Social

Bonding in

the

Modulationof
the
of

Physiology

Ritual

EDE FRECSKA and ZSUZSANNA

Trance
KULCSAR

"FAITH ... QUENCHED THE VIOLENCE OF FIRE."

(HEBREWS 11:34)

All traditional shamanic practices pursue the same end: to destroy

"profane" sensibility.1 The monotonous chants, the endlessly repeated refrains, the fatigue, the fasting, the dancing, the narcotics,
and so forth, create a sensory condition that is wide open to the "supernatural." This is not only, of course, a matter of physiological
techniques: traditional ideology directs and imparts values to all
these effortsintended to break the frame of profane sensibility. What
is above all indispensable is the absolute belief of the subject in the
spiritual universe that he desires to enter; nothing can be attained
without the "faith." (Eliade 1976:85)
Over the past decade it has become obvious on several levels that
social attachments are important to normal human development
EDE FRECSKA is Research Psychiatrist and Clinical Pharmacologist at the National Institute of Nervous and Mental Diseases, Budapest, Hungary.
ZSUZSANNA KULCSAR is Professor of Psychology at the Lorand Eotvos University, Budapest, Hungary.

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and psychobiological functioning. Disruption of attachment may

lead to psychological disturbances, physiological disorganization,
and ill health, while social bonding appears to be related to improved health and well-being. With a range of attachments, that is,
early parent-infant relationships, subsequent peer interactions and
later intimate adult-adult bonds, Homo sapiens is clearly a social
animal and develops and functions optimally in an environment
where such links are available. This is neither a new, nor a culturespecific phenomenon, since complex social attachments and relationships are common to all cultures and eras, and appear to have
constituted a major factor in our species' evolutionary history (Reite
and Capitanio 1985).
In this essay we examine from a psychobiological perspective
some of the characteristics of healing rituals, which are considered
as neurobiologically mediated, complex forms of attachment, and
which result in a deep psychobiological synchrony between adults.
In the course of recent studies in psychological anthropology, a
consensus has emerged that the vast majority of ritual ceremonies
are primarilyconcerned with healing in a general sense because they
exert influence on well-being, heighten identity and enhance community cohesion. In spite of the cultural diversity of therapeutic institutions and practices, the fundamental healing principles show a
good deal of cross-cultural uniformity. The basic factors are inherent in the healer-patient relationship and in cultural belief systems.
These include:
the world view shared by patients and healers; the healers' culturally ascribed extraordinarypowers; their labeling of the illness, designation of its cause, and selection of therapeutic measures based upon these; the patients' expectancy and hope;
and, of course, the overriding importance of suggestion and the placebo effect.
[Prince 1982a:299]

Faith in protective others, in the healers themselves and/or in

transcendental beings, is essential in healing practices. In this way
the healer is able to manipulate the reintegration of patients into
their social group, which also plays a significant role in the healing
process. Ritual therapeutic experience relies on the patients' own
intrinsic healing forces by various altered states of consciousness
(dreams, micro-psychoses, religious experiences, spirit possession
and trance states, for example), which healers have learned to manipulate and control. However,
One of the foremost dilemmas in ethnomedicine is understanding how it is that the
manipulations of the shaman or healer actually influence the physiological state of
the patient. [Moerman 1983:156]

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ETHOS

RITUAL TRANCE AND ENDOGENOUS OPIOIDS

The conference entitled "Shamans and Endorphins" held in
Montreal in 1980 proposed an internal defensive power to endorphins (the body's endogenous opioids) and suggested that the
trance state might be the result of the mobilization of these substances. To some extent healing practices are indeed aimed at triggering the release of endogenous opioid peptides. Austere conditions
such as strict fasting and thirsting, forced strenuous exercise, seclusion, hyperstress with feelings of terror, inducing of pain, temperature and kinetic stimulations, all known to produce altered states of
consciousness, are used as treatment modalities in the rituals. These
stressors are the best agents to elicit endogenous opioid release resulting in the well-known opiate effects such as analgesia, anxiety
reduction, euphoria and amnesia (Jilek 1982a). Miraculous cures of
even strictly somatic complaints might also be interpreted on this
basis if we take into consideration the finding that some of the endogenous opioid peptides increase immunocompetence (Morley
and Kay 1986; Teschemacher and Schweigerer 1985).
This neurobiological interpretationof anthropologic observations
is supported by other findings concerning the physiological role of
endogenous opioid peptides in privation, in conservation or expenditure of bodily resources and energy (Margules 1979), and in confrontation with stress and pain especially in situations of helplessness (Maier 1986). Maier emphasized "uncontrollability"2 as a
main factor in the opioid-inducing effect of pain. He has found that
the opioid form of pain-induced analgesia occurred only if the
shocks were inescapable, and suggested that the opioid system is
more activated when the organism learns that it has no control over
aversive events to which it is being exposed. When an aversive situation is behaviorally uncontrollable, pain and anxiety, as fightflight signals, lose their adaptive value. Rather, it is adaptive to act
palliatively to repress the consequences of the stressful situation and
conserve energy resources until a time when active behavioral coping becomes possible. Margules (1979) argued that the activation of
endogenous opioid systems tends to function to conserve energy in
a variety of emergency situations, and Maier (1986) added that decreased pain sensitivity would make it easier to withdraw and conserve energy in a painful situation. Therefore passive endurance of
pain or other stress is one of the most effective strategies for mobi-

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lizing endogenous opioids. The paradigm of "learned helplessness"

as an opioid-dependent state was the first attempt to connect endogenous opioid functions to complex psychological phenomena.
Nevertheless, the question arises: How are the healer's role and
the patients' group participation involved in these neurobiological
processes? Why can nothing be attained without the "faith," as it is
emphasized by Eliade (1976)?
RITUAL TRANCE AND ATTACHMENT
Henry (1982) pointed out that ritual trance almost invariably occurs in a social context and that expectation is one of the main characteristics associated with trance induction. He characterized those
most susceptible to enter trance as persons whose social position
predisposes them to the experience: leaders of the community or
priests who are expected to provide an example or guidance. Others
are individuals participating for personal reasons, including those
fulfilling an obligation to a deity or those disadvantaged by ill
health, poverty or fear of evil spirits.
We would add that healing power is related to the fulfillment of
social expectations: it is a function of the participants' identification
with the community. In other words, social attachments facilitate
trance.
ATTACHMENT

AND ENDOGENOUS

OPIOIDS

The clearest evidence for involvement of endogenous opioids in

social behavior derives from the pattern of emotional responses most
infants exhibit when they are separated from their mothers. Infants
show a predictable set of behaviors during separation. The initial
anxious phase, that of "protest," begins almost immediately with
distress vocalization, searching activity and agitation. During the
succeeding phase of "despair" the infant's behavior suggests increasing helplessness, characterized by retarded activity, reduced
and postural collapse
appetite, insomnia, hypo-responsiveness,
(Bowlby 1969). Individual variability and species differences do occur, but the broad outline and even some of the details are similar
for different species. The need for affiliation seems to be a primary
drive, its expression appears to require no previous learning, and it
is likely that these reactions are direct manifestations of innate
neural circuits. Presently there is a growing body of knowledge con-

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cerning brain mechanisms that sustain the social motive. The approach of Panksepp, Herman, Vilberg, Bishop, and Deeskinazi
(1980) to this problem emphasizes the analogy between social separation symptoms and the biphasic syndrome subsequent to withdrawal from narcotics (lacrimation, irritability, agitation, and vegetative disturbances as an initial response, followed by lethargy, insomnia, and anorexia). According to these authors, withdrawal distress, whether opiate or social, manifests itself physiologically
through common response systems. The degree of symptom overlap
between the two processes suggests that both may arise from a common neurobiological substrate. Considering the similar dynamic of
opiate addiction and affiliative social interaction3 (both are characterized by the development of powerful dependencies and intensified by punishment), brain opioid systems should be reasonable
candidates for providing neurochemical mediation of social bonding. For the evolutionary minded it comes as no surprise that a
higher order behavioral process such as social attachment (whose
major elective advantage is to enhance survival) should have arisen
from elementary brain structures (which subserve a compatible
function), in this case from the opioid system (which mediates defense mechanisms).
These lines of inference suggested the notion that endogenous
opioids might be involved in primary social affiliation. The idea has
been evaluated experimentally in infant animals: opioid agonists decreased while opioid antagonists selectively increased the signs of
distress caused by social deprivation as well as other indices of the
social motive (Fabre-Nys, Meller, and Keverne 1982; NewbySchmidt and Norton 1981; Panksepp, Herman, Conner, Bishop,
and Scott 1978). An abundance of furthercorroborativeevidence for
opioid control of social processes has been presented by other laboratories. Morphine effects on social proximity (Plonsky and Freeman 1982) and play (Beatty and Costello 1982) have been reported,
and naloxone has been found to disrupt schooling behavior in fish
(Kavaliers 1981). Social isolation has been shown to modify brain
opiate receptor densities (Bonnet, Miller, and Simon 1976) and to
increase voluntary opiate consumption (Alexander, Coambs, and
Hadaway 1978). Utilizing substractive auto-radiography, Panksepp and Bishop (1981) have demonstrated that brain opioid systems are quite active in the presence of social stimuli, namely during
the normal course of play.

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While little data is still available regarding the maternal side of

attachment, Panksepp, Siviy, and Normansell (1985) suggest that
the elevated plasma opioid activity observed during pregnancy
(Csontos, Rust, Hollt, Mahr, Kromer, and Teschemacher 1979)
and parturition (Facchinetti, Centini, Parrini, Petraglia, D'Antona,
Cosmi, and Genazzani 1982) might facilitate the subsequent bonding process. It seems that the hormonal levels at the time of parturition are critical in determining the attachment of mother to infant.
Once this attachment has occurred, it persists for an important part
of the life cycle. To a less dramatic degree the same occurs in humans. Of course, we must be very careful in attempting to generalize
across vast phylogenetic distance; nonetheless, we know that evolution tends to be conservative, using what is available and adding
new features in new species, but retaining much of the old. Klaus
and Kennell ( 1981) have shown that if a mother must defer the fondling of her newborn baby for hours or even days, it is harder for
her to become attached and devoted to it. Such is not the case if she
is allowed to care for it within minutes of birth. The precise circumstances, especially the elevated endogenous opioid levels at the moment of delivery, are important factors in her later behavior.
On the one hand, opioids affect social emotions and, on the other,
loss of social bonds has a biphasic effect on opiate-dependent analgesia. Brief periods of isolation increase pain sensitivity in infants,
while concurrently diminishing the analgesic efficacy of morphine.
These indicate a deficit in socially generated endogenous opioids.
Conversely, when infants are isolated for prolonged periods, stressrelated opioid peptides are induced and responsivity to morphine
increases (Alleva, Caprioli, and Laviola 1986).
In summary, opioids alleviate separation distress and separation
modulates opioid analgesia. This reciprocal relationship suggests
the following ideas. Modulation of distress vocalization by endogenous opioids is a mechanism that could be selected for phylogenetically. The infant that does not respond vigorously at the time of
initial separation reduces the probability of maternal detection. The
converse strategy is also dangerous; whether in isolation or in the
nest, the infant that does not temper its level of vocalization increases the likelihood of falling victim to a predator (Kehoe and
Blass 1986). Endogenous opioids modulate the range: on the one
side, as stress hormones they exert a calming effect in circumstances
of prolonged separation and, on the other, as reward transmitters

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they help to elaborate the positive affective state of social comfort in

maternal reunion (Panksepp et al. 1985). These effects are most
likely mediated by different neurobiological processes at different
neuroanatomical sites.
Although many brain areas surely contribute dimensions to social
behavior, it is tempting to suppose that the affect of social comfort
and the other pleasurable qualities of social interactions are mediated by the enkephalins of the ventral tegmental area, which is
known to participate in self-stimulation reward and where the positive incentive effects of opiate drugs are most pronounced. Alternatively, the negative symptoms, that is, the signs of discomfort, are
mediated by those structures that are involved in physical dependence to drugs (for example, periventricular gray matter) where
withdrawal symptoms can be precipitated in addicts (Wei, Loh, and
Way 1973). Distress vocalization control circuitry is concentrated
in this part of the brain (Herman and Panksepp 1981). The powerful stress opioid, beta-endorphin, may quell separation distress at
this area. Of course, strict analytical separation of such functions
could be misleading because, in the functioning organism various
limbs of the opioid system are activated at the same time. From
studies on complex brain organization of social behavior so far it
appears that the integrity of three cortical areas-the orbital frontal
cortex, the temporal pole, and the amygdala-is crucial to the
maintenance of affiliativeinteractions and social bonds. It is striking
that these areas have the highest density of opioid receptors (mu
type) and are precisely the same as those involved in processing
multimodal sensory information. These areas also play a role in selective attention, and even perform top-hierarchical physiological
regulation (Steklis and Kling 1985). This latter function strongly indicates that attachment may influence core biological functions.
ATTACHMENTS AS REGULATORS
Hofer and his colleagues have tried to identify the specific processes within the mother-infant relationship that were withdrawn
by separation. They have reported a comprehensive and systematic
series of findings on the multiple roles of the mother in regulating
the physiology of the infant (Hofer 1981). From their work the infant's homeostatic system appears to be relatively "open" and biological regulation is delegated in part to the mother. Body temperature, blood circulation, oxygen consumption, sleep patterns, activ-

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ity levels, growth, and immunocompetence all depend on maternal

factors such as milk and body warmth as well as tactile, vestibular
and olfactory stimulation. The separation symptoms seem to result
from withdrawal of these hidden regulators. For instance, metabolically significant biochemical effects of maternal deprivation in infant rats can be ameliorated with a highly specific form of brisk
stroking that may mimic components of normal maternal behavior
(Butler, Suskind, and Schanberg 1978; Evoniuk, Kuhn, and Schanberg 1979).
However, separation reactions are not limited to infants. They occur at all ages. In adult bereavement, for example, there are changes
in the cardiovascular, endocrine, and immunologic systems, as well
as disturbances in body temperature and sleep, muscular strength
and body weight. According to Hofer, the features of maternal stimulation that structure the mammalian infants' organization become
increasingly complex during development (and are thus more difficult to identify). Separation effects that are attributable to the loss
of simple sensorimotor stimuli for young organisms are mediated by
increasingly complex configurations of stimuli in older ones in
which such mediation appears increasingly social.
Hofer concluded that independent self-regulation may be limited
even in adulthood, and homeostatic regulatory mechanisms remain
under environmental control at least to a certain degree. Social interactions with "significant others" may continue to play an important role in the everyday regulation of biological systems throughout
life and, at least in primates, they help to set internal clocks. Biological rhythms, in others words, are under social entrainment (Hofer
1984). It has been postulated that the properties of biological pacemakerswould be affected by opioid peptides and this interaction has
been shown in rodents (Meck and Church 1984). The notion has
emerged that indeed one, if not the major, component of attachment
is the promotion of psychobiological synchrony between attached
organisms, and such synchrony between participants' rhythms is essential for the integrated functioning of these individuals (Reite and
Capitanio 1985). Also, although this synchrony is evident most
clearly in mother-infant interactions, it seems to persist through life
(Field 1985).
Human relationships are conducted originally at the sensorimotor level, but in the course of ontogeny the role of internal representations becomes prominent, and symbolic signs or mental images

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may take the place of actual persons. Thus, it seems possible that
the regulating influence of important social relationships upon biological systems may be transduced not only by the sensorimotor and
temporal patterning of the actual transactions, but also through the
internal experiences of the relationship as it is carried out in the
mind of the subject involved (Hofer 1984). "Identification" is a suitable term for labeling the complex process of internalization of social
relationships that can maintain the psychobiological synchrony
mentioned above.
EXPERIENCE OF IDENTITY AND ENDOGENOUS
OPIOIDS
The conclusion that can be drawn from Panksepp's (Panksepp et
al. 1980) concept and findings is that social (first of all maternal)
induction of endogenous opioid activity serves as the basis for the
experience of trust, whose roots lie in the anticipation of social reward. This early experience receives representation at the cognitive
level, and plays a fundamental role in the subject's worldview. Early
(and thus more directly mediated) positive social experiences establish identity and, in an appropriate cultural milieu, determine religious beliefs such as faith in an internalized, omnipotent, protective
other.
The social connotation of endogenous opioid release may arise
when these substances are mobilized in another way, for example,
in hyperstress, in confrontationwith stress and pain, in situations of
helplessness or in the multimodal instance of trance. The same happens in the case of the "omnipotence maneuver" (Prince 1982b) in
near-death experiences when the threatened and helpless individual
suddenly experiences a feeling of passive resignation to death accompanied by tranquillity, and the dissolution of loneliness with a
sense of the presence of a protective other. The subject links these
experiences with the idea of supernatural intervention and designates it as the "grace of God," or attributes it to spiritual powers,
depending on cultural belief systems.
On the other hand, endogenous opioid mobilization may more
easily occur in response to a real person who is regarded as protective and omnipotent, since this situation involves a regressive, symbiotic form of attachment and closely resembles the early ontogenetic situation. We postulate this type of social attachment, which
applies in particular to ritual experiences.

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In summary, we propose that the social connotations and activation of the endogenous opioid system become cross-conditioned
during early ontogenesis, so that later in life whenever the opioid
system is activated by stress and pain, social connotations could
arise together with the paradoxically occurring euphoric states and,
vice versa, opioid-mediated euphoric and trans-like states are enhanced by social affiliation (Kulcsar, Frecska, and Varga 1987).
The need for and the possibility of identification are interwoven at
a psychobiological level: regression promotes endogenous opioid
mediation while endogenous opioids mediate affiliation, and help
depersonalization by loss of ego boundaries.
IMPLICATIONS FOR RITUAL EXPERIENCE
On the basis of this long survey it seems plausible that the experience of social identity (that is, the experience of being affiliated)
has a mobilizing effect on endogenous opioids and, conversely, ritually induced endogenous opioid activity supports social identity.
Thus we interpret Henry's remarks concerning trance susceptibility as follows. Leaders or priests, whom onlookers and participants expect to set an example and provide guidance, may have an
intensive sense of duty, thus a better ability to experience group
identity. Those participating for personal reasons, especially those
fulfillingan obligation, commit themselves to the deity who is a symbol of their group's social conscience and this kind of identity experience helps them to enter an altered state of consciousness. In the
case of disadvantaged, helpless individuals who sufferfrom diseases,
privation and fears of losses, their "uncontrollable" distress generates endogenous opioids (videsupra)as an internal mechanism that
enhances identification and trance.
Let us consider now a condition described by Jilek (1982b) as
"spirit illness" among the American West Coast Indians. This condition is in many respects analogous to the initiatory sickness of Siberian shamans. In this illness-like state subjects sufferanorexia, insomnia, weakness and emaciation, and experience hallucinatory or
illusional perceptions of a psychogenic type. According to Hofer:
Evidence from the studies on sensory deprivation and chronobiology indicate that
we are surprisingly dependent on the level and patterns of stimulation in our everyday lives for maintaining and regulating the complex organization of our mental
and physical functioning. We are not directly aware of the role that this stimulation
plays until it becomes insufficient or its patterning is radically changed. Then, we

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notice that our concentration and attention are impaired, our perception is somewhat distorted, we do not sleep well, our appetite is reduced . . . and we are periodically overcome with fatigue. In its extreme form, we feel that we are falling
apart mentally. We see and hear things that are not there. [1984:191]

The similarities between these symptoms and the symptoms of

"spirit illness" are striking. One could interpret this as the subjects'
sufferingfrom the withdrawal of patterns of community ritual stimulations that had been exerting a hidden regulating action on the
participants' mind and on their physiological function, and what is
more, subjects had become addicted to the opioid effect of trance
state. It was the essence of traditional "spirit illness" that suffering
became actually a reward and was anticipated by those who had
previously sought spirit power individually. This ailment was no
more than a strictly seasonal, highly stereotyped, goal-directed, ritualized pathomorphic (illness-like but not pathologic) prelude to
the public experience of this power in the winter dance ceremonial
(Jilek 1982b). From our psychobiological perspective, their symptoms seem to manifest an avid desire for socially induced endogenous opioids and are due to the lack of transactions and experiences
gained in regular ceremonials. Differential seasonal patterns of opiate responsivity, with a graver abstinence syndrome in the fall, are
not unknown phenomena in pharmacology (Beckman, Llados-Eckman, Stanton, and Adler 1982). Moreover, circannual variations in
the concentrations of endorphins and opioid receptors have also
been observed with highest levels occurring in the winter (DeCeballos and DeFelipe 1984; Von Knorring, Almay, Johansson,
Terenius, and Wahlstrom 1982). These phenomena presumably
serve as the basis of greater reward mentioned above. There is a circadian variation of opioid responsiveness as well, with the greatest
sensitivity late in the evening (Frecska, Arato, Banki, Bagdy, Perenyi, and Fekete 1987), a typical time for many shamanic activities
(Winkelman 1986).
"Anomic" depression is a chronic dysphoric state with a similar
symptom pattern, accompanied with a sense of rootlessness and cultural alienation common to adolescent West Coast Indians as a consequence of deculturation and perplexed identity. This syndrome
essentially corresponds to "spirit illness" and approximates Western "neurotic/reactive" depression, and is a foundation for understanding the high rates of alcoholism, suicide, violent death, and the
adjustmentproblems among native youth. These disorders are often

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refractory to Western therapeutic approaches but responsive to

healing ceremonials through personality depatterning and reorientation in altered states of consciousness. The task of initiation is no
longer only to provide entrance into a ceremonial but to overcome,
by obtainding a new identity, the sickness and faulty behavior contracted by exposure to an alien culture (Jilek 1982b). The ancestral
names are revived, the traditional "others" are internalized and
conditioned to the endogenous opioid flush of trance which has potent rewarding effect. In this way ancestors become "significant"
and plant cultural values.
Moerman (1979) regarded ritual healing as a version of a therapeutic procedure that he called "symbolic healing." In an outline
for the universal structure of symbolic healing Dow proposed its
stages as follows:
(1) a generalized cultural mythic world is established by universalizing the experiences of healers, initiates, or prophets, or by otherwise generalizing emotional experiences. (2) A healer persuades the patient that it is possible to define the patient's relationship to a particularized part of the mythic world, and makes the definition, (3) The healer attaches the patient's emotions to transactional symbols in
this particularized mythic world. (4) The healer manipulates the transactional
symbols to assist the transaction of emotion. [1986:66]

Dow considers emotions as generalized media that link the psychic

sphere and the somatic system. By means of emotions transactional
symbols may generate a curing effect. He definitely states that the
social environment acts by symbolic transfer not solely on the mind
but on the biological system of patients. The opioid way of social
bonding and its conditioning to cognitive structures may explain his
statements. For example, due to the strong reinforcing effect of
opioid release in the trance of initiation ceremony, the culturally determined "transactional symbols" receive their emotional value, the
"mythic world" is established and the cross-conditioning between
cognitive and endocrine spheres takes place. In this manner cultural
norms are effectively transferred.
In addition to the role of modulation, social relationships can become regulators of trance states in community healing ceremonials
with "boiling energy" among the Kalahari !Kung (Katz 1982a).
The transformation of consciousness is also at the core of their experience of healing. This transformation, which comes only after a
painful transition accompanied by sweating into an altered state of
consciousness, brings on a sense of relatedness between a spiritual
healing power (that is, culturally connoted endogenous recuperative

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mechanisms), the healers and their community. Critical to this transition is the control and regulation of the healing power, a process
whose physiological and behavioral components merge, leading to
a deep psychobiological synchrony. The healers serve as a medium
to channel healing from the community back to the community.
Their spiritual strengths are drawn from the public, and the community in turn benefits from the battles healers carry on with the
malevolent ghosts of ancestors and with their own inner fears. The
net effect is a body of protective "spiritual energy" endlessly recycled from healer to community and back in a process that extends
deep into the past and represents a whirling, reciprocal kind of identification. Healers experience trance more intensely and share it
with the members of the community. The singing, clapping and rubbing of the participants helps to regulate the depth of the trance,
keeping dynamic balance between its risks and benefits (Katz
1982b). For example, the experience of pain in their trance is a homeostatic process controlled by others but we assume that the same
holds true for body temperature as well. Katz writes:
The dance fire is one of the specific elements used in the regulation of n/um.4There
is n/umin the fire, and the !Kung work with the fire to help heat up the dancer's nl
um.The singers will rub coals in their hands before they work on a dancer who has
fallen in !kia.5Dancers will go to the fire, walk in it, put their heads in it, pick up
coals and rub them over their hands and body. But it is not just the fire's heat that
helps dancer's n/um boil. Healers use the same word (da'a) to describe both the
central dance fire and the fire within their own bodies that heats up the n/um.The
fire also helps the dancer toward !kia because it adds its own n/umto the dancer's
n/um.This makes the fire an especially strong stimulant for !kia. [1982b:358]

Relevant to this ethnographical description is the neurobiological

finding that ambient temperature and the body's water content do
have a strong influence on endorphin release during strenuous exercise, with hot and dehydrated conditions producing the greatest
increase, followed by hot and euhydrated conditions (Kelso, Herbert, Gwazdauskas, Goss, and Hess, 1984).
It is striking how sweat is the critical element of their healing. As
sweat first pours out of the healer, it is the visible expression of "boiling energy," a sign of trance. The !Kung believe that human sweat
generated during the medicine dance trances has a powerful therapeutic effect. Trancers rub the sweat from their skin onto the body
of the person being healed and upon others to protect them from
illness.

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In the following section we shall attempt to provide an explanation for this therapeutic tradition.
RITUAL EXPERIENCE AND EXOGENOUS OPIOIDS
It seems that below both the symbolic level of identification and
the psychophysiological level of sensorimotor stimulation there lies
a core biological level of social contacts.
Work currently going on has made it clear that the skin as the
largest organ of the body directly exposed to the environment is not
merely a package. Rather, it is a blotter, a transmittal device, where
a great deal of interaction between the inside and outside of the body
goes on, even on the humoral level. In addition to its digestive function, the same goes for the gut as well. Identical bioactive peptides
secreted by the cells of the so-called "diffuse neuroendocrine system" (Margules 1981) in the brain, gut and skin suggest this trans-

mittal role.
It is thus tempting to speculate that concomitantly with the initiation of trance (when n/umbegins to boil and to induce !kia) sweat
glands secrete extra opioid peptides or substances enhancing the
opioid effect, acting endogenously in trancers, modifying thermoregulation, supporting energy expenditure, stimulating alteration of
consciousness, and being able to penetrate the skin, thus acting exogenously as well. It can be assumed that in other participants of
the healing ritual they prevent hyperthermia and affect immuno-

competence. Opioids released during proximity to companions are

known to decrease hyperthermia (Frohm and Wallnau 1983) but to
date such a paracrine feedback role of the sweat glands in thermoregulation has not yet been established.

However, the idea of exogenously acting opioid peptides is not

uncommon in neuropharmacology.
There is new evidence that
such
substances
as
opioid
casomorphin, morphiceptin and gliadin
from dietary sources escape digestion and are capable of getting
through gastrointestinal bounds, entering the circulation and passing the blood-brain barrier, thus exerting an opioid effect both peripherally and centrally (Brantl, Teschemacher, Blasig, Henschen,
and Lottspeich 1981). These so-called exorphins, or exogenous

opioid peptides, may have functional relevance for the homeostasis

and behavior of infants (Panksepp, Normansell, Siviy, Rossi, and
Zolovick 1984).

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84

ETHOS

The phenomenon of placentophagia indicates that such an effect

is not limited solely to infants but exists in adults, at least at the
subhuman level. Ingestion of the placenta dramatically enhances
analgesia that results from increased opioid level in labor. It is likely
that the placenta contains or stimulates the release of a substance
that enhances the effect of opioids already in the system (Kristal,
Thompson, and Grishkat 1985). The advantage of an opioid facilitator is clear for the parturient and for attachment bonds.
We are of course aware that several points of this paper are clearly
speculative in nature. However, we think it is necessary to try to see
what the latest results of psychobiology can tell us that might get us
to look at human questions in a new way. Ethnological and psychobiological data have to be linked up in order to arrive at a holistic
theory of human behavior.
SUMMARY
In this essay we examined some phenomena of community rituals, especially healing ceremonials, which are considered as neurobiologically mediated, complex forms of attachment. Recent studies
in medical anthropology have pointed out that the ritual therapeutic
experience relies on the patients' own healing processes by means of
various altered states of consciousness that healers are able to control. Ritual trance invariably occurs in social context and the healer's personality and the expectation of community are profoundly
involved in the induction of altered states of consciousness. Trance
state is regarded as a result of the mobilization of endogenous opioid
peptides, as an outcome of the release of an organism's defensive
substances in face of the stress of ceremonial. On the other hand,
there is a growing body of evidence that opioid mechanisms are involved in social behavior as well, especially in symbiotic bonds. It
is suggested that this is the neurobiological reason that attachment
facilitates trance induction. The homeostatic role of social relationships as physiological regulators is also discussed.
NOTES
We want to thank Jolan Haraszti, Mihaly Hoppal, Zoltan Kovecses,
Acknowledgments.
Maria Kristof, and Klara Majoros for their comments and assistance in preparing this manuscript.
'This paper was presented in part at the 2nd World Congress of Neuroscience, August 1621, 1987, Budapest, Hungary.

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RITUALTRANCE

85

2It deservesmentioningthat "uncontrollability"

is a typicalconditionin earlychildhood
and in near-death situations.
3Affiliative social interactions are those behaviors that promote the development of and

thatserveto maintainsocialbondsbetweenindividuals(Steklisand Kling 1985).In thispaperwe discussthesekindsof socialinteractionsunderthe conceptof "attachment."

4healing power
5trance

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