The Surgical Ritual--Central Activity

In my previous blog, I enumerated the features of ritualistic preparation that enhance the suggestibility of subject involved in either a shaman's ritual or a modern surgical operation. In this blog, I'll review the central ritual activities that reinforce the suggestibility of the entire curative encounter.

CENTRAL RITUAL ACTIVITY
Both surgeons and shamans, after elaborate preparations, perform procedures designed to bring about a cure. I've grouped these activities into three distinct categories:  extracarporal, surface, and penetrative.

Extracorporal
Many central ritual activities do not involve actual contact with the subject, including such things as animal slaughter, prayer, sand painting, and the shaman trance-vision journey to the spirit world. Each of these activities follows prescribed patterns based on the practitioner's belief system. Prayers to specific deities or saints or spirits accomplish the same thing.  Only a fool or an ignoramus, when dealing with female infertility, would pray to a rain god or the patron saint of travelers or the deity of volcanoes. Often times, failure to promote a cure is blamed on wrongly directed, inadequate, insincere, or impure prayers.

A sand painting, whether Navajo or Tibetan, consist of a precisely sequenced series of symbols having meaning to those who have spent at least a decade of their lives learning how to interpret them. Every figure, every stroke, and every dot in a sand painting exists for a purpose, one easily explained by the practitioner. In content, the Navajo sand painting describes (in a cultural context) the consequences of a struggle between the forces of good and evil that bear upon the hoped-for outcome. The sand painting clearly impacts upon the subject but has its greatest effect on the shaman, who feels a sense of potency conveyed by the symbols, which enhance effectiveness by dispelling powers aligned with the forces of evil.

In the modern surgical ritual, there exists a sand painting equivalent: the patient consent document.  It too consists of a precisely ordered sequence of symbols incomprehensible except to those who have spent at least a dozen years learning to interpret the little figures (letters).  And, as with the sand painting, its greatest influence is upon the practitioner who senses empowerment offered by the document, which also (like the sand painting) serves the practitioner by dispelling malevolent demons (trial lawyers) aligned with the forces of evil.  Only under the most extraordinary circumstances would a Navaho shaman or orthopaedic surgeon move forward to complete the ritual without a proper sand painting/consent document.  And, as with sand paintings, consent forms don't always work successfully.

Surface
Most healing rituals go beyond words and diagrams, involving physical contact between the practitioner and subject. Therapeutic touching is so widespread that I need not remind readers of its value as a hypnotic tool. The relaxed sense one experiences after a massage is more mental than physical.  Entire professions (i.e., chiropractic) rely on this sort of contact therapy, the effect enhanced by thrust maneuvers designed to elicit a pop from a joint.  Reflexology (massaging the bottom of the feet where organs are supposedly represented) is yet another example of this process.  It has no therapeutic value unless the practitioner believes strongly in the concept, transferring that belief system to the subject.

For surgeons, therapeutic touching consists of hand holding, a pat on the back and other elements of perioperative contact that convey a caring attitude to the subject.  Suggestibility is thereby enhanced.

Penetrative
Penetration of the body's cutaneous envelope defines the most serious invasion of bodily space and sets up the subject to a level of suggestibility unobtainable by other means, I suspect.

Bloodletting
Many cultures incorporate bloodletting in their rituals.  A Mayan king would pierce the dorsal vein of his penis using a stingray spine, spilling blood onto various objects, thereby sanctifying both them and him. For centuries, physicians practiced bloodletting in an attempt to restore balance to the four humors that served as life's vital fluids.  Removing a pint or two of blood often results in faintness (caused by hypovolemia), an altered state of consciousness that may, along with the other measures increase suggestibility.

The modern surgical experience starts with an intravenous needle insertion.  The patient may watch his or her vital fluid flow backwards a couple of inches into a transparent I.V. tube.  The sight of one's own blood makes many people feel queazy or faint, both altered states of consciousness that may affect suggestibility.

Penetration
In primitive cultures, deep penetration as part of mystical ceremonies occurs in many ways.  Among the ancient Mayans, the queen pulled a rope through her tongue. Members of certain Native Americans groups experienced an ordeal whereby wooden pegs are pushed through the flesh of their chest walls and attached to ropes that are, in turn, tossed over a tree limb and attached to heavy weights. The young "brave" (a good term for the participant of such a ritual!) stands for hours or even days in this position facing the sun as a test of endurance and will power.  The mind is so altered by this tribulation that hallucinogenic visions often appear without the use of supplementary drugs.

Hindu celebrants pierce their bodies with numerous objects and parade through their villages during special festivals. Muslims of some sects draw blood during religious processions by beat themselves over their back with chains, a practice similar to the self-flagellation of certain Catholic orders. An altered consciousness called ecstasy results, probably from the endorphins released in response to pain.

Acupuncture has become popular in certain western cultures.  The practitioner inserts thin needles into specific locations along "meridians," which have their origins in ancient Chinese philosophy rather than human anatomy. Some acupuncturists claim that the human ear is formed like an inverted homunculus, with every organ represented by a point on the ear lobe. Similarly, Korean hand acupuncture assumes representation of bodily organs and structures on the palmar surface of the hand and digits.  The middle finger, for example, contains components representing the human face looking very much like a finger puppet.

Placebo-controlled studies of acupuncture often fail to confirm the claims of acupuncturists. Nevertheless, the high apparent placebo value of the procedure fascinates many involved in pain management research.

Modern operations, although conducted under pain-relieving anesthesia, are hardly painless procedures once the medication has worn off.  Pain stimulates the release of natural opioids, like increasing suggestibility.  Likewise, an individual enduring a surgical ordeal often uses heavy-duty medication for pain control, thereby ingesting more mind-altering substances. I'll discuss the post-procedure suggestibility enhancements in my next blog.