Hsieh-Ping Syndrome (a.k.a. "Ghost Sickness") a brief trance state during which one is possessed by an ancestral ghost, who often attempts to communicate to other family members. Symptoms include tremor, disorientation and delirium, and visual or auditory hallucinations. Patients also experience of spirit possession. Symptoms may include dissociative episodes with laughing, shouting, hitting the head against a wall, singing, or weeping. Individuals may show apathy and withdrawal, refusing to eat or carry out daily tasks, or may develop a long-term relationship with the possessing spirit. Such behavior is not necessarily considered pathological locally. Affected individuals can even achieve status by being seen as having supernatural powers of healing and understanding. Alternatively, these experiences can be regarded as abnormal, particularly when possessed individuals become so distressed and dysfunctional that they seek assistance from healers and mental health professionals. Possession cases clearly regarded as abnormal present challenges of diagnosis and treatment. Little systematic research into this phenomenon has been done in psychiatry.
Many of the patients were (apart from being illiterate and of female sex) suffering from pseudo-psychotic hysteria with understandable thematic content in the symptomatology, or were cases of depression with hysterical features brought on by real environmental difficulties. This appears to be in contrast with data from other cases who not infrequently suffer from more highly structured psychoneuroses based, apparently, on sexual (or homosexual) conflicts. It is tentatively suggested that the difference may be due to the contrasting cultural backgrounds, specifically the belief or absence of belief in possession by the Malignant Ones who is the source of all evil.
It is particularly important to examine persons whose experience of possession is dysphoric and disruptive to their social and occupational functioning. These individuals believe their experience is pathological and attribute their distress to supernatural causes, but they seek the help of physicians to alleviate their suffering. A physician who is unaware of the cultural contributions to the illness may overpathologize it, attributing a patient's belief in possession to psychosis. Alternatively, the patient could be diagnosed as suffering from a culture-bound illness. The danger of applying the culture-bound label is that illness may be misinterpreted as only a function of culture, when in fact these experiences, like most forms of psychopathology, usually result from a combination of factors.
Treatment is aimed at removal of psychological conflict, stress, and adverse environmental influences with the cooperation and assistance of the family. Patients are instructed in how to cope with daily life and work problems and in the cultivation of self-discipline and how to overcome personality deficiencies. Symptomatic relief is offered to highly suggestible patients through suggestive treatments such as intravenous injection of glucose, electrical stimulation of affected body parts, verbal suggestion, massage, and exercises. Neuroleptic therapy is also used for relief of acute symptoms.
