'Jinn possession' is a cultural syndrome…

Childhood traumas are very important in personality disorders. Psychiatrist Prof. Dr. Nevzat Tarhan states that the brain transforms trauma too severe to confront into a disease form to cope with it. Tarhan notes that if the brain does not do this, schizophrenic disintegration would occur, and emphasizes that personality disorder can develop when genetic predisposition combines with trauma. Tarhan adds that in addition to medication and psychotherapy treatments, there are methods called metacognitive therapy that enable trauma management, and states that memory can be temporarily erased. On the other hand, Tarhan states that the concept of 'jinn possession' is also a cultural version of dissociative disorder, a culture-specific syndrome.

Üsküdar University Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan provided information about the causes, triggers, and treatment methods of multiple personality disorder.

Multiple personality disorder has many types

Prof. Dr. Nevzat Tarhan stated that multiple personality disorder is an interesting subject about which many films have been made, adding, “Since it is a disease group with a very easy artistic aspect, many films have been made, exaggerating it a bit. In fact, it is not a very common disorder. Approximately 20 percent of the situations in films are true. 80 percent are usually exaggerations.”
Tarhan, emphasizing that multiple personality disorder has many types, pointed out that it should not be confused with other cognitive disorders. Tarhan explained the differences between cognitive disorders, stating, “In multiple personality disorder, an individual temporarily experiences a split in their personality. When areas related to emotional regulation are disrupted, bipolar disorder emerges. Perception and self-disorder become schizophrenia. Multiple personality disorder occurs in situations where there is a disruption in perception, memory, consciousness, and identity processes.”

“The brain transforms trauma into a disease form with a more acceptable defense”

Tarhan stated that an individual, while living as personality A, suddenly assumes an alternative personality, also called an ‘alter personality’. He said, “Suddenly they become childlike. They act like a child, talk like a child. They do childish things. Or different situations can emerge. For example, I had a case; it was a girl whose father was a retired officer. When her alter personality emerged, she would refer to people as corporal, sergeant, and give orders.”
Tarhan, emphasizing the critical role of childhood traumas in personality disorders, stated, “The person experiences a trauma in childhood. This is an unresolved trauma, one that cannot be confronted or discussed. The brain puts that trauma into such a disease form with a more acceptable defense. The brain does this automatically. If it doesn't, schizophrenic disintegration will occur. A brain region that talks to itself and dreams will form. It will become completely isolated and detached from reality. Multiple personality disorder is not like schizophrenia. The person experiences this condition from time to time, not continuously.”

“Under stress, the brain cannot distribute serotonin”

Tarhan stated that the need for serotonin increases in the brains of individuals who experience stress, especially while living a healthy life. He said, “Serotonin is present in the brain at a certain level. Some individuals also have a serotonin transporter gene in their brain. So, there is a genetic predisposition. Under stress, the brain cannot distribute serotonin. When it cannot, that unresolved childhood trauma resurfaces. The person starts reliving that trauma. Only when serotonin levels in the brain return to their former state can the person emerge from this condition.”

“Psychiatric illnesses have biochemical counterparts in the brain”

Prof. Dr. Nevzat Tarhan underlined that treatment should involve both medication and therapy, stating, “This illness has both biological and psychological dimensions. In these individuals, a region of the brain functions differently from the whole. Studies conducted with brain imaging methods show how the brain works. For example, different parts of the brain work when speaking different languages. We don't mix up words. A healthy person can speak any language without mixing them up. It's the same in people's daily lives. Automatically learned things are immediately retrieved and used. In this disorder, the brain shelves unresolved traumas. But under intense stress, that lid reopens. The situation, like an extinct volcano, flares up again and erupts just as volcanoes do from time to time. It creates chaos. The person strengthens their feelings of control and defense and can return to normal life or recover with treatment. Therefore, this illness has a neurobiological dimension and should not be considered an abstract disease. Psychiatric illnesses largely have biochemical counterparts in the brain.”

“If genetic predisposition is triggered by trauma, multiple personality disorder can develop”

Tarhan noted that the genetic factor manifests as a predisposition, stating, “If it exists in parents and close relatives, the child also uses it as a defense mechanism under stress. If there is childhood trauma, that unresolved trauma can be expressed this way later on. This is not done consciously; that's where the problem lies. Perception and memory work differently. The person experiences that period, often forgetting it. When you ask why they did it, how they did it, a completely different state of consciousness has formed in the person. That's why hypnosis is very effective in its treatment; we use hypnosis.”

Consciousness temporarily fogs… 

Tarhan stated that in this disorder, it is first investigated whether epilepsy is present. He said, “In departments like forensic medicine where inpatient observation is conducted, there are brain electro devices. These detect psychomotor seizures to understand whether a person's actions are involuntary. Someone experiencing psychomotor seizures does not have criminal responsibility. That person does not intentionally commit a crime. If the person is not prone to crime, you cannot direct them to crime through hypnotic suggestion. If they believe in crime and had prior intent, they can be directed in that situation. However, a person diagnosed with a dissociative disorder has criminal capacity. Because judgment is not impaired. Consciousness temporarily fogs, but conscious control is not disrupted, and the person's criminal responsibility is not lifted. For this reason, this illness is not considered a mental illness; it is not in the psychosis group.”

“'Jinn possession' is a cultural syndrome...”

Tarhan noted that in our culture, the concept of ‘jinn possession’ is a cultural version of dissociative disorder. He said, “However, this condition does not receive a dissociative diagnosis. Because it is a cultural teaching, it is called a culture-specific syndrome. These individuals are, of course, not healthy, but their consciousness is intact. Since they believe culturally, they can be easily guided. For example, many reincarnation cases emerge. The reason for their emergence is the cultural teaching present in that region. A person experiences something in their childhood years, then forgets it, but starts recounting things in old age.”
Tarhan also mentioned a case that entered the literature related to this topic, saying, “A person suffers a head trauma and is admitted to intensive care. In intensive care, they speak something in Italian to themselves. The intensive care specialist curiously records the conversations. When the person recovers and leaves intensive care, they are played the recordings. They say, ‘But I don't know Italian.’ So, how did it happen? This event is immediately interpreted as reincarnation. When investigated, it turns out that they had an Italian-speaking caregiver when they were 2-3 years old. Since it was between 0-3 years old, they don't remember it, but the brain had recorded it. With the trauma, those memories emerged. Since the control of most learning in the brain is lifted, the initial learnings come to the surface.”

They have a separate identity and life history; they live it…

Tarhan stated that multiple personality disorder can be easily defined: “If a person sometimes acts very mature, sometimes like a child, talks to themselves, laughs, and does not remember or denies these behaviors, it means an Alter personality in a region of the brain is activated. If you immediately confront and question the person about this situation, they can come out of it. In therapies, it is possible to help them return to their established personality structure. Their self-perception can be re-established. Therefore, it is necessary to correctly define alternative personality. For example, some individuals may have an autobiographical memory within themselves. They have their own separate identity and life history, and they live it. You can understand this by observing and questioning. This person usually reverts to childhood trauma; physical and sexual abuse are very common. Since sexual abuse is something their own family cannot accept, the person cannot tell anyone. They experience feelings of guilt and regret. For instance, they have unexplained abdominal pains, and when investigated, it turns out that behind these abdominal pains are feelings of sexual guilt. They forget the sexual abuse they experienced in childhood, but with contractions like abdominal pain, they relive the feelings they had at that moment, as if the event is recurring.”

Trauma can be accepted and managed, rendered silent…

Tarhan stated that in cases of multiple personality disorder where a person's daily life activities are affected, communication functionality is impaired, and family harmony is disturbed, treatment should be sought. He said, “Two protocols are applied in treatment: medication and psychotherapy. Sometimes medication therapy is not sufficient, and trauma work is done. A logical resolution is brought to the unresolved trauma. There is a new method called metacognitive therapy. With this method, even if the person cannot resolve the experienced trauma, they can accept and manage it. When this treatment is applied to the person, that trauma becomes silent in the brain. It is not forgotten but sent to long-term memory.”

Memory is temporarily erased…

Tarhan stated that the illness disrupts social life and in advanced cases, the patient needs to be hospitalized. He said, “Memory is temporarily erased with electrical treatments that clear memory. The person remembers necessary things, while unnecessary ones are sent to long-term memory. There is also a clinical hypnosis technique. For this, the person must first trust the specialist. If they trust, they let go, give their attention, the body opens a window, and the specialist navigates within their brain. Hypnosis is a conscious sleep or the consciousness is awake but control has been relinquished to someone else. We have an emotional radar in our brain; whichever region of the brain it goes to, it uses the information in those regions. If the specialist knows the person's past, they find their traumas based on that past. They tell them that there is no longer a threat or danger. They alleviate their fears by providing positive reinforcements, just as there is a remedy and solution for this. With a few sessions of suggestion work, the person can recover. However, the person must fully commit to the treatment. Hypnosis is very effective for individuals who are open to suggestion. People accustomed to taking commands, such as police officers and soldiers, are open to suggestion, so they easily enter hypnosis. However, you cannot easily hypnotize someone who questions everything and has a scientific identity.”

20 personalities are not realistic

Tarhan stated that he has not seen more than three personalities in a single person with multiple personality disorder, adding, “Since vividness is expected in films, they exaggerate events; 20 personalities are not realistic.” He concluded his remarks as follows:
“In real life, I have never seen 20 personalities in the literature either. But dissociative identity disorders are a condition we encounter. A specialist should always consider this as an option, especially in individuals who frequently change personalities or identities. Some patients also gain secondary benefits from this. Those who behave this way attract the attention of the whole family as being sick and escape many burdens and tasks. This is more common in immature, childlike individuals.”