Unlike a sacrament, exorcism's "integrity and efficacy do not depend ... on the rigid use of an unchanging formula or on the ordered sequence of prescribed actions.
The ritual assumes that possessed persons retain their free will, though the demon may hold control over their physical body, and involves prayers, blessings, and invocations with the use of the document Of Exorcisms and Certain Supplications.
[citation needed] Solemn exorcisms, according to the Canon law of the Church, can be exercised only by an ordained priest (or higher prelate), with the express permission of the local bishop, and only after a careful medical examination to exclude the possibility of mental illness.
[6] The Catholic Encyclopedia (1908) enjoined: "Superstition ought not to be confounded with religion, however much their history may be interwoven, nor magic, however white it may be, with a legitimate religious rite."
By the late 1960s, Roman Catholic exorcisms were seldom performed in the United States, but by the mid-1970s, popular film and literature revived interest in the ritual, with thousands claiming demonic possession.
"[5] According to the Vatican's guidelines issued in 1999, "the person who claims to be possessed must be evaluated by doctors to rule out a mental or physical illness".
[7] Most reported cases are not seen as requiring an exorcism because twentieth-century Catholic officials regarded genuine demonic possession as an extremely rare phenomenon that is easily confused with mental illness.
Particular sacramentals, such as the wearing of a cross necklace or usage of blessed salt, are believed by the Church to offer protection against Satan when used with faith.
Certain theologians have held that the wearing of a headcovering by Christian females confers protection against fallen angels, which they teach are referenced in 1 Corinthians 11:3–10.
"[13] On this subject, there is the book by journalist Matt Baglio[14] called The Rite: The Making of a Modern Exorcist, first edited in 2009 and then in 2010, which inspired the 2011 film The Rite[15][16][17][18] and which mentions Psychiatrist Dr. Richard E. Gallagher, who has also written a book on the subject, published in 2020 by HarperCollins, called Demonic Foes, A Psychiatrist Investigates Demonic Possession in the Modern United States.