Deliverance & Exorcism Ministry SIG

Guidelines for Mental Health Professionals Supporting Persons Seeking Freedom from Possession and Other Spiritual Afflictions (2nd Edition)

Introduction

Numerous cultural and religious traditions throughout human history have documented beliefs in and experiences of ‘good’ and ‘evil’ – or ‘positive’ and ‘negative’ – immortal spiritual beings, commonly referred to respectively as ‘angels’ and ‘demons.’ Many religious traditions (including Christianity, Buddhism, Haitian Voodoo/Voudun, Wicca, Hinduism, Islam and Southeast Asian and African traditions, etc.) also endorse the possibility of spirit possession, that is, the embodiment or substitution of a spiritual entity within a human body. Cultures vary widely regarding their views of spirit possession, whether possession is voluntary or can be involuntary, and whether experiences of possession can be neutral or beneficial (non-pathological), or are generally problematic (pathological). Similarly, professionals studying and practicing in the areas of psychology and mental health hold varying opinions, based upon their cultural and religious viewpoints, which are inevitably intertwined with their perception and interpretation of human experience and pathology. This is reflected in the ways which the Diagnostic and Statistical Manual of Mental Disorders (APA) has categorized experiences of spirit possession previously as culture-bound phenomena referred to as Possession/Trance Phenomena (APA, 2000), and currently categorizes such experiences as a culturally based variation of dissociative identity disorder (APA, 2013; 2022).

Within cultural and religious contexts, groups have addressed problematic spirit possession via rituals and practices often referred to as spiritual healing, deliverance, or exorcism. For readers who are interested, Driscoll (2015) and other authors noted in Appendix A (starting on page 40 of this booklet) offer more comprehensive documentation of spirit possession worldwide and historically. Many branches of Orthodox and Protestant Christianity share the outlook of the authors of this paper with regards to demons (fallen angels), possession, and exorcism, owing to how Biblical teachings and Catholic theology regarding the devil, exorcism, and healing have been the long-term basis for reasoning through these problems for centuries. Clergy and lay ministers of other branches of Christianity besides Catholic Christianity are known to offer deliverance and inner healing prayer ministries, and may sometimes collaborate or consult with Catholic exorcists regarding complicated and/or severe cases.

In recent centuries, the Catholic Church has also varied in its emphasis and practice of the ministry of deliverance and exorcism. After a previous decline in training and appointment of exorcists, every Roman Catholic diocese is explicitly required to have an exorcist as of 1999. This was reiterated by Pope Benedict XVI in 2007. While this requirement of Church law remains in force, its implementation has varied widely. Some dioceses have not followed through and have not appointed an official exorcist while others have more than one priest serving in this role. At the same time, some dioceses have highly developed and organized teams of clergy, lay persons, and professionals (medical, psychological, etc.) who support the exorcist and the bishop in this ministry, raising questions, challenges, and opportunities for interdisciplinary collaboration.

The interplay and integration of psychological and spiritual aspects of the person is of particular interest to mental health professionals. Persons seeking services from mental health professionals may allege experiences of possession or other spiritual afflictions, and may present symptoms which are not explained by nor respond to psychological treatment. It is not within the role or responsibility of a mental health or medical professional to diagnose possession and/or other spiritual afflictions; it is their role to diagnose mental health or medical problems and conditions and determine whether the phenomena that are occurring are solely attributable to them.

Exorcists within the Roman Catholic tradition have observed that many people referred for exorcism present a need for both spiritual and psychological evaluation and intervention (Amorth, 2000). This necessitates collaboration between mental health professionals and clergy, which is particularly essential when persons are suspected or identified as having experienced possession. In such cases, it is vital to properly identify and treat both natural (ordinary) and supernatural (extraordinary) causes for the presenting symptoms. Referral may be made to mental health professionals by clergy, or the mental health professional may refer the person to their local diocese for evaluation for the Rite of Exorcism (Szada, 2017). Understanding that specific roles and procedures related to this collaboration will vary by diocese, this document offers general information and guidelines that will assist mental health professionals to identify and discern the components and boundaries of their roles in this situation.

According to criteria published by the American Psychological Association (2002), this document best fits the category of a ‘practice guideline.’ These guidelines will address common questions and issues related to ethical and faithful practice in roles related to the ministry of exorcism and deliverance, psychological evaluation, differential diagnosis, treatment, and self-care. Professionals who are new to the topic of these guidelines will also gain insight into possession and other spiritual afflictions, and the ways in which this aspect of spiritual diversity may intersect with their practice.

While these guidelines will focus primarily on supporting persons who are or have been possessed, some generalization may be made toward working with persons who are suffering or have suffered from lesser forms of spiritual affliction (e.g., demonic obsession, oppression, and/or other spiritual afflictions). Recommendations for professional conduct and issues to be considered will be offered, with the intention that this document will be informational to both mental health professionals and other interested persons. Lastly, an extended bibliography outlining known literature from both the spiritual and psychological perspectives worldwide is provided in Appendix A.