Shamanistic healing typically occurs in a community context. Community participation facilitates therapeutic effects derived from psychosocial influences (positive expectation and social support). These collective rituals strengthen group identity and commitment, enhancing community cohesion by reintegrating patients into the group. Communal healing practices reinforce attachment needs in the mammalian biosocial system (Kirkpatrick, 1997). Attachments and affectional bonds that evolved to maintain proximity between infants and care-givers provide a secure basis for the self, feelings of comfort, and protection from powerful figures (e.g., shamans, spirit allies).
Shamanistic practices enhancing social cohesion elicit psychosociophysiological mechanisms that release endogenous opiates. Frecska and Kulcsar (1989) review evidence that shamanistic practices elicit psychobiologi-cally mediated attachment based in opioid mechanisms. Opioid release is produced through cultural symbols that have been cross-conditioned with patterns of attachment and their physiological and emotional responses. Emotionally charged cultural symbols associated with physiological systems during attachment socialization link mythological and somatic spheres, providing a basis for elicitation of the opioid system in shamanistic ritual. Endogenous opioids are also stimulated by a variety of physical aspects of shamanic ritual (Prince, 1982;
Winkelman, 1997), including: extensive dancing and other exhaustive rhythmic physical activities (e.g., clapping); temperature extremes (e.g., sweat lodges); stressful procedures such as fasting, flagellation, and self-inflicted wounds; emotional manipulations, especially fear and the elicitation of positive expectations; and night-time activities when endogenous opioids are naturally highest. Opioid release stimulates emotions and physiological processes, including endocrine and immunological systems (Frecska & Kulcsar, 1989), enhancing psychoneuroimmunological responses. The euphoria from activation of the body's opioid system produces a sense of certainty and belongingness. These dynamic functions of the psyche provide coping skills and mechanisms for maintenance of bodily homeostasis (Valle & Prince, 1989). Endogenous opioids facilitate environmental adaptation, enhance biological synchronization within a group, reduce pain, and enhance tolerance of stress. These experiences strengthen social relationships in an experience of communitas, the essential bonds among group members. This community identity induces dissolution of self-boundaries, identification with others, and the development of an integrated self that can heal others, exemplified in shamanic healing.
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