Louisa Muskovits appeared to be having a panic attack. It was March of 2016, and Louisa, a 33-year-old with a history of alcohol abuse, was having a regular weekly session with her chemical-dependency counselor in Tacoma, Washington.

Louisa had recently separated from her husband, Steven. When the counselor asked about her marriage, she said she wasn’t ready to talk about it. The counselor pressed, and again Louisa demurred. Eventually the conversation grew tense, and Louisa started to hyperventilate, a common symptom of a panic attack.

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The counselor rushed down the hall to get Louisa’s therapist, Amy Harp. Together they moved Louisa to Harp’s office, where they felt they could better calm her. But once Louisa was there, Harp recalls, her demeanor transformed. Normally friendly and open, she started screaming and pulling out clumps of her hair. She growled and glared. Her head flailed from side to side, cocking back at odd angles. In jumbled bursts, she muttered about good and evil, God and the devil. She told the counselors that no one there could save “Louisa.”

According to Harp, Louisa seemed to vacillate between this unhinged state and her normal self. One minute she would snarl and bare her teeth, and the next she would beg for help. “It definitely had this appearance where she was fighting within herself,” Harp told me.

Harp had never seen this kind of behavior before, and wasn’t sure what to do. But she knew that Louisa had occasionally experienced episodes in which she felt something indescribably dark overtake her, and that she would read scripture to beat back these states. “You need to read Bible verses,” Harp said. Her bearing still frantic, Louisa picked up her smartphone and began looking up passages. As she read, she started to calm down. Her flailing diminished; her frenzied affect ebbed. She vomited in a trash bin, and after that she was her old self again, full of apologies, her eyes wet, her face red.

The encounter left Harp baffled about what she’d just witnessed. For Louisa it had a more profound effect, prompting a search for answers that would ultimately lead her away from modern medicine and its well-worn paths for mental-health treatment, and toward the older, more ritualized remedies of her Catholic faith.

Louisa Muskovits experienced a series of troubling episodes that her therapists couldn’t explain. These incidents led her to seek spiritual help. (Ian Allen)

The conviction that demons exist—and that they exist to harass, derange, and smite human beings—stretches back as far as religion itself. In ancient Mesopotamia, Babylonian priests performed exorcisms by casting wax figurines of demons into a fire. The Hindu Vedas, thought to have been written between 1500 and 500 b.c., refer to supernatural beings—known as asuras, but largely understood today as demons—that challenge the gods and sabotage human affairs. For the ancient Greeks, too, demonlike creatures lurked on the shadowy fringes of the human world.

But far from being confined to a past of Demiurges and evil eyes, belief in demonic possession is widespread in the United States today. Polls conducted in recent decades by Gallup and the data firm YouGov suggest that roughly half of Americans believe demonic possession is real. The percentage who believe in the devil is even higher, and in fact has been growing: Gallup polls show that the number rose from 55 percent in 1990 to 70 percent in 2007.

Perhaps as a result, demand for exorcisms—the Catholic Church’s antidote to demonic possession—seems to be growing as well. Though the Church does not keep official statistics, the exorcists I interviewed for this article attest to fielding more pleas for help every year.

Father Vincent Lampert, the official exorcist for the Archdiocese of Indianapolis, told me in early October that he’d received 1,700 phone or email requests for exorcisms in 2018, by far the most he’s ever gotten in one year. Father Gary Thomas—a priest whose training as an exorcist in Rome was documented in The Rite, a book published in 2009 and made into a movie in 2011—said that he gets at least a dozen requests a week. Several other priests reported that without support from church staff and volunteers, their exorcism ministries would quickly swallow up their entire weekly schedules.

The Church has been training new exorcists in Chicago, Rome, and Manila. Thomas told me that in 2011 the U.S. had fewer than 15 known Catholic exorcists. Today, he said, there are well over 100. Other exorcists I spoke with put the number between 70 and 100. (Again, no official statistics exist, and most dioceses conceal the identity of their appointed exorcist, to avoid unwanted attention.)

In October of last year, the U.S. Conference of Catholic Bishops had Exorcisms and Related Supplications—a handbook containing the rite of exorcism—translated into English. The rite had been updated in 1998 and again a few years later, but this was the first time it was issued in English since it had been standardized in 1614. “There’s been a whole reclaiming of a ministry that the Church had set aside,” one exorcist from a midwestern diocese told me.

The inescapable question is: Why? Or rather: Why now? Why, in our modern age, are so many people turning to the Church for help in banishing incorporeal fiends from their body? And what does this resurgent interest tell us about the figurative demons tormenting contemporary society?

In 1921, a German psychologist named Traugott Oesterreich collected historical eyewitness accounts in his book Possession: Demoniacal and Other. One incident that crops up again and again involves a young woman named Magdalene in Orlach, Germany. Born into a family of peasant farmers, Magdalene was an industrious child, “threshing, hemp-beating, and mowing” from dawn until after dusk. Late in the winter of 1831, Magdalene began seeing strange things in the barn where she tended cows. By the following year, she was being tormented by voices, sensations of physical assault, and, according to witnesses, spontaneous outbursts of flames.

That summer, Magdalene complained of a spirit that had “flown upon her, pressed her down, and endeavored to throttle her.” Soon, she would fall victim to full possessions: An entity she referred to as the “Black One” would descend and supplant her consciousness with its own. “In the midst of her work she sees him in human form (a masculine shape in a frock, as if issuing from a dark cloud; she can never clearly describe his face) coming towards her,” a contemporary observer wrote. “Then she sees him approach, always from the left side, feels as it were a cold hand which seizes the back of her neck, and in this way he enters into her.”

One witness to Magdalene’s possessions was dumbfounded. “The transformation of personality is absolutely marvelous,” he wrote.

The girl loses consciousness, her ego disappears, or rather withdraws to make way for a fresh one. Another mind has now taken possession of this organism, of these sensory organs, of these nerves and muscles, speaks with this throat, thinks with these cerebral nerves, and that in so powerful a manner that the half of the organism is, as it were, paralyzed.

The case studies Oesterreich collected served as one of the chief inspirations for William Peter Blatty’s 1971 novel, The Exorcist, which was adapted into the 1973 horror film of the same name—it was nominated for 10 Academy Awards, and is considered by many to be one of the most frightening films ever made.

Another inspiration for The Exorcist was the 1949 case of a teenage boy known by the pseudonym “Roland Doe.” He was an only child who developed a strong attachment to his aunt, a spiritualist who showed him how to use a Ouija board. After she died, Roland and his parents reported strange phenomena in their house—furniture moving on its own, scratching noises coming from Roland’s mattress, objects levitating. The paranormal occurrences, Roland’s parents observed, always seemed to happen around their son. According to some accounts, a priest conducted an exorcism on Roland at Georgetown University Hospital, a Jesuit institution in D.C., during which the boy managed to snap off a bedspring from underneath his mattress and use it to slash the priest’s arm.

Roland and his parents eventually left their home in Maryland to stay with extended family in St. Louis. There, priests carried out at least 20 exorcisms over the course of a month. Witnesses claimed that Roland spoke in a deep, unrecognizable voice and spouted Latin phrases he’d never learned. He reportedly vomited so profusely that the exorcist performing the rite had to wear a raincoat, and he fought so violently that 10 people were required to hold him down. One of the priests said that at a certain point he saw the word hell appear as though etched into Roland’s flesh.

In April 1949, several hours into an exorcism, Roland finally surfaced from his trancelike state. “He’s gone,” Roland told the priests. Several researchers have since cast doubt on whether anything supernatural took place during the exorcisms, but none has been able to definitively contradict the priests’ accounts.

Part of The Exorcist’s appeal may have been the faint but unmistakable sense that it was drawn from real events. One Catholic exorcist I spoke with who was around for the film’s release believes that its success revealed a latent aspect of the American character. “It confirmed something deep in the popular imagination,” the priest, who asked that I not use his name so as to keep his identity as an exorcist private, told me. “Very visceral, very irrational, beyond science, far buried underneath medicine and psychology: this huge fear that these things are true.”

Louisa’s grandmother, who was an American Indian and a devout Catholic, warned her about evil spirits. (Ian Allen)

Louisa’s troubles had started long before that late-winter session with her chemical-dependency counselor. In 2009, at age 26, she’d had an experience in the middle of the night that had left her badly shaken. She was living in Orlando with Steven, and she’d just fallen asleep. Louisa had recently given birth to their first child, a son, who was tucked between his parents in bed. At one point during the night, she awoke and found herself paralyzed. “There was something holding me down,” she remembers. “I couldn’t move, I couldn’t breathe, and I thought I was going to die.” She desperately wanted to wake up Steven, but her body was inert, pinned to the mattress. All she could move were her eyes, and they darted around the room in horror.

When Louisa told friends and family about the episode, most shrugged it off. Some suggested that it might have been a lingering effect of having just undergone a strenuous delivery (she had needed a cesarean section). Louisa decided they were probably right.

In 2011, she was finishing up her undergraduate degree in women’s studies at Washington State University. For a required internship that fall, she chose to travel to Kathmandu, Nepal, to work for an organization that provides aid to impoverished women and children in the region.

After a month in Kathmandu, Louisa became infected with E. coli and had to be hospitalized for two days. When she was discharged, she debated flying home right away. She’d completed her internship, but her scheduled flight wasn’t for another four weeks. She’d been looking forward to making the famous Annapurna Base Camp trek. But now she was drained and weary of her surroundings. The other interns had left the apartment complex where she was staying, and the city’s streets had been shut down because of political protests.

The night after she left the hospital, Louisa locked the door to her apartment, secured the window with a wooden bar, and went to bed. As Louisa tells it, she awoke in the darkness to the sound of someone’s breathing. It seemed close: She could feel the hot exhales on the back of her right ear and her neck. There’s no way anybody could get into the room, she thought, lying motionless in her sleeping bag. How is this possible?

Thoughts of evil spirits rushed to Louisa’s mind. Her grandmother, who was both an American Indian and a devout Catholic, had warned her about them. If Louisa ever encountered evil spirits, her grandmother had told her, she should do her best to ignore them, because they feed on attention. Louisa tried, but the breathing continued, a heavy, rhythmic rasp. Then, after a minute or so, she felt a hand brush against her collarbone.

At that sensation, which to this day she cannot account for, Louisa leapt out of her sleeping bag and ran to turn on the light. She swears that as soon as she flipped the switch, she heard a pack of stray dogs break out in wild yelps. By dawn Louisa had cleared out, walking several miles to the U.S. Embassy in Kathmandu. She took the next flight back to Orlando.

Louisa had yet another incident in 2013, just after giving birth to her second child, a daughter. This episode was more like the first—she woke up abruptly, only to find her body locked in place—but with the added shock of what seemed to be visual hallucinations, including one of a giant spider crawling into her bedroom. Louisa was so jolted that she barely ate or slept for three days. “I didn’t feel safe,” she said. “I felt violated.”

She’d been seeing a psychiatrist in Orlando. “This is the third time this has happened,” Louisa remembers telling her. “Am I crazy?” The doctor flashed a look of surprise but offered no satisfying insights. So Louisa turned to the internet.

Sleep paralysis seemed like a promising explanation. A phenomenon in which sufferers move too quickly in and out of rem sleep for the body to keep up, sleep paralysis causes a person’s mind to wake up before the body can shake off the effects of sleep. Hovering near full consciousness, the person can experience paralysis and hallucinations.

But Louisa didn’t think this could account for the hand on her collarbone, which she swore she’d felt while she was completely awake. She started to wonder whether something was pursuing her. Amid consuming fear, she waded into some darker internet waters: elaborate descriptions and YouTube testimonials of people who claimed that a demon or some other evil entity had dragged them down to hell. She pored over artists’ renderings of hell—naked bodies writhing like snakes, being consumed by orange flames. “I became obsessed with this topic,” she told me.

On the Sunday after her third incident, in the grips of these new fears, Louisa attended Mass in Orlando, at Saint James Cathedral. After the service, she recounted all three of her experiences to the priest, who immediately asked whether she’d ever dabbled in the occult. When she told him that she had used a Ouija board after her grandfather had passed away a couple of years earlier, he told her to get rid of it, along with anything else that could be construed as occult: tarot cards, amulets, pagan symbols, even healing crystals and birthstones. Any of these things, he told her, could serve as a doorway for a demon.

It may surprise some Catholics to learn just how literally the modern Church interprets Satan and his army of demons. While many people today understand the devil as a metaphor for sin, temptation, and unresolvable evil in the world, the pope consistently repudiates such allegorical readings.

In sermons, interviews, and occasionally in tweets, Pope Francis has declared that Satan—whom he has referred to as Beelzebub, the Seducer, and the Great Dragon—is a literal being devoted to deceiving and debasing humans. In an apostolic exhortation released in April, he wrote, “We should not think of the devil as a myth, a representation, a symbol, a figure of speech or an idea,” but rather as a “personal being who assails us.”

Exorcisms also occur in some Protestant and nondenominational Churches, but the Catholic Church has the most formal, rigorous, and long-standing tradition. The Church sees the influence that demons and their leader, the devil, can have on human beings as existing on a spectrum. Demonic oppression—in which a demon pressures a person to accept evil—lies on one end. Demonic possession—in which one or more demons seize control of a person’s body and speak through that person—lies on the other end.

Catholic priests use a process called discernment to determine whether they’re dealing with a genuine case of possession. In a crucial step, the person requesting an exorcism must undergo a psychiatric evaluation with a mental-health professional. The vast majority of cases end there, as many of the individuals claiming possession are found to be suffering from psychiatric issues such as schizophrenia or a dissociative disorder, or to have recently gone off psychotropic medication.

For some, being told they do not suffer from demonic possession can be a letdown. Father Vincent Lampert, the exorcist from Indianapolis, remembered a young man who came to him seeking an exorcism but was told he was experiencing symptoms of schizophrenia. “You can tell me that I’m schizophrenic, but you can’t tell me why,” Lampert recalled the young man saying. “If it’s demonic, at least I have my why.”

If neither the mental-health evaluation nor a subsequent physical exam turns up a standard explanation for the person’s affliction, the priest starts to take the case more seriously. At this point he may begin looking for what the Church considers the classic signs of demonic possession: facility in a language the person has never learned; physical strength beyond his or her age or condition; access to secret knowledge; and a vehement aversion to God and sacred objects, including crucifixes and holy water.

Only a very small number of exorcism requests make it through the discernment process. The Catholic exorcists I interviewed—each with more than a decade of experience in the role—had worked on only a handful of cases deemed to be true possession. “The Church wants to tread lightly and be skeptical” when examining possible cases of demonic possession, Lampert said, and thus treats exorcism “like a nuclear weapon”—a countermeasure that is important to have in the arsenal but that should be used only when no other explanation can be found.

The ritual begins with the exorcist, who is typically assisted by several people, sprinkling holy water on the possessed person. The exorcist makes the sign of the cross and kneels to recite the Litany of the Saints, followed by several readings of scripture. He then addresses the demon or demons, establishing the ground rules they must abide by: to reveal themselves when called, give their names when asked to identify themselves, and leave when dismissed. Because the exorcist is working with the full authority of God and Jesus Christ, Catholic doctrine stipulates, the demons have no choice but to obey.

At the rite’s climax, sometimes an hour or more into the ritual, the exorcist calls on the devil directly: “I cast you out, unclean spirit, along with every Satanic power of the enemy, every specter from hell, and all your fell companions.” Sessions typically end with a closing prayer and a plan to continue. For those few people the Church believes are truly possessed, a half-dozen or more exorcisms may be carried out before the priest is confident that the demons have been fully expelled.

According to Catholic doctrine, in order to take possession of a person in the first place, demons rely on doorways—what the priest in Orlando warned Louisa about. These can include things like habitual sin and family curses—in which an act of violence or iniquity committed by one generation manifests itself in subsequent generations. But the priests I spoke with kept coming back, over and over, to two particular doorways.

Nearly every Catholic exorcist I spoke with cited a history of abuse—in particular, sexual abuse—as a major doorway for demons. Thomas said that as many as 80 percent of the people who come to him seeking an exorcism are sexual-abuse survivors. According to these priests, sexual abuse is so traumatic that it creates a kind of “soul wound,” as Thomas put it, that makes a person more vulnerable to demons.

The exorcists—to be clear—aren’t saying sexual abuse torments people to such an extent that they come to believe they’re possessed; the exorcists contend that abuse fosters the conditions for actual demonic possession to take hold. But from a secular standpoint, the link to sexual abuse helps explain why someone might become convinced that he or she is being menaced by something sinister and overpowering.

The correlation with abuse struck me as eerie, given the scandals that have rocked the Church. But it doesn’t seem to answer the “why now?” question behind exorcism’s comeback; no evidence exists to suggest that child abuse has increased. The second doorway—an interest in the occult—might offer at least a partial explanation.

Most of the exorcists I interviewed said they believed that demonic possession was becoming more common—and they cited a resurgence in magic, divination, witchcraft, and attempts to communicate with the dead as a primary cause. According to Catholic teaching, engaging with the occult involves accessing parts of the spiritual realm that may be inhabited by demonic forces. “Those practices become the engine that allows the demon to come in,” Thomas said.

In recent years, journalists and academics have documented a renewed interest in magic, astrology, and witchcraft, primarily among Millennials. “The occult is a substitution for God,” Thomas said. “People want to take shortcuts, and the occult is all about power and knowledge.” One exorcist pointed to Harry Potter. The books and films “disarmed Americans from thinking that all magic is darkness,” he said.

After listening to the priests and poring over news articles, I started to wonder whether the two trends—belief in the occult and the rising demand for Catholic exorcisms—might have the same underlying cause. So many modern social ills feel dark and menacing and beyond human control: the opioid epidemic, the permanent loss of blue-collar jobs, blighted communities that breed alienation and dread. Maybe these crises have led people to believe that other, more preternatural, forces are at work.

But when I floated this theory with historians of religion, they offered different explanations. A few mentioned Pope Francis’s influence, as well as that of Pope John Paul II, who brought renewed attention to the exorcism rite when he had it updated in 1998. But more described how, during periods when the influence of organized religions ebbs, people seek spiritual fulfillment through the occult. “As people’s participation in orthodox Christianity declines,” said Carlos Eire, a historian at Yale specializing in the early modern period, “there’s always been a surge in interest in the occult and the demonic.” He said that today we’re seeing a “hunger for contact with the supernatural.”

Adam Jortner, an expert on American religious history at Auburn University, agreed. “When the influence of the major institutional Churches is curbed,” he said, people “begin to look for their own answers.” And at the same time that there has been a rebirth in magical thinking, Jortner added, American culture has become steeped in movies, TV shows, and other media about demons and demonic possession.

Today’s increased willingness to believe in the paranormal, then, seems to have begun as a response to secularization before spreading through the culture and landing back on the Church’s doorstep—in the form of people seeking salvation from demons through the Catholic faith’s most mystical ritual.

Louisa sought help from a priest at Saint Stephen the Martyr Church in Renton, Washington. (Ian Allen)

When I first began talking with Louisa, she recounted the three nighttime episodes in great detail, giving me the impression that they were the only precursors to the incident in Amy Harp’s office. But just after my visit to Tacoma in March, I spoke by phone with Steven, with whom Louisa had recently reconciled, and he told me that she had been suffering for years from daytime episodes, too. The incidents in the middle of the night frightened Louisa more and felt, to her, more supernatural, but Steven found these daytime experiences much harder to explain.

One of these episodes occurred on the Saturday after Thanksgiving in 2014. Louisa had followed the instructions of the priest at Saint James Cathedral, throwing out her Ouija board and some healing crystals. She and Steven had moved back to Washington State with their two children, hoping that proximity to family and friends would do her good. They settled into a routine—Steven worked at a nearby warehouse; Louisa looked after the children—and for a while, Louisa all but forgot the nighttime incidents in Orlando.

On that November Saturday in 2014, Louisa spent a few hours at a friend’s house in Tacoma. She came home in the early evening and spent some time upstairs in her bedroom. She eventually returned to the living room and spoke briefly with Steven. Then she fell silent. When she began talking again, a new persona emerged. Normally an affable, meandering conversationalist, Louisa assumed a slow, measured tone.

Steven had seen these transformations before, at least half a dozen times during the decade or so he’d known Louisa, who could never remember them afterward. Recognizing the signs of what was happening, he told me, he grabbed his tablet and began filming.

The footage is dark and the sound quality poor. The camera is pointed directly at Louisa. The video lasts for about 20 minutes. “You humans have your own sense of time,” Louisa tells Steven at one point. “I have plenty of time. I have all the time in the world.” She then shifts into a staccato whisper. “It’s your wife I want,” she says, “not only her body, but her soul.” As she speaks, she jerks her head from side to side, at first quickly, like a marionette, then slowly, like a viper swaying to the sounds of a snake charmer’s pungi.

Halfway through the video, Louisa leans toward Steven and freezes, her face just a few inches from his. “God can’t save her,” she tells him. “Do you understand that? She’s mine.” After a period of tense silence, she suddenly arches her spine, and her face goes through a series of contortions.

As I watched, I struggled to make sense of what I was seeing. The grating static and long, empty silences lent an air of both amateurism and authenticity—I didn’t get the feeling that the video had been faked. All I could settle on, though, was that the camera had captured Louisa in some kind of dissociative state in which her emergent identity believed itself to be inhuman.

When Steven first started witnessing these episodes, he assumed they were symptoms of a psychiatric disorder. Louisa certainly had had her share of struggles: In addition to these unexplained incidents, she also suffered from post-traumatic stress disorder and had a history of alcohol abuse. But Steven changed his mind when, he claims, strange things began happening alongside Louisa’s episodes—electronic devices abruptly turning on, lights he was sure were broken suddenly illuminating. The things he’s seen since knowing Louisa, he told me, “disturb your reality.”

Wynonna Gehrke, who became close friends with Louisa at Washington State University, recalls witnessing something similar. One night, they were hanging out at Gehrke’s house along with another friend when Louisa slipped into a persona her friends didn’t recognize. The emergent identity told them it was a demon that wanted to hurt Louisa. “Her facial expression,” Gehrke told me—“it didn’t seem like her. It creeped me out so bad.” Fearing for both her own safety and Louisa’s, Gehrke wrestled her friend to the ground and eventually managed to calm her. She gave Louisa her bed that night, and she slept on the couch.

On a mild, drizzly morning in late March, I made plans to meet Louisa at Saint Stephen the Martyr, a Catholic church in Renton, Washington. It was Palm Sunday, and parishioners began pouring in long before the start of the 8:30 Mass. I found a seat in one of the back pews and waited for Louisa.

Midway through the service, I felt a hand brush my shoulder. It was Louisa. She’d arrived late and was listening to the Mass from the foyer with her third child, a 1-year-old daughter.

A few minutes later I slipped out to join them. Louisa pushed the baby back and forth in a stroller while her eyes strained toward the altar. She’d told me that the Catholic churches she’d spent time in as a child had always been a source of calm for her—the readings, rituals, and silent prayer ineffably soothing. Although this wasn’t the church she regularly attended, she knew the priest, Father Ed White, well.

After her experience with her chemical-dependency counselor in 2016, she’d become convinced that she was being harassed by a demon and had started looking for a Catholic exorcist. A woman she’d met online suggested she contact White. He wasn’t the designated exorcist for the Archdiocese of Seattle, but he had experience in deliverance ministry—the work of helping people overcome different kinds of spiritual difficulties through prayer.

In his first session with Louisa, in early 2017, White began by encouraging her to discuss the problems she was experiencing. He then left for a few minutes, returning with the purple stole around his neck that priests wear for both confessions and exorcisms. At that point the session took on the more structured feel of a Christian ritual.

In his deliverance ministry, White often asks the person he’s counseling to renounce evil spirits. But when he gave Louisa a piece of paper with renunciation prayers to recite, she froze. Struggling to read the words in front of her, she began moaning and then dry-heaving. Moments later, she slipped into guttural babbling.

Louisa’s upper body began contorting, her neck swinging at unnatural angles. White remembers her appearing as though she was in agony. “It didn’t strike me as voluntary or concocted,” he told me. At one point while he was praying aloud, she broke out in hysterical laughter.

After the first session, White considered starting the discernment protocol for an exorcism. He invited Louisa back for a second session, which went more smoothly. The two talked and prayed, and Louisa read the renunciation prayers without a problem. “Because I saw progress with what I was doing,” White told me, “I thought it was debatable as to whether she needed an exorcist.” Eventually, because she seemed to be responding to the prayers, White made the determination that Louisa’s case was one of demonic oppression, not possession. She would not have an exorcism.

After Mass, I met Louisa at her home in Tacoma, a two-story clapboard house 10 minutes from the Puget Sound, where she described the larger arc of her life and the torments she’d endured.

Louisa’s parents separated when she was 3 years old. Her mother eventually remarried and settled with Louisa and her older brother in Fife, a small city just east of Tacoma. Louisa’s childhood and adolescence were marked by abuse: She was molested by a family member, which has caused lifelong post-traumatic stress. She still has nightmares about the experience. “It’s like I’m back there again,” she said. “Thirty years ago, all over again. And then I wake up and I’m like, I’m okay. I’m not there.” But the dreams are saturated with the same sense of helpless dread that pervaded her childhood, which she compares to being “in hell, almost.”

As we talked, the baby, quietly tucked in the crook of Louisa’s arm, fell asleep. With her other hand, Louisa dabbed her eyes. To this day, specific triggers—including certain music genres and foods—will send her into a gale of rage and despair. “Walking by a store and it’s playing ’60s music, like Beach Boys or something, I would lose it,” she said. Hamburger Helper, too, has permanently absorbed some residue of her abuse: She thinks her abuser must have made it shortly before or after a molestation episode.

Some abused children are subjected to such agonizing experiences that they adopt a coping mechanism in which they force themselves into a kind of out-of-body experience. As they mature, this extreme psychological measure develops into a disorder that may manifest unpredictably. “There is a high prevalence of childhood abuse of different kinds with dissociative disorders,” Roberto Lewis-Fernández, a Columbia University psychiatry professor who studies dissociation, told me. In certain countries, including the U.S., Lewis-Fernández explained, the prevalence of physical and sexual abuse among people with a dissociative disorder is particularly pronounced.

Several psychiatrists I’ve asked about Louisa’s case felt that some type of dissociative disorder—whether dissociative identity disorder or a subtype linked to PTSD—could be a plausible clinical explanation for what has been happening to her. But Amy Harp, Louisa’s former therapist, was less certain. “I see a lot of trauma, and it manifests in a lot of different ways,” she told me. Louisa’s, though, was “the most extreme I’ve ever seen.” She ultimately found Louisa’s episodes ambiguous—“possibly trauma, possibly something else.”

Jeffrey Lieberman, the chairman of Columbia’s psychiatry department, told me that if you conducted a survey of the population seeking exorcisms, a great majority would likely suffer from a known psychiatric condition, and dissociative identity disorder would be “at the top of that group of conditions.” But Lieberman also acknowledged the possibility that a small percentage of these cases could be spiritual in nature. Over the course of his career, he’s seen a couple of cases that “could not be explained in terms of normal human physiology or natural laws.”

The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM-5, seems to recognize this still-mystifying dimension in abnormal psychology: It lists a “possession-form” subtype of dissociative identity disorder and notes that the “majority of possession states around the world” are an accepted part of specific spiritual practices—whether they be trances, shamanic rituals, or speaking in tongues. The DSM-5 is not saying that possession is a scientifically verifiable phenomenon, but rather is acknowledging that many people around the world understand their abnormal mental experiences and behaviors through a spiritual framework. Lewis-Fernández, who was on the committee that made this change, explained that Western psychiatry had long failed to accommodate widespread spiritual traditions. There are “societies where the supernatural is a daily occurrence,” he said. “It’s really modern Western societies that draw a sharp line between experiences attributed to the spiritual or the supernatural, and the material, daily world.”

Pore over these spiritual and psychiatric frameworks long enough, and the lines begin to blur. If someone lapses into an alternate identity that announces itself as a demon bent on wresting away that person’s soul, how can anyone prove otherwise? Psychiatry has only given us models through which to understand these symptoms, new cultural contexts to replace the old ones. No lab test can pinpoint the medical source of these types of mental fractures. In one sense, the blurry shadow-selves that surface in what we call dissociative states and the demons that Catholic exorcists believe they are casting out are not so different: Both are incorporeal forces of ambiguous agency and intent, rupturing a continuous personality and forever eluding proof.

Louisa has never gotten a diagnosis of dissociative identity disorder. And she’s always had a bracing faith in the Catholic Church. When I visited her, she told me she hoped to make another appointment with Father White sometime soon. She also talked about possibly reconnecting with Amy Harp, whom she’d stopped seeing last year but with whom she’d seemed to have had a strong, trusting relationship. I didn’t know which path to healing, if any, she would choose. She seemed torn between the avenues of faith and psychology, uncomfortably astride two roads that ran alongside each other but never quite converged.

About a month after I visited her, I got a call from Steven, who told me that Louisa had had another incident. At first he’d thought she was having a seizure—several years had passed since he’d seen one of her dissociative episodes—and he’d considered calling an ambulance. But as he watched, an alternate identity once again took over Louisa, referring to her in the third person and threatening her life. The episode lasted only a few minutes, but it shook Steven. “When you’re witnessing it, it seems like it’s going on forever,” he told me.

Whatever was tormenting Louisa wasn’t finished with her yet. When I texted her the next day to see how she was doing, she told me she was managing as best she could. Earlier that morning, she said, she’d made another appointment with Father White.


This article appears in the December 2018 print edition with the headline “Why Are Exorcisms On the Rise?”