Therapeutic mechanisms of shamanistic healing derive from ASC, community relations, and ritual spirit-world interactions. ASC have physiological effects, including the relaxation response, the elicitation of opioid release, and enhanced serotonergic action. The spirit world plays a role as "sacred others," representing personal and community identity models and aspects of the psyche. The spirit world and community's therapeutic roles include models for development, social support, and community bonding. Ritual processes manipulate physiology, psychology, and social relationships for therapeutic processes.
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