03Chapter 2. Cast Out the Demon, Kill the Body: Exorcism, Bedlam, and the Invisible Religious Psychiatry

On the night of July 1, 1976, in Klingenberg, a small Bavarian town, twenty-three-year-old Anneliese Michel died in her bedroom. At the time of her death, she weighed just thirty-one kilograms. Her knees had been shattered by hundreds of hours spent praying on the floor. Dried traces of her own urine were found on her lips and tongue; according to witnesses, she had tried to drink it shortly before she died. Her last words to her mother were: “Mama, I’m afraid.”

Cause of death, per autopsy: exhaustion and dehydration. Immediate cause: six months without food.

The deeper cause, later established by the court and still debated by theologians and psychiatrists, was the 67 exorcism sessions performed on her by two Catholic priests with the bishop’s approval. Each session lasted four hours. All the while, they held her down, prayed, held up crucifixes, and invoked the names of the demons believed to possess her—several in number, it was thought: Lucifer himself, Cain, Judas, Nero, and—strange as it sounds—Adolf Hitler. Detailed reports were drawn up after the sessions. Forty-two hours of recordings survived on magnetic tape; they were later played in court.

Anneliese wasn’t possessed.

Anneliese had temporal lobe epilepsy—a diagnosis made when she was sixteen, after her first convulsive seizure. Later, a psychotic disorder developed alongside her epilepsy. She was prescribed anticonvulsants, antipsychotics, and antidepressants. Treatment was difficult, and her symptoms worsened: she began having auditory hallucinations, hearing voices, and seeing “d••••••••••e faces” in the ordinary faces of passersby. She became physically aggressive toward herself, refused to eat, bit her mother, drank her own urine, and ate insects.

Her family was deeply Catholic. Her father had once trained for the priesthood. Three aunts were nuns. When the medication didn’t work as quickly as the family had hoped, her mother Anna arrived at a simple, familiar explanation: my daughter is possessed.

And so began what would later be called one of the most infamous tragedies of the twentieth century—and one of the bitterest reminders that we, the people of the twenty-first century, living in an age of tomograms, neuropharmacology, and evidence-based medicine, still, in large part, believe that madness is a possession by spirits.

Picture this: you think exorcism is a dusty relic of the Middle Ages. A scare tactic for tourists, fodder for cheap horror films. Forget it. It is an official, active practice of the Catholic Church. Right now. At the very heart of the Vatican operates the International Association of Exorcists — Associazione Internazionale degli Esorcisti. It has received official recognition from the Holy See. The year is 2014. Not 1614. Two thousand fourteen. The ritual is laid out in the “Roman Ritual” — Rituale Romanum. The latest edition came out in 1999. Under John Paul II. And now — the most important part. Open the document. Find the line. It states outright: during the rite of exorcism, a fatal outcome is possible. A person dies. Let that sink in. This is accounted for in the document. It is not an obstacle. It is an acceptable price. Why? Here is the theological logic, word for word: “the body we may lose, but the soul we shall save.” The body — to lose. The soul — to save. Cooling flesh, the final breath — and eternity. One life on the scales against infinity. The Church made its choice. And put it in writing.

Anneliese Michel died by this logic.

She died because, by the time she was twenty-three—in modern Germany, in the heart of Europe, in an age when tomography scanners were plentiful and antiepileptic drugs readily available—her parents and church pastors chose to regard her epileptic seizures as an attack by six demons, and opted for rites to cast out those demons instead of continuing medical treatment.

The court deemed it a case of negligent homicide. Two priests, Arnold Renz and Ernst Alt, were sentenced to six months in prison (later changed to three years’ probation). The parents were also found guilty but exempted from punishment—“they had already suffered enough.” A few years later, the Catholic Church quietly withdrew its recognition that she had been possessed, agreeing that she had been mentally ill.

But it was already too late.

And this is the most important thing to understand. She died only after psychiatry, pharmacology, and neurophysiology had already acquired all the tools needed to save her. She did not die in the Neolithic, nor in the Middle Ages, nor in the time of the Inquisition. She died in the 1970s—in Germany—after 67 sessions sanctioned by the official church hierarchy.

And her grave remains a place of pilgrimage to this day for those who see her as a “martyr for the sins of the world.

The case of Anneliese Michel is not an isolated incident. It’s just the tip of the iceberg.

Every year, dozens of cases occur worldwide. Dozens of people with mental and neurological disorders die at the hands of those who call themselves healers. Researchers and journalists collect the numbers. Behind each one lies an exorcism. Romania, 2005. Tanacu Monastery. A monk named Daniel chains a twenty-three-year-old nun, Irina Cornici, in irons, gags her mouth, and leaves her like that for three days. The goal: to “cast out demons.” Three days without water or air. Irina dies of dehydration and suffocation. Milwaukee, 2003. A mother beats her eight-year-old daughter to death. The girl has autism. It all happens during a “healing session” at a charismatic church. The mother believes. The mother strikes. The child dies. London, 2015. A grandmother and an aunt drown a four-year-old girl in a bathtub while performing a ritual of “cleansing from d•••••s.” Water. Hands. Silence. Three countries. Three years — 2003, 2005, 2015. Three rituals. Irina. The girl from Milwaukee. The girl from London. Chains. Beatings. Water. This is not the Middle Ages. This is today.

These are only the cases that made the news. How many more are there in countries where the press is weaker, where police don’t investigate a••••s within religious communities, where relatives never file a report? There’s no way to know.

Look. Here is a fact that chills the blood. The victims of such rites are almost always patients in psychiatric hospitals. Not sinners. Not possessed. Sick. Now—the chain. Four links. Follow each one. First. Schizophrenia. Voices tear the mind apart from within; the self shatters into fragments—and it is taken for possession. Second. Severe depression. A person falls silent. Their throat tightens in spasm; they stop speaking. And this is branded a “spirit of despondency.” Third. Epilepsy. The body convulses. Muscles jerk in automatisms. And just like that—“demonic possession.” Fourth. Autism, especially with self-stimulation. This is declared “the influence of the unclean one.” Four diagnoses. Four death sentences signed by ignorance. But here is what is terrifying. When mental illness is taken for a spiritual phenomenon, a fatal substitution occurs. Then the irreparable happens: the help that could have saved someone never comes. Something else comes instead.

Modern exorcisms are the end point. But the idea behind them predates any school of psychiatry, and indeed any medicine at all.

The idea that mental illness stems from possession by an external force runs like a red thread through all pre-Christian history. The Babylonians compiled extensive lists of demons, each responsible for a specific type of “madness.” The ancient Greeks recognized epilepsy, which they termed the “sacred disease” (morbus sacer), viewing it as a sign of divine intervention. Yet in the fifth century BC, Hippocrates boldly broke with tradition by writing On the Sacred Disease—a treatise where he calmly and firmly declared: This illness is not divine. It is like other diseases, with a natural cause rooted in the brain.

Hippocrates was right. But his voice was drowned out by a thousand-year chorus of reverse logic.

In the Judeo-Christian tradition, the idea of possession takes on a new meaning, pulsing with tension. The texts of the New Testament leave no room for doubt: Jesus casts out demons again and again. But look at the context. Demons are not an illness. They are agents of evil. They are enemies of man and of God. The logic strikes like a blade: if there is a demon inside you, it must be cast out. Only then will you be healed. Theology would go on to hone this idea for centuries. And by the Middle Ages it would become the beating heart of psychiatry—which did not yet exist.

In 1247, an institution opened in London whose name would, seven centuries later, enter the English language as a byword for chaos and savagery: Bedlam. Its full name was the Hospital of St Mary of Bethlehem. It began as a shelter for the poor, but by the end of the thirteenth century it had started taking in the “insane” — those whom their families and parishes could not, or would not, help.

It is almost impossible to describe calmly what was done to these people at Bedlam over the following five centuries.

Patients were kept in chains. Filth. Cold. In the frozen stone cells, they became living shadows. What passed for treatment? They gave them “baths”—plunging them into ice water and holding them there until they lost consciousness. They “treated” them with bloodletting—up to a liter or more of blood in a single session. The blood drained away, and life with it. They induced vomiting with herbal mixtures until the body began to fail. They shaved their heads. They applied mustard plasters. To “draw poison from the brain.” They locked them in spinning chairs and whirled them at breakneck speed. To “shake out the black bile.”

The seventeenth century. London. Bethlem Hospital. Bedlam. This is where the darkest spectacle in the history of medicine unfolds. Admission cost a penny. What did a city dweller buy for those few coppers? A ticket to the zoo. Except instead of animals in the cages — people. Patients behind bars. Visitors poked them through the ironwork with sticks — exactly the way they did with macaques. Waiting for a reaction. Howling with laughter. By the eighteenth century, this was no longer some casual racket. It was fashion. Entertainment for the London middle class. A weekend outing: go to Bedlam, gawk at the lunatics. Then — off to the tavern. Over a mug of ale, to talk it over.

Only in 1770, under pressure from reformers, did Bedlam close its doors to the public. But conditions inside remained appalling for decades to come.

What did all this have in common? A basic logic. A mentally ill person is less than fully human. He can be treated as an object. He can be tortured—not out of malice, but for “therapeutic reasons.” He can be put on display. His suffering is not considered real suffering. Because he is not entirely one of us. He has been taken over.

But nowhere did the idea of possession assert itself more powerfully than in the church courts of the Inquisition.

1486. Europe shuddered. Out of the printing house came a treatise by two Dominicans—Heinrich Kramer and Jacob Sprenger. The Hammer of Witches. Malleus Maleficarum. A bell tolling blood. From the late fifteenth century onward, the continent plunged into a three-century-long hunt. Darkness fell over towns and villages. The dead? Anywhere from forty thousand to a hundred thousand people. The overwhelming majority—women. Dragged from their beds, hauled to the stake and the gallows for “witchcraft.” But who were they, really? The answer lies buried in dusty archives. Surviving court records lay bare a horrifying truth. Many of those executed were not witches. They were mentally ill. Europe was killing its mad.

Voices. Conversations with the void. Convulsive, unnatural movements of the body. Wounds inflicted by one’s own hand. For the inquisitor, there was only one answer. Clear signs of a pact with the devil. But who was actually hiding behind this terrifying mask? A woman suffering from postpartum psychosis. In terror, she claimed her infant had been replaced by a shapeshifter. The verdict? The stake. An epileptic seized by psychomotor automatisms. The stake. An elderly woman with dementia, incoherently muttering something unintelligible. The stake. A young girl with schizophrenia and suicidal tendencies. The stake. Before the flames roared up, there was an “interrogation.” Hours upon hours of torture. Tormented flesh screamed in pain. And she confessed to things she had never done. Because any other answer — any phrasing short of a confession — brought down fresh agony upon her. The torture continued until the poor wretch broke completely.

The Inquisition was essentially Europe’s first mass psychiatric service—horrific, violent, and exterminatory. Yet it dealt with those who today would be treated in psychiatric hospitals. The stake served the role of insulin coma. Torture took the place of electroshock. Public execution stood in for institutionalization.

This is why, when we read Foucault and other medical historians claiming that psychiatry emerged as a tool for social isolation, this is only half true. Long before psychiatry, this tool already existed. It was wielded by the Church. Its instruments were called exorcism, expulsion, torture, and burning.

Psychiatry stripped her of those functions. And—slowly, through tears and blood—tried to reshape them into something more human.

I said “attempted.” Because the task has not yet been completed.

We think of Bedlam and the Inquisition as things of the distant past. To us, they seem like historical nightmares. But let’s face the truth.

In 1976, Anneliese Michel died of starvation in Klingenberg after undergoing 67 exorcisms. Her death was ruled by the court as negligent homicide.

Today. The twenty-first century. The 2020s. What once seemed a relic of the Middle Ages is returning. Not underground, not in the basements of sects—officially. In 2014, the Catholic Church recognized the International Association of Exorcists. Recognized it. On paper. With all the legal consequences. Courses have opened in Rome. Priests arrive from all over the world. By plane. By train. By bus. They sit at desks and learn to cast out the devil. 2016. The Vatican publishes a new manual. The procedure has been updated. Word for word. Clause by clause. Like a technical regulation. And now—the numbers. Over the past twenty years, the number of official exorcisms in the Catholic world has risen several times over. These are the Church’s own figures. Not journalists’. Not skeptics’. The Church’s. The United States. More than one hundred accredited exorcists. One hundred. Active. Now. In 1990, there were a tenth as many. A tenfold increase in thirty years. The question is simple. If there is no devil—what is happening?

In the Orthodox world, the picture is much the same. Russian, Romanian, and Georgian monasteries perform “otchitki”—rites functionally equivalent to exorcism. These are carried out over people, many of whom suffer from schizophrenia, bipolar disorder, or epilepsy. Families bring such patients to elders, monks, and “seers,” and take them home again—sometimes dead, sometimes worse.

In Protestant Pentecostal churches, particularly in Latin America, Africa, and the post-Soviet world, “deliverances”—exorcism rituals to cast out demons—have become a widespread practice. Thousands of churches. Millions of congregants. Hundreds of thousands of “deliverances” a year. No official death toll is kept.

In the Islamic world, it’s ruqyah — reciting the Quran over someone possessed. In the Hindu tradition, special rituals to cast out spirits. In African traditions, healers who work with “ancestral spirits.” Everywhere, the same story. A mentally ill person ends up not with a doctor but with someone who “sees spirits.

A skeptic might object: “But Orthodox monasteries don’t chain people up like Bedlam or burn them at the stake like the Inquisition. People go there of their own free will. Nobody forces them.

This objection demands a response.

Firstly, “they come on their own” doesn’t always mean willingly. Often, relatives bring a mentally ill person to a priest in a state where they are incapable of giving informed consent. Precisely because they are ill. In the last months of her life, Anneliese Michel was unable to rationally refuse exorcism—her mental and physical state had already been irreversibly compromised. Yet, legally, this was considered “voluntary.

Second. Religious rites performed on the mentally ill aren’t just mysticism. They pose a real medical threat. Rejection of medications under spiritual pressure. Physical exhaustion from hours of fasting and vigils. The escalation of psychosis in the heated atmosphere of a collective ritual. Each of these factors is backed by clinical psychiatry. But what really happens when a schizophrenic patient—whose delusion is fixated on themes of religious guilt and d••••s—finds themselves at the epicenter of such a ritual? Exorcism promises them salvation. But look into the eyes of the person being bound by prayer. Participation in the rite of exorcism brings them no relief. It confirms their delusion instead.

Third—and this is the most important part. Exorcism and modern esoteric practices are two wings of the same bird. A bird that never flew away and still hovers over modern psychiatry.

A priest exorcising a demon. A ThetaHealing practitioner removing “negative energies.” A Hellinger method facilitator tracing the cause of depression to an unforgiven ancestral spirit. Three people. Three different eras. Three seemingly incompatible rituals. Piece them together. And a chilling pattern emerges. All three operate within the same paradigm—pre-scientific. Ancient, like humanity’s first fear of the unseen. What does this mean? To them, the body is but a vessel. An empty shell. Inside lurks something. Incorporeal. External. Hostile. It crept in from the outside and seized control. Like an occupier. Like a foreign agent burrowing into flesh. Yet here lies the mystery hidden at the end of this reasoning. This something can be removed. Carved out. Cast out. Like a parasite. Like a splinter lodged beneath the skin. Through ritual acts.

All of them are equally removed from scientific psychiatry. And all of them are equally dangerous to those genuinely in need of help.

Due to exorcisms, Bedlam no longer sells tickets. However, television ratings for “The Battle of Psychics” continue to rise year after year. Thanks to the Inquisition, witches are no longer burned at the stake. Yet “family constellation” practitioners across the former Soviet empire proclaim fortune-tellers as their “spiritual heirs” and charge fees for “ancestral cleansing.

Forms change. The essence remains.

The question we raised in the preface comes back to us: who, in this situation, has lost touch with reality?

A patient diagnosed with schizophrenia, experiencing hallucinations, harming no one but himself?

Or a church hierarchy in the twenty-first century sanctioning rituals in which people starve to death?

Or a society that silently agrees that such rituals are “a private matter for the faithful”?

The answer to this question does not lie with the clergy. It belongs to psychiatry. And to society.

I fear that we—both one side and the other—still avoid him to this day.