Psychopathology in Religious Ideation: The Case of Death by Proxy (2013)
Though there is no unequivocal evidence for a causal relationship between religiosity and psychopathology, a large body of data suggests a connection between these two phenomena. (For some of the controversial research findings, see my paper with Daniela Kramer titled "We are Too Weak to Walk Unaided.") Some of this data is anecdotal: "The association of unusual emotional states and psychic experiences with religion is of great antiquity and undoubtedly antedates any documentary evidence" (Rosen 1968, 48-49). The emotional states include seizures, trances, hallucinations, and other abnormal behavior (Rosen 1968, 49). In her Introduction Karen Armstrong similarly mused: "Had the visions and raptures of the saints also been a mere mental quirk?" (1993, xviii-xix). Yet there is no lack of "documentary evidence," either. Consider, for instance, the 18th-century practice of self-castration in Eastern Russia to atone for the sexuality of Adam and Eve (Menninger 1938), and its repetition in the United Kingdom in the 1960s as "an offering to God" (Kushner 1967). Or take the case of Kenneth Pickett, an extremely religious Jehovah's Witness who killed his former wife because he thought that she was in another relationship, which was forbidden in his interpretation of the Bible. Now jailed for life, Pickett justified the killing by saying that he saved his former wife from sin (Bennett 2009). No wonder that Nietzsche spoke of "that strange and sickly world into which the Gospels lead us—a world apparently out of a Russian novel, in which the scum of society, nervous maladies and 'childish' idiocy keep a tryst" (1895/1918, 96).
DSM-IV (APA 2000) makes a distinction between bizarre and nonbizarre delusions. Though both types indicate psychotic disorders, the former are symptomatic of schizophrenia (especially 295.30 or paranoid type schizophrenia), while the latter serve as the major diagnostic criteria of delusional disorder (297.1). The authors of DSM-IV admit that cultural factors often make it difficult to determine whether a given delusion is bizarre or nonbizarre. Take, for instance, the Capgras delusion, the belief that your relatives have been replaced by impostors. Or take the Cotard delusion, the belief that you have died (Young, Leafhead, and Szulecka 1994). Are they bizarre or nonbizarre? Given this ambiguity, I leave it to readers to decide whether the following phenomena "involve situations that can conceivably occur in real life" (APA 2000, 324).
Consider the case of Aelius Aristides (Rosen 1968, 110-121). This 2nd-century Greek sophist and orator was gravely ill when he decided to put himself under the care of Asclepius, the god of healing in Greek mythology. He lived in Asclepius' shrine and received commands from the god in his dreams for about ten years, prescribing for himself painful and apparently nonsensical treatments. Among other methods, Aristides practiced "sacrificial substitution," identical to pars pro toto ("part taken for the whole") rites once performed on the Nicobar Islands and in Tonga (Tylor 1958, 486). Asclepius demanded that in order to avert death, Aristides sacrifice a finger, later permitting the offering of a ring in place of the finger. When this did not suffice, Aristides (or was it Asclepius?) raised the stakes: He believed that two children of his foster sister died in his stead. Aristides' religious delusion is a good example of the dilemma concerning bizarreness: Though delusional, his ardent following of his god's unconventional treatment methods was culturally accepted, and therefore nonbizarre, in his social environment (Rosen 1968, 120; see also Spiro 1987).
Another delusional believer in death by proxy was Spanish-born Rabbi Yosef Caro, a highly influential Jewish scholar of the 16th century. While living in Salonika, Caro recorded in a diary the messages he received during nightly visitations by a celestial mentor (his Maggid). R. J. Zwi Werblowsky (1962, p. 8) refers to this document as "an intimate diary, recounting a life-time of mystical, if not pathological, experiences," finding great resemblance to the manifestations reported by Caro of "mediumistic states and trances" and of automatic speech (Werblowsky 1962, 22). The Maggid rebuked him in practically every communication for having eaten or drank too much, for having slept half an hour between prayers, and for having had unclean thoughts: "Beware of food and drink and bodily pleasures. Whenever you experience pleasure at eating or drinking, meditate on the repulsiveness of food as it is chewed and even more on its repulsiveness as it is evacuated from the body" (Werblowsky 1962, 163). Another command had to do with studying the Talmud: "always return to the study of my Mishnayoth [part of the Talmud] and never separate your thoughts from them, even for a single moment" (Werblowsky 1962, 267). This injunction is reminiscent of John Dollard and Neal Elgar Miller's "Mrs. A," who was obsessed by the thought that her heart would stop unless she counted the beats; this kept her from having sexual thoughts that caused her great anxiety (Dollard and Miller 1950).
As in the case of Aristides (see above), Caro's delusion escalated:
You have thought of improper things, wherefore you have been condemned to death. But I, the Mishnah, have interceded for you, as also did Jacob Tur, Moses Maimonides, Rashi ... and they redeemed you from death. Your sentence was commuted to illness instead, and also many worthy people were substituted for you. (Werblowsky 1962, 150)
The dead included his first wife (of five wives) and three children. When his wife miscarried, Caro recorded the Maggid's interpretation: "the pregnancy was true and God would not have withdrawn his gift ... even if your sins would have warranted it. But because you were sentenced to death, God, in the abundance of his mercy, wanted to redeem you and put the pregnancy in your place" (Werblowsky 1962, 132).
From Greek orator, through Jewish scholar, I now move to Carl Jung, the famous Swiss psychiatrist and psychoanalyst, founder of the school of analytical psychology. Jung strongly believed not only in God, but also in synchronicity—"temporally coincident occurrences of acausal events" (Jung 1952/1993). In his Foreword to the 2010 edition of Jung's Synchronicity: An Acausal Connecting Principle, S. Shamdasani writes that Jung regained his soul "by enabling the rebirth of a new image of God in his soul and developing a new worldview in the form of a psychological and theological cosmology." As a child Jung was greatly influenced both by his father—a Protestant pastor—and his mother, who suffered from severe depression and had visions of nightly visitations by spirits. In his memoires Jung (1965) related that one night he had seen a luminous figure coming from his mother's room, with a head detached from the neck and floating in the air in front of the body.
During a serious illness Jung had a mystical vision of his physician, Dr. H:
Suddenly the terrifying thought came to me that Dr. H. would have to die in my stead.... In actual fact I was his last patient. On April 4, 1944—I still remember the exact date—I was allowed to sit up on the edge of my bed for the first time since the beginning of my illness, and on this same day Dr. H. took to his bed and did not leave it again.... Soon afterward he died of septicemia" (Jung 1965, 293).
The delusions of Aristides, Caro, and Jung involving death by proxy belong to a broader class of religious practices that border on the psychopathological. Scapegoating is a very old sacrificial practice, vividly described in Leviticus 16:10 (ca. 6th century BCE): "the goat, on which the lot fell to be the scapegoat, shall be presented alive before the Lord, to make an atonement with him, and to let him go for a scapegoat into the wilderness." This was also an accepted practice in ancient Greece, where a human or animal scapegoat (the pharmakos) was killed either in an annual rite for the purification of the people, or in times of famine, plague, or drought, to appease the angry deities (Rosen 1968, 85). Here are two examples of ritual scapegoating that have survived in modern times:
On one day of the year the Bhotiyas of Juhar [aka Shaukas], in the Western Himalayas, take a dog, intoxicate him with spirits and ... chase and kill him with sticks and stones, and believe that, when they have done so, no disease or misfortune will visit the village during the year. (Frazer 1959, #458)
The Jewish New Year's Rite of Caparot [Ransoms] consists of saying three times, holding a fowl above one's head: "I have found a ransom. This is my change, this is my compensation, this is my redemption. This hen (cock for males) is going to be killed, while I shall enter upon a good, happy and peaceful life. (Sephath Emeth n. d., 301)
In Violence and the Sacred (1972) the French historian and philosopher René Girard hypothesized that both archaic religion and ritual sacrifice originated in the victimization process: when a crisis occurs, the group selects an arbitrary victim who is brutally eliminated. This act serves as a psychological relief for the group, which now regards the victim as a miracle-worker, for peace has been regained: The victim has become sacred. A myth is created, and subsequent acts of sacrifice are ritual repetitions of the original event. (See Moore 1977 regarding the parataxic nature of this act, that is, seeing causal relationships between logically unrelated events.) Those, described above, who believe in death by proxy have gone a step further: overwhelmed by anxiety, they delude themselves into believing that a divine power has taken such an interest in them that another human being can be sacrificed in their stead. Their condition comes closest to what DSM-IV (APA 2000) has labeled delusional disorder—grandiose type.
 William James, the son of a Swedenborgian theologian and a member of the Theosophical Society, admitted the psychotic and neurotic origins of religious fervor, but claimed that they were irrelevant. No wonder he treated Nietzsche with disdain: "Poor Nietzsche's antipathy [toward saints] is itself sickly enough" (1902/1963, 373).
 See also Novalis' "Fragmente und Studien 1799-1800": "It is marvelous enough that the association of voluptuousness, religion, and cruelty has not attracted the attention of men to their close kinship and common tendency" (1968, 568).
 In The Maccabean Martyrs as Saviours of the Jewish People, Jan Willem Van Henten mentions several cases in Greek tragedy (especially in Euripides), as well as in Roman history, where there is "vicarious death," but these are all cases where a person willingly sacrifices him or herself in order to save others.
 A literary example of death by proxy appears in Virginia Woolf's Mrs. Dalloway. According to Manly Johnson, Woolf originally intended for Clarissa Dalloway to kill herself, and created the character of Septimus Smith (whom the heroine never meets and who commits suicide) to serve as a "dark double" who takes upon himself this act of desperation.
 Christian theology is largely founded on Jesus' vicarious death ("Substitute Sacrifice"). An often quoted verse is 2 Corinthians 5:21: "For God made Christ, who never sinned, to be the offering for our sin..." See also Matthew 21:28: "The son of man came ... to give his life a ransom for many."
 In the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, the diagnostic criteria for this type include delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person (APA 2000, 329).
American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association, 2000.
Armstrong, Karen. A History of God: The 4,000-year quest of Judaism, Christianity and Islam. New York: Ballantine Books, 1993.
Bennett, Michael. "Man Jailed for Life Over 'Religious' Killing." The West Australian. November 6, 2009.
Dollard, John and Neal Elgar Miller. Personality and Psychotherapy: An Analysis in Terms of Learning, Thinking and Culture. New York, NY: McGraw-Hill, 1950.
Frazer, James G. The New Golden Bough, ed. Theodor H. Gaster. New York, NY: New American Library, 1959. [Originally published 1890.]
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James, William. The Varieties of Religious Experience. New Hyde Park, NY: University Books, 1963. [Originally published 1902.]
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Menninger, Karl. A. Man Against Himself. New York, NY: Harcourt, 1938.
Moore, Michael. "Symbolic Burning and the Modern Sacrifice." International Journal of Symbology, Vol. 8, No. 1 (March 1977): 94-102.
Moore, Michael and Daniela Kramer. "We are Too Weak to Walk Unaided: A Family Therapist View of the Pathogenic Aspects of Prayer" (2000). The Secular Web. <http://www.infidels.org/library/modern/michael_moore/weak.html>.
Nietzsche, Friedrich. The Antichrist, trans. H. L. Mencken. New York, NY: Knopf, 1918. [Originally published 1895.]
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Sephath Emeth (Speech of Truth) Prayer Book. New York: Hebrew Publishing Co., n.d.
Spiro, Melford E. (1987). "Religious Systems as Culturally Constituted Defense Mechanisms." In Culture and Human Nature: Theoretical Papers of Melford E. Spiro, ed. Benjamin Kilborne and L. L. Langness. Chicago, IL: University of Chicago Press, 1987: 145-160.
Tylor, Edward B. Religion in Primitive Cultures. New York, NY: Harper & Brothers, 1958. [Originally published 1871.]
Van Henten, Jan Willem. The Maccabean Martyrs as Saviours of the Jewish People. Leiden, Netherlands: Brill, 1997.
Werblowsky, R. J. Zwi. Joseph Karo: Lawyer and Mystic. Oxford, UK: Oxford University Press, 1962.
Young, Andrew W., Leafhead, Kate M., and T. Krystyna Szulecka. "The Capgras and Cotard Delusions." Psychopathology, Vol. 27, No. 3-5 (May-September 1994): 226-231.
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