SOCIETY TODAY

Medicine

Bell, book and stethoscope

John Linklater

Doctors are taught to explain unwelcome, unacceptable and anti-social behaviour in terms of medical illness. The general practitioner will therefore make a diagnosis of idiopathic obesity, scarcely aware that he is describing what was once upon a time the sin of gluttony; so will he write a certificate for neurasthenia, so often merely the sin of sloth, seen in fancy modern dress. Sloth and gluttony were not acceptable diagnoses at medical school because spiritual illness did not form part of the curriculum.

This is. why the general practitioner meets an increasing number of patients whose problems are superficially in the psychiatric field, but whose signs and symptoms of stress and distress cannot easily be squeezed into a medically recognised diagnostic slot. The savage and macabre killing of Mrs Christine Taylor is an extreme example. Her tongue, face and eyes were torn out by her fond husband, the father of their five children, after an all-night exorcism conducted by the Reverend Peter Vincent in St Thomas's Church, Barnsley. The obvious diagnosis of resistant demonic possession is medically meaningless and most doctors would accordingly have been forced, in spite of the stable, viable and contented family background and absence of psychiatric history, to make a tentative diagnosis of a fulminating schizophrenia inappropriately handled.

The Bishop of Wakefield does not believe in demons either. He therefore criticised the Reverend Peter Vincent for performing the Barnsley exorcism unwisely. He also spoke of banning further exorcisms on the grounds that they are dangerous and little understood.

The danger of exorcism is not in dispute, but the fact that we cannot explain it in scientific terms raises the fundamental question of how much we can truly explain, even of the tangible world in which we live. Late nineteenth century scientists fell into the trap of believing that their increasingly complex re-descriptions constituted an explanation; men accordingly imagined themselves to be living in a stable, material world, stilt based on an immutable atomic structure.

Technological advances over the last fifty years have severely shaken our complacent security, however. We are now confronted with a seemingly unending variety of sub-atomic entities, with black holes in space, with the accepted existence of anti-matter, with the mind-boggling inter-relationship of space and time and with the fact that mass can be altered, not only by conversion into force and vice versa, but also by altering its speed.

The more we discover, the less we seem to understand. The Victorian scientist who could not believe Christian doctrine because he could not analyse God samples and soul samples in his laboratory, is now replaced by a new generation of scientists who are asking us to accept an ever-increasing number of articles of faith.

Victorian medical technology led, • inevitably, to the separate treatment of the body, as contrasted to the mind and spirit. Mens sana in corpore sano, indeed, implied that mental and spiritual disease would cease to exist if the body were in perfect health. Freudian psychiatry challenged this view by explaining the pathogenesis of neurosis in terms of environmental stress, regardless of the state of physical health. Mental disease thereafter re-entered the field of medicine, and the Church was left with the cure of souls.

But the Church itself had become brainwashed by materialism and science. Instead of specialising in the treatment of spiritual diseases including acute infestation by demons, the church was content to let these also slip from the confessional into the surgery.

The trouble was that when Freud explained away neurotic, selfish and, even, criminal behaviour by blaming the environment rather than the individual, he unwittingly proposed himself to replace God as the forgiving father figure; he exploited confessional technique and adapted it to suit his new explanatory concept of human nature. No longer was it necessary to kneel in humility. Freud provided a comfortable couch to sprawl on instead.

Neither was it necessary to repent and make amends nor, even, to promise never to trangress again. Freud offered easier terms. The explanation itself was enough: sin had ceased to exist. There seemed to be nothing left for the church to do. Beelzebub had undergone metamorphsis into a wrongly conditioned reflex. Exorcism had become re-education.

Perhaps this is what the Archbishop of Canterbury, Dr. Coggan, had in mind when, referring to the Barnsley case, he said that the church should "move out of the realms of mumbo-jumbo." He did not actually condemn the practice of exorcism but said that "when called for. . . it should be performed in collaboration with the forces of medicine" and "never in the light of much publicity." Dr. Coggan's statement is in line with the findings of the Bishop of Exeter's Commission on Exorcism, but it nevertheless discloses a veiled disapproval, coupled with some doubt about its reality and efficacy. It suggests that, if performed at all, exorcism should take place in respectable seclusion, without publicity, between consenting adults, so to speak.

Psychiatrists likewise generally decry exorcism, especially if it takes place in groups or in public; they employ denigratory terms to describe it, like "mass hysteria". Somewhat inconsistently, however, psychiatrists accept the therapeutic value of the emotional upheaval, or catharsis, upon which the success of the psychiatric session may often depend. Noi-• do they object to the increasingly popular group therapy sessions, where a number of patients gather together specifically for the purposes of healing.

Cautious members of the Church hierarchy advocate post-ordination courses in exorcism before allowing a priest to perform. But this is contrary to the modern trend in psychiatry where group and other therapy sessions are now often run by nursing staff. It also shows less than complete confidence in the operation of the Holy Spirit.

A correct diagnosis is, however, essential, and it may be that post-ordination training would be devoted to this. Mental disease is a dysfunction of the physical brain. If that dysfunction consists of a fragmentation of the psyche, the patient is suffering from a schizophrenia. This, and other psychoses, are primarily a matter for the psychiatrist rather than the exorcist. It would be as inappropriate to exorcise schizophrenia as it would be to exorcise a fragmented femur. Medical clearance to exclude the psychotic is therefore probably essential.

Having taken reasonable precautions, there would not seem to be any reason for low profile privacy. The cheerful witness and carefree faces of men and women from whom various demons had been exorcised by the Reverend Trevor Dearing at Hainault, is surely something that should be publicised rather than hidden. Many of the patients had been treated medically, for years, without success.

It all ultimately depends on faith. If Beelzebub has been replaced by a diffuse, generalised force of evil, then God has likewise been dispersed, and no longer exists. If exorcism is mumbo-jumbo, then so is prayer. A man who does not believe in demons cannot believe in the divinity of Christ, or in the New Testament. He cannot therefore be a Christian.

By the same token, if there is no real, personal God, then man, including the Bishop of Wakefield, is no more than an accidental collection of molecules, each consisting of a cat's-cradle of force, precariously and transiently suspended, without value or meaning, in a hostile universe. When doctors collude with the Church to bring gluttony, sloth, guilt and despair out of the reach of the exorcist, and into the surgery, they effectively strip mankind of personal dignity, individual choice and responsibility and reduce man to the status of a rather sick molecular joke.