Hektoen International

A Journal of Medical Humanities

Faith, neuroscience, and “the thorn” in Paul’s side: Abrahamic interpretations of epilepsy

Christina Perri
Stony Brook, New York, United States

 

Despite the stigma surrounding epilepsy in the Abrahamic faith traditions, some Christian art uses the boy with epilepsy as a visual metaphor for the Passion. As the boy appears to die and rise from a seizure,
so too Christ dies and rises to Heaven.

The experience of epileptic seizures, as characterized by Russian author Fyodor Dostoevsky and others, resonates with the intense religious consciousness of shamans, who describe losing all sense of time, place, and even self.1 Most religious traditions have complex or even ugly relationships with epilepsy that offer explanations for the disease and speculations that figures in their religious histories may have manifested it. Despite contemporary supplanting of religious explanations by neuroscience, this history lingers through the burgeoning field of neurotheology, which explores the neural correlates of religious experience. This relationship between epilepsy and religious experience may be explored through the lens of the Abrahamic religions of Judaism, Christianity, and Islam.

Epilepsy comes from the Greek for “to seize” or “to possess,”2 and spiritual possession dominated ancient thought on the disease. The oldest known description of epilepsy comes from the Sakikku, a Babylonian medical text that ascribes seizures to ghosts and demons.3 It was only when later challenged by the Hippocratic school in the treatise “On the Sacred Disease” that epilepsy became no more holy than any other sickness.4 Tension persisted between religious and material explanations during the Greco-Roman period; however, following the fall of Rome and the subsequent dominance of the Catholic Church, the religious framework fully ascended in Western Europe. As the Renaissance and Enlightenment later revitalized scientific thought, however, strictly religious explanations of epilepsy gave way to improved scientific theories that placed the locus of disease in the nervous system.5

Today, with the EEG, neuroimaging, and neurosurgery, the scientific understanding of epilepsy has advanced further still, yet epilepsy continues to defy simple classification.6 Its rich subjective dimension renders epilepsy simultaneously neurological and psychological, and the experience of epilepsy becomes a product of both brain and mind. Although we now understand epilepsy in neuroscientific terms, it is instructive to consider its religious history to provide a perspective that remains a part of the legacy of the Abrahamic traditions.

 

Possession and punishment: Abrahamic explanations of epilepsy

The Hebrew Bible is rich with examples of spiritual possession and divine punishment. Notably, Saul is punished when “the Spirit of the LORD [departs] from [him], and an evil spirit from the LORD [torments] him.”7 Later, “lying spirits”8 punish Ahab when they speak through his prophets. Illness and death more generally may also be divine retribution, as in the death of David and Bathsheba’s firstborn son following Uriah’s murder.9 This provides the textual basis for the overtly negative explanations of epilepsy found in the Talmud: epilepsy is a punishment visited on a child for the parents’ sexual sins, and epilepsy invalidates a woman from marriage.10 It is alternatively explained as a manifestation of demonic possession, and spiritualism, incantations, and soothsaying are linked with epilepsy.11

Roots for the Christian interpretation of epilepsy planted in the Hebrew Bible come to fruition in the New Testament, wherein seizures result explicitly from demonic possession. The boy with epilepsy, named thus by Matthew, appears in all three synoptic gospels: a demon “[convulses] the boy, and he [falls] on the ground and [rolls] about, foaming at the mouth” before Jesus casts it out.12 The difficulty of curing seizures is later attributed to the disciples’ insufficient faith13 and a need for prayer and fasting.14 The connection between seizures and possession boded ill for people with epilepsy in the Christian world: Malleus Maleficarum, a Dominican treatise, identified seizures as a hallmark of witches, with exorcisms and executions becoming commonplace “cures” for epilepsy.15

Islam, by contrast, offers the benign option of inhaling a narcissus flower to cure epilepsy.16 Diseases, including epilepsy, take on no special spiritual significance in Islam, and unlike the Bible, there are no direct references to seizures in the Quran. However, there is emphasis throughout on the total supremacy of Allah and the impotence of all others. Allah “did not create the jinn and mankind except to worship [Him],”17 and attributing equals to Allah is strongly rebuked.18 Jinn, while different in origin and substance from humans,19 are beneath Allah, may be cast into hell,20 and are beholden to Allah’s mercy.21 Lowly jinn thus may be less likely to cause disease than the demons of Christianity. Despite epilepsy’s physical explanation in Islam, many Muslim patients nonetheless view the disease as a test from God.22

Texts from the Abrahamic religions may lend themselves to a negative (or, at best, neutral) interpretation of epilepsy, but idealized experiences do emerge from this perspective. Dostoevsky famously insisted on the validity of his religious experiences, saying “the heaven was going down upon the earth and…it engulfed me. I have really touched God. He came into me myself, yes God exists, I cried…you all, healthy people…can’t imagine the happiness which we epileptics feel during the second before our fit.”23 Such compelling descriptions of ictal ecstasy have intrigued modern scientists and spurred the search for the neuroscience of religion.

 

Saints, prophets, and epilepsy: neural correlates of religion

In epilepsy, religious experiences may be a preictal prodrome, the ictal event itself, postictal psychosis, or even an interictal personality trait (i.e. Geschwind Syndrome).24 The temporal lobes have received the most attention in neurotheology research; temporal lobe epilepsy (TLE) is associated with ecstatic seizures,25 sudden religious conversion,26 hyperreligiosity,27 and even an automatism of prostration.28 Religious experience, however, will not be reduced so easily. Further research implicates the hippocampus and the frontoparietal region in religious seizures,29 and the anterior insula has received attention for its role in ecstatic seizures because of its high dopamine usage and apparent similarities between ecstatic seizures and the effect of stimulant drugs.30 Even within the temporal lobes proper the story is unclear, with equal instances of lateralization between the left and right lobes and no obvious correlation to handedness.31 The neural changes that occur during religious experiences vary widely, and to reduce it all to a single epilepsy syndrome is to lose the mystery and wonder of both the brain and the experience.

As scientists attempt to unravel the relationship between religious experience and the brain, epilepsy’s role in the lives of major religious figures has become a subject of interest and potential controversy.

The falling that often accompanies Jewish prophecies in the Hebrew Bible heightens their potential resemblance to epileptic seizures. Balaam, upon “[seeing] the vision of the Almighty, [falls] down, but [has] his eyes uncovered”32 and Daniel’s eschatological visions are accompanied by “[turning his] face toward the ground.”33 Most vivid are Ezekiel’s visions, replete with clouds of fire,34 the sound of earthquakes,35 and the voice of God,36 accompanied by several references to falling.37 The compelling link between such examples and the Talmudic relationship between epilepsy and spiritualism raises the possibility of an implicit or explicit role for epilepsy in Old Testament prophecy.

In Christian literature, “the thorn”38 in Saint Paul’s flesh has been debated since he first penned the letter to the Corinthians. Paul describes ecstatic experiences paired with this thorn that are characterized by depersonalization, a connection to heaven, and auditory revelation.39 This description, as well as Paul’s dramatic conversion on the road to Damascus, have led some in recent scholarship to suggest TLE as an etiology.40 However, the unlikeliness that Paul would have experienced ecstatic auras, temporal lobe seizures, and three days of postictal blindness (an extraordinarily rare combination) has led some to challenge this hypothesis.41

The religious experiences of Joan of Arc that spurred her fight for France’s freedom have also been speculatively attributed to epilepsy. She began hearing voices at age thirteen, accompanied by light on her right side, and occasionally had complex visions of saints and angels triggered by the sound of bells.42 The short duration and relative frequency of her visions would be consistent with TLE with auditory symptoms.43 Joan of Arc’s otherwise normal and organized behavior, including an ability to galvanize troops to her cause, favors a paroxysmal condition such as epilepsy over the oft-discussed alternative, schizophrenia.44

Complex partial seizures have also been proposed to play a role in Muhammad’s religious revelations. As with Joan of Arc, the paroxysmal nature and complex audiovisual content of his revelations could suggest TLE, while the organized nature of Muhammad’s political and military exploits and the loyalty his evangelism inspired steer the differential diagnosis away from schizophrenia.45 However, the late age at which Muhammad’s revelations began and his apparently settled mental state following them conflict with epilepsy.46

It should be noted that the role epilepsy played in the lives of religious figures, if any, remains a matter of intriguing speculation cobbled together from historic texts and with total absence of neuroscientific data.

 

Conclusion

Epilepsy and the Abrahamic religions have a complex, intertwined history that have shaped the Western perspective on the disease well into modern times. Simultaneously, certain epilepsy syndromes have been linked to religious experiences, and perhaps played a significant role in the development of the Abrahamic faith systems. The question remains, then, if religious experiences can be reduced, through epilepsy, to neurobiology.

If we assume a materialist metaphysics, reductionism becomes the obvious, and perhaps only, answer. The brain is not just concordant with the mind, but is mind itself, and thus religious experiences arise from specific patterns of electrical discharge. However, we may also assume a nonmaterialist metaphysics. Aberrant electrical discharge may correlate with religious experiences without defining or equating to them. The facts of epilepsy remain the facts, scientifically understood as such. However, differing frameworks of brain and mind lead to vastly different conclusions about these facts and the nature of epilepsy. The reality of gray matter changes and overexcitability of neurons is not in dispute, but epilepsy may also be interpreted as existing at an interface of material and nonmaterial that we do not fully understand.

 

Image Credit

  • The Transfiguration of Christ, Raphael Sanzio, 1516-1520, the Vatican Museums. Image in the public domain, acquired from Art and the Bible, https://www.artbible.info/art/large/613.html

 

Notes

  1. Mircea Eliade, Shamanism: Archaic Techniques of Ecstasy (New York: Bollingen Foundation, 1964), 345.
  2. Emmanouil Magiorkinis, Kalliopi Sidiropoulou, and Aristidis Diamantis, “Hallmarks in the History of Epilepsy: Epilepsy in Antiquity,” Epilepsy and Behavior 17, no. 1 (2010): 104.
  3. Edward H. Reynolds and James V. Kinnier Wilson, “Psychoses of Epilepsy in Babylon: The Oldest Account of the Disorder,” Epilepsy 49, no. 9 (2008): 1489.
  4. James Longrigg, “Epilepsy in Ancient Greek Medicine—the Vital Step,” Seizure 9, no. 1 (2009): 14.
  5. J.M.S. Pearce, “Early Accounts of Epilepsy: A Synopsis,” Journal of Neurology, Neurosurgery, and Psychiatry 64, no. 5 (1998): 679.
  6. Edward H. Reynolds and Ernst Rodin, “The Clinical Concept of Epilepsy,” Epilepsy 50, no. Suppl 3 (2009): 6.
  7. 1 Sam. 16:14
  8. 1 Kings 22:22
  9. 2 Sam. 12:14
  10. Shulchan Arukh 39:4
  11. Sefer HaChinukh 256:1
  12. Mark 9:20
  13. Matt. 17:20
  14. Mark 9:29
  15. Krzysztof Owczarek and Joanna Jedrzejczak, “Christianity and Epilepsy,” Neurologia i Neurochirurgia Polska 47, no. 3 (2013): 226.
  16. Anna Vanzan Paladin, “Epilepsy According to the Christian, Jewish and Islamic Religions: An Overview, Epilepsi 1 (1995): 40.
  17. Surah 51:56
  18. Surah 6:100
  19. Surah 15:27
  20. Surah 11:119
  21. Surah 11:94
  22. Hadeel A. Alkhamees, Caroline E. Selai, and Simon D. Shorvon, “The Beliefs among Patients with Epilepsy in Saudi Arabia about the Causes and Treatment of Epilepsy and Other Aspects,” Epilepsy & Behavior 53 (2015): 136.
  23. Orrin Devinsky, “Religious Experiences and Epilepsy,” Epilepsy & Behavior 12, no. 4 (2008): 76.
  24. Orrin Devinsky and George Lai, “Spirituality and Religion in Epilepsy,” Epilepsy & Behavior 12, no. 1 (2008): 638.
  25. Bjorn Asheim Hansen and Eylert Brodtkorb, “Partial Epilepsy with ‘ecstatic’ seizures,” Epilepsy & Behavior 4, no. 6 (2003): 667.
  26. Kenneth Dewhurst and A.W. Beard, “Sudden Religious Conversions in Temporal Lobe Epilepsy,” The British Journal of Psychiatry 117, no. 540 (1970): 497.
  27. Michael Trimble and Anthony Freeman, “An Investigation of Religiosity and the Gastaut-Geshwind Syndrome in Patients with Temporal Lobe Epilepsy,” Epilepsy & Behavior 9, no. 3 (2006): 408.
  28. Liling Dong and Xiangqin Zhou, “An Uncommon Automatism with Religious Connotation—Prostration in a Case of Right Temporal Lobe Epilepsy,” Seizure 35 (2016): 33.
  29. Anne-Marie Landtblom, “The ‘Sensed Presence’: An Epileptic Aura with Religious Overtones,” Epilepsy & Behavior 9, no. 1 (2009): 187.
  30. F. Picard and A.D. Craig, “Ecstatic Epileptic Seizures: A Potential Window on the Neural Basis for Human Self-Awareness,” Epilepsy & Behavior 16, no. 3 (2009): 545.
  31. Asheim Hansen and Brodtkorb, “Partial Epilepsy ‘Ecstatic’ Seizures,” 671.
  32. Num. 24:16
  33. Dan. 10:15
  34. Ezek. 1:4
  35. Ezek. 1:24
  36. Ezek. 1:25
  37. Ezek. 1:28; Ezek. 3:23
  38. 2 Cor. 12:7
  39. 2 Cor. 12:1-4
  40. D. Landsborough, “St Paul and Temporal Lobe Epilepsy,” Journal of Neurology, Neurosurgery, and Psychiatry 50, no. 6 (1987): 660.
  41. James R. Brorson and Kathleen Brewer, “St Paul and Temporal Lobe Epilepsy,” Journal of Neurology, Neurosurgery, and Psychiatry 51, no. 6 (1988): 886.
  42. Giuseppe d’Orsi and Paolo Tinuper, “‘I Heard Voices…’: From Semiology, a Historical Review, and a New Hypothesis on the Presumed Epilepsy of Joan of Arc, Epilepsy & Behavior 9, no. 1 (2006): 154.
  43. Nicolas Nicastro and Fabienne Picard, “Joan of Arc: Sanctity, Witchcraft or Epilepsy?” Epilepsy & Behavior 57, no. Pt B (2016): 248.
  44. d’Orsi and Tinuper, “I Heard Voices…” 155
  45. Frank R. Freemo, “A Differential Diagnosis of the Inspirational Spells of Muhammad the Prophet of Islam,” Epilepsia 17, no. 4 (1976): 424-425.
  46. Ibid.

 

Bibliography

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  2. Asheim Hansen, Bjorn, and Eylert Brodtkorb. “Partial Epilepsy with “Ecstatic” Seizures.” [In eng]. Epilepsy Behav 4, no. 6 (Dec 2003): 667-73.
  3. Brorson, James R., and Kathleen Brewer. “St Paul and Temporal Lobe Epilepsy.” [In eng]. J Neurol Neurosurg Psychiatry 51, no. 6 (Jun 1988): 886-7.
  4. d’Orsi, Giuseppe, and Paolo Tinuper. “”I Heard Voices…”: From Semiology, a Historical Review, and a New Hypothesis on the Presumed Epilepsy of Joan of Arc.” [In eng]. Epilepsy Behav 9, no. 1 (Aug 2006): 152-7.
  5. Devinsky, Orrin. “Religious Experiences and Epilepsy.” [In eng]. Epilepsy Behav 4, no. 1 (Feb 2003): 76-7.
  6. Devinsky, Orrin, and George Lai. “Spirituality and Religion in Epilepsy.” [In eng]. Epilepsy Behav 12, no. 4 (May 2008): 636-43.
  7. Dewhurst, Kenneth, and A. W. Beard. “Sudden Religious Conversions in Temporal Lobe Epilepsy.” [In eng]. Br J Psychiatry 117, no. 540 (Nov 1970): 497-507.
  8. Dong, Liling, and Xiangqin Zhou. “An Uncommon Automatism with Religious Connotation-Prostration in a Case of Right Temporal Lobe Epilepsy.” [In eng]. Seizure 35 (Feb 2016): 33-5.
  9. Eliade, Mircea. Shamanism: Archaic Techniques of Ecstasy. Translated by W. R. Trask. New York: Bollingen Foundation, 1964.
  10. Freemo, Frank R. “A Differential Diagnosis of the Inspirational Spells of Muhammad the Prophet of Islam.” Epilepsia 17, no. 4 (1976): 423-27.
  11. Landsborough, D. “St Paul and Temporal Lobe Epilepsy.” [In eng]. J Neurol Neurosurg Psychiatry 50, no. 6 (Jun 1987): 659-64.
  12. Landtblom, Anne-Marie. “The “Sensed Presence”: An Epileptic Aura with Religious Overtones.” [In eng]. Epilepsy Behav 9, no. 1 (Aug 2006): 186-8.
  13. Longrigg, James. “Epilepsy in Ancient Greek Medicine–the Vital Step.” [In eng]. Seizure 9, no. 1 (Jan 2000): 12-21.
  14. Magiorkinis, Emmanouil, Kalliopi Sidiropoulou, and Aristidis Diamantis. “Hallmarks in the History of Epilepsy: Epilepsy in Antiquity.” [In eng]. Epilepsy Behav 17, no. 1 (Jan 2010): 103-8.
  15. Nicastro, Nicolas, and Fabienne Picard. “Joan of Arc: Sanctity, Witchcraft or Epilepsy?” [In eng]. Epilepsy Behav 57, no. Pt B (Apr 2016): 247-50.
  16. Owczarek, Krzysztof, and Joanna Jedrzejczak. “Christianity and Epilepsy.” [In eng]. Neurol Neurochir Pol 47, no. 3 (May-Jun 2013): 271-7.
  17. Paladin, Anna Vanzan. “Epilepsy According to the Christian, Jewish and Islamic Religions: An Overview.” Epilepsy 1 (1995): 38-41.
  18. Pearce, J. M. S. “Early Accounts of Epilepsy: A Synopsis.” [In eng]. J Neurol Neurosurg Psychiatry 64, no. 5 (May 1998): 679, 82.
  19. Picard, F., and A. D. Craig. “Ecstatic Epileptic Seizures: A Potential Window on the Neural Basis for Human Self-Awareness.” [In eng]. Epilepsy Behav 16, no. 3 (Nov 2009): 539-46.
  20. Reynolds, Edward H., and James V. Kinnier Wilson. “Psychoses of Epilepsy in Babylon: The Oldest Account of the Disorder.” [In eng]. Epilepsia 49, no. 9 (Sep 2008): 1488-90.
  21. Reynolds, Edward H., and Ernst Rodin. “The Clinical Concept of Epilepsy.” [In eng]. Epilepsia 50 Suppl 3 (Mar 2009): 2-7.
  22. Trimble, Michael, and Anthony Freeman. “An Investigation of Religiosity and the Gastaut-Geschwind Syndrome in Patients with Temporal Lobe Epilepsy.” [In eng]. Epilepsy Behav 9, no. 3 (Nov 2006): 407-14.

 

 

CHRISTINA PERRI is a dual degree student at Stony Brook University, pursuing both her medical degree and a master’s degree in bioethics. She received her undergraduate degree in biology and psychology from Providence College in 2016 and studied as part of its Liberal Arts Honors Program. Academic interests include the impact of illness on the human person, dignity and existential questions in the context of neurodegenerative disease, medical ethics, writing in the medical humanities, and the intersection of the illness experience with religion and spirituality.

 

Highlighted in Frontispiece Volume 11, Issue 3 – Summer 2019
Spring 2019  |  Sections  |  Neurology

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