Incense clouds the sunroom entry to Sharon Caulder’s Oakland abode, where a squatting wicker monkey stands guard, a tabletop perched on its head. In the small room beyond, a man sits on a straight-backed chair, hands on his knees, eyes closed. He’s flanked on one side by an imposing Japanese rosewood altar bearing bottles, family photos, small statues, stones, flowers, and lit candles. The granite counter of a wet bar behind him is crowded with plastic packets of herbs and stones, and more bottles and burning candles. A brass cobra on the floor peeks out from a pile of what look like dried cobra eggs. Pretty much standard equipment, one might imagine, for someone who rids people of their demons.
Daniel is undergoing the final stages of exorcism. In prior sessions, Caulder has driven out the spirit that possessed him since birth, causing a distorted sense of himself and an inability to maintain relationships with women. But there’s yet work to be done. Daniel came to Caulder in January with a ringing in his left ear; a common symptom, the exorcist notes, of an unwanted being on board. “This was a helpful spirit, sort of an invisible playmate,” she says. “It was probably very helpful to him in early childhood. But they begin to live your life. You should live your own life.”
Daniel, in fact, has a life. With his short, silver-shot hair, goatee, and wire-rim glasses, he looks exactly like the sales manager and former software executive he is. What he doesn’t look like is someone who would believe in this stuff; at best, he seems like a guy who might let his wife drag him to couples counseling — as long as it wasn’t game night.
For that matter, the session begins like a visit to a therapist. Daniel sits in a chair in the center of the rug, while Caulder perches on a carved wooden chair about three feet away. Unlike Daniel, she looks the part. Caulder is sixty years old but appears forty, petite and curvy with wavy highlighted dark hair, a diamond nose piercing, and a ruby stud below her lower lip. A graphic black snake tattoo winds around her right arm. She favors bold jewelry like a rhinestone tarantula worn on a ribbon around her neck. Today, she’s dressed in a loose white silk shift with a nylon slip underneath. Her feet are bare, her fingernails, toenails, and lips painted the same frosty mauve. “So, how’s it going?” she asks Daniel in that supportive but neutral tone favored by regular psychologists.
Work’s been crazy, he says. His usual ten-hour days are now twelve hours. The company is doing better although he’s short a couple of employees, which means more work for him. But his relationship has been good.
It’s only when the conversation turns to Daniel’s exorcised spirit that things stray from the ordinary. “You’re looking shiny,” Sharon says. “This is the first time I’ve seen you shiny.” She pulls out a small whiteboard and draws a quick outline of a person’s head and shoulders. Another swipe of the marker takes a chunk out of the left side of the head, like a bite from an apple. This, Caulder explains, is where the spirit entered and nestled. And although the stowaway is gone now, Daniel still has a hole in his energy shield; if it isn’t mended, other spirits might get in. “Every cell in your body has the footprint of your soul,” she says. When a spirit enters you, it takes up space in the body and changes the shape of that footprint to its own. After it’s exorcised, she notes, the original soul footprints have to be re-created so that the person’s own soul can fully inhabit its body. Today, she’ll help Daniel reshape the footprints and “hulk up” his own spirit.
As they chat, Caulder rises and begins moving around her client, then suddenly begins to motion with her hands. It’s as if Daniel were encased in a foot of thick, malleable, invisible clay. She picks and grabs at the stuff, flicking her fingers to the side, casting off bits of spiritual schmutz. She steps back to survey her work, then moves back in, patting and picking some more. This goes on for about twenty minutes. Finally, she squats in front of him. “You’re in really good shape,” she says in a tone that suggests she’s trying to imprint him with a posthypnotic suggestion.
After Daniel leaves, Caulder prepares an elixir at the wet bar in readiness for Magi, her next client, who grew up in a satanic church in Los Angeles, and as a child experienced what she calls satanic blood-sex rituals. A shamanic healer herself, Magi has asked Caulder to perform a traditional healing ritual.
“I can set a goal and get to that goal through any number of ways,” Caulder says, dripping essential oils into a fancy perfume bottle. “In traditions like voodoo or any shamanic tradition, they usually heal by bringing in divinities, sacred spirits to do the work.” She adds flakes of gold leaf. “Because this lady is looking for the energy of ritual, I can make the energy of ritual for her.” Caulder then tries to force a few red stones into the narrow mouth of the bottle, but they won’t fit. “Shit.” She puts the packet of stones aside and adds some smaller, rosy stones to the mixture. “But let me be clear,” she continues. “I will do the work, I will cleanse her psyche or soul myself.”
Magi has the vibe of a grade-school teacher, friendly and blonde and dressed in jeans, a turtleneck sweater, and big dangly earrings. She takes a seat, and Caulder explains that she’ll be invoking the spirits of Nâete, the voodoo deity of the sea, and Kali, the Hindu primal mother goddess. Magi nods and smiles as if Caulder were mentioning mutual friends.
The healer creates an ad hoc altar on the floor next to her client. She lines up a colored statue of a woman with a snake — voodoo goddess Mami Wata — a shallow ceramic bowl, and a pint of Seagram’s gin. Then she kneels on the floor in front of Magi and prays. Twice she swigs gin from the bottle, then spits it on the statue. She then takes a gourd from the altar and begins moving around the seated woman, shaking it as Magi sits erect, her eyes closed. Next comes a plain white egg, which Caulder passes around Magi’s body, front and back, holding it near her heart, her stomach, her groin. She darts to the door, opens it, and cracks the egg against the door frame, spilling its contents on the wooden deck then dumping the dripping shells into a potted bamboo.
Caulder then picks up a small axe, its wooden handle and brass blade incised with decorations. She makes chopping motions behind her client’s back as though cutting thick vines that tie her to something unseen. Laying down the axe, she rubs a small cup on the crown of Magi’s head. The women murmur to each other, indistinguishable words. “Kali,” Caulder says. Magi hums in agreement, “Mmm hmmm, mmm hmmm, mmm hmmm.” Caulder completes the ceremony by piling rose petals on Magi’s head and letting them spill off her and onto the floor.
Magi opens her eyes, contented. “Ooh, I’m zippy,” she says. She then quizzes Caulder, one pro to another: “What’s your take on what happened when I was going to that place and hesitated?”
“I’m monitoring you all the time,” Caulder says, “so when I saw your hesitation, I stopped the process and said Kali’s name. I did what I needed to do so that when you went there, you could get the benefit with the least amount of damage.”
“It felt like I was traveling through black sludge,” Magi says. “Then Kali came. She and I linked arms and kicked butt. Kali, Mami, they’re soul sisters to me.”
“I ritually cut you from that with the Buddhist axe,” Caulder says.
“I could feel that at my genetic level,” Magi says.
Over a glass of champagne, which Caulder says is part of the ritual, the women proceed to discuss their past lives as casually as if talking about favorite restaurants. “I’ve been a black slave many times,” Magi says. “In fact, I don’t understand why I’m white. This body seems foreign to me.”
“I was Chinese once, and didn’t like it,” Caulder says. “But I’ve been Japanese several times and liked that very much.”
As she prepares to leave, Magi turns to Caulder’s visitor. “Most people don’t know they have a soul — or that it can be entered, taken over, eaten,” she says vehemently. “My roommates would tell me, ‘You just think you’re possessed.’ Noooo. I can see them.”
Having witnessed all this, a rational observer might reasonably ask the question: Are these people completely nuts? It’s weird stuff to be sure. But perhaps even weirder is that, according to experts on the subject, demand for these sorts of rituals is on the rise among ordinary people. Not to mention that spiritual healers of Caulder’s ilk have been surprisingly successful in winning acknowledgment, and patient referrals, from practitioners of Western medicine. Even the federal government is funding research to see whether treatments based on supernatural forces are effective (see sidebar). If Caulder’s crazy, in other words, what does that say about the National Institutes of Health, or for that matter, psychiatrists like Jakob Camp?
Camp, for one, is open to any possibility that might help his patients. Tall and lanky, he just about fills the interior of the Sausal Creek Outpatient Stabilization Center, an Alameda County-run drop-in center for the mentally ill housed in a cramped prefab building on a dead-end street in Oakland’s Fruitvale district. Most of the center’s clients are chronically mentally ill, many with dual diagnoses, and often drug-addicted. This is where they come to get meds, chill out, act out, and avoid the county’s lock-in facility.
Camp has seen and heard a lot more than your typical shrink. He’s a forensic psychiatrist, an MD who applies psychiatry to legal problems. In his experience, those problems have tended to be horrific, often involving people who have slaughtered family members, friends, or even complete strangers. The doctor has worked in prisons and institutions in seven states, including the infamous maximum-security Atascadero State Hospital. In New Zealand a few years back, he helped set up a program to transition scores of the country’s most disturbed and violent inmates back into their communities.
While still a medical resident at the University of Chicago, Camp saw how religion and culture could work on the mind in hurtful ways. Working at methadone clinics on the city’s rough South Side, he acted as a liaison for students in the university’s anthropology and sociology departments who were studying the influence of religious belief on substance abusers. “There was a great variety of charismatic and intense religious groups represented at the clinics,” he says, “and that’s often a large part of what people were warring with in their addictions. Some people were struggling with very intense conflicts over religious issues and moral questions.”
Indeed, it’s not uncommon for Camp’s patients to complain of mysterious ailments of the sort Caulder knows well: They gripe of such things as being hexed, having a body part controlled by some outside force, or experiencing an overpowering need to perform bizarre rituals for a dead child. “I don’t automatically dismiss these as a delusion or symptom of schizophrenia,” Camp says. “I’ve seen things happen to other people that keep my mind open.”
In such cases, Camp suspends his judgment and tries to understand the cultural and social context of the patient. For help, he often turns to people like Sharon Caulder. The doctor found her through her Web site (SharonCaulder.com) and contacted her soon after he arrived at Sausal Creek early last year. So far, he has consulted her on two cases, and says he’d have no problem referring a patient to her for treatment “if the context were appropriate.” In other words, if a patient believed he were possessed by evil spirits, Camp might have Caulder perform an exorcism. If someone felt she’d been cursed, Caulder might be asked to remove it.
It’s more difficult to pin down Camp about what he thinks is actually happening in such situations. Asked directly whether he believes a spirit can enter a person’s body, he exhibits classic hem-haw behavior. Finally, he answers: “I’m not sure we understand enough about how we connect together in this world to make any absolute statements about what really happens in human encounters. I believe that people are affected by beliefs within the context of their religious and cultural backgrounds, enough to be affected by them and become ill.”
But are those effects psychosomatic, or real?
“My mind is open about these things,” the doctor replies.
It was during his time in New Zealand that Camp saw how religion could help people. Discharging Maori inmates back into their family groups required the cooperation — and intervention — of the tohunga, Maori priests and traditional knowledge-keepers. He would watch as a newly released prisoner sat among his relatives for a ritual of encounter and welcome. “The setting encourages every individual, no matter their age or status, to talk about how they feel about the situation no matter how irrational or counterproductive it might seem,” he says. “Tohungas are often able to take the context of some very intense verbal violence and shift it into language that can be very healing and transformative.” Although Camp couldn’t understand the language, he could see a transformation take place. “It’s like spiritual dynamic therapy,” he says.
Now, wherever he goes, Camp builds a network of alternative healers. “It’s something that needs to happen more,” he says. “Psychiatrists tend to interface with people in some of the most unique psychological experiences that you can have. It’s tragic when they’re blind to something that really fits the context of a religious or spiritual issue.”
If Sharon Caulder hopes to make her healing crafts more palatable to the mainstream — which she does — she may be doing herself a disservice by touting all of her credentials. Caulder is one of those healers with an alphabet soup of educational degrees after her name. There’s the Ph.D in mythology and depth psychology from Pacifica Graduate Institute, and the Ed.M in education and Ed.D in neuroscience from Columbia University’s Teachers College. She also boasts two physical therapy degrees and even a certificate in Transpersonal Psychology from the New York Psychosynthesis Institute, a credential with an undeniable Ghostbusters ring to it.
But Caulder has another credential that has brought her both minor acclaim and her share of disdain: By the authority of the government of Benin, a small West African country between Nigeria and Togo, Caulder is a bona fide voodoo chieftain. That’s a certificate few healers can boast, and perhaps few would want to. Despite the public’s abstract belief in the supernatural, the word “voodoo” still has negative connotations. Just last week, a defense lawyer for Scott Peterson — who stands accused of killing his wife and late-term fetus in a case being followed nationwide — publicly disparaged the prosecution’s “voodoo-type investigation,” citing its use of “psychics, voice-stress analyzers, [and] people who study facial expressions.”
Still, voodoo is Caulder’s claim to fame. It was her soul-searching trip to the religion’s birthplace that became the subject of her 2002 book, The Mark of Voodoo: Awakening to My African Spiritual Heritage. (Most practitioners call it voudoun, voudou, voudu, or vodun — but Caulder chose to use the Hollywoodized spelling better known to the average reader.)
While it’s an entertaining and funny yarn of adventure travel and culture clash, the book clearly stretches some people’s willingness to believe, judging from its reception at Amazon.com. One scathing reader review from Columbia, Missouri, is titled “The Tale of the Know-It-All and the Charlatan.” A more sober one from Publishers Weekly concludes: “For those who can discern legitimacy and have a strong stomach for animal slaughter, Caulder’s account is not without merit.”
Her story certainly makes for a good read. During the 1970s, Caulder had a thriving New Jersey physical therapy practice, which specialized in treating chronic pain. Along with the usual treatments, Caulder says, she began tinkering with nonphysical aspects of healing. “I realized I was touching more than the body, I was touching psyche, which was wonderful,” she says.
Over the years, she sought additional training to address her clients’ psychological and spiritual problems. The ’70s were a giddy time for psychology, with all sorts of radical and experiential theories battling the traditional ones. Caulder sampled them all, but none jibed with the kind of work she wanted to do. “At that point I really claimed my own abilities seeing and working with spirit,” she says. “I promised myself I wouldn’t call myself a physical therapist anymore.”
In 1993, she moved to California, where she began studying with energy healers and became a teacher for New Age superstar Barbara Brennan. Around the same time, she decided to come to terms with some disturbing childhood memories that had begun to surface — scenes of being buried alive or tied to a cross while a cat was sacrificed at her feet. Her nice middle-class African-American family’s Christian Scientist religion, she came to believe, was a cover for voodoo practices, which included sadistic rituals and even human sacrifice. She soon realized, she claims in her book, that she’d been conceived and groomed to take over as her clan’s chief.
To explore what she now considered her ancestral religion, Caulder set off for the Republic of Benin. Upon arrival, she asked around for the chief of voodoo, and was taken to Ouidah, a little coastal town that she claims felt strangely familiar. There, she met Daagbo Hounon Houna, whom a translator introduced as “the reigning supreme chief of the voodoo peoples.” They looked into each other’s eyes, Caulder wrote, and their “spirits locked.”
A week later, Caulder began her initiation in Daagbo’s compound, where she would be initiated as a chief, not as a common Vodusi, as voodoo initiates are called. First, in a ceremony to see which deities Caulder was related to, her hosts sacrificed a goat as her offering. But the assistant had trouble cutting its throat with the rusty ceremonial knife. As the goat bleated in pain, Caulder wrote, she pulled out a switchblade acquired in Manhattan and offered it to the priest, impressing her hosts mightily. In voodoo rites, blood is spilled on altars and shared among participants, while the body and its entrails are used for divination. But the sacrifices troubled her. In her three subsequent years practicing voodoo, she would come to the conclusion that ritual slaughter doesn’t help people on their spiritual paths.
Caulder was dedicated to Hervióso, the god of thunder, and Nâete, the chief of all divinities and mother of the waters. Over the next three and a half months, she learned to shape her Western values and attitudes to fit the African voodoo ways, taking a swig of palm wine to loosen up before practicing the dances of her divinities, and refraining from offending the souls of the giant cockroaches by dousing them with insecticide.
Her “spirit” bond with Daagbo soon took an erotic turn. It began with “nocturnal energetic lovemaking” — while their bodies lay in different rooms, Caulder says, their spirits connected and reeled upward, bringing them to a higher level of consciousness. They bedded down for real soon after, even though an initiate wasn’t supposed to have sex at all, let alone with the supreme chief. Decidedly Western in her attitudes, Caulder wanted a serious commitment and extracted a promise of monogamy from the chief, who had wives and children all over Benin. To replace the energy he would no longer get from his sexual network, she instructed him to eat more protein, greens, and fresh fruit. Needless to say, the recommended diet failed to satisfy the chief’s sexual appetite.
Through two more visits to the village, Caulder decided that the voodoo practice of letting deities possess the body, even temporarily, was harmful. “My years of working with people and time spent watching people in ceremonies like that made me realize that our evolutionary journey is to come home to ourselves,” she says, “not to throw ourselves out then bring ourselves back in. My sense is that religion often keeps us separated from ourselves — and psychology sometimes does the same.”
While some readers enjoyed her book simply for the tale, others took it as the story of a naive and impressionable American woman who gets taken — financially and physically — by an African flimflam artist. Among her critics was Mamaissii Vivian Odelelasi Hounon, a Martinez, Georgia, woman who is the chief priest of the Mami Wata Healing Society of North America. In a withering review on Amazon, she disputes Caulder’s claim that Daagbo is the supreme chief of voodoo and calls Caulder’s own initiation into question. Caulder is philosophical about it. “You never know if the voodoo queen thing is going to work for you or against you,” she says.
She’s now a card-carrying voodoo chieftain, thanks to the Benin government, which began licensing practitioners of traditional religions in part to bolster its tourist industry. Caulder takes the credential seriously. “I’m practicing under my religion; I also got a minister’s license so I can do marriages and other ceremonies,” she says. “That makes me official and legitimate — but I certainly use all the skills I’ve accumulated over the years,” not just voodoo.
Legitimacy, of course, can be subjective. Her clients, Caulder says, are mostly professionals unwilling to go public about their problems and the treatments they seek. That’s understandable, since few people around the office are going to relate to the scary world she claims to occupy. In Caulder’s world, your next-door neighbor might be harboring a werewolf spirit, or the person in the next cube may be sending beams of destructive energy toward you. Tony Upper East Side cocktail parties turn into vampiric orgies, and even your local florist may be standing by to slam you with a curse.
Caulder is working on a second book, From the Files of an Exorcist, which will relate juicy stories of people looking for love or kicks who inadvertently open themselves up to invasion by all sorts of unpleasant beings. One of her case studies is a Bay Area nurse who was sexually abused by her mother. “My client,” she writes, “was devoured early in life by her natural mother and therefore was prey for the classically devouring werewolf.”
The young woman, Caulder says, met a man in a bar who was attracted to her distorted spirit. That night, they took drugs and he took her to a cemetery. “They laid upon the cold hard ground between the headstones,” she writes, “allowing the drugs to open them up to the random and degenerate spirits roaming restlessly in the cemetery. Enchanted and excited by the astral spirits, she followed them into the depths of the low astral worlds. … Her partner guided her into the cavernous world of the werewolves.”
The woman came to Caulder asking for help in dealing with her childhood abuse. After reading her energy field — and getting slammed by a destructive barrage of psychic force — Caulder knew, she claims, that the woman was a werewolf herself. “My strategy,” she writes, “was to perform a progressive exorcism of the possessing werewolf spirit, as I simultaneously retrieved and then enhanced and rebuilt her damaged spirit.”
Twisted as this stuff seems, more folks are open to supernatural notions than one might think. In a survey conducted last year, Barna Research Group — a Southern California marketing research company that analyzes Christian cultural trends — found that 54 percent of adult Americans believe a person can be “under the control or the influence of spiritual forces such as demons.”
Caulder backs up her own theories with references to everyone from folklorists to psychiatrists to movie creators. She’s as likely to cite Montague Summers — author of a 1928 goth favorite on vampire philosophy — or Silence of the Lambs character Hannibal Lecter as Ralph Allison, the psychiatrist credited for getting the medical establishment to acknowledge multiple personality disorder as a legitimate affliction.
While her tendency to take fiction at face value comes off as smarmy, it’s worth noting that both academics and clerics credit a couple of earlier potboilers with opening the door to mainstream belief in demons and demand for exorcism rituals.
Michael Cuneo, a sociology professor at New York’s Fordham University, says exorcisms are on the rise in middle-class America and that Hollywood and entertainment culture are key driving forces. While researching his 2001 book, American Exorcism, he attended all kinds of Christian exorcisms — Catholic, Episcopal, evangelical Protestant. He pegs the initial boom in belief to Peter Blatty’s 1971 best-seller The Exorcist and the 1976 book Hostage to the Devil by Malachi Martin.
Most influential, Cuneo says, was the gut-churning 1973 film The Exorcist, in which Linda Blair, as the possessed twelve-year-old, spews fluorescent vomit and spins her head 180 degrees to curse the beleaguered priest who’s trying to expel her foul-mouthed demon. In his book, Cuneo quotes mainstream priests and pastors saying, without a trace of irony, that The Exorcist had publicized the problem of demonic possession while also increasing it by somehow activating dormant demonic energies.
“We should never underestimate the power of the popular entertainment industry in shaping popular consciousness — including popular religious consciousness,” the professor says. “Not only rank-and-file believers but also priests and clerics, the leaders of the flocks, take their cues from entertainment.”
The gates further opened in 1990, Cuneo notes, when John Cardinal O’Connor, archbishop of New York, sermonized on a plague of satanism and suggested his parishioners had plenty to learn from the movie.
Believers in spirit possession come from a wide range of religious and spiritual persuasions. After Jesus died, according to the New Testament, the Holy Spirit entered into his disciples and believers, causing them to prophesy and speak in other languages. Pentecostal Christians still experience a similar transcendent state they call baptism in the Holy Spirit. While in these trances, they are said to receive gifts, or charisms, that include the ability to speak in tongues — and sometimes, it is claimed, the ability to heal sickness and, yes, cast out devils.
Such experiences are socially acceptable in many circles throughout the United States. In the early 1960s, Cuneo says, these aspects of Pentecostalism moved into mainstream churches, along with a belief in possession, both divine and satanic, and in the practice of exorcism. There are charismatic congregations among Episcopalians, Catholics, and Protestants, as well as an immense variety of independent charismatic churches. As proof of their authority to conduct exorcisms, which they call “deliverance,” these sects often cite the words of Jesus from the Bible: “And these signs shall follow them that believe; in my name shall they cast out devils.”
There are two approaches to deliverance, Cuneo writes: “The gunslinging approach … where demons were assumed to be present in almost every circumstance and the goal was to draw them into the open and then send them packing; and a more temperate and therapeutic approach … where demons were dealt with within a broader context of healing prayer.”
Over the years, Caulder has moved firmly into the latter camp. “If someone has a spirit within them, I don’t do a quick fix like they show on TV,” she says. “There’s nothing then that keeps the invading spirit from coming back. And whatever allowed that spirit to stay hasn’t been healed. I do exorcism as a healing process.”
This is why Daniel keeps coming back. “I’m sure there are exorcisms out there where people writhe on the floor and spit green pea soup,” he says. “My experience with Sharon has been her masterful skill level. It’s like someone who’s an expert fencer can take the tip of that foil and do very precise things with it. She knows how deep to go, how far to go.”
Daniel hadn’t come seeking an exorcism. A victim of child abuse, he’d spent his adult life in self-help — books, psychotherapy, tai chi, John Bradshaw’s inner-child stuff. “I knew I was broken,” he says, “and I had to get better. But I never seemed to quite get anywhere.”
Feeling stuck with his most recent therapist, he found Caulder’s ad in a free magazine, headlined “Soul Marks: Ancient and Contemporary Wisdom for Healing (Body, Psyche, and Soul).” After vetting her and a few other healers by phone, he made an appointment with Caulder.
They sat and talked for a while, and then she pulled out her whiteboard. “She drew my head and said, ‘Here’s this spirit that’s over part of your brain and down the side of your head,'” he recalls. “She explained how it could have come about. For me, it was like, ‘Finally! This is the problem.’ It was like if the bull’s-eye was the spirit possession, I was always around it. Going to Sharon hit it, wham!”
He’d never thought of his problems in terms of being possessed, but immediately felt relieved. “Just knowing what it was and being able to articulate it, giving it a name, there was a lot of relief in that.
“Probably another reason I felt relief,” he continues, “was that I had done so much work on shame.” But this spirit possession was something he didn’t need to feel ashamed of. Instead, he says, the feeling was: “Get the fuck out! I’m 47, I want my life back. You need to go somewhere else and get your own body.”
Within the first few weeks, Daniel says, he started feeling different. “I felt more of my authentic self was coming through. I had a choice to really be me. It started happening more and more naturally.” Caulder worked on him both face-to-face and remotely; they would talk on the phone, then he’d lie down and she would do the work at a distance.
Before long, Daniel says, the invader was gone. “I feel much more anchored in my own self, my own soul. I hear it in my voice, and I hear when I’m not anchored. My relationship with my wife has changed dramatically for the better, because I’m who I am; it’s not, ‘Who’s going to show up today?'”
Over the last decade, even traditional-minded members of the psychiatric community have become more open to the idea that spirit possession, real or otherwise, may contribute to physical and mental ills. The watershed event was the inclusion of a category called “Religious and Spiritual Problems” in the 1994 edition of the Diagnostic and Statistical Manual of Mental Disorders, better known as the DSM. The DSM is the bible of mental health, according to David Lukoff, a professor of psychology at Saybrook Graduate School in San Francisco. “Anybody who operates in the mental health field has to make use of it in their initial phase of working with any patient,” he says. “It’s pretty much obligatory that the treating health-care professional render a DSM diagnosis.”
The addition of new DSM categories is controversial: Since the process is controlled by the American Association of Psychiatrists, adding a new entry is tantamount to validating the condition. It took years of intense debate, for example, before multiple personality disorder showed up in the book. Prior to that, it was considered a manifestation of hysteria. These days, a person with MPD is entitled to accommodation under the Americans with Disabilities Act.
Lukoff proposed and coauthored the “Religious and Spiritual Problems” category because he saw people who had undergone intense mystical experiences being diagnosed as psychotic and treated with drugs to bring these ecstatic states back down to earth. “The prior editions of the DSM had a very antireligious stance,” the psychologist says. “They routinely used religion as an example of psychopathology, hallucination, or delusion. It never mentioned anything about the way in which religion is, for most people, a support system and a mechanism for coping.”
The quest for enlightenment outside the Judeo-Christian belief systems has been accompanied by an increase in what Lukoff calls “spiritual emergencies.” For example, someone performing yoga might feel a rush of energy moving through the body. In India, it is recognized as the release of kundalini, or life force. But someone unprepared for the rush might think he was going crazy. “If they seek treatment they can get a diagnosis of psychosis,” Lukoff says. “We realized that the best way to create a system that was more responsive and aware of these experiences would be to get a category into the DSM.”
Lukoff worked with Francis Lu, a psychiatrist and professor, and Robert Turner, a psychiatrist in private practice, to author the category. After plenty of argument and politicking, the result is rather bland: “This category can be used when the focus of clinical attention is a religious or spiritual problem. Examples include distressing experiences that involve loss or questioning of faith, problems associated with conversion to a new faith, or questioning of spiritual values that may not necessarily be related to an organized church or religious institution.” The trio’s original language including “near-death and after-death experiences” was axed.
Still, the category’s placement in a section titled Other Conditions That May Be a Focus of Clinical Attention, rather than in the main listing of disorders, was a win for its authors. It takes patients’ mystical experiences out of the realm of mental illness and places them alongside such quotidian complaints as job dissatisfaction, failing grades in school, and prolonged mourning. Lukoff, who doesn’t know Caulder or her work, says spirit possession would also be recognized as one of these religious or spiritual problems. “Over 80 percent of world cultures believe in possession, according to one study,” the professor says. “If it happens to someone here, they’re seen as crazy. But if you have a broader perspective, it’s well within the range of human behavior and can even be healing.”
Does he believe a human being can be under the influence of spiritual forces? “I don’t even want to go there,” he says. “I don’t think my role as a therapist is to debate whether there are UFOs or spirits or not. These are meaningful and powerful experiences for the person.”
Caulder regards the DSM category as a validation of her profession. “It took most of my lifetime for the mental health community to recognize that there are religious and spiritual problems, and that when people go through them they shouldn’t be given a diagnosis, because they’re not sick,” she says.
Her dream is to bring her own practice into the mainstream. When it comes to problems like spirit possession, she asks, “How many psychologists are trained to work with these problems? Not so many. The healers who are able to, there’s not enough to go around.” Meanwhile, she gets calls and e-mails every day from people asking for exorcism or energy work. Caulder would like to find a treatment that could be taught fairly easily to medical professionals, psychologists, or healers, she says, “so that they can deal with these problems en masse.”
She’s willing to concede, however, that describing herself as a voodoo chief could get in the way of winning over a wary public. Caulder shrugs. “I’ve always been ostracized,” the healer says. “I have to be true to myself.”
Does Spiritual Healing Work?
Mainstream science aims to find out.
Sharon Caulder claims her brand of healing can ease physical disease and dysfunction such as whiplash or chronic back pain, and psychological disorders including depression and addictions. Anecdotally at least, exorcism and other spiritual healing rituals make a lot of people feel better. Fordham University sociologist Michael Cuneo — who witnessed more than fifty exorcisms for his book on the subject — is convinced some of the people he met were significantly improved.
The mainstream medical establishment has begun taking alternative treatments such as energy healing seriously enough for the federal government to establish and fund the National Center for Complementary and Alternative Medicine in 1992. This division of the National Institutes of Health has seen its budget increase from $2 million at the outset to $104.6 million last year. The research it funds covers a broad swath of alternative therapies, with studies on everything from the effects of massage on weight gain in premature babies to the efficacy of “distant healing” for cancer and AIDS. Distant healing is a catchall term for any treatment that doesn’t involve physical intervention or personal interaction with the patient.
Two NCCAM clinical trials in distant healing are under way at San Francisco’s California Pacific Medical Center, a nonprofit medical research facility. One looks at whether nurses and alternative healers, working from afar, can affect the outcomes of AIDS patients. A second study, which began in 2001 and is slated to run through 2004, asks whether distant healing can help patients with glioblastoma multiforme, a highly lethal brain cancer.
The researchers recruit their healers from a variety of traditions such as Christian prayer, energy healing, or Native American shamanism — but for the studies, the healers don’t officially work within their traditions.
In the glioblastoma study, they focus their efforts on the patient by looking at the patient’s photo three times a week for an hour at a time. The only instruction they get is to “send treatment intention” to the person in the photos. Healers switch patients every two weeks, so each patient gets a total of sixty treatments over twenty weeks from ten different healers. What’s being tested is whether or not distant healing can increase patient longevity or alter the rate of cancer progression. It’s a double-blind experiment, meaning that only half the patients get the healing treatments while a control group doesn’t, and neither the researchers nor the patients know which group is which. (All patients receive appropriate medical treatment for the cancer.)
Heading the study is Andrew Freinkel, a neurologist and psychiatrist who also is a staff physician at Stanford University Hospital. “The NIH has decided to fund this research — they’re not idiots,” he says. “There is a real question on the table about whether or not the use of distant healing is an effective treatment for patients with cancer. This is a very important question to answer, if only because we don’t know. There are oncologists whose patients ask, ‘Does prayer work?’ Oncologists will say, ‘We don’t know.’ The reason we don’t know is because a study hasn’t been done.”
Far from being controversial, Freinkel says, these clinical trials are solid science. “Medical research is question-driven. We frame a hypothesis, find a way to test it, we test it. After you test it you know something.”
Earlier clinical trials at California Pacific and elsewhere have found some evidence suggesting clinical benefits to distant healing. Of forty advanced-AIDS patients in a 1998 double-blind study reported in the Western Journal of Medicine, subjects treated by distant healers had fewer new AIDS-related illnesses and lower illness severity, and required fewer doctor visits and days in the hospital.
A September 2001 double-blind trial conducted in Seoul, South Korea, and published in the Journal of Reproductive Medicine looked at the effect of prayer on pregnancy rates for 219 women undergoing in-vitro fertilization. After four months, half the women in the group that was prayed for conceived, while only 26 percent of the control group got pregnant. The prayed-for subjects also had a higher implantation rate for the cultured embryos, 16.3 percent, versus 8 percent for the control group.
Such findings are what scientists call “statistically significant” — they can’t be explained by chance.
Freinkel won’t speculate about how or why distant healing might work. “This is designed as an efficacy study; it’s just designed to see if it works,” he says. “Clearly this study will not tell anything about the mechanism — it will be evidence only that the phenomenon in this particular study or model either is an effective treatment or is not.”
If enough clinical trials show that such treatments work, the next step will be to design new experiments to figure out the mechanisms involved. Does Freinkel think it’s possible for science to understand those mechanisms?
“Sure,” he says.
Talk about a leap of faith.