Netherlands Institute for Forensic Psychiatry, The Hague, The Netherlands ; Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands.
Leiden University Medical Center, Leiden, The Netherlands ; Centrum '45, Oegstgeest, The Netherlands.
Int J Ment Health Syst. 2014 Jun 9;8:24. doi: 10.1186/1752-4458-8-24. eCollection 2014.
As in many cultures, also in Uganda spirit possession is a common idiom of distress associated with traumatic experiences. In the DSM-IV and -5, possession trance disorders can be classified as dissociative disorders. Dissociation in Western countries is associated with complicated, time-consuming and costly therapies. Patients with spirit possession in SW Uganda, however, often report partial or full recovery after treatment by traditional healers. The aim of this study is to explore how the development of symptoms concomitant help-seeking steps, and explanatory models (EM) eventually contributed to healing of patients with spirit possession in SW Uganda. Illness narratives of 119 patients with spirit possession referred by traditional healers were analysed using a mixed-method approach. Treatments of two-thirds of the patients were unsuccessful when first seeking help in the medical sector. Their initially physical symptoms subsequently developed into dissociative possession symptoms. After an average of two help-seeking steps, patients reached a healing place where 99% of them found satisfactory EM and effective healing. During healing sessions, possessing agents were summoned to identify themselves and underlying problems were addressed. Often-mentioned explanations were the following: neglect of rituals and of responsibilities towards relatives and inheritance, the call to become a healer, witchcraft, grief, and land conflicts. The results demonstrate that traditional healing processes of spirit possession can play a role in restoring connections with the supra-, inter-, intra-, and extra-human worlds. It does not always seem necessary to address individual traumatic experiences per se, which is in line with other research in this field. The study leads to additional perspectives on treatment of trauma-related dissociation in Western countries and on developing effective mental health services in low -and middle-income countries.
与许多文化一样，在乌干达，精神附身也是一种常见的痛苦表达，与创伤经历有关。在 DSM-IV 和 -5 中，附身恍惚障碍可归类为分离障碍。在西方国家，分离与复杂、耗时和昂贵的治疗相关。然而，在 SW 乌干达，患有精神附身的患者在接受传统治疗后，常常报告部分或完全康复。本研究旨在探讨患者在寻求帮助时的症状发展、伴随的寻求帮助的步骤以及解释模型（EM）如何最终有助于 SW 乌干达患有精神附身的患者康复。使用混合方法分析了 119 名由传统治疗师转介的患有精神附身的患者的疾病叙述。当三分之二的患者首次在医疗部门寻求帮助时，他们的治疗并未成功。他们最初的身体症状随后发展为分离性附身症状。在平均经历两次寻求帮助的步骤后，患者到达了一个治疗场所，其中 99%的患者找到了满意的 EM 和有效的治疗。在治疗过程中，附身者被召唤来识别自己，并解决潜在问题。常提到的解释如下：忽视仪式以及对亲属和遗产的责任、成为治疗师的召唤、巫术、悲伤和土地冲突。结果表明，精神附身的传统治疗过程可以在恢复与超人类、人际、内在和外在世界的联系方面发挥作用。似乎并不总是需要单独解决个人创伤经历，这与该领域的其他研究一致。该研究为治疗与创伤相关的分离症在西方国家以及为在中低收入国家发展有效的心理健康服务提供了额外的视角。
