An important question in the research of spirit possession is why certain individuals experience possession and others do not. Exposure to traumatic events and stressful events, dissociative tendencies, and somatization have been discussed as predisposing factors (Igreja et al. 2010; Neuner et al. 2012; Sapkota et al. 2014; Seligman 2005a; Van Duijl et al. 2010). Whether spirit possession necessarily involves some kind of dysfunction or psychopathology has been the theme of a long-lasting scientific debate (Boddy 1994; Owen 1990). In this discussion, anthropologists have tended to argue that spirit possession is a culturally sanctioned and rewarded phenomenon that fulfils a social function and needs to be interpreted within its cultural context (Boddy 1988; Crapanzano 1977; Lambek 1989). Other authors, mostly from psychological and medical disciplines, have described spirit possession cases associated with chronic affliction and dysfunction, sometimes as a cardinal, sometimes as a secondary symptom of a pathological syndrome such as psychosis, somatization, or a dissociative disorder (e.g., Gaw et al. 1998; Goff et al. 1991; Ng 2000; Somasundaram et al. 2008; Ward and Beaubrun 1981; for a review see Cardeña et al. 2009). In either case, it may be too simplistic to assume that there is only one path towards the development of dissociative tendencies. For instance, high hypnotisability is differentially related to high punishment/trauma on the one hand, and the development of a rich fantasy life on the other (Hilgard 1970). It is also simplistic to assume that possession is exclusively either functional or dysfunctional. In this vein, Somasundaram, Thivakaran, and Bugra (2008:249) found that possessions had been of financial benefit to 43 % of experients within recognized community groups, while about 47 % of psychiatric patients who experienced prolonged and uncontrollable possession reported having suffered financially.
Based on a questionnaire- and interview-based survey, our study evaluated factors related to Vodou possession in the Dominican Republic, comparing possessed individuals to a group matched in terms of socioeconomic status (SES) and religious belief. Possible predictors of possession included traumatic experiences, somatoform dissociation, environmental and familial influences, and some aspects of inner experience. Moreover, we explored whether or not possession was associated with chronic affliction or, contrariwise, with personal or social benefits.
The notion that a person’s ordinary identity may be replaced by a different one, usually that of a spiritual entity, is commonly referred to as spirit possession. Spirit possession typically results in noticeable changes in consciousness and behaviour followed by reported amnesia for the event. Variants of it are found throughout history and the globe (Boddy 1994; Bourguignon 1973; Oesterreich 1921/1974). Spirit possession is one of a number of alterations in the sense of self and identity (Cardeña and Alvarado 2011), sometimes discussed under the term of ecstatic religions and referred to as central possession when the alterations are part of a culturally sanctioned set of beliefs and practices, or peripheral possession when they occur independently or at the margins of cultural or religious practices (Lewis 1971/1989). In this paper we refer to spirit possession as the phenomenon, as evidenced in behaviour and experience, of one identity being replaced by another, and not to the explanation of diverse phenomena such as illness being caused by some kind of spiritual interference (for this distinction see Bourguignon 1976; and Cardeña et al. 2009). This distinction is sometimes difficult to make, as evidenced in the study of Sapkota et al. (2014), in which medically unexplained fainting spells were attributed to spirit possession rather than necessarily involving episodes of a replacement of the usual identity for another one.
The experience of pathological possession is now included in the DSM-5 under the description of identity disruption, a feature of Dissociative Identity Disorder (DID), on the condition that the alterations in consciousness are distressing and/or dysfunctional, and that the disturbance is not part of a broadly accepted cultural or religious practise (American Psychiatric Association 2013:292). However, empirical evidence for the validity of possession states as a psychopathological phenomenon and its possible connection to trauma is still scarce (Neuner et al. 2012:549), and Van Duijl et al. (2010) have recommended more quantitative research on this link.
Spirit Possession, Dissociation, and Trauma
Spirit possession has been etically discussed under the umbrella of dissociative psychological processes (e.g., Cardeña 1992; Spiegel et al. 2011). Dissociation is a complex construct involving experiential detachment such as depersonalization, and/or cognitive and phenomenal lack of access to psychological processes that are ordinarily accessible, as in psychogenic amnesia or the experience of alternate identities (Cardeña 1994; Cardeña and Carlson 2011). Western psychology and psychiatry have defined possession as dissociative because it can be described as the “splitting” of the experiencing ego into two or more identities (cf. Janet 1919/1976), and Wimmer (1924/1993) specifically discussed cases of unwilled possession from a dissociation perspective. Dissociative phenomena are not necessarily pathological and may be part of a culturally sanctioned practice associated with creative activities, a religious meaning system, or manifest as innocuous spontaneous fluctuations in ordinary conscious experience (Cardeña 1997; Maraldi 2014). Yet, dissociative reactions can also constitute a response to stress or trauma (Dalenberg et al. 2012; Hinton and Lewis-Fernández 2010; Lewis-Fernández et al. 2007; Nijenhuis 2004; Spiegel et al. 2011; Van Ommeren et al. 2001) that may become dysfunctional and bring about acute or long-term psychopathology (Cardeña and Carlson 2011).
The notion that dissociative symptoms develop in response to traumatic events was already present in Freud’s, Breuer’s and Janet’s scientific works on hysteria, and in Prince’s scholarly pieces on multiple personality and dissociation (Spiegel and Cardeña 1991). Because a considerable research database, mostly but not exclusively from industrialized nations, has shown a clear link between traumatic events and acute and long-term dissociative manifestations (Dalenberg et al. 2012), various studies have discussed possession as a dissociative phenomenon perhaps triggered by traumatic experiences (Igreja et al. 2010; Neuner et al. 2012; Van Duijl et al. 2010). For instance, systematic observation in Sudan revealed that (zar) possessed females had typically undergone pharaonic circumcision (female genital mutilation) (Boddy 1989), within a culture described as a “culture of pain” (Boddy 1998:104). In Uganda, health workers and counselors, but not traditional healers, discussed a link between trauma and possession, and all three groups saw a relation between trauma and dissociative amnesia or depersonalization (Van Duijl, Cardeña, and de Jong 2005). In another study, some of the same authors (Van Duijl et al. 2010) found trauma to be a general predictor of dissociative phenomena, including possession. In their study, possessed individuals reported more cumulative potentially traumatizing events, as well as more events related to health, injury, and having been in mortal danger than a non-possessed comparison group, but attributed possession to socio-cultural factors rather than traumatic events. Furthermore, the possessed respondents also scored higher on somatoform dissociation. Also in Uganda, Neuner et al. (2012) reported that extreme levels of trauma, such as those found among abducted child soldiers, were associated with high levels of dissociation including possession phenomena. In a study in a low SES, conservative part of Turkey, Sar, Alioğlu, and Akyüz (2014) found that spirit possession and various types of ostensible psi phenomena such as telepathy were reported across their sample, but were substantially more prevalent within the most traumatized group who also exhibited dissociative and trauma-related disorders.
In American countries, the most commonly studied cultural expression of distress may be ataque de nervios (literally: attack of nerves) (e.g., López et al. 2011), but possession is also common particularly in some countries (Brazil, Cuba, the Dominican Republic, Haiti, and Venezuela). Spirit possession has been interpreted as corporeal display of recent collective violence and distress in Venezuela (Ferrándiz 2009) or a form of social memory in the aftermath of slavery in Cuba (Pichler 2010). Hitherto, quantitative research on possession/mediumship (mediumship is a broader term than possession, but sometimes is used synonymously with it) and dissociation has been undertaken, to the best of our knowledge, only in Brazil and Cuba. In research with 110 mediums from a Kardecist Centre in São Paulo, Negro, Palladino-Negro, and Louzã (2002) found that controlled dissociation was positively related to formal training in mediumship, with mediums reporting good socialization and adaptation. Dysfunctional forms of dissociation were associated with younger age, less control of mediumship activity, poor social support, and previous psychiatric history. Seligman (2005a) compared Candomblé mediums with nonmedium initiates, frequenters of spiritual centres, SES-matched controls, and high-SES controls. She proposed that a tendency to dissociate is not the defining characteristic of Candomblé mediumship because other Candomblé practitioners had similar dissociation scores, although they had significantly higher scores than the two comparison groups. She concluded that somatization is a cardinal aspect differentiating mediums from other groups, but reported that Candomblé mediums exhibited only “a trend” towards greater somatization than the other comparison groups (after removing high-SES controls and thus poverty as potential cause for somatization). Because of the small size of her sample (only 11 initiated mediums) and lack of clarity in her report as to whether the mediums differed significantly from the other Candomblé groups, her conclusions must be taken guardedly.
Also in Brazil but with a different group (Kardecist Spiritists) Moreira-Almeida, Lotufo Neto, and Greyson (2007) reported that their sample of 115 mediums’ social adjustment was comparable to that of the general population and better than that of psychiatric patients, and the mediums had a lower prevalence of common mental disorders than that observed in other studies with non-clinical groups. Moreira-Almeida, Lotufo Neto, and Cardeña (2008) compared data of a sample of Brazilian mediums with those from dissociative disorder identity patients from other countries. The first group reported less history of trauma and better indexes of psychological health and social adjustment than the latter. Similarly, in Cuba Laria (1998) compared three groups: spirit mediums, mental health patients, and a comparison group. Mediums reported higher levels of “normal” dissociative experiences, lower levels of psychopathology, fewer traumatic experiences, and less subjective distress than mental health patients, although they had experienced more stressful events than the comparison group.
Spirit Possession and Local Context
Located in the Eastern part of the Caribbean isle of Hispaniola, and previously colonized mostly by Spain, the Dominican Republic is a predominantly Catholic country with an increasing number of protestant evangelical congregations (CIA 2014; U.S. Department of State 2005). The country, however, has a strong African heritage and has preserved some aspects of African religions and evolved them into what nowadays is called 21 divisiones or brujería, a Dominican variety of Haitian Vodou. An important difference between the two varieties is that Dominican Vodou is less structured but more influenced by European Christian and kardecistic elements. The practice of Vodou involves singing and dancing, elaborate dress, ritual practice, and connection to the spirits (Davis 1987; Deive 1975/1996).
The Dominican Republic differs from some other countries in which possession has been researched after their recent history of enormous social violence and upheaval. Although the Dominican Republic is not free from poverty and social problems, it has not undergone mass violence for a number of decades. Previously published studies that relate spirit possession to traumatic experience, in contrast, have generally been conducted in areas haunted by collective violence, such as Uganda (e.g., Van Duijl et al. 2010) or Mozambique (Igreja et al. 2010). An important research question is whether a link between trauma and the practice of spirit possession can be observed in non war-ravaged countries that nonetheless experience considerable everyday violence, such as some Latin American and Caribbean countries.
Vodou in the Dominican Republic differs from the practices of “central morality” of the elites, and may be seen as an alternative of the powerless against the powerful (Lewis 1971/1989:127). Poor women generally rank among the most disenfranchised groups and predominate as possession practitioners throughout the globe (e.g., Boddy 1989; Schmidt 2010). Women may gain in status as they are inducted into membership of the possession cult group and graduate into the position of a female healer. Furthermore, they may gain in self-control as “what is considered to begin with as an uncontrolled, unsolicited, involuntary possession illness” readily develops “into an increasingly controlled, and voluntary religious exercise” (Lewis 1989/1971:83).
The specific characteristics of Vodou are not easy to classify. Its spirits, in the Dominican Republic commonly referred to as misterios (mysteries), vary from benign to aggressive. Once they arrive in the ritual space they “mount” (possess) their (human) horses, who are said to be “ridden”, a metaphor used cross-culturally, for instance in rural Nepal (Sapkota et al. 2014). Whether or not the spirits harm their human hosts is said by some practitioners to depend on the ability of the latter to master possession. Although some authors describe Vodou possession in general as a culturally sanctioned benevolent variety of possession, a privilege only available to a chosen few who possess certain mental predispositions (see Bourguignon 1976; Davis 1987; Desmangles and Cardeña 1994), it has also been stated that Vodou possession often follows affliction (Agosto Muñoz 1972; Lewis 1971/1989:60).
General experiences at the onset of and during possession by the misterio spirits include unusual sensations in different body parts; emotional alterations; changes in voice and face expression, posture and gesture, vision and hearing; as well as the experience that some entity has taken control over one’s body, which results in a changed sense of identity (Schaffler et al. in preparation). The spirits are invoked and worshipped with their corresponding songs, ritual prayers, gestures, salutations, and drawings on the ground with flour (firmas or veves), as well as with offerings that consist of different types of food, sodas, and alcohol (Davis 1987). The most important cues to trigger possession are drums and dance (Rouget 1985). However, the spirits also manifest spontaneously, within and outside the ritual setting, for instance with the intention to deliver urgent messages. Unbidden possession may also have violent features. In general, though, practitioners seek to transform unintentional possessions into intentional, “executive” ones (cf. Sapkota et al. 2014).
The first author conducted extensive fieldwork in the Dominican Republic, (Schaffler 2009a, b, 2012, 2013, 2015) and observed that vodouists, especially at the beginning of their careers, suffer at times from violent possessions as they flail about or convulse before falling to the ground where they are tossed about. This phenomenon is emically referred to as caballo lobo (literally: wolf horse) in the Dominican Republic, or chwal gate (literally: spoiled horse) or bossal possession in Haiti (Bourguignon 1965:49). Aside from acute states of hard to control possession with violent features, spiritual development is reported to be accompanied by headaches, stomach-aches, vertigo, or other somatic symptoms (Schaffler 2009a, 2012, 2013).
Concerning the phenomenal aspects of possession, experience is of vital importance. Generally speaking, the more experienced possessed individuals are, the more their possessed actions are controlled and follow a cultural script. Readily initiated individuals are expected to carry out symbolic acts during public celebrations (fiestas) involving singing and drumming, or during private counselling sessions (consultas), with the intention to influence positively the fate of their peers (Bourguignon 1976:40).
In the present study, we inquired about two common experiences of possessed individuals, namely about not being able to control the moment when possession starts (unbidden possession), and about the spirits entering them in such gross fashion that they fall down and are tossed about (violent possession). Unbidden possession is characterised by a lack of control of the moment of possession. Spontaneous communications through the spirits are usually considered valuable, and being contacted by the spirits without consent is seen as a sign of spiritual election rather than of illness. Violent possession, on the other hand, is both unbidden and renders the individual unable to speak or perform ritual actions. This phenomenon, which in extreme cases may resemble epileptic seizures, is emically explained as the spirits entering with too much force the body of an inexperienced and thus “spiritually weak” individual (caballo lobo), or interpreted as punishment by the spirits (castigo) for neglected spiritual duties (Schaffler 2009b:121ff, 2015). Because illness related to spirit possession may cause much affliction, some Vodou centres offer the possibility of temporary hospitalization (Schaffler 2009b:273ff). Local treatment consists in rituals that aim at strengthening the affected individual’s spiritual force or at reconciliation with the angry spirits. Affected individuals may also seek medical treatment.
After experiencing possession, individuals usually report amnesia for the possession, but authors have described a variety of alterations of consciousness, not all of them followed by amnesia (Bourguignon 1976:40; Cardeña 1989, 1992; Frigerio 1989; Van Duijl, Kleijn, and de Jong 2013). In Dominican Vodou, one specific level is described as a state of slight consciousness alteration during which the misterio spirits only “touch” or “inspire” people without actually possessing them. This level is, however, emically considered to be different from possession. It is seen as less dangerous in that it never leads to loss of control, and non-possessed individuals may experience it, too. Such state of inspiration is a prerequisite for vista clara (literally: clear sight), the ability to use spiritual inspiration for the purpose of foretelling (for a similar division among Cuban practitioners, see Espirito Santo 2014). The misterios are assumed to inspire their devotees’ thoughts and dreams or send them signs in the environment, for instance through manipulating the shape of clouds, ashes, watermarks, or candle wax. Like unbidden possession, these communications through the spirits are interpreted as signs of spiritual election and we included them as possible predictors of possession.
Our cross-sectional study evaluates possible predictors of Vodou possession in the Dominican Republic, on which there has been little research so far. Using a comparison of individuals who do or do not experience possession, we examined the association of spirit possession with the experience of traumatizing events, somatoform dissociation, and problems with sleep. We predicted that those who experienced possession would differ significantly from SES-matched non-possessed peers in terms of environmental and familial influences because we believed that dissociative behaviour could be either socially learned or an inherited dissociative tendency. We predicted that spirit possession would be related to experiential predictors such as dreams, visions or unbidden thoughts attributed to the spirits, and to friends or family having reported that an individual would some day become possessed.
Since narratives about Vodouist spiritual development often refer to the experience of unbidden and violent possession, we inquired about the frequency of such experience, assessed the possessed individuals’ degree of suffering due to violent possession, and hypothesized that a segment of the possessed group had already seen a physician for violent possession and symptoms they connected to spirit possession.