Possessed or Insane? Diagnostic Puzzles in Contemporary Egypt

“At the heart of this topic is a puzzle (lughz),” my long-term friend and interlocutor Ahmad often said. I long thought Ahmad's interest in questions of disease at the intersection of psychiatry and Islam was only intellectual until I learned about one of his cousins’ past ailments. A skillful narrator, Ahmad had colorful ways of depicting that puzzle. “Imagine,” he once told me, “a young pious woman, a college student. Suddenly, she stops praying and studying, is morose, even aggressive sometimes. She locks herself in her room when she does not wander the streets, disappearing for hours. The family is worried, and they wonder: what is the problem?” Switching the tone from evocative to analytic, Ahmad continued: “In Egypt, when it comes to symptoms like seizures, hallucinations, and sudden behavioral changes, people use one of two main diagnoses: jinn possession (mass al-jinn) or mental illness (maraḍ nafsī). The young woman is either possessed or insane.” Ahmad's appeal to the imagination worked, as I came to think of Wittgenstein's famous duck-rabbit image that can alternatively be seen as a duck or a rabbit, with the duck's beak appearing as the rabbit's ears and vice versa.