The Vatican has officially recognized a leading association of demonologists, despite debates in the Catholic Church over the impact of exorcism rites. The decision stems from the faith of Pope Francis, who appears to believe in a literal Satan.

The endorsement of the International Association of Exorcists, which counts around 250 members from 30 countries in its ranks, was announced in the Vatican’s mouthpiece L’Osservatore Romano.

The organization – considered the most respectable practitioners of a rite that is widely performed around the world – was formed by the charismatic priest Gabriele Amorth in 1991. The 88-year-old, whose favorite film is The Exorcist, has claimed to have expelled more than 150,000 evil spirits, since completing his training nearly three decades ago.

While some of his exorcisms can be performed by a simple prayer following an appeal, others involve months-long investigations, and lengthy rituals involving loud recitations of saints’ names, holy water and crucifixes.

Symptoms suffered by patients vary, but typically include hallucinations, speaking in tongues, uncontrollable tremors, and less frequently, vomiting improbable amounts of bodily fluids, and even inedible objects, such as nails and pieces of electronic equipment.

The causes? Amorth’s chief bugbear is the occult – which he says has infiltrated popular culture, aided by the internet – but also phenomena regarded as relatively innocuous, such as yoga and Harry Potter, which he has said provide a gateway to full-on Satan-worship.

The revival of official support for exorcism chimes with the views of the 77-year-old Argentinian Pontiff. Francis famously appeared to exorcise demons from Angel, a wheelchair-bound Mexican man during a visit to St Peter’s square, by laying his hands and chanting (though the man later admitted that they returned). At the time, the Holy See issued a soft rebuttal – that the Pope did not “intend” to perform the rite – which did little to dispel the idea that Francis is an exorcist himself.

Whatever the specifics of the incident, Francis often talks about the Devil in public, and “incessantly” in private, according to an anonymous source in the Vatican, who spoke to the Washington Post. This is in sharp contrast to the modernist drift of Catholic clergymen, who now often talk of evil as an abstract concept, more than demons possessing the soul – something Francis has admitted himself.

“The Prince of this world, Satan, doesn’t want our holiness, he doesn’t want us to follow Christ. Maybe some of you might say: ‘But Father, how old-fashioned you are to speak about the devil in the 21st century!’ But look out because the devil is present! The devil is here… even in the 21st century! And we mustn’t be naïve, right? ” the Pope said earlier this year.

While there is no doubt that there are heartfelt reasons behind the exorcism endorsement, and there will be ritual benefit from a licensing system that filters out “untrained” exorcists, it will leave the Catholic Church open to accusations of backwardness, superstitious thinking, and outright quackery.

A Washington Post report from an exorcist convention at the Vatican earlier this year, painted a picture of intense, but somewhat eccentric, not to say bigoted, caste of clergymen. One of the exorcists told a story about sensing the presence of the Devil when he sat in front of a couple of lesbians, when they began emitting a “Satanic growl” and throwing chocolates at him. Amorth himself said that the relapse of the Mexican man touched by Francis to his previous state is a signal from God that Mexico should abandon a liberalization of its abortion laws.

While theological rigidity is par for the course for some segments of the Catholic Church, a bigger concern could be the denial of psychiatric therapy or medicine to those who need it. Catholic priests are told not to use exorcism as a first line treatment, and only those cases that cannot be tackled conventionally are referred to the exorcist. It is also possible that even as a placebo, an exorcist may bring solace to some afflicted with manageable disorders.

Whether any of these worries are enough to alienate the public – and practicing Catholics – from the popular Pope is unclear, but a complex picture is emerging of a Pontiff who combines modern-day communication skills and appealing agendas with a sharp fundamentalist Catholic edge.