Customize your JAMA Network experience by selecting one or more topics from the list below.
[E]xorcisms…are the natural resort and refuge…of active imagination co-operating with deficient observation and little-developed understanding.Henry Maudsley1(p39)
[E]xorcisms…are the natural resort and refuge…of active imagination co-operating with deficient observation and little-developed understanding.
We need more understanding of human nature, because the only real danger that exists is man himself.…His psyche should be studied, because we are the origin of all coming evil.Carl Jung2(p1)
We need more understanding of human nature, because the only real danger that exists is man himself.…His psyche should be studied, because we are the origin of all coming evil.
Belief in demons as the cause of mental health problems is a well-known phenomenon in many parts of the world. A Gallup poll reported that 42% of Americans believe that “people on this earth are sometimes possessed by the devil.”3 It was unclear to its surveyors how many people believe this literally and how many interpret it metaphorically. Yet, clearly, many do have such convictions. Thus, exorcism to drive out demons as a cure for mental illnesses is an enduring belief. Its popularity peaked in the 1970s with the release of the film The Exorcist, which dealt with the exorcism of a 12-year-old girl who was “possessed by the devil.” The film is rated as one of the best and most frightening horror films of all time. The horror is the deep and abiding fear that the psyche can be invaded by alien forces that can take over the body and force the possessed to relinquish self-control.
In the late 1880s, the prominent English psychiatrist Henry Maudsley (first epigraph) and the French neurologist Jean-Martin Charcot addressed the fallacies of demonic possession in mental illness.1,4 In Les Demoniaques Dans L’Art (The Demonic in Art),4 Charcot and his assistant Paul Richer examined illustrations of demonic possession and spiritual ecstasy in early modern paintings. They compared these depictions with the observed behaviors of their patients afflicted with la grande névrose hystérique (grand hysterical neurosis) in their clinic.4 A contemporary painting of Charcot shows him demonstrating grand hysteria in his weekly clinic with his patient Blanche Wittman.5
Charcot and Richer wrote that artists have provided science with evidence that establishes the ancient existence of great neurosis.4 Two Rubens altarpieces (one in Vienna, Austria, and the other in Genoa, Italy) of St Ignatius of Loyola exorcising demons were cited by Charcot and Richer. Rubens’ depiction of an exorcised woman provided a perfect trait-by-trait example of the convulsive scenes seen daily in Charcot’s clinic at the Salpêtrière in Paris, France.
Peter Paul Rubens (1577-1640), Flemish. The Miracles of St Ignatius of Loyola, altarpiece. Oil on canvas (circa 1617-1618). © Kunsthistorisches Museum, Vienna, Austria. Photo credit: Erich Lessing/Art Resource, New York, New York.
The first of these altarpieces, Rubens’ Miracles of St Ignatius of Loyola (Figure), painted for the high altar of the Jesuit Church in Antwerp, Belgium, portrays the exorcism of a woman and a man. Rubens illustrates the tumultuous spectacle of an exorcism.6 Ignatius stands facing the congregation with his back to the altar. He has completed the celebration of the Mass, a step that must precede an exorcism. A halo of gold shines above Ignatius’ head, and his eyes are red from weeping. He wears majestic priestly garments; his chasuble is a shining liturgical vestment of gold. His left hand rests on the high altar, on which there is a chalice and a burning candle. Ignatius’ right hand, raised in a priestly gesture of exorcism, directs the viewer across the axis of the painting toward banished and fleeing demons that are shown in the nave of the church, in the upper left part of the painting. The fleeing demons are mocked by angels. One demon, a dragon, sends out fiery smoke. Another, a horned beast with glowing eyes looks back. Three putti carrying wreaths are suspended above Ignatius in tribute to him. Six Jesuits wearing black robes bear witness to certify the exorcism. Other Jesuits stand behind them.
Detail of woman being exorcised by St Ignatius.
At the foot of the altar, an anguished crowd of people in disarray look up toward the priest. They surround a woman and a man whose demons have been cast out. The exorcised woman, who so interested Charcot, is supported by others as she falls backward apparently in the midst of a “convulsion” (detail). Her mouth is open, her nostrils are dilated, and her blackened tongue protrudes. The globes of her eyes convulse upward, hiding her pupils under her eyelids. She furiously rips open her bodice with her left hand so that her dress falls to her hips. With her right hand, she grips and pulls back strands of her hair. In the midst of this emotional turmoil, Rubens reminds the viewer of the Stoic philosophy of controlling the emotions and maintaining equanimity by depicting an old bearded man above her with features similar to those of the Roman Stoic Seneca.7 He seems not to be perturbed or preoccupied with the devils or angels.
In the foreground, an exorcised man, nearly nude and wearing only a loincloth, has fallen to the ground. His face is horribly contorted, with the globes of his eyes turned upward and mouth open. His lips are blue, and he is foaming at the mouth. He has broken his restraints. A half-nude man is lifting his head. Another man, facing the priest, kneels in prayer. Yet, on the right, there is relative calm: a mother with an infant in her arms looks up at Ignatius; another mother with 2 children looks back over her shoulder; and, to the right of these 2 mothers, a man who has already been successfully exorcised holds up the bonds that restrained him.
With the revival of the Catholic Church during the Counter-Reformation in the 16th century, exorcism received renewed emphasis. It demonstrated the Roman Catholic Church’s capacity to triumph over evil forces and was an important means used to convince and reconvert Protestants. In the United Kingdom, where English Catholics were outlawed and persecuted, exorcisms were widely publicized to demonstrate the divine sanction of the Catholic Church.
The rite of exorcism was formalized in 1614 under Pope Paul V before Rubens completed his painting. It was used virtually unchanged until 1999, when the style of language was modernized, although the content remained essentially the same. In Rome in 1999, Cardinal Jorge Medina clearly stated that the existence of the devil is an article of faith and part of the doctrine of the Catholic Church and that anyone who says the devil does not exist is no longer a believer. Thus, the rite of exorcism persists because of religious beliefs regarding the nature of evil—personified by belief in the devil.
The rite of exorcism presumes that possessed persons retain their free will. However, the demon may have control over his or her physical body. It involves prayers, blessings, and invocations. Speaking foreign or ancient languages with no previous knowledge of them, apparent supernatural strength, knowledge of hidden or remote things, aversion to anything holy, blasphemy, and sacrilege characterize demonic possession. Vatican guidelines issued in 1999 require medical evaluation to rule out a mental or physical illness in anyone who claims to be possessed. Most reported claims do not require exorcism; 21st century Catholic officials consider genuine demonic possession as extremely rare and understand that it can be easily confused with known mental disorders. Despite this requirement, symptoms of schizophrenia are still being classified as demonic possession by priests in some countries.8
Psychodynamic explanations of demonic possession have been largely based on Freud’s retrospective application of libido theory9 to the Christoph Haitzman case. Freud’s view influenced the psychoanalytic theory of paranoid symptom formation and the psychoses. Object relations theorists have viewed demonic possession in the context of bad internalized objects. Carl Jung’s focus on dissociation, autonomous feeling-toned complexes, and loss of unity of the personality in schizophrenia have drawn the greatest attention. Jung was first assistant to Eugen Bleuler when Bleuler was developing criteria for schizophrenia. He assigned Jung the task of examining psychotic mental phenomena. Religious themes in psychosis influenced Jung’s theory of archetypes. For Jung, “evil” results from individual conscious decisions (second epigraph) and must be confronted ethically when dehumanizing and immoral thoughts come into consciousness.2 Only in that way can humankind be protected and dehumanizing and unethical beliefs be “exorcised.”
Corresponding Author: James C. Harris, MD, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287 (firstname.lastname@example.org).
Conflict of Interest Disclosures: None reported.
Harris JC. Exorcism: The Miracles of St Ignatius of Loyola: Peter Paul Rubens. JAMA Psychiatry. 2014;71(8):866–867. doi:10.1001/jamapsychiatry.2013.2747
Coronavirus Resource Center
Create a personal account or sign in to: