Dr. Ali Madeeh Hashmi is a psychiatrist, author and translator. He taught and practiced psychiatry in the United States for 12 years. He currently teaches at King Edward Medical University in Lahore. He has written about the lives and works of Faiz, Ghalib, Iqbal and Manto, among others. His writings have been published in literary and popular magazines and online in Pakistan, India and the United States. His forthcoming book, a biography of his grandfather, Faiz Ahmed Faiz, will be published later this year.
Dreams Are Wiser Than Men
The science of psychology (the study of mental illness and its treatment) and its close cousin psychiatry (the medical treatment of more severe forms of mental illness) respect the central role of spirituality and faith in a person’s life and its importance in maintaining optimal mental health. However, the role of spiritual, religious, or ‘faith-based’ treatment in traditional medical science (including psychology) is limited for a simple reason: the investigation and treatment of illness is a branch of science, which is the empirical, evidence based investigation of natural phenomena. Occurrences that claim their origin outside the world as it exists (‘metaphysical,’ ‘paranormal’ etc.) by definition fall outside the realm of science and thus outside the sphere of investigation of psychology and psychiatry. The brain is an immensely complex organ and we are only now beginning to understand some of its workings. A lot still remains to be done. In addition, the interaction between the mind (a function of the brain) and the outside world is still mostly virgin territory. Attributing mental phenomena to ‘magic’ or other ‘supernatural’ forces though, violates the most elementary principles of scientific investigation. This article, therefore, proceeds from the standpoint that all human beings, as part of nature, are subservient to natural laws. All illnesses, including mental illness, follow the same laws. There is no magic in this world except as practiced by our imaginations.
The first time I saw a person claiming to be possessed was, of all places, in Arkansas, USA. There, amidst the lush rice and soybean fields, in a small Southern town referred to as the ‘buckle of America’s Bible belt’, I met her.
She was from my native city, Lahore, and in her forties with three pre-teen children. She had recently moved to the United States to reunite with her husband. He had been living in Arkansas for a long time and was a successful businessman. He had married her, a cousin, in Lahore and she had stayed there. He would visit once or twice a year, staying for a few weeks each time. Over the years, they had three children and, once the oldest was a pre-teen, they decided that the family should join their father in Arkansas. That was when the trouble began. The first time I saw her, she had been hearing voices; she thought there were ghosts in her house and that the pictures on the walls were talking to her. The Quranic wall hangings – so ubiquitous in desi Muslim households – taunted her in the US, changing shape and moving some days and cursing her on other days.
In my Arkansas patient’s case, there could be no disputing that she was sick. She would beat her children for no apparent reason, throw furniture or household groceries into the front yard saying they were contaminated, or run out into the neighborhood and make a scene until the neighbors called the police. Her mind produced a variety of ‘physical’ symptoms, such as nausea, dizziness, stomach pain, and shortness of breath. She was unable to eat or sleep and certainly could not manage a household with three young children. In psychiatric parlance, she had an illness called ‘Depression with Psychosis’. In layman’s terms, her sorrow (at losing her country, her identity as a member of a large extended family, and a community) had become so extreme that it had started to impair her reality. She could no longer differentiate between what was real and what was not. Without appropriate treatment, she would continue to deteriorate both mentally and physically, and would eventually succumb to malnutrition, a medical illness, or perhaps even suicide.
And what of the ghosts she thought were in her house, the Quranic verses taunting and cursing her? These too, were a manifestation of her unhinged state of mind. In Pakistan, and in most developing countries, belief in the supernatural, spirits, jinns, and the occult is widespread. This is all garnished with a thick helping of religious obscurantism and references from various divine texts about the ‘proof’ of existence of ‘things beyond’. There is even a collective agreement of sorts that ‘magic is real’ (expressed in a majestic Urdu phrase ‘Jadoo ber-Haq hai,’ which translates as “Magic exists”).
My patient remained isolated in rural Arkansas although she gradually improved with treatment. Over time, she befriended an elderly woman from her neighborhood who was, like most people in those parts, a devout Christian. This friendship brought my patient some comfort but of course, she was very impressionable in her fragile mental state, and the next thing I knew, she was sporting a Christian cross around her neck. During one session, she asked for my help in choosing between Jesus and Mohammad, describing her pain on being pulled between the two (i.e. Christianity and Islam).
Despite a strong family history of mental illness (one of her sisters lived in a mental institution in Lahore), my patient refused to regularly take medication or participate in treatment. This too is a common consequence of the belief that illness of the mind is somehow less real than illness of the body. And of course, for those who feel this is a spiritual malady or worse, a result of malevolent demons or jinns, the answer does not lie in medical treatment. And so she cycled between taking medicines and feeling better and discontinuing medication and experiencing voices and visions. If she took her medication for a while, she would get better; the voices and visions would stop and she would be happier, but then the reality of her situation would set in and she would begin to descend back into her insanity. She came to see me off and on for a few months; eventually, we lost touch.
It is interesting to note the qualities that are attached in our culture to people who are susceptible to possession by malevolent spirits: “the impotent, the lustful, the lately widowed, bankrupts, sons and brothers of whores, convicts, the idle, the brooders on the unknowable, gluttons and starvers… Intelligent and educated men and healthy intelligent women are free from spirit attacks.”
These, of course, are also the people in a society or community that one would expect to be ostracized, ridiculed or otherwise face persecution in one form or another. Such treatment at the hands of their community and in many cases even their own families would be expected to lead to emotional distress or, if extreme, full blown mental illness. Perhaps the case of someone from our culture’s past might help explain it further.
The young man in question – let’s call him M – was born in a North Indian town of note in the early 18th century. His grandfather had been an employee of the princely state in which they lived and his father was a ‘dervish’ who married twice. M’s mother was his father’s second wife. His father died when he was in his teens. This was a huge blow for the young man since he was very attached to his father. In his own words, “when the dervish closed his eyes, the world darkened before my eyes. It was a terrible calamity; the sky fell upon me. My tears poured out in torrents. Losing all self-control, I rolled in dirt and struck my head upon the walls. There was so much turmoil in me that you might have thought the day of reckoning had arrived.”
M’s misery was multiplied when his older stepbrother refused to assume any responsibility for the young man since the ‘dervish’ had died as he had lived: impoverished and penniless. The stepbrother even wrote to M’s mentor and protector in Delhi saying, “’M’ is a snake in the grass. Do not make any effort towards his upbringing. In fact, in the guise of friendship, have him killed.”
The multiplicity of grief, financial worries, and the harsh treatment of those whom he considered his loved ones, drove M mad. “My already tortured mind grew more tortured; my already constricted heart became more constricted. A dreadful solitariness took hold of me and I developed madness. I closed the door of my tiny room and sat in it alone, burdened with grief,” he wrote.
So far, our account of M’s tribulations follows the typical path suffering from grief at various losses. In some cases, this is as far as it might go. Eventually the person begins to recover. M, however, went over the precipice into the netherworld where reality ceases to exist and all the monsters that live in our deepest fears begin to arise. M wrote,“[e]very night when the moon rose up into the sky, it brought upon me a calamity. Ever since (a very young age), I was fascinated by the moon. But not to the extent of going mad. Now however, I became so crazy that people were scared to open my door or come near me. Every night, a moon-faced lovely form came towards me from the moon and caused me to lose my senses. Wherever I looked, my glance fell upon that person who was more beautiful than a fairy; no matter which direction I turned, I saw only that fair ‘hoor’. The walls, the terraces and the courtyards of the house appeared like paintings, for that same bewitching forma appeared from every direction. Sometimes she showed me her face like the full moon of the fourteenth; other times she remained hidden within my heart’s confines… no sooner had the dawn gleamed on the horizon, than she heaved a deep sigh and disappeared with the moon… I would be frothing at the mouth like a madman and would carry stones in my hands. And as I stumbled around in that state, people ran away from me. For four months, that illuminating flower showed herself in a new aspect every night… Then it was spring and the shade of my madness turned darker. I became totally possessed, totally devoid of any power to act…”
M remained in this shape for close to a year. Physicians were called to treat him, as were exorcists and spell casters. Finally, in the autumn, the madness began to recede; the apparition that had taken a hold of his mind and his senses loosened its grip and M began to recover. His medicines were changed and he began to sleep more. His strength came back gradually and M went on to become one of the most celebrated poets and writers of the Urdu language.
Our young man is none other than Mir Muhammad Taqi ‘Mir’ and he wrote an account of his own malady in his autobiography Zikr-i Mir.
Our mind is the instrument with which we perceive and interpret the world around us. Take the example of seeing. Light from the object we are looking at enters our eyes and activates nerve cells in the retina, the innermost layer of the eye. The nerve impulses then travel up the optic nerve through several visual processing centers before finally arriving at the occipital cortex, the area of the brain actually responsible for making sense of the image. Any malfunction in this process can cause all sorts of visual problems from seeing distorted images to seeing something totally different from the object at hand. In the case of extreme emotional states, our brain, because of a complex interaction between memory, emotions and visual images can cause us to, for example, ‘see’ a deceased person on the street or even inside our room. This sort of phenomenon, which would technically be considered a ‘hallucination’ can occur in any sensory modality: smell, touch, sound, taste etc.
A final story would be appropriate to round up our account of the world of humans and jinns. ‘A’ was a young girl of around 11 when I first saw her. She had been admitted in our large teaching hospital in Lahore, part of one of the oldest medical colleges in Asia. She had just spent a month inside the pediatrics ward of our hospital. She had initially been brought to our hospital for ‘fits': unexplained, frightening convulsions of her body in which she would lose consciousness, start moaning and thrashing around, and be oblivious to those around her. These had been happening several times a day and since she was at an age when the medical illness of epilepsy often presents itself, her mother had brought her into the hospital where she had been admitted for extensive testing and treatment. But after a month of extensive medical tests, nothing was found. She was not epileptic and was not medically sick in any way. She continued to have her intermittent ‘fits’ while in the hospital and just when her parents had despaired of medical treatment and were considering taking her to a ‘Pir’ (spiritual healer), one of the pediatric doctors called the psychiatry department and asked us to examine her. By this time, even the doctors had no answers for the patient or her family.
‘Hysteria’, from the Greek word ‘hystera’ (‘uterus’) was first described in the writing of Hippocrates (460-370 BC), the ‘Father of Western Medicine’. For thousands of years, until the late nineteenth century, it was the name of a medical condition thought to be particular to women and to be caused by disturbances of the uterus. The writings of Hippocrates refer to a variety of medically unexplainable symptoms, such as suffocation, that were supposedly caused by the movement of a woman’s uterus to various locations within her body as it became light and dry due to a lack of bodily fluids. The ‘wandering womb’ theory persisted in European medicine for centuries.
In the late nineteenth century, it was the works of two pioneering scientists that advanced the understanding of this mysterious disorder. Jean Martin Charcot and a certain Sigmund Freud, who worked with him briefly in the 1880s, investigated and wrote extensively about this disorder. Freud’s seminal paper Studies on Hysteria published jointly with another pioneer in the field, Josef Breuer, introduced the world to the brilliant young doctor and to five of his patients whom he treated with his new technique of ‘psychoanalysis.’ Freud’s theory attributed the symptoms of hysteria to the unconscious mind’s attempts to protect the patient from psychic stress. The treatment was not medical tests and medications (or in some cases harmful surgery or other invasive bodily procedures). Freud’s method encouraged the expression of the afflicted person’s distress through talking with his or her doctor (trained in the treatment) over a period of time. Over time, as the stresses and pains that a person had internalized and hidden, even from him or herself, came to the fore, the symptoms abated and in many cases completely disappeared. Thus was born the discipline of ‘psychoanalysis’, which persists today as the more general term ‘psychotherapy’ or ‘talk therapy’.
In the case of our patient A, we were finally summoned to her bedside after her doctors had admitted defeat. None of their tests had shown anything and she was still having her fits. Her story, as we learnt gradually, was familiar and is common in many parts of the world today where women, in particular, remain oppressed and subdued, unable to pursue their talents, ambitions and desires as openly as men.
She was the youngest of three siblings. Her father worked overseas and sent money back to the family, a common situation in Pakistan and many developing countries. She lived with her mother and two older brothers in Lahore. The family, like many in this part of the world, was religiously conservative. A was a brilliant student and had always been at the top of her class. Just before she got sick, she had passed her class 7 exams and moved into class 8 where her class teacher was an extremely strict woman who had rigid ideas about standards of behavior and morality for the young girls in her charge. Being precocious and lively, A immediately began to clash with her new teacher. She found the syllabus boring since she was quite bright and her interest was in extracurricular activities like debating and writing. She also began to show the typical rebellious spirit of children on the verge of puberty. In the case of girls being raised in conservative, religious societies, this is cause for great consternation amongst parents, families, and teachers, leading to redoubled efforts at stamping out all signs of ‘looseness’ and any hint of ‘immorality’.
Soon after her new class started, A developed vague physical symptoms (stomach pain, nausea, headaches) and shortly thereafter began to be unable to go to school because of these ailments. Her mother pressured her to return to school since she was such a bright student, whereupon her ‘fits’ and seizures started. Her parents tried the usual faith healers first but to no avail. Fortunately for A, her family lived in Lahore where access to medical care is relatively easy compared to remote rural areas. In spite of this, there exist on every corner, faith healers and witch doctors promising to align a person’s stars, rid them of evil spirits and ‘evil eyes’ cast on them by jealous relatives, enemies and sometimes random strangers. A typical establishment may promise quick relief from many afflictions including ‘bhoot-pareet’ (malignant spirits), madness, epilepsy, ‘mardana kamzori’ (roughly, ‘male weakness’ – referring to either impotence or premature ejaculation and infertility in the case of males) and barrenness in the case of women etc.
The young and single are thought to be especially susceptible to the influence of these supernatural beings with young, adolescent women being special favorites. In mythology, ‘bhoot’ is the vengeful spirit of those who meet an untimely and violent death, ‘pareet’ is the spirit of a child who died in infancy or was born deformed. There are other characters in this pantheon with one of the most feared being the ‘churail’, the ghost of an unhappy widow, a childless woman or more generally, any woman who died with her desires grossly unsatisfied.
In the case of A, she was spared the tender attentions of the more vicious faith healers who have no qualms about beating a person black and blue with staffs to drive out the malignant spirit. Other methods of exorcism might include forcing them to inhale acrid smoke from burnt red peppers or chili powder, bloodletting of various kinds and, in the case of women, rape, sodomy or other forms of sexual violence, all in the name of ‘curing’ the patient.
After two or three sessions with our team, A’s convulsive episodes stopped and she was sent home from the hospital. She came to see me regularly once a week or so for a few months. Thinly built, with a dark complexion and large sparkling eyes, she would bounce into my office without knocking and walk up to my desk, even if I was in the middle of something, and extend her hand while her burqa-clad mother looked on, bemused. I would shake her hand and then we would chat about how she was doing. She would always shake my hand when she left. Her mother, at my urging, gradually loosened up and allowed her to read the things she liked to read about, take part in the debating competition in her school and even, on one occasion, to paint her nails (although that required a session with both her mother and one of her older brothers – a serious looking young man with a beard and a prayer cap on his head).
Over the subsequent two years, she stayed well for the most part and did well in school. She was also beginning to blossom into a beautiful and vivacious young girl and would still insist on shaking my hand even though she seemed more self-conscious about it. We have not seen her back for over a year, but I am confident that she is doing well.
In today’s tumultuous world, more and more people seem to be drawn to the world of the ‘unseen,’ which contains spirits and beings both malevolent and kind, where the harsh realities of daily life no longer exist and where our most fervent human desires can once again be fulfilled: to return to a blissful state of infantile dependence where all our needs are met by others without our expending any efforts – other than perhaps rubbing a lamp we found in a cave! – where there is no failure, no pain, and nothing to fear.
That world never actually exists except in our own imagination and cannot, thus, be achieved except in our imagination. The jinns, fairies, hoors and demons, wherever they exist, are forbidden from crossing over into our world, unless we give them permission to do so.
 Hastings, Encyclopedia of Religion and Ethics, p. 604.
 A Sufi Muslim ascetic.
 Mir, Mir Muhammad Taqi. CM Naim (Tr). 2002. Zikr-i Mir: The Autobiography of the Eighteenth Century Mughal Poet: Mir Muhammad Taqi Mir. Delhi. OUP India. Passim