Culture-Bound Syndromes: Zar

Zar is an ancient healing practice based on a folk belief that possession by alien spirits can cause disease and that disease can be managed by the ceremonial placation of the possessing spirits. The word zar is used in reference to the type of possessing spirit, the illness it inflicts on humans, and the rituals performed to pacify it. Believed to have originated in Ethiopia, the cult currently prevails under different names (sar, bori, tumbura, dastur, red wind, shaitani), in many countries of Africa and the Middle East, including Sudan, Egypt, Ethiopia, Somalia, Algeria, Morocco, Nigeria, Kenya, Tanzania, Zambia, the Arabian Peninsula, and Iran. Although it has unmistakable pre-Christian and pre-Islamic features, contemporary zar is strongly influenced by these two religions.

Zar spirits constitute a broad spectrum of individually or collectively named entities, including holy saints, sect leaders, great monarchs, victorious generals, colonial officers, wealthy aristocrats, professional elites, nomadic warriors, savage bushmen, rebellious youth, flirtatious playgirls, and many others. By ethnicity, they include Ethiopians, Arabs, Southern Sudanese, Europeans, West Africans, Turks, Gypsies, and others. The reservoir of zar spirits continually expands to encompass ongoing sociodemographic and cultural changes.

Each spirit or group exhibits a distinctive pattern of behavior, personality traits, mood, attitudes, habits, mannerisms, idiosyncratic whims, and social interests. However, they share a common quality of being amoral, capricious, hedonistic, and intrusive.

Most clients resort to zar after unsuccessful treatment by Western physicians and traditional religious healers for complaints such as persistent headaches, palpitations, tightness of the chest, anorexia, gastrointestinal disturbances, generalized body aches, fatigue, dizziness, insomnia, anxiety, fear, sadness, and motor or sensory impairments. The formal “diagnosis” of zar is a faculty of the zar shaykha (leader), usually a woman who embarked on zar as a patient herself before apprenticing with a recognized shaykha and becoming formally recognized as a zar practitioner.

Once a novice is convinced that she has zar, she is to make an inception ceremony under the supervision of the shaykha and with the active participation of the shaykha's aides, musicians, and clientele.

Symbolically mimicking a wedding festivity, the inception celebration continues for seven days of fervent drumming, singing, dancing, and feasting in a large, jubilantly decorated room with a profusely incensed and perfumed background. During the heat of the activity, the novice, referred to as the “bride” of [Page 147]zar, is escorted by two bridesmaids into the room, gracefully swaying in her new clothing adorned with jewelry, henna, and fragrance to the participants' roaring applause. As the drumming, singing, and dancing grow progressively more vigorous, the shaykha begins summoning the spirits, each by its characteristic “thread” (chant), until the bride lapses into a trance, marking the entry of a particular spirit into her body and the displacement of her earthly self. A dialogue commences between the shaykha and the spirit to reach a negotiated appeasement. Thereafter, the client is to become symptom free, subject to her unwavering compliance with the spirit's demands, which are enjoyed through the senses of the host.

Field surveys have consistently reported the preponderance of zar among middle-aged women who are infertile, divorced or unhappily married, unemployed, of rural origin, or uneducated or who have a family history of zar or enduring interpersonal conflicts. Clinical studies have consistently reported higher prevalence of zar among patients who are diagnosed with dissociative, conversion, somatoform, or anxiety disorders.

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