Whenthefamilysayspossessionandthecliniciansaysotherwise

The situation

A young man is unwell. He is not himself, he says things that frighten people, and something is plainly wrong. The hospital says one thing; his mother, his uncle and half the community say another. He is in the middle of it, too unwell to arbitrate, pulled between two groups who both love him.

This happens constantly, and there is almost nothing written for the people inside it.

Why both sides dig in

The family have reasons. They have seen him change, they know him in a way no clinician does, they have heard of cases like this before, and the clinical explanation offered in ten minutes by a stranger often feels like a label rather than an understanding.

The clinicians have reasons too. They have seen this presentation many times, it has a name, and there is a treatment with evidence behind it; and they have watched families remove patients from care for exactly this reason, and seen what followed.

Both are trying to help him, which is what makes it so hard, and why treating either side as the enemy makes everything worse.

The move that is certainly wrong

One thing on this page is stated absolutely: refusing one of the two tracks.

If the family stop the treatment and the case is medical, the harm is severe and it is theirs. If the clinicians could stop the family reciting — they cannot, and it would achieve nothing anyway, since recitation harms no one.

The asymmetry is not symmetrical. One track can be added at no cost; the other cannot be removed at no cost.

To the family

Keep every appointment and take every prescribed treatment, because nothing spiritual is lost by it; if this turns out to be what you believe it is, ruqyah loses nothing whatever by the tablets continuing.

Recite as much as you like. Nobody can stop you, nothing in the treatment forbids it, and it is good in itself.

Do not diagnose him out loud, and never in front of him. Being told by the people who love you that something is inside you is a heavy thing to carry, and he will carry it long after this is over.

And keep a record — sleep, mood, behaviour, three lines a night. It is the single most useful thing you can hand a clinician, and it will also show you in six weeks what actually changed.

To a clinician reading this

The belief is not the problem, and arguing with it will cost you the family.

Almost half of Muslim patients in mental-health settings consider the jinn a possible cause of what they are experiencing. That is not a fringe to be corrected; it is the room you are standing in. The families we see keep treatment going when nobody has asked them to abandon their framework, and they stop when somebody does.

To the person in the middle

If you are well enough to read this, you are allowed to do both, and you are allowed to say so. Nobody in either camp is entitled to make you choose.