Padmanabhan Divya
a School of Social Sciences, Jawaharlal Nehru University , New Delhi , India.
Anthropol Med. 2017 Dec;24(3):261-275. doi: 10.1080/13648470.2017.1389168.
This paper critiques the category of possession-form dissociative identity disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) published in 2013 by the American Psychiatric Association (APA). The DSM as an index of psychiatry pathologises possession by categorising it as a form of dissociative identity disorder. Drawing upon ethnographic fieldwork, this paper argues that such a pathologisation medicalises possession, which is understood as a non-pathological condition in other contexts such as by those individuals who manifest possession at a temple in Kerala, South India. Through medicalising and further by creating distinctions between acceptable and pathological possession, the DSM converts a form of distress into a disease. This has both conceptual and pragmatic implications. The temple therefore becomes reduced to a culturally acceptable site for the manifestation of a mental illness in a form that is culturally available and possession is explained solely through a biomedical framework, denying alternative conceptualisations and theories which inform possession. By focussing on the DSM-5 classification of possession and the limitations of such a classification, this paper seeks to posit an alternative conceptualisation of possession by engaging with three primary areas which are significant in the DSM categorisation of possession: the DSM's conceptualisation of self in the singular, the distinction between pathological and non-pathological forms of possession, and the limitations of the DSM's equation of the condition of possession with the manifestation of possession. Finally, the paper briefly highlights alternative conceptualisations of possession, which emerged from the perspective of those seeking to heal possession at the Chottanikkara temple.
本文对美国精神病学协会（APA）2013年出版的《精神疾病诊断与统计手册》第5版（DSM - 5）中所定义的附身形式分离性身份障碍类别进行了批判。作为精神病学的一个索引，DSM将附身归类为分离性身份障碍的一种形式，从而使其病态化。基于人种志田野调查，本文认为这种病态化将附身医学化，而在其他情境中，比如在印度南部喀拉拉邦一座寺庙中表现出附身现象的那些人看来，附身被理解为一种非病理性状况。通过医学化以及进一步区分可接受的附身和病理性附身，DSM将一种痛苦形式转变为一种疾病。这具有概念和实际两方面的影响。因此，寺庙沦为了一个在文化上可接受的场所，以一种文化上可行的形式呈现精神疾病，而且附身仅仅通过生物医学框架来解释，否定了其他为附身提供依据的概念化和理论。通过聚焦于DSM - 5对附身的分类以及这种分类的局限性，本文旨在通过探讨在DSM对附身的分类中具有重要意义的三个主要领域，提出一种关于附身的替代概念化：DSM对单一自我的概念化、病理性附身和非病理性附身形式之间的区别，以及DSM将附身状况与附身表现等同起来的局限性。最后，本文简要强调了从那些试图在乔塔尼卡拉寺庙治愈附身现象的人的角度所产生的关于附身的替代概念化。
