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Kleinman writes: ‘trance and possession states are ubiquitous in non-western societies and were so in the West prior to the modern age ... Only the modern secular west seems to have blocked individuals’ access to these otherwise pan-human dimensions of self’ (1988, p.50).
A trance deliberately induced as part of a shamanic ritual is not, of course, regarded as a disorder. However, if such states occur spontaneously or persist outside of the ritual practice they become a problem. The person who experiences this may seek treatment.
It is not surprising that disorders in which these states are the main symptom are a particular problem for Western diagnostic systems. The ICD-10 provides a special category of dissociative disorder called trance disorder and possession states. In the DSM-IV a diagnosis of ‘dissociative trance disorder’ is one of several diagnoses listed at the back ‘for further study’.
In trance disorder, the individuals’ attention narrows down to one or two aspects of the immediate environment. They lose a sense of personal identity.
In possession states, individuals act out an identity different from their normal one. Amafufunyana has features of possession trance, when individuals speak in a strange voice. Individuals take on the identity of the spirit that is supposedly possessing them.
In Egypt, Ethiopia, Somalia and Sudan there is a culture-bound syndrome called zar. Affected individuals believe that they are possessed by a spirit. They may experience dissociative episodes in which they shout, laugh, weep, sing or hit their heads against a wall. They can also become apathetic, withdrawn and fail to carry out daily tasks. Some develop a relationship with the possessing spirit.
Spell is a trance state found among African Americans and European Americans in the Southern United States. These groups do not consider this state to be pathological. People with spell communicate with deceased relatives or spirits and may show distinct personality changes.
Izizwe is a Zulu possession trance state. Sufferers experience severe shaking of the body and speak in a strange language, as if possessed by another identity (Edwards et al., 1982).
Extract from Psychology: An Introduction for Students in Southern Africa by Louw, DA and Edwards, DJA (1997) Heinemann: Johannesburg
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