Abstract
KS, a 13-year-old schoolgirl, accidentally saw the dead body of her close friend hanging from the ceiling of the girl's residence. A few days later, she started experiencing flashbacks, in which she clearly saw the distorted face of the victim with a noose around her neck. She began to avoid the street where the home of the deceased was located. She was reported to be depressed, irritable and sleepless.
A month later she experienced the abrupt onset of an ‘attack’ during which she claimed that she was the spirit of her friend. She tossed her body and shouted as though she were in discomfort. The attack ended abruptly and she had no recollection of the event. As days passed, there was further deterioration in her clinical picture with several attacks in a day.
Observation of attacks confirmed the description given by the relatives. Her IQ on formal testing was seventy. EEG recording was normal. A drug-assisted interview was performed with injections of thiopentone; during the interview she confided that whenever she was threatened by the horrific image of her friend, she felt she was possessed by the spirit of the friend. She was commenced on amitryptyline 100 mg/day to treat the emerging depressive symptoms and insomnia.
The patient was trained to relax using Jacobson's method of progressive muscle relaxation. During therapy sessions, she was encouraged to discuss the traumatic event. In the initial stage of therapy, ‘possession attacks’ were common but in due course there was a gradual reduction in their frequency. At follow-up evaluation after 3 months she was free of those attacks.
The possession phenomenon has been reported predominantly in women of lower educational background across cultural groups world-wide [1]. In our case, the dissociative phenomenon expressed itself in the form of a trance attack which is essentially a culturally sanctioned mechanism.