How shamanism works, from an outsider

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How shamanism works, from an outsiders point of
view
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Paper-writing hint 2

• Whatever recommendations you make should include
  specifics. A good recommendation would not, for
  example, simply state that a cultural
  interpreter should be placed on permanent staff.
  A good recommendation would state what the new
  staff person would do, and why. So a good
  recommendation would state something like there
  should be a cultural interpreter on staff who can
  offer reassurance to Hmong patients by doing the
  following things a) b) and c)

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Paper-writing hint 2, cont.

• OK, but how do I come up with specifics?
• Identify specific points of DIFFERENCE between
  Hmong and non-Hmong worldviews and values
• Identify specific points of SIMILARITY between
  Hmong and non-Hmong worldviews and values.
• pay special attention to chapters 17 and 18

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The Sleeping Death

• SUNDS Sudden Unexpected Death Syndrome
• Cardiac failure caused by sudden shock
• Associated with preexisting cardiac irregularity,
  obesity, sleep apnea sometimes with severe
  potassium and thiamine deficiencies
• Also associated with clinical depression, severe
  survivor guilt and post-traumatic stress syndrome
• May include belief in encounter with angry spirit
  of ancestors
• If you are interested Shelley Adler, Refugee
  Stress and Folk Belief Hmong Sudden Deaths,
  Social Science and Medicine 1995, 40 (12), June,
  pp. 1623-1629. (Based on interviews with 118
  Hmong men and women in Calif. Since 1977)

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What happened to Dale?

• Dale improved
• Within two weeks after ceremony, symptoms
  significantly improved
• gastro-physical pains receded
• sleep became more regular
• began to put back weight
• Why?

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The Hmong Interpretation

• According to the Hmong, why did the shamanic
  intervention work?

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The psycho-analytic dimension

• Psychoanalyst Thomas Scheffs theory, advanced in
  his Catharsis in Healing, Ritual and Drama (1979)
• Applying theory to Dales case
• Example from Professor Burdicks own experience

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The physiological dimension the placebo effect

• From Latin placere, to please
• any positive physiological effect of an
  intervention (administration of a substance,
  performance of a procedure) that results not
  from the objective qualities of the intervention
  but from the patients belief in the power of the
  intervention.
• Frank (1985) estimates that 40-60 of
  effectiveness of biomedicine due to placebo

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Physiological placebo effects

• Pain reduction (Lewis, Gordon, and Field 1988)
• lowered anxiety associated with increased pain
  tolerance, and with release of endogenous
  endorphins (analgesics)
• Heightened immune response (Akil and Watson 1978)
• lowered anxiety reduces epinephrine production
  from adrenal glands
• lowered epinephrine levels reduce blood pressure
  and heart-rate
• lowered blood pressure enhances immune response
  (ability to fight infection and absorb vitamins
  and minerals)
• Further reading Michael Jospe, The Placebo
  Effect in Healing (Heath, 1978)

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Sociological aspects

• Effects of gathering together supporters (family,
  shaman)
• feelings of isolation and helplessness increase
  stress and anxiety, exacerbate symptoms (McGuire
  1989)
• reduction of isolation and helplessness decrease
  stress and anxiety, alleviate symptoms (McGuire
  1989)
• Effects of perceived alteration in judgment and
  behavior of significant others
• Social stressor (in-laws disapproval) removed
  from barren Ndembu woman
• Social stressor removed from Dale. What was it?

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Self-healing

• Self-healing
• The oncologists skepticism
• Structured delay in Hmong shamanistic healing

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What if the ritual fails to heal?

• The kidnapping spirit may be unexpectedly mean
  and tenacious a shaman with a solid reputation
  will not lose it
• the shaman may not yet be sufficiently
  well-developed to do effective battle
• the initial diagnosis may have been faulty other
  diagnoses will be tried (e.g., a curse spell
  witchcraft wrath of a nature or house spirit,
  the anger of an ancestor)
• imbalance of hot and cold in body
• still shaman with a long record of failure may
  be incompetent