A 24 year old girl was brought to Psychiatry OPD by her mother with complaints of multiple attacks of seizure like episodes with no tongue biting, involuntary passage of urine, or aura for past 3 years. She also admitted that the girl during the episode took the identity of some known person in the neighborhood or at times the identity of her deceased sister, who died by committing suicide several years ago and two spirits. She was very much distressed with such episodes and lost appetite and weight. There was a history of a death of a sister six years ago, due to suicide. Blood investigations, EEG and Brain Imaging as per Epilepsy protocol were undertaken, which were within the normal range. A diagnosis of Dissociative Trance Possession Attack was made and she was treated with Tab. Sertraline 50 mg OD, Tab Lacosamide 50 mg OD. On subsequent visits, she didn’t admit any improvement and a detailed work-up was done. The patient’s mother reported that her one daughter had committed suicide 6 years ago by consuming insecticides (organophosphoros), the cause of which was not ascertained, but claimed to be the act of witchcraft, by the patient and patient’s mother. On asking the rationale for such beliefs, they said, during the last rite ritual which is performed on 10th day in some cultures in India, they saw the inscriptions on some leaves of a tree (which they worshipped), which read like Aunty and thereafter they started suspecting one old lady in their neighborhood to have done some black-magic to the deceased girl who died by suicide. They also said that the old lady keeps spreading narratives regarding the delay in patient’s marriage. Subsequently, the third daughter in the family once got a possession attack, and tried to commit suicide by hanging, but was saved as she was seen by the family members. On asking she said, that she was possessed by three spirits, including her sister who died by suicide. As per, the patient, she requested the three spirits to let go her sister and ultimately she got possessed. The patient had since been getting the episodes of possession attacks, which she claims to be due to the old lady. She also reported, to have been possessed by her deceased sister, who confirmed during the episode, that she consumed poison because she was hypnotized to do so by the old lady. She also complained that on some occasions, she saw snake in the house, which was sent by the old lady. The patient also reported that during the possession, she gets sensation of something going inside her mouth, which comes out by exhaling once through mouth. She attributes it to the spirit which enters and comes out of her body. Patient complained of hearing voices, which comes from the mind, the voices of the old lady suggesting her to commit suicide, though she didn’t report having any suicidal ideation, nor she ever attempted suicide in the past. The frequent possession attacks made the girl and her family members, anxious, depressed and fearful. The family members took the girl to faith healers, but of no use. Patient’s family members are convinced that the girl is possessed by the old lady, who is jealous of her and passes comments on the patient and some spirits. During the interview, the patient was suggestible, and developed possession attack, during when she was breathing fast and exhaled with mouth once, and relaxed. She looked terrified after the attack and was calm and quiet for some time. Based on the detailed work-up the diagnosis was revised as- A case of Possession attack + Persistent Delusional Disorder. She has been supplemented with Tab Olanzapine 5mg HS, Tab Clonazepam 0.25 mg HS, and Tab Sertraline was up titrated to 75 mg OD. Patient has been asked to attend Behavior Therapy and Expressive Techniques sessions. Patient’s mother was advised to separate the patient and the second girl from the family for some time.