Trance and possession disorder: symptoms, causes and treatment

This rare dissociative disorder is usually triggered by traumatic events.

Dissociative disorders involve a break in the processes of memory, identity, perception and/or consciousness. Among them we find trance and possession disordercaused by a shocking experience that has generated much suffering in the person.

In this article we will know the symptoms of this disorder, how it is related to cultural and religious practices, and the differences between a state of trance and a state of possession. In addition, we will explain which cases are excluded to diagnose a disorder like this.

Trance and possession disorder: what is it?

The disorder of trance and possession is a type of mental disorder classified as a subtype of Dissociative Disorder. (conversion)m in the International Classification of Diseases (ICD-10). In the DSM-IV-TR (Diagnostic Manual of Mental Disorders), trance and possession disorder is referred to as "dissociative trance disorder".

Dissociative disorders involve a disruption or disconnection in the processes of memory, consciousness, identity and/or perception.. That is, there is a lack of continuity (or disconnection) between thoughts, actions, identity and memories.

Included in trance and possession disorder are only involuntary or unwanted trance states, and which also take place outside of religious or culturally accepted situations. This disorder is more typical in some cultures than in others (e.g. Latin American cultures).

What is it not?

The trance and possession disorder excludes all those states related to: schizophrenia, intoxication by a psychoactive substance, post-concussive syndrome, organic personality disorder and acute and transient psychotic disorders. That is to say, if any of these psychopathological conditions exist, a trance and possession disorder cannot be diagnosed. a trance and possession disorder.

Causes

The root causes of trance and possession disorder are usually traumatic experiences that have involved great psychological suffering, either acute or prolonged.either acute or prolonged, to the person suffering from the disorder.

It appears mainly in adolescent females with psychological conflicts, family dysfunctions, difficulties in interpersonal relationships and with a history of abuse, mistreatment or important affective deficiencies.

In order to diagnose trance and possession disorder, it is important to rule out other possible non-psychiatric causes, such as neurological disorders, it is important to rule out other possible non-psychiatric causes, such as neurological disorders (brain tumors, epilepsy, etc.) and the (brain tumors, epilepsy,...) and the consumption of psychoactive substances.

On the other hand, a trance and possession disorder is not diagnosed when the symptoms of the disorder are "normal" within the cultural and religious context of the person manifesting it (i.e. when the symptoms can be "understood" within that context, religion or cultural practice).

Symptoms

In trance and possession disorder, a number of characteristic symptoms occur. On the one hand, there is a temporary loss of a sense of identity and full awareness of the environment.. On the other hand, attention and awareness of the environment may be limited to one or two immediate and specific aspects.

The sufferer also manifests a strange, illogical or incoherent language, and acts as if possessed by another person, by a spirit or by a "supernatural" force.by a spirit or by a "supernatural" force. It also manifests a set of particular and very expressive movements, postures and gestures.

In addition, the person suffering from the disorder feels an important psychological discomfort, or there is a global deterioration in his or her functioning.

State of trance and state of possession

Within the trance and possession disorder, we must differentiate between two types of states that can occur: trance and possession. Thus, while during the trance state the "loss" of the habitual identity that occurs is not associated with the appearance of alternative identities, in the state of possession, one or more distinct and alternative identities appear.. These identities, moreover, present characteristic movements, memories and attitudes.

Another difference between the two is that in the trance state the activity developed by the individual is not complex (for example, running, falling, convulsive movements, etc.), while in the possession state the activities are complex (for example, the person maintains coherent conversations, shows characteristic gestures, facial expressions in accordance with the cultural canons of the place, etc.).

Trance states in cultures

It is important to keep in mind (and as we have already mentioned), that the trance and possession disorder does not occur voluntarily and is not framed in the cultural and religious context of the person..

These voluntary (and non-pathological states, which also do not cause discomfort) account for the majority of trance and possession states that we can find in different cultures. However, we insist, the trance and possession disorder is involuntary and causes significant discomfort.

This is not to say that the non-pathological states mentioned above may not sometimes involve symptoms typical of this disorder, and even be configured in their entirety as a disorder (but this is not as frequent).

Heterogeneity

The trance and possession disorder may present a lot of variability in different culturesespecially with regard to the nature of the behavior expressed during the trance state, the presence (or absence) of dissociative sensory disturbances (e.g. deafness or blindness), the identity assumed during the state, and the presence or absence (or degree) of amnesia following the episode.

That is, the same disorder can vary not only from one person to another, but also from one culture to another, especially in relation to how its symptoms manifest themselves; this occurs even if the symptoms are the "same" (since a series of diagnostic criteria must be met in order to diagnose a trance and possession disorder).

Treatment

The treatment of trance and possession disorder is that of dissociative disorders, combining psychotherapeutic and psychiatric methods (the latter, to mitigate symptoms).

Bibliographical references:

• Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) (American Psychiatric Association [APA], 2000).
• WHO (2000). ICD-10. International classification of diseases, tenth edition. Madrid. Panamericana.
• Orengo, F. (1995). Dissociation, trance, possession. Lecture given at the Third Congress of the Institute of Spanish Language Psychiatrists on Magic, Myth and Psychiatry.