Community Mental Health Journal

, Volume 50, Issue 3, pp 348–353

Cultural Variations in Interpretation of Postnatal Illness: Jinn Possession Amongst Muslim Communities

Authors

  • Jane Hanely
    • Department of Public Health and Policy StudiesSwansea University
    • Department of Public Health and Policy StudiesSwansea University
Original Paper

DOI: 10.1007/s10597-013-9640-4

Cite this article as:
Hanely, J. & Brown, A. Community Ment Health J (2014) 50: 348. doi:10.1007/s10597-013-9640-4

Abstract

Maternal experience of emotional and physical disturbance during the postnatal period is a worldwide occurrence but may be interpreted differently according to cultural background. Little is known about different expressions and treatment of cultural phenomena during the postnatal period such as the affliction of Jinn possession in Arabic cultures. Jinn are considered to be evil spirits, which cause emotional and physical distress at times of vulnerability such as the postnatal period. The aim of this paper was to explore maternal experience of Jinn possession and draw parallels with Western interpretations of postnatal illness. Ten women in an Arabian Gulf state who had recently given birth and identified themselves as having Jinn possession were interviewed as to their experiences of Jinn possession. Mothers described the Jinn as evil spirits who cause symptoms such as sadness, anxiety and physical malaise during the postnatal period. Numerous risk factors for possession emerged such as lack of familial support, poverty and a traumatic birth. Clear parallels emerged between Western concepts of postnatal illness and Jinn possession Mothers in Muslim cultures may experience Jinn possession during the postnatal period, which reflects similar symptoms and aetiology to Western concepts of postnatal illness. With increasing multiculturalism in the UK, understanding the origins and perception of Jinn possession is important for health professionals working in Muslim communities here.

Keywords

Postnatal depressionChildbirthAnxietyMulticulturalJinn possession

Introduction

Postnatal depression is the most common postnatal psychiatric disorder affecting ten per cent of mothers (Henshaw 2003). Symptoms vary in severity including loss of pleasure, lack of interest, and sleep and appetite disturbances (Hildebrandt and Young 2007). Risk factors include previous psychological illness, poverty, social isolation, difficulty adjusting to motherhood and competing stressors (Henshaw 2003, Spinelli 2004).

The majority of research examining postnatal illness has been conducted in Western cultures (Oates et al. 2004). However, there is growing awareness that the physical and affective symptoms associated with the Western concept of postnatal depression may be present in many more mothers during the postnatal period but interpreted and managed differently in different communities (MacLachlan 2006; Bugdayi et al. 2004). For example, exploration of women’s postnatal experiences in areas such as Turkey, India and Zimbabwe have shown that whilst overarchingly, women may experience symptoms such as loss of pleasure, anxiety and physical symptoms, the way in which these manifest themselves, are labelled or treated may be markedly affected by cultural context and beliefs (Bugdayi et al. 2004; Chandran et al. 2002; Nhiwatiwa et al. 1998).

Alongside variations in how postnatal depression encountered and treated cross culturally, specific cultural beliefs may affect the label maternal behaviour during the postnatal period is given. For example, in Arabic mythology, the phenomena of Jinn possession is widely accepted. Jinn are supernatural spirits created from a smokeless flame of fire which have a negative influence on the mind and the body. Jinn possession is considered an affliction over which the recipient has little or no control (Ghubash and Eapen 2009). Once within the body, Jinn alter mood states instigating anxiety, weeping, anhedonia or emotional lability (Al Bahrani 2004). Although Jinn can present at any time of vulnerability, possession during the postnatal period is common. Notably, the symptoms of Jinn possession mirror those experienced by women suffering from postnatal depression in Western Cultures (Oates et al. 2004). However, these symptoms are rarely considered to be due to postnatal illness but instead the result of the Jinn’s influence (Ghubash and Eapen 2009).

Empirically, there has been little exploration into how beliefs regarding jinn may impact on women during the perinatal period, how they may be interpreted within the realm of postnatal illness and the support that women may need. With increasing Muslim populations in the UK (ONS 2010), health professionals may encounter the experience of Jinn possession but may have little understanding of how to best support the woman and family. The aim of this study was thus to explore the beliefs of Muslim mothers in an Arabian Gulf State in relation to the phenomenon of Jinn possession and consider lessons for the UK.

Methodology

Participants

The research was carried out in a Muslim community in an Arabian Gulf state. The purposive sample consisted of ten married Muslim mothers who had given birth during the past year and personally identified themselves as currently being possessed with a Jinn. All mothers were aged between 14 and 44 years. Mothers were recruited and interviewed by a respected, established local source who was known to the community and had detailed knowledge of relevant cultural beliefs and practices. Mothers were however made aware that the primary researcher was British and non Islamic but were happy to continue with their participation.

Data Collection

Permission to conduct the study was granted by a Government official with consent to access the mothers gained from the tribal elder. Verbal consent was gained from all mothers as some of the mothers were illiterate. The importance of cultural etiquette and the significance of strong gender role delineations within a closed social system was acknowledged. Mothers were individually interviewed in the Arabic language by the source. Interviews took an open ended format. Mothers were asked to describe their Jinn, discuss how it made them feel and why they believed it had possessed them. They were also asked to describe their wider feelings and circumstances surrounding the birth of their baby and new role as a mother. A field diary was also used to record observations of maternal behaviour.

Data Analysis

All interviews were recorded, transcribed verbatim and verified before being translated into the English language for analysis. The coding method was predominantly descriptive in order to develop a basic vocabulary of the data to form themes for further analytic work (Sandelowski 2010). Themes within the data were identified using an inductive approach and were undertaken manually. The initial codes were generated and collated into potential themes by visually laying out the terms (Braun and Clarke 2006). All scripts were read by two independent coders who reached agreement on over 90 % of the themes. The emergent themes were then organised, along with the field notes and the discussion group data, into more robust categories which attempted to reflect items and beliefs of significance to the women.

Results

From the data four broad themes were identified: shared knowledge of Jinn possession, symptoms of possession, risk factors for possession and preventing and treating Jinn possession. Parallels to Western concepts of postnatal illness were considered. A brief comparison is displayed in Table 1.
Table 1

A comparison of Jinn symptoms and risk factors and postnatal depression

Symptoms of Jinn possessiona

Postnatal depressionb

Jinn possession made the woman feel sad, anxious and lonely

A range of emotions from sadness, tearfulness and depression through to guilt, anger and self blame (Henshaw 2003)

Mothers felt responsible for Jinn possession

Feelings of self blame and guilt (Haga et al. 2012)

Mothers believed their Jinn gave them feelings of tiredness, lack of energy

Lethargy and lack of energy (Robertson et al. 2004)

Jinn possession was difficult to avoid or recover from

Feelings of helplessness and hopelessness (Beck 1999)

Jinn cause difficult behaviour in infants

More likely to report baby has a difficult temperament (Vik et al. 2009)

Wider social circumstancesa

Risk factors for postnatal depressionb

Feelings of loneliness

Lack of social support

Mothers had difficult relationships

Poor familial/partner relationships (Beck 1999)

Financial difficulties

Low socioeconomic status (Patel et al. 2002)

Mothers reported stressful situations

High stress (Beck 1999)

Complications surrounding childbirth or wider health

Childbirth/health complications (Nielsen et al. 2000)

Concept of ‘familial Jinn’

Runs in family (Ghubash and Eapen 2009)

aAs described by the participants

bAs reflected in the literature

Shared Knowledge of Jinn Possession

Mothers described their knowledge and perception of the appearance and behaviour of Jinn. The Jinn appeared to be the malevolent parasite responsible for ills and bad luck, synonymous with being jinxed. It was this Evil Jinn that could possess new mothers after the birth of their baby and appeared synonymous with the Western concept of Postnatal Depression. This evil concept of Jinn was a shared construction with similar descriptions of both how the Jinn looked and the effect it had on new mothers. Jinn were viewed as monstrous creatures; powerful and destructive beings full of fire and wrath.

Her face is dog like and fire discharges from her mouth. She has an overriding power and none are safe from her clutches. She is a curse to babies in the womb.

Jinn possessed a new mother affecting both how she felt and how she behaved towards her baby, husband and family. Jinn possession was believed to cause great sadness, anxiety and emotional pain, drawing clear parallels between the emotions experienced by women with postnatal depression in Western countries (Beck 1999).

When the baby was born I did not want to see her…I cried and cried.

Overall mothers discussed specifically how the Jinn made them feel, their strategies for trying to avoid the Jinn and how Jinn possession could be cured.

Symptoms of Jinn Possession

One of the key elements of postnatal depression in a Western culture is that it is multifaceted in its symptoms. Mothers report a range of emotions from sadness, tearfulness and depression through to guilt, anger and self blame (Leahy-Warren and McCarthy 2007). Women’s discussion of their Jinn possession mirrored that of Western women suffering from postnatal illness including feelings of sadness and loneliness alongside self blame and guilt for feeling that way. Notably, as can be the case with postnatal depression (Hanley and Long 2006), many of the women dismissed these feelings as being a normal occurrence after childbirth

I had been feeling sad and lonely but I did not think anything about it.

Mothers with Jinn often reported finding looking after their baby difficult, feeling that they cried a lot or would not settle. This perception of infant behaviour was attributed to the Jinn having affected their baby too. Likewise, in Western cultures mothers with postnatal depression are more likely to report that their baby has a difficult temperament (Milgrom et al. 2011) or suffer from prolonged crying (Vik et al. 2009).

…I too became ill with the Jinn. My son would not sleep nor settle very well.

Alongside this, mothers often described physical symptoms of malaise and a lack of energy, synonymous with how many women with postnatal illness describe their physical functioning. Common physical symptoms of postnatal depression for example include loss of appetite, sleep disturbances and fatigue (Robertson et al. 2004).

She makes me feel very tired all the time, I have no energy and I cannot look after my baby I have to ask my mother and she told me she felt the same way as I do.

Risk Factors for Jinn Possession

Mothers reflected on why the Jinn had possessed them. A common theme was a perception that the mother had brought the Jinn upon themselves and that they were to blame for their sadness. This is reflective of symptoms of self blame in women with postnatal depression, that they are somehow responsible themselves for how they feel (Haga et al. 2012).

Perhaps it was your fault that you have the Jinn. Perhaps you walked on the land of the Jinn or drank from their well.

However, women also held a conviction that once a Jinn had decided to possess a woman she had no control over it entering her body. Jinn would find a woman when she was vulnerable and take over her being. This echoes findings that women with postnatal illness in Western culture often feel powerless and helpless to control their emotions and recovery (Beck 1999)

She may stay inside you for months…I do not know if she will ever go.

However, mothers also revealed wider experiences and emotions that mirror the known psychosocial risk factors for postnatal illness in Western cultures. Mothers reported feeling lonely or lacking in social support. Difficult relationships with their husband or family were common. Considerable evidence has shown that in Western cultures, women who feel socially isolated and lacking in support or who have difficult relationships (Beck 1999) are more likely to be diagnosed with postnatal depression

I am lonely because I love my husband very much but he is always away at sea and I don’t see him very often.

I cannot rely on my family to help me as they are wrapped up in themselves’.

Others reported having financial difficulties or having to continue working whilst caring for their baby. In the West, women from lower socio-economic groups (Patel et al. 2002) or who experience stressful life events around the time of the pregnancy and birth (Beck 1999) are at increased risk of postnatal illness

I come from a poor family, my husband is not working in the town and so we do not get much money. I have to work to look after the few goats and sheep we have.

Physical health difficulties, exhaustion or a difficult or traumatic birth were also common leaving women feeling run down. Anxiety during pregnancy (Beck 1999), poor physical health (Brown and Lumley 2000) or complications during the birth (Nielsen et al. 2000) are all known to increase risk of postnatal depression.

I am tired of having children but that is my duty…I am not a well woman but that does not matter either.

A family history of Jinn possession was also common echoing familial patterns for postnatal depression (Ghubash and Eapen 2009). Many women who had a Jinn possession reported that their mother or sister also had a Jinn. This pattern was perceived to be due to a ‘familial Jinn’ that specifically affected a family, returning to all female members. In these situations Jinn possession was believed to be inevitable.

My mother and my sister had Jinn, so it wasn’t surprising that I had the same Jinn.

Overall, mothers who were possessed by Jinn described a number of bio-psycho-social variables that are known predictors for postnatal depression in Western cultures but the interpretation of symptoms and causation was very different. This leads to the next question—how is Jinn possession treated and how might it be approached in the UK?

Preventing and Treating Jinn Possession

Finally, mothers discussed how they attempted to prevent and cure Jinn possession. To prevent Jinn, women described how they observed rituals during pregnancy such as remaining in the home at dusk, dressing demurely and covering their hair. Following the birth the female family members were vigilant to watch out for Jinn possession.

My sister said to burn frankincense and to wipe by brow with my wardd (rose water).

Despite this, possession by Jinn was believed to be sometimes inevitable. Prior to commencing appropriate treatment, it was important to identify the Jinn. The most common method described was to call out, what appeared to be random numbers, to which the Jinn responded. Secret writings were consulted and the identity of the Jinn established. The mothers reported responding with a ‘stranger’s voice’ and the reasons for the possession were established. They felt that it was the responsibility of the Healer to dispossess the woman but the wider community often participated.

The people of the village they all feel sorry for you and come and see if they can help. They know you have a tiny baby and they feel that perhaps the Jinn could have left you alone…they try to help you as best they can.

Often mothers believed that exorcism was necessary before the Jinn would concede to withdraw from the body. Pungent smells were felt by participants to be formidable deterrents to the Jinn. Frankincense was frequently burnt over charcoal and used to infuse clothes and rooms. Sheiks often devised therapeutic body pastes concocted from frankincense, sand, charcoal and spices mixed with oil, water or animal’s urine. Recitation of the Noble Qur’an shared was often thought to be effective.

The Muttawah made my mother’s Jinn go away, perhaps her will do the same for me.

More eclectic treatments described included the ritualistic sacrifice of a sheep or goat. It was not consumed but positioned somewhere visible to the Jinn. The offer of gold, precious stones or money necessary to appease the Jinn often depended on the depth and extent of the request.

My father paid for the Muttawah and frankincense…it would have been difficult to have slaughtered animals…but we would have done so if that was the wish of the Jinn.

Overall, women reported using very alternate and spiritual treatments to deal with Jinn possession that were based around family involvement, the community and spiritual experts.

Discussion

This paper explored the beliefs and experiences of Arabic mothers who were considered to have been possessed with a Jinn during the postnatal period. It examined their cultural norms and beliefs, the expectations of those around them and how such a possession impacted upon their behaviours and emotions. The descriptions of Jinn possession in terms of its symptoms, risk factors and impact upon the mother clearly mirror the symptoms of postnatal depressive disorder in Western cultures. Mothers felt sad, anxious and physically exhausted, often blaming themselves for the possession and feeling powerless in escaping it. This fits well within the extensive literature examining the symptoms of postnatal depression (Beck 1999; Chan and Levy 2004). The findings offer important insight into this condition, especially for those working to support women postnatally within the Muslim culture.

Awareness of the occurrence of Jinn possession is important for practitioners working within Western cultures. With rising levels of multiculturalism in the UK (ONS 2010) it is likely that practitioners may encounter a mother who believes she has been possessed by a Jinn postnatally, or who is suffering but not disclosing her feelings. If a mother is suffering from symptoms of sadness, guilt and lethargy postnatally, it is on one level irrelevant how this is labelled, but essential that it is recognised in some way and treatment offered for recovery. However, if a mother believes in Jinn possession conventional screening methods might have limited use. The symptoms may reflect those of postnatal depression in western terms, but the causality, as explained, will be different. An awareness of Jinn possession and its symptoms and parallels may thus ensure the health professional is responsive to this cultural void and the impact this may have. Acknowledging the belief in the power of Jinn possession might be a crucial first step to facilitating support for mothers

This however leads to the question of how Jinn possession should be approached and treated in a Western setting. On the one hand, research has demonstrated that signs of postnatal illness are often missed within Muslim communities in the UK (Trivedi et al. 2007; Cross-Sudworth et al. 2011) suggesting that increased awareness is needed. Efficacious treatments in the UK for postnatal depression include postnatal support groups (MacInnes 2000), psychotherapeutic group approaches (Dennis and Hodnett 2007; Kurzweil 2008; Smith et al. 2010) and cognitive behaviour therapy (Stevenson et al. 2010). However there is a paucity of data examining such approaches specifically for Muslim or Arab mothers. Moreover, pharmaceutical approaches are common in the UK (Grime and Pollock 2004) but neurochemical causation goes against the idea of Jinn possession (Powell 2006).

Conversely, it may be that Arabic communities may offer their own solution to Jinn possession. Western society has constructed postnatal depression within a medical framework with women often relying on pharmaceutical approaches for recovery (Powell 2006). However, all women in the sample were accessing help and support through wider family, community and expert members in some form. It could well be that although it is important for Health Professionals to recognise and be aware of symptoms of Jinn possession, treatment may also be culturally different. The Health Professional still plays an important role in acknowledging the illness and how the woman is feeling, but allowing the woman to choose the treatment approach which is right for her. Acknowledging an individual’s belief system is an important element of helping an individual in therapy (Powell 2003), thus simply being supportive and knowledge of here Jinn may encourage recovery.

The study does have its limitations. Firstly, the sample size is relatively small but data saturation principles were followed (Creswell 2007) and a strong degree of consensus beliefs between participants emerged. Participants were also self selecting and had identified themselves as having a Jinn possession. Potentially participants who interpreted their symptoms in different ways or who felt perhaps ashamed by their possession did not volunteer. Secondly, the data was collected in an Arabian Gulf state with parallels drawn between mothers experiences in Western cultures. Although insightful, this does not confirm that mothers who live in a Western culture experience Jinn possession in the same way. Further research should explore postnatal Jinn possession in a Western culture.

Overall this paper offers an interesting insight into an alternate interpretation of typical symptoms of postnatal illness from a Western perspective in an Arabic community. The findings offer useful insight for practitioners working to support Muslim communities during the postnatal period. Further research is needed to consider how such an interpretation should be acknowledged and treated in Western cultures to best support new mothers at this vulnerable time.

Conflict of interest

The authors declare no conflicts of interest with respect to the authorship and/or publication of this article.

Copyright information

© Springer Science+Business Media New York 2013