Mental illness within evangelical Christian communities is frequently stigmatised, with many attributing it exclusively to demonic possession, lack of faith, personal sin, or other negative spiritual influences. This study explores perceptions of self-harm in the context of evangelical Christian faith communities using the novel qualitative story completion task. A convenience sample of 101 UK-based evangelical Christians completed a third-person fictional story stem featuring a devout female Christian who self-harms. A contextualist informed thematic analysis was carried out focusing on perceptions of cause, cure, and treatment. Most stories positioned spiritual causes of mental illness (that is, demonic possession or personal sin) as harmful to the individual by rendering individuals as stigmatised objects or as socially displaced. The stories also provided insight into negative perceptions of females experiencing mental illness within evangelical communities. The stories suggested that these views often led to stigma and shame, which ultimately exacerbated illness and led to reduced help-seeking. Conversely, stories depicting the integration of relational care alongside spiritual resources frequently led to recovery. That the stories represented the need for relational support, within a spiritually syntonic framework, for recovery from mental illness highlights the limitations of a dichotomised approach to pastoral care. Methodologically, the study demonstrates the usefulness of a seldom-used tool within the pastoral psychology context – the story completion task – for accessing sociocultural discourses and wider representations surrounding stigmatised topics or populations.

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Accounts of the demonic within the Christian tradition as causative in differing forms of illness and suffering can be traced back to the New Testament. Demonic accounts also exist more centrally in the language of spiritual warfare that pervades some evangelical groups. Contemporary research suggests that belief in the demonic as aetiologically culpable in mental illness has potentially stigmatising effects for those with mental illness and can also negatively impact help-seeking behaviours. However, no research has explored how evangelical groups which subscribe to belief in demonic entities represent the demonic and their relative role in relation to mental illness. This study explores perceptions of the demonic in relation to mental illness, with a sample of evangelical Christians who actively subscribe to belief in the demonic, by using the novel qualitative story completion task. A convenience sample of 43 evangelical Christians completed a third-person fictional story stem featuring a gender-neutral character (Alex) who encountered the demonic (in an ambiguous way) in relation to their mental health. A contextualist informed thematic analysis suggests that while mental ill health was often positioned as having a biopsychological cause, demonic activity was also frequently cited as exacerbating mental illness. Narrations of the demonic positioned Alex in either an active position, wherein they were responsible for their engagement with the occult and the subsequent onset of their mental illness (causative), or a passive position, wherein their pre-existing mental ill health made them vulnerable to demonic attack. In relation to recovery, storied data situated medical and spiritual interventions as effective. Significantly, participants positioned Alex’s Christian faith as a source of power over the demonic and over mental ill health – thus, despite demonic attacks, a sense of agency was often maintained. That the stories positioned demonic influence as external to the self, thereby maintaining a level of individual agency amidst suffering, highlights the potential limitations of assuming all demonic accounts are singularly stigmatising and negative in nature. Findings underline the need for future research to explore demonic accounts in religiously and culturally syntonic ways without imposing meaning.