Abstract

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and its Text Revision (DSM-5-TR) include experiences of diabolical possession and human relationships with spirits as a cultural variation of dissociative identity disorder (DID). Consideration of potential cultural factors is essential to making an accurate diagnosis and employing ethical treatment. However, the DSM and existing literature offer little to assist professionals making a differential diagnosis when these “cultural factors” may be present and someone does not otherwise meet criteria for DID. A Catholic Christian perspective allows for instances of possession and dissociative disorders to be distinct or to coincide. Each diocese/bishop is required to appoint a priest to function in the role of exorcist and to minister to people who are seeking spiritual help, including for possession. When the Roman Catholic Church concludes that the rite of exorcism may be warranted, mental health professionals are appropriately tasked to assess whether the symptoms experienced by the person can be explained and treated psychologically. Given the current DSM criteria, mental health professionals in this role must be equipped to rule in or rule out a diagnosis of a dissociative disorder. This article discusses relevant history, current literature, diagnostic criteria, and assessment tools for dissociative disorders, and DID in particular, from a Catholic lens.

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