On July 1, 1976, Anna Elisabeth “Anneliese” Michel, a twenty-four-year-old college student from the town of Klingenberg in Bavaria, Germany, died of what appeared to be severe battery and starvation. A physician was called to the house to issue a death certificate, but refused on the grounds he was not convinced she died of natural causes, having found her emaciated and with contusions on her face, hands, arms, and legs. Father Ernst Alt, a Jesuit, phoned the district attorney’s office to explain that he had been conducting a series of exorcisms on Anneliese, believing her to be demonically possessed. The case quickly became a sensation, and over the years has been adapted into film several times, most famously in 2005 as The Exorcism of Emily Rose.
It all began when in 1968, around the time of her sixteenth birthday, Anneliese had the first of several seizures. She lost consciousness during school and was found by her classmate to be in a trance-like state. Later that night, Anneliese awoke claiming she felt as if something was pressing down on her. She couldn’t move, couldn’t breathe or speak, and lost control of her bladder. Although the experience frightened her a great deal, when it did not happen again she put it out of her mind. Then, on August 24, 1969, Anneliese suffered another seizure. When examined by neurologist Dr. Siegfried Luthy, her EEG showed “a normal, physiological alpha-type brain activity” (Goodman 1981). Dr. Luthy later explained to investigators, “I judged from the description I was given that this was probably a case of cerebral seizures of the nocturnal type, with the symptoms of a grand mal epilepsy.”
Tonic-Clonic seizures, formerly known as grand mal seizures, comprise two stages: a tonic phase and a clonic phase. According to John Hopkins Medicine, seizures may begin with a simple or complex partial seizure known as an aura during which persons may experience sensations such as unusual smells, vertigo, nausea, or anxiety. During the tonic phase, persons may lose consciousness and experience bodily and respiratory paralysis as the muscles involuntarily contract. Finally, during the clonic phase, the person’s face, arms, and legs spasm and jerk uncontrollably and rapidly. When the body relaxes, the bladder may also release.
Anneliese’s symptoms certainly fit the criteria of a Tonic-Clonic seizure, and there’s good reason to believe on at least one occasion she also experienced aura. One day while praying the rosary, she related smelling a sweetness “wafting about her like the fragrance of violets” (Goodman 1981) and a euphoric feeling that lasted into the next day. She was found by other girls to be in a trance-like state with her hands rigidly outstretched “like you had a cramp or something. Like when my cat stretches her claws” and her pupils dilated “I thought they were blue. Now they are all black.”
After her third seizure, Anneliese began experiencing one of the longest lasting side-effects, which continuously filled her with fratzen, German for “grimacing faces.” Another EEG showed “an irregular alpha pattern with some theta and delta waves, but nothing pathological” (Goodman 1981). By 1973, her friends and family reported her behavior had changed—she was irritable and withdrawn, prone to lashing out in anger. Anneliese fell into a deep and prolonged depression, which was serious enough she contemplated suicide and would later describe as “This is no longer a depression, this is a condition”; she claimed “someone else is manipulating me” and that “My will is not my own.” She mentioned to her psychiatrist she “could not love sufficiently” that she felt “castrated, ice-cold” and told her boyfriend “I can’t feel any love at all. I am all numb, sort of. I can’t feel emotions like that.”
Anneliese stopped associating with her usual group of friends and became drawn to a group of students considered to be religious zealots. One of her childhood friends noted that “After her illness Anneliese was changed. She was quiet and withdrew from her friends. I also noted that she kept wanting to carry on mostly religious conversations.” For her part, Anneliese became convinced of her own damnation and began warning others of the imminent end of the world. She believed she had personal visions and communed with the Virgin Mary and became particularly drawn to the life of Barbara Weigand, a Catholic mystic and “prophetess” who also claimed to experience visions of the Virgin Mary.
Both ictal and interictal (during and between the onset of seizure), experiences of depersonalization-derealization have long been associated with complex partial seizures arising from the frontal lobe. Other behavioral characteristics unique to persons with Temporal Lobe Epilepsy include hyperreligiosity, a psychopathological form of extreme religiosity (Bear 1979), a drastically reduced interest in sex (Blumer and Walker 1967), and a tendency to withdraw from human contact in general (Maclean 1970), all changes in behavior exhibited by Anneliese.
In addition to the visual hallucinations, Anneliese also claimed to begin experiencing olfactory hallucinations known as phantosmia: “She started smelling a horrid stench not perceived by others” (Goodman 1981). The nature of this malodor changed over time, however, as later it was related “[Anneliese] exuded a stench like Frau Hein had never smelled before, like fecal matter or something burning. Everyone in the bus could smell it.” This would seem to indicate that the source of the stench was in fact Anneliese herself. Further evidence in support of this comes from a visit Father Roth paid to the Michel household: “Herr Michel received me and took me immediately to the living room. It was filled with a horrible stench, of something burning, and of dung, that penetrated everything. Herr Michel expressly called my attention to it and told me that Anneliese had been in the room just before. In the other rooms of the Michel home and on the outside I could detect no trace.”
The malodor was not, however, present all the time. During the criminal investigation in October 1976, Father Hagiber recalled his first meeting with Anneliese and mentioned nothing of an odor. Father Herrmann, who met with Anneliese about ten times from 1973 to 1975, stated, “From her parents I heard that on occasion she evidenced disrespect toward sacred objects and there was a stench of dung or of something burning in the room where she was. However, these symptoms never occurred in my apartment” (Goodman 1981). Likewise, none of Anneliese’s doctors, classmates, or teachers ever complained of a foul odor emanating from or percolating around her. Her boyfriend was completely unaware of her problem with the odor until she mentioned how it plagued her. Based on what Anneliese herself revealed to her psychiatrist, we know she was intimate with her boyfriend. One might expect he would’ve notice something so odoriferous.
We know the hormone adrenaline increases the production of apocrine sweat, the kind of sweat upon which bacteria feast, producing body odor. During times of stress or exertion, body odor may become more intense. This was a hypothesis that author and anthropologist Felicitas Goodman also entertained. The stresses of college and navigating her relationship with a boyfriend do not seem to have triggered the malodor. In each case, the odor was present only when Anneliese was experiencing what she believed to be attacks of demonic possession.
During a pilgrimage to a shrine in San Damiano, Italy, in 1973, Anneliese’s behavior grew more bizarre and resembled the classic symptoms of demonic possession the Catholic Church looks for as she began exhibiting an aversion to sacred objects: “She was unable to enter the shrine. She … said that the soil burned like fire and she simply could not stand it. She … had to avert her glance from the picture of Christ [in the chapel of the house]. She also noted that she could no longer look at medals or pictures of saints; they sparkled so immensely that she could not stand it” (Goodman 1981).
Anneliese would later begin refusing food, claiming that the demons wouldn’t permit her to eat. She did however begin consuming spiders, flies, and coal from the fireplace and even drank her own urine off the floor. She would only sleep one or two hours a night, spending all night running through the house or in prayer and screaming to Jesus Christ for mercy. Despite her fervent praying, she also destroyed rosaries or religious pictures hanging on the wall. She would genuflect an estimated 400–600 times a day (accounts vary) to the point that her knees swelled.
As Anneliese’s condition worsened several priests, including the aforementioned Father Alt, at the behest of her family became involved in her case. Although they were fully aware of her history and diagnosis of epilepsy, they grew likewise convinced she was possessed. Finally, the priests were granted permission in September 1975 by Bishop Josef Stangl, “after careful consideration and good information” (Goodman 1981), to perform the rite of major exorcism according to the Rituale Romanum. Bishop Stangl granted his permission based entirely on faith in the written correspondence of Father Alt; he never asked for any documentation of Anneliese’s mental health history or any second opinion from either her psychiatrist or neurologist. It wouldn’t be until 1999 that the rite of exorcism would be revised and “forbid exorcisms on people who are believed to have been subjected to evil spells/curses and/or are mentally ill. A thorough medical examination is essential” (Burton 2017).
During her exorcisms, the “demons” identified themselves as Cain, Judas, Nero, and Hitler, as well as several others. No examples of glossolalia were present; Judas didn’t speak in Aramaic, Nero answered in Latin, but Anneliese was familiar with that language through church and school, and Hitler naturally spoke her native German. As a test, Father Renz questioned Anneliese—or one of the demonic personalities—in Chinese, to which the response was “If you want to ask something, ask it in German” (Goodman 1981), although Anneliese (or the demon) quickly followed up with, “But I did understand that.”
It’s also curious to note that, among the many threats and profanities, growling and screaming, Anneliese, or rather the “demons,” seemed peculiarly interested in the modern changes the Catholic Church was undergoing following the Second Vatical Council, which ended in 1965, changes Anneliese and her fiercely conservative circle of friends opposed. For example:
“In church all too few pray because the priests think it unfashionable.”
“The communion rails must go back in … priests must be recognizable as priests … they also may not get married”
“Holy water should come back in the homes and the crucifix should return to its place of honor in homes” (Goodman 1981).
One might reasonably wonder why demonic entities would be so interested in matters that clearly would be detrimental to their own diabolical interests. Other attempts were made to test whether or not Anneliese was truly possessed. Father Renz purportedly filled five bottles with water, some with tap water and some with holy water. The bottles were unmarked, yet Anneliese still responded only when the holy water was used. Unfortunately, no mention is made what kind of control conditions, if any, may have been implemented to prevent Anneliese from having any knowledge of which bottles were which.
Once the exorcisms commenced, Anneliese refused further medical treatment and requested her parents stop consulting with doctors and instead trust fully in the power of exorcism. During the exorcisms, she was, at times, forcibly restrained, and the autopsy report later indicated she had fractured teeth and bruised limbs in addition to blackened eyes, which are also visible in the horrific photographs that were taken during the exorcisms and are publicly available. The autopsy report concluded she had also broken her knees from constant genuflexion.
On the day of the last exorcism, June 30, 1976, Anneliese Michel weighed between sixty-eight and seventy-two pounds. Her last words were a request “Please, absolution” and “Mama, stay with me. I am afraid” (Goodman 1981). The next day, around 8 am. Anna Michel found her daughter dead. The autopsy report declared the cause of death to be “advanced emaciation” owing to severe malnutrition and dehydration. When asked why medical intervention had not been sought, Father Alt stated that he never considered the woman dangerously ill, and that if he had he would’ve immediately called for medical assistance.
By contrast, Father Renz contemptibly said, “The exorcism ritual expressly states that the clergymen should not burden themselves with medical matters.” In this, Father Renz was correct, as the rite of exorcism they were using at the time, the 1614 “De exorcizandis obsessis a daemonio” from the Rituale Romanum, said nothing about the priest’s responsibilities for the physical well-being of the possessed and instead suggested “The exorcist should guard against giving or recommending any medicine to the patient, but should leave this care to physicians” (Burton 2017). In the case of Anneliese Michel, there were no physicians. One would expect prudence (if not pity) would have motivated the priests to act. Father Renz testified that he had written to the Bishop prior to Annaliese’s death that her condition was deteriorating but had received no response. Bishop Stengl explained that neither he nor Father Rodewyk had any direct contact with Anneliese or her parents during the nine-month period of exorcisms and were unaware that she was not receiving medical treatment.
To this day, skeptics and believers continue to argue whether or not Anneliese Michel was really possessed or someone who suffered from a neurological disorder. Author and cultural anthropologist Felicitas Goodman argued that “There is sufficient evidence to support the contention that Anneliese was indeed not sick, that she was not an epileptic, that what looked to the uninformed like symptoms of a disease were actually manifestations of a religious experience” (Goodman 1981). These mystical or religious experiences are known as altered states of consciousness (ASC), periods of wakefulness that experientially are quite different from normal. I disagree with Goodman’s claim there is sufficient evidence Anneliese did not have temporal lobe epilepsy. Goodman’s argument seems predicated on the fact that multiple EEGs in addition to the autopsy report after her death failed to indicate anything abnormal with Anneliese’s temporal lobe: no anatomical defects, tumors, or scarring. However, this is not unusual. In roughly one in four cases of temporal lobe epilepsy, the cause remains unknown. Many different factors may cause temporal lobe epilepsy, including infections such as encephalitis or meningitis, malformations of the blood vessels in the brain, or genetic mutations.
Additionally, there is reason to believe that Anneliese may not have been taking her medication as prescribed. This is something Goodman contradicts herself on, stating both that “Anneliese continued taking the drugs conscientiously” and “Roswitha remembers that Anneliese often took less than the three tablets per day (of Tegretol) when her prescription was beginning to run out, and then made up for it as soon as it was renewed by taking more than the prescribed dosage.” If this were true, the question of why, despite the anticonvulsants and the mood stabilizers Anneliese’s behavior and mental state continued to decline and she continued to have seizures, becomes less mysterious. As my friend Dave Shumacher points out, her serum concentration and steady state levels may have dropped below the threshold of therapeutic levels. Without knowing her dosage or how long she may have been below therapeutic level, we can’t determine whether or not the drug worked at all as prescribed. In addition, it’s only a hypothesis to correlate low dosing or no dosing with increased seizure activity or possessed states.
Even if we grant Goodman’s claim that Anneliese Michel did not have temporal lobe epilepsy, that she was someone who could enter into these ASC but had no control over them, I would argue there’s good reasons to doubt Goodman’s further claim that “We may even assume after a great deal of suffering she would have recovered on her own. Or she might possibly have discovered some way to bring about her own cure without the aid of others” (Goodman 1981). For one thing, no one should have to endure a “great deal of suffering” before recovery if their symptoms can be treated. For another, while it’s true the power of suggestion—otherwise known as the placebo effect—has long been recognized as exerting a strong influence on people’s thoughts, behaviors, and even treatment outcomes, no amount of placebo effect was going to fix Anneliese’s broken bones or provide her with adequate nutrition to stay alive.
Furthermore, I would argue that even assessing Anneliese Michel’s case as non-pathological, there were still good reasons to have called for some form of medical intervention. Griffith and Ruiz (1977) offer some good starting points by which to evaluate an ASC as dangerous, such as whether it lasts too long, whether there is no perceivable stimulus or condition, and whether it has a negative orientation. The case of Anneliese Michel meets all three criteria. While it might be argued there was no harm in Anneliese Michel and her family seeking the help of an exorcist as a form of alternative medicine, it certainly was a mistake (and a fatal one) to disregard the diagnosis and advice of medical professionals.
Treating mental illness and neurological disorders, such as temporal lobe epilepsy, is no simple matter. There’s no magic bullet cure. Working with your doctor to find a new medication or a combination of treatment options (even including something as unusual as exorcism) is the safest, most likely to be effective approach. Anneliese Michel’s doctors ultimately did what was within their professional purview to do: they diagnosed her to the best of their ability, based on their expertise and experience, prescribed her the medications they judged to be necessary, and monitored her symptoms for safety and efficacy making adjustments as needed. They could’ve continued to do so, at any time, during the eleven months of exorcism, except Anneliese Michel believed her suffering was an act of penance and had resigned herself to die. The priests who presided over the exorcism failed to recognize the seriousness of her condition and failed to intervene. Perhaps they could’ve convinced Anneliese to seek medical care if they had reasoned with her that it was God’s will she be well. Ultimately, it was their negligence and failure to act that resulted in her death.
References
Bear, D.M. 1979. The temporal lobes: an approach to the study of organic behavior changes. In Handbook of Behavioral Neurobiology, vol. 2, ed. By M. S. Gazzaniga, p. 75–79
Blumer, D., and A. E. Walker. 1967. Sexual Behavior in temporal lobe epilepsy. Archives of Neurology, 16: 37–43.
Burton, Chris. 2017. Traditional and Revised Catholic Rites of Exorcism: Volumes 1 & 2: Traditional and 1999 Revised English Translations. CreateSpace Independent Publishing Platform.
Goodman, Felicitas D. 1981. The Exorcism of Anneliese Michel. Oregon. Resource Publications.
Griffith EEH, Ruiz P. 1977. Cultural factors in the training of psychiatric residents in an Hispanic urban community. Psychiatry Quarterly; 49:29–37.
MacLean, P.D. 1970. The limbic brain in relation to the psychoses. The Physiological Correlates of Emotion, ed. By P. Black, p.129–146. New York. Academic Press.