Can DSM-5 Differentiate between Non-Pathological Possession and Dissociative Identity Disorder? A Case Study from an Afro-Brazilian Religion

The aim of this paper is to examine if the diagnostic criteria of DSM-5 are able to differentiate between non-pathological religious possession and dissociative identity disorder (DID). We use the case study of an individual who leads an Afro-Brazilian religious group (Umbanda), focusing on her personal development and possession experiences from early childhood to the present, spanning a period of over 40 years, and examine these data following DSM-5 criteria of DID (300.14). Her experiences of possession can be broken into two distinct stages. In the first (childhood and early adulthood), she displayed intrusive thoughts and a lack of control over possession states, which were associated with a heightened state of anxiety, loneliness, amnesia and family conflict (meeting all five criteria for DID). In the second stage (late 20s up to the present), she regularly experienced possession states, but felt in control of their onset and found them religiously meaningful. In this second stage, she only fulfilled three criteria for DID. We question the accuracy of diagnosing this individual with DID in her earlier life, and suggest that the DSM-5 criteria fail to address the ambiguity of affect surrounding possession experiences (positive at the individual level, negative at the interpersonal), and lack a clearer acknowledgement of the prevalence of possession and other unusual experiences in general populations.