Spirit Possession Presentations in Clinical Psychiatry: Diagnostic Challenges and the Role of Collaborative Spiritual Care

Location

LSUHSC-NO

Publication Date

April 2026

Start Date

9-4-2026 10:00 AM

End Date

9-4-2026 2:00 PM

Description

Introduction: Spiritual possession presentations are widely reported across diverse cultural contexts. In addition to distinguishing culturally normative possession experiences from psychopathology, clinicians must formulate differentials for a range of presentations that may meet criteria for several DSM-5 diagnoses. This review explores how culturally and spiritually sensitive explanatory models, along with collaborative care approaches, are central to maintaining diagnostic integrity while sustaining a strong therapeutic alliance with these patients.

Methods: We conducted a narrative literature review using the PubMed database with two structured search queries for free English full-text articles: (1) possession experiences combined with collaboration/spiritual care terms and (2) possession experiences combined with psychiatric differential diagnosis terms. The searches yielded 16 and 14 results respectively, with 6 overlapping records and 1 exclusion for lack of relevance, resulting in 23 search-derived articles. Citation mining with the inclusion of foundational global mental health literature expanded the reference base to 42 total sources.

Results: These presentations commonly overlapped with dissociative disorders, psychotic disorders, and psychogenic nonepileptic seizures (PNES), with trauma-related symptoms frequently reported. Some medical and neurological conditions, including seizures and delirium, have also been interpreted as spiritually influenced. Experiences characterized by displacement of personal agency often reflected dissociative disorders; when occurring in discrete, recurrent episodes, cases also included seizures and PNES. Individuals often sought help through religious or traditional healing systems before psychiatric evaluation, and collaboration between clinical and religious care has been documented in several settings.

Discussion: Diagnosis of spiritual possession presentations depend on the definition of possession, which may differ across cultures and clinical contexts. Critics of the DSM illustrate that these cases remain diagnostically ambiguous because it's classifications often fail to account for sociocultural context. Critics of the DSM illustrate that these cases remain diagnostically ambiguous because it's classifications often fail to account for sociocultural context. Literature supports culturally informed assessments that differentiate normative spiritual experiences from psychiatric illness; for example, attribution to normal behavior or psychotic delusion was delineated by functional impairment and cultural appropriateness. Incorporating collaboration with clergy and traditional healers may improve engagement while preserving diagnostic and treatment standards

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Apr 9th, 10:00 AM Apr 9th, 2:00 PM

Spirit Possession Presentations in Clinical Psychiatry: Diagnostic Challenges and the Role of Collaborative Spiritual Care

LSUHSC-NO

Introduction: Spiritual possession presentations are widely reported across diverse cultural contexts. In addition to distinguishing culturally normative possession experiences from psychopathology, clinicians must formulate differentials for a range of presentations that may meet criteria for several DSM-5 diagnoses. This review explores how culturally and spiritually sensitive explanatory models, along with collaborative care approaches, are central to maintaining diagnostic integrity while sustaining a strong therapeutic alliance with these patients.

Methods: We conducted a narrative literature review using the PubMed database with two structured search queries for free English full-text articles: (1) possession experiences combined with collaboration/spiritual care terms and (2) possession experiences combined with psychiatric differential diagnosis terms. The searches yielded 16 and 14 results respectively, with 6 overlapping records and 1 exclusion for lack of relevance, resulting in 23 search-derived articles. Citation mining with the inclusion of foundational global mental health literature expanded the reference base to 42 total sources.

Results: These presentations commonly overlapped with dissociative disorders, psychotic disorders, and psychogenic nonepileptic seizures (PNES), with trauma-related symptoms frequently reported. Some medical and neurological conditions, including seizures and delirium, have also been interpreted as spiritually influenced. Experiences characterized by displacement of personal agency often reflected dissociative disorders; when occurring in discrete, recurrent episodes, cases also included seizures and PNES. Individuals often sought help through religious or traditional healing systems before psychiatric evaluation, and collaboration between clinical and religious care has been documented in several settings.

Discussion: Diagnosis of spiritual possession presentations depend on the definition of possession, which may differ across cultures and clinical contexts. Critics of the DSM illustrate that these cases remain diagnostically ambiguous because it's classifications often fail to account for sociocultural context. Critics of the DSM illustrate that these cases remain diagnostically ambiguous because it's classifications often fail to account for sociocultural context. Literature supports culturally informed assessments that differentiate normative spiritual experiences from psychiatric illness; for example, attribution to normal behavior or psychotic delusion was delineated by functional impairment and cultural appropriateness. Incorporating collaboration with clergy and traditional healers may improve engagement while preserving diagnostic and treatment standards