, one variant of the so-called pseudo-possession syndrome. Still not without controversy as a diagnostic entity, D.I.D., as many diagnoses formerly too broadly labeled "hysteric," is highly fluid.7 It is now generally better recognized as a condition that may sometimes be fabricated, may be expressive of a delusional frame of mind, or at times may even be partially caused by treatment. The disorder generally surfaces in an individual who is highly suggestible or, more rarely, frankly manipulative. One example of the latter tendency involved a young man who had punched a staff member of a psychiatric unit. He immediately attempted to exonerate himself by claiming the action was done by his "other personality," his "bad" one, although this self-serving use of the diagnosis is more the exception than the rule.

Any of these three categories of patients, but perhaps most easily this third group, may provide fertile ground for those invested in exploiting the subject of demonic influence, such as televangelists or poorly trained members of some deliverance ministries.8 Some of the individuals who fall prey to these groups are largely conscious of their tendency to exaggerate or distort; others are fully self-deluded and without any insight or self-knowledge. They can become fully caught up in their disorders and their supposed need for "spiritual" rather than psychiatric therapy. Frequently, it is a great chore for helping professionals to convince such individuals of their need for mental healthcare, not deliverance or an exorcism. All the above patients are highly vulnerable and may too readily be led to believe that they are being attacked by the devil or evil "spirits." If those around them are prone to jump to such conclusions too -- sadly sometimes for misguided reasons of their own -- delayed treatment and much consternation and damage can ensue.

Pastoral & Theological Reflections

There is no implication here that the case of Julia reflects a common occurrence, although it is not unique either. Her case though, with her Satanist background and several decidedly idiosyncratic features, represents an especially clear-cut example of possession from the start. Despite commonalities, each possession is different and, as a rule, initially less obvious. Because I have served as consultant to an unusually high number of possible cases, only a scant few of which turn out to involve a genuinely diabolical element, I might perhaps possess a unique vantage point. Although some studies that call into question the existence of the reality of such phenomena are well meaning in their desire to stem a certain fundamentalist, subcultural mania of exaggeration in this area,9 they are often marred by their lack of experience with the very few real cases, such as the one documented here.

However unusual, no case of possession or oppression -- or for that matter any of the many "counterfeit" versions -- is trivial. For any suffering individual, the responsibility of the clergy and healing professionals is to offer the proper, well-informed help, no matter how obscure or controversial the presenting problem.

The mystery of the phenomena of demonic activity, prominently referred to in the Gospels and Apostolic Age, but noted, as well, throughout the life of the Church, can profitably be compared with the history of miracles, also never absent from the history of Christian life. These two permitted eruptions, if you will, of the supernatural into our everyday world follow similar historical patterns. Despite many attempts, historically skeptical critics and "de-mythologizers" have never in any convincing manner successfully extricated the element of the miraculous or the demonic from our reports of Christ's activity while on earth. No less the same can be maintained of later ecclesiastical history -- every age of the Church has exhibited historically credible, indeed sometimes obviously verifiable miracles. So has our own era, as any serious student of, say, Lourdes, among other examples, must surely attest.

Attempts to explain away the activities of Satan or devils in the Gospels are analogous to irrational skepticism about miracles. Most argue that the inclusion of demonic elements reflects the outmoded and superstitious ideas of that age, which the Church should now disavow. There are several solid objections to this critique with a pedigree of several centuries. These attempts to reinterpret Gospel events end up implying that Jesus was either ignorant or disingenuous in His sharing of such beliefs. Such a notion is, of course, contrary to all genuinely orthodox understanding of His divine as well as His human nature. Also, this argument flies in the face of common sense, as if the world of first-century Palestine could not recognize the obvious intent of these episodes and Jesus' clear and forceful actions vis-à-vis the demonic.

In the Synoptic Gospels, Christ is portrayed quite unequivocally as dramatically commanding specific diabolic entities to leave certain individuals and be displaced elsewhere. Some commentators maintain that much manner of illness in that era was mistakenly ascribed to sin and the influence of the devil, a point true enough to a degree. Nevertheless, the Gospel record of Jesus' activity nowhere presupposes that fact. Indeed, Christ explicitly contradicts that traditional Jewish and more generally ancient viewpoint in His discourse about the effects of transgenerational sins (Jn. 9:2-3). Jesus repeatedly challenged and condemned in a straightforward manner many of the false beliefs and superstitions of His age.

Finally, as with miracles, credible and verified reports of the saints' and the Church's successful battles against demonic assaults exist, not just in the Apostolic Age, but throughout the whole of subsequent Church history, very much including the well-documented modern era.10 The contention, therefore, that such scriptural accounts are historically conditioned holds little weight.

Blaise Pascal, the 17th-century mathematical genius, was an ardent student of human nature and religious history. He had an interesting comment about the issues under consideration here. Recorded in the Pensées is his astute reflection that "there would be no false miracles were there not true miracles."

Much superstition, exaggeration, fakery, and sheer ignorance have accompanied the history of both purported miracles and suspected diabolic activity throughout the life of the Church. The harm to the faith and the harm to individuals can be great, a truism never more evident than today. Behind these false traditions, however, as Pascal well grasped, lay the real thing, the originals from which the Frenchman well knew the counterfeits drew their false legitimacy. In this and every age, going back to the Gospels themselves, we refer ultimately to the consistent record of the healing and freeing power of our Lord Himself, on body and soul, as manifested to the unbiased mind. My task here has been to provide some guidance in discerning the counterfeit, but also in acknowledging the very infrequent but legitimate cases of diabolic activity. Contrary to what secular opinion facilely asserts, an objective medical view can confidently conclude that assaults by the devil, like genuine miracles, are rare but quite real scientific facts, verifiable to all who are not afraid to confront the truth.

Endnotes

1. A fuller discussion of the different kinds or degrees of demonic attacks is a complex one, beyond the scope of this article. Part of the confusion about these distinctions is a consequence of varied terminology used by different spiritual writers over the centuries. Attack by a demon short of possession, but clearly beyond normal "temptation," is often now called "oppression" or "infestation"; the older term "obsession," widely employed historically, is especially apt to be misleading to a modern audience. Discernment of an "oppression" often takes an especially close collaboration between a priest and an experienced mental-health professional, preferably a psychiatrist.

2. This distinction does not imply that an individual cannot suffer from both possession or oppression and a mental disorder -- another reason psychiatric input is invaluable -- but one should presume first that this combination is to be considered exceptional. Nevertheless, a severe emotional disorder in some cases may mask an underlying, highly rare but genuine possession. Conversely, a possession or oppression will inevitably have effects on one's emotional well-being. The issue of what may "open" an individual to such an assault is not touched upon here.

3. "Deliverance ministries" are teams of spiritually minded laity and/or clergy who say prayers of "deliverance" with individuals who are suspected of being affected in some way or another by the demonic.

4. "Dissociation" is the separation of one's attention from the mainstream of consciousness -- e.g., falling into a trance-like state.

5. Levitation, while a highly rare phenomenon in religious history, has, nevertheless, been reported in possession cases and in the lives of various mystics. For the classic scholarly discussion of this subject, see the works of Herbert Thurston, S.J., especially The Physical Phenomena of Mysticism (Regnery, 1952). Also see Robert D. Smith, Comparative Miracles (Herder Book Co., 1965), ch. 3, "Levitations."

6. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association Press, 1994) is widely employed as the standardized version for making psychiatric diagnoses; its terms will be employed here, unless otherwise noted.

7. "Hysteria" is a somewhat outmoded term in today's psychiatry, as it was often used in a pejorative or loose sense in the past. As a general term, it is still sometimes applied to individuals acting in a histrionic or bizarre manner.

8. No denigration in general of deliverance ministries is intended here, only of overly credulous or uninformed ones and groups acting outside Church approval. One American psychiatrist, who has written about cases of possession, performed an exorcism himself, a highly dubious practice indicative of poor or nonexistent ecclesial direction. See M. Scott Peck, Glimpses of the Devil: A Psychiatrist's Personal Accounts of Possession, Exorcism, and Redemption (Free Press, 2005).

9. Michael W. Cuneo, a professor of sociology at Fordham University, has written the best recent work about this societal trend in the U.S., American Exorcism: Expelling Demons in the Land of Plenty (Doubleday, 2001). Cuneo argues persuasively for the most part that an unbalanced, exaggerated preoccupation with discerning and ministering to individuals assumed to be influenced or confronted by occult or demonic forces has arisen as a not uncommon, distinct American phenomenon in certain subcultures over the past 25 or so years. He traces its origin in part to the sensationalism and media attention given to the enormously successful film The Exorcist in the early 1970s. Cuneo contends that the movement has been sustained by much broader cultural trends, most notably the proclivity of American popular culture to look for instant solutions to complex problems by way of simplistic pop psychology and the shallow religiosity so endemic to our nation. His overall analysis is valuable but limited, perhaps by a certain methodological skepticism but more clearly by his apparent difficulty in locating any genuine example of possession or oppression.

10. For instance, any objective student of the 19th-century life of St. John Vianney, the celebrated Curé d'Ars, cannot help but conclude that this holy and very sane priest was quite literally the object of frequent demonic attacks. See, for example, The Curé d'Ars by Abbé Francis Trochu (Burns, Oates & Washbourne, 1927). For other treatments of these phenomena in the modern era, see also J. Lhermite, Vrais et faux possédés (1956); Léon Cristiani, Présence de Satan dans le monde moderne (Editions Franc-Empire, 1962); René Laurentin, Le démon: Mythe ou réalité (Fayard, 1995).