Healing Symbols in Psychotherapy

A Ritual Approach

Erik D. Goodwyn

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317311164
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Ritual scholars note that rituals have powerful psychological, social and even biological effects, but these findings have not yet been integrated into the practice of psychotherapy and psychiatry. In Healing Symbols in Psychotherapy Erik D. Goodwyn attempts to rectify this by reviewing the most pertinent work done in the area of ritual study and applying it to the practice of psychotherapy and psychiatry, providing a new framework with which to approach therapy. The book combines ritual study with depth psychology, placebo study, biogenetic structuralism and cognitive anthropology to create a model of interdisciplinary psychology.

Goodwyn uses examples of rituals from history, folklore and cross-cultural study and uncovers the universal themes embedded within them as well as their psychological functions. As ritual scholars show time and again how Western culture and medicine is 'ritually impoverished' the application of ritual themes to therapy yields many new avenues for healing. The interdisciplinary model used here suggests new ways to approach problems with basic identity, complicated grief, anxiety, depression meaninglessness and a host of other problems encountered in clinical work.

The interdisciplinary approach of this accessibly-written book will appeal to psychotherapists, psychiatrists and Jungian analysts as well as those in training and readers with an interest in the science behind ritual.

Part II

A Dynamic Interdisciplinary Approach

In the following chapters, we will discuss what rituals do from a biological perspective, centering the discussion on biogenetic structuralism, neuroscience, and placebo studies. In Chapter 4 we will explore the cognitive science of religion and ritual and the ways recurrent symbols are created and maintained across many generations and/or are independently invented cross-culturally. We will see why this occurs and propose an explanation for why such symbols find their way into the collective element, and how rituals play into this. After that we will examine depth psychological theories of ritual and look at the ways rituals have been observed by therapists and clinicians to make profound impressions on individual minds. Finally, we will survey the various anthropological theories of ritual which have emerged in the last century or so and note the numerous points of intersection between them and the previous three branches. From there we will discuss how the study of ritual may be utilized in psychiatric and psychological practice.

Chapter 3

The Biological Branch

Mind/Body Interactions

The great error of our day in the treatment of the human body [is that] physicians separate the soul and the body.

– Plato

It will become apparent later when we review the field of ritual studies that our society is ritually “impoverished,” meaning that compared to other cultures, we do not engage in much ritual activity. The reasons for this are complex and we’ll get to them, but for now suffice it to say that generally ritual is not felt to be very useful or “effective,” consisting of only so much pretense and “play acting.” Though this trend is slowly changing, we can still see that, within the mainstream post-Protestant, post-Enlightenment Western approach to life that is quite dominant today, ritual behavior is not felt to be important. Contrast this to many traditional societies around the globe, in which certain rituals are simply not optional. Thus, in our society it is something of a surprise that rituals have so many potent effects at so many levels. To many other societies, however, this would be no surprise at all.

The Biology of Ritual

The field of biogenetic structuralism is a synthesis of neurobiological, anthropological, and phenomenological approaches to human nature that presages and overlaps with my dynamic interdisciplinary approach here. With Walter Freeman (1999), biogenetic structuralist Charles Laughlin (1990) points out that neurobiologically the mind does not passively record the world as it is, but anticipates certain kinds of sensory information that it selectively seeks out to help structure its “cognized world,” or world of mentally structured phenomenal experience, and this very fact blurs the boundary of mind/body, culture/nature, and, I add, self/other. As we will see, rituals emphasize this blurred quality through several distinct mechanisms, making things “blurrier” and therefore enhancing the intense feeling of connectedness that often accompanies it, though the things connected vary greatly depending on the ritual. We will see that ritual incorporates all the mental associations, including conceptual, imaginary, affective, arousing, metabolic, and physical-motor connections, that elaborate the meaning of ritual objects, concepts, and participants.

Laughlin explains that ritual is so important to human functioning because of its enhanced effects on the highly symbolic nature of thinking in general (Laughlin 1990: 5). Biogenetic structuralists therefore argue that the brain plays a fundamental part in ritual experience through its capacity to co-create a cognized and highly symbolic world—that is, one in which the mind participates through its various biological mechanisms. In ritual, this cognized world is different than the everyday world, since it is

thoroughly symbolic in nature. The symbolic function amounts to the relationship between a sensory object and neurocognitive, neuroendocrinal, neuroimmunological, or other somatic processes intent upon this object . . . [it] is the means by which the whole network of models mediating the meaning of an object is neuro-dynamically associated with that object.

(Laughlin 1990: 20)

That ritual involves an intensely symbolic mode of thinking is discussed in great detail by the cognitive science of ritual, discussed later, as well as by depth psychologists and anthropologists; here we note that this mode of thought now has a firm biological underpinning according to biological science, and we are beginning to see how intense ritual activity can alter physiological function. Psychoneuroimmunologists, for example, suggest that concentration on certain kinds of vivid imagery (used often in ritual performance) may produce enhanced immunological activity at specific body regions (Ader 1980; Ganong 1986; Laughlin 1990: 30), encourage the elimination of pain and anxiety, or balance the autonomic nervous system functions in various ways, as can dancing, drumming, chanting, using entheogens, fasting, sleep deprivation, or physical ordeals. It should not be surprising, then, that ritual is an absolute universal. All of these techniques will be discussed in the following chapters.

Laughlin also points out that the reverse process, where biological activity can trigger certain kinds of dream imagery, can occur (1990: 30), a process I explore in much greater detail in The Neurobiology of the Gods (Goodwyn 2012). Laughlin argues that symbolically rich rituals (which is most of them) may furthermore intensify right-brain processing to produce an “alternative reality” rich in intuitive, vivid sensory and emotional experience (1990: 30–31)—types of experience that we are constantly trying to access in psychotherapy, and that are particularly difficult to access due to the typically low-ritual, abstract, and verbal nature of most psychotherapy modes.

Laughlin also observes that rituals use myths—sacred narratives—in a specific way, not as merely an “expression” of the myth, but by providing a way for ritual performers to participate in the myth as lived experience through metaphor. The importance of narrative will be discussed in full when we review the psychodynamic effects of ritual; here it is important to note its biological connection. A function of myth according to Laughlin is to provide an explanation for the origin of the cosmos and for society, to explain life and death and answer the “why” questions. Such myths are “grounded and vivified” (1990: 23) by ritual, bringing the cognized symbols to life. Myth also provides a cosmology that helps to interpret experience—this is crucial for human functioning, as we will also explore in more detail when we discuss the depth psychology of ritual. Interpretation imparts meaning to the events of life, and without it, we are left without any meaning. What, however, is the evidence that ritual activity (or even mental activity in general) can affect physiology? Such evidence can be found in abundant studies of the placebo effect.

Placebo Effects: Altering Biology and Physiology with Minds Engaged in Ritual

Meaning is perhaps the most crucial element of what is known as the placebo effect—the effect in which our physiology is shaped by medical interventions that do not have anything to do with biochemistry or other mechanisms of healing known to medical science. The most relevant data available to understand how ritual actions can affect physiology (such as what may have happened to my grandfather), hinted at by Laughlin, are therefore in the growing field of placebo studies. The placebo effect is a long-known effect in medical science, where the patient responds to treatment that does not have a specifically identified biochemical or surgical mechanism. In other words, a person who feels relief from back pain by the administration of a sugar pill is experiencing the placebo effect. Put another way, it is not the chemical in the pill that relieves the pain, it is the meaning of seeking medical attention, finding a physician, getting an explanation of her/his pain, and administering a physical object into his/her body which relieves the pain.

Often dismissed as a nuisance phenomenon, an example of “quackery,” or a confounder of research trials, the placebo response is actually highly relevant to the questions posed by the present work because placebo studies examine exactly the kinds of physiological responses to actions that interest us; ones associated with actions that are known not to have any directly measurable biochemical or surgical cause. The placebo effect therefore shows us how our bodies can be directly altered by social variables, mental images, cultural beliefs, and so forth. Thus, to understand the wider question of how ritual might affect biology, it is worth going into placebo responses in greater detail.

We are only now beginning to understand what factors go into placebo responses; however, the efficacy of many healing rituals has been touted throughout the ages, and it is likely that ancient humans used the placebo response to maximal effect simply through generations of trial-and-error. Placebo researchers Shapiro and Shapiro even go so far as to say “The history of medical treatment is essentially the history of the placebo effect” (Shapiro and Shapiro 1999: 13). In any case, we will explore many such examples throughout this volume.

Physician, psychoanalyst, and placebo researcher Richard Kradin highlights the cultural nature of placebo responses: “A distinguishing feature of psychosomatic disorders is their ability to change with the times—a feature shared by the placebo response” (Kradin 2008: 59). Kradin observes that placebo responses are universal, and that there are no specific personality traits that distinguish placebo responders from non-responders—only the context of the interaction created by the caregivers seems to matter (Kradin 2008: 85). The placebo effect has emerged in some literature as a legitimate subject of study in itself (Kradin 2008), and as will be seen, placebo effect studies provide us with many examples of ways in which symbolic experiences can affect brain and body physiology, and in some cases there are solid clues as to the precise mechanism of how this works.

What Systems Can Be Influenced by Placebo Effects?

Anthropologists Thompson et al. (2009) argue that “direct embodied experience” may be the most important part of placebo responses, and they argue that the placebo response may be an evolutionarily adaptive trait, and Kradin agrees on this count (Kradin 2008: 117). According to placebo researcher and neurobiologist Fabrizio Benedetti, the placebo effect is a potent psychobiological phenomenon where the body and brain anticipate and participate in clinical improvement. This phenomenon, furthermore, is generated by psychosocial context (Benedetti 2009: viii). Koshi and Short continue by arguing that the placebo effect is a highly significant kind of psychosocial interaction between patient and physician (two socially constructed roles), and does not equal quackery: “Studies mentioned here showed that meaning can have considerable physiologic action . . . Therefore, placebo is not the equivalent of ‘no therapy’ ” (Koshi and Short 2007: 13).

Placebo effects, to date, have been observed in a variety of mental and physical disorders, including irritable bowel syndrome (Vase et al. 2005), depression (Khan et al. 2007; Leuchter et al. 2002; Vallance 2007), pain (Colloca and Benedetti 2005), Parkinson’s disease (Colloca et al. 2004; McRae et al. 2004; Oken 2008), coughs and asthma (Benedetti 2009: 188–189), dyspepsia, ulcerative colitis, Crohn’s disease (Benedetti 2009: 195), multiple sclerosis, epilepsy, dementia (Oken 2008), arthritis, ulcers, hypertension, warts, and cancer (Kradin 2008). One famous study showed that for chronic knee pain a “sham” procedure was effective and showed persistent alleviation of symptoms—equal in effectiveness to common knee surgery (Moseley et al. 2002). In a large meta-analysis of depression therapies, Sapirstein and Kirsch (1998) concluded that 73 percent of therapeutic responses to antidepressant medication were due to psychological factors surrounding the administration of antidepressant medication and other non-specific factors, as opposed to 27 percent due to the drug itself. For a psychiatrist, this means that I have to treat nine patients successfully with antidepressant medication before I can be reasonably certain that at least one of them improved due to the drug itself and not placebo effects. Placebo interventions have been shown to cause measurable change in brain physiology in brain imaging studies (Vallance 2007) that are distinct from those associated with medication (Leuchter et al. 2002). Placebo response to depression has also been shown (Khan et al. 2007) to be long-lasting rather than temporary, as is the common misconception.

Medical anthropologist Daniel Moerman (2002) reports that sham medical procedures for chest pain, lumbar disc herniation, knee surgery, and Ménière’s disease often show similar responses to actual procedures. Notice that there is really very little difference between a “sham procedure” and a “magic ritual.” In some cases these sham procedures produce improvements in symptoms that last for years. Other studies have shown placebo effects to be highly significant and inducible via symbolically meaningful visual, auditory, and olfactory stimuli as well as ritually. All had conscious as well as unconscious effects (Koshi and Short 2007). These, as we will see, are correlated with psychologically resonant principles and agree with many of the observations of anthropologists. Interestingly, the placebo effect is not unique to humans—it has been observed in other animals (Ader and Cohen 1982).

Most ailments can improve with placebo—or “non-specific”—interventions, and these appear to depend greatly on the subject’s state of mind. Shapiro and Shapiro (1997) suggest that modern treatments—in first world nations, that is—do not maximize the potential for placebo enhancement of treatment, and furthermore placebo response appears to be state-related rather than trait-related.¹ These observations agree with anthropological observations that modern Western culture is essentially ritually impoverished. Other factors include the subject’s state of suggestibility and expectation of cure (Bandura 1997; De Pascalis et al. 2002; Price et al. 1999), number of visits during a treatment course (Thomas 1987), and the perceived meaning of the symptoms (Brody and Brody 2000). More frequent administration of a medication, larger pills, newer pills, and even the color of a pill can enhance or diminish placebo responses, as does the physician’s optimism/pessimism, reputation and personality, and what the patient is told about the treatment and by whom (Moerman 2002). One dramatic case observed a euglycemic patient with multiple personalities in which one of the alter-egos was an insulin-dependent diabetic. This study (Rossi and Cheek 1992) provides fascinating evidence of how the mind can profoundly affect brain and body. Medical anthropologist Moerman (2002) argues that the placebo response should be reconceptualized as a “meaning response,” citing a large array of studies.

Mind/body researcher Richard Kradin observes that many aspects of the doctor–patient relationship can promote wellbeing, including gaze attunement, touch, meaning, and imagery (2008: 147; see also Colloca et al. 2008; Oken 2008). Kradin also argues that placebo and nocebo response are types of Jungian complexes (Kradin 2004), recalling that Jung (1919) suggested complexes were mediated by internal images. This, he states, is strong evidence that mental images can actually induce physiological responses. This is plausible because we know that mental images are in fact linked to most responses in the nervous system (Kradin 2008: 186).

Kradin has thus already connected the biological and depth psychological aspects of such responses. Elsewhere he observes that the data on the placebo response argue for a comprehensive self-regulatio...

Table of contents

• Cover Page
• Front1
• Half Title page
• Title Page
• Copyright Page
• Contents
• Part I Foundations
• Part II A Dynamic Interdisciplinary Approach
• Part III Applications
• Part IV Conclusions
• Bibliography
• Index