Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.
Philos Trans R Soc Lond B Biol Sci. 2011 Jun 27;366(1572):1849-58. doi: 10.1098/rstb.2010.0385.
Using a comparative analysis of Navajo healing ceremonials, acupuncture and biomedical treatment, this essay examines placebo studies and ritual theory as mutually interpenetrating disciplines. Healing rituals create a receptive person susceptible to the influences of authoritative culturally sanctioned 'powers'. The healer provides the sufferer with imaginative, emotional, sensory, moral and aesthetic input derived from the palpable symbols and procedures of the ritual process-in the process fusing the sufferer's idiosyncratic narrative unto a universal cultural mythos. Healing rituals involve a drama of evocation, enactment, embodiment and evaluation in a charged atmosphere of hope and uncertainty. Experimental research into placebo effects demonstrates that routine biomedical pharmacological and procedural interventions contain significant ritual dimensions. This research also suggests that ritual healing not only represents changes in affect, self-awareness and self-appraisal of behavioural capacities, but involves modulations of symptoms through neurobiological mechanisms. Recent scientific investigations into placebo acupuncture suggest several ways that observations from ritual studies can be verified experimentally. Placebo effects are often described as 'non-specific'; the analysis presented here suggests that placebo effects are the 'specific' effects of healing rituals.
本文通过对纳瓦霍族治疗仪式、针灸和生物医学治疗的比较分析,考察了安慰剂研究和仪式理论作为相互渗透的学科。治疗仪式创造了一个易受权威文化认可的“力量”影响的接受者。治疗师为患者提供来自仪式过程中明显符号和程序的想象、情感、感官、道德和审美输入——在这个过程中,将患者的独特叙述融合到普遍的文化神话中。治疗仪式涉及到在充满希望和不确定的气氛中的唤起、表演、体现和评估的戏剧性。对安慰剂效应的实验研究表明,常规的生物医学药理学和程序干预包含着重要的仪式维度。这项研究还表明,仪式治疗不仅代表了情感、自我意识和对行为能力的自我评估的变化,而且还通过神经生物学机制调节症状。最近对安慰剂针灸的科学研究提出了几种可以通过实验验证的仪式研究观察方法。安慰剂效应通常被描述为“非特异性”;本文的分析表明,安慰剂效应是治疗仪式的“特异性”效应。