Symbolic, ritual and social dynamics of spiritual healing

Sm. Sci. Med. Vol. 27, No. II, pp. I 197-1206. 1988 Printed in Great Bntain. All rights reserved

SYMBOLIC,

Copyright c

RITUAL AND SOCIAL DYNAMICS OF SPIRITUAL HEALING DEBORAH

School

of Public

0277~9536188 163.00+ 0.00 1988 Pergamon Press plc

Health,

University

C. GLIK

of South

Carolina,

Columbia,

SC 29206,

U.S.A.

Abstract-Participant observation among white, middle class spiritual healing groups in the Baltimore area (1981-1983) revealed distinct sociocultural and interpersonal patterns of action and influence among two types of groups found. Types of groups were (1) Christian, Pentecostal, neo-Pentecostal or ‘charismatic’ healing groups and (2) ‘New Age’, or ‘metaphysical’ healing groups. Qualitative findings highlight similarities and differences between these two types of groups through examination of organizational characteristics, leadership patterns, ideological systems, and ritual processes. Illness and social characteristics of participants are also compared. Analysis of characteristics of groups and participants shows how the incorporation of explanatory models, social roles, myths, and symbols into the social, ideational, and ritual context of spiritual healing is essential to its therapeutic effect, and that spiritual healing exemplifies a symbolic healing system. Finally, a substantive theoretical model for healing research is suggested. Key words-spiritual

healing,

religion

and health,

INTRODUCTION

This paper documents defining characteristics of spiritual healing groups found in a large, mid-Atlantic, American city. Analysis of these characteristics focuses on their symbolic qualities. for here it will be shown that spiritual healing is aptly conceptualized as a symbolic healing system [1,2]. Spiritual healing relies to a large extent on myth and metaphor, verbal and visual images, ritualized roles and action [3-S]. Through a comparative examination of healing groups and their participants in regards to their attributes and the larger social structure, it will be shown how symbolic elements mediate personal and group processes that are integral to the healing of individuals [6]. Spiritual healing has had a long and colorful history within American culture [69], inspiring volumes of commentary from numerous disciplines [lO-141. Recent scrutiny by social scientists has demonstrated its complex, multidimensional nature [15-221, and its similitude with nonmedical healing systems worldwide [23-261. In American culture at present, spiritual healing is an important dimension in numerous New Religious Movements (NRMs) [27-291, is found in evangelical and mainstream church services, and is associated with holistic and humanistic movements in health care [30-321. In Baltimore, where this study took place, the two types of spiritual healing groups most commonly encountered were Christian Pentecostal, charismatic healing groups, and New Age, metaphysical healing groups. Patterns of difference and similarity between these two types of healing group are elaborated through the description of their exogenous, endogenous, and mediating social attributes. Exogenous attributes are socioeconomic status, age, gender, and type of illness of participants. Endogenous attributes are the organizational structure, ideology and symbology, rituals, and interpersonal patterns of leadership and friendship within healing groups. Mediating factors are the social and communications

symbols,

rituals

networks that allow persons to join and to leave groups. For the remainder of the paper the following acronyms will be used: CHGs will refer to Christian, charismatic groups, MHGs will refer to ‘New Age’, metaphysical groups.

FORM AND FUNCTION OF HEALING GROUPS A question which can be posed is: how has spiritual healing survived in this century, given the competition from scientific and ‘rational’ healing systems? One way to address this question is to investigate the impact of healing on individuals involved. For the term ‘spiritual healing’ refers not only to its ideational and social forms, but also to associated psychodynamic or ‘biopsychosocial’ processes and outcomes among participants. Healing is thus differentiated from the notion of cure of disease [20,23, 331. There is accumulating evidence in the literature, mainly from in depth studies conducted in one particular type of group (e.g. Christian Scientists [ 151, Pentecostals [16], Fundamentalists [17], etc.), to suggest that spiritual healing practices, carried out in meaningful social or religious contexts, can aid in the relief of psychosocial distress, existential malaise, or life stress among participants [l&20. 33-351. Some have suggested that group rituals stimulate altered states of consciousness among participants, with beneficial psychological effects [36-381. Others have shown that healing carried out in ritual contexts use the powerful symbols to evoke changes in persons [2-4]. Findings from the study reported here conform to patterns these researchers suggest: the majority of respondents in both MHGs and CHGs reported positive and sometimes transforming experiences associated with healing, however to great extent these ‘healings’ transpired on subjective levels [35]. Conceptualizing psychosocial or subjective outcomes of healing however only partially addresses the issue of the emergence of distinct social forms for 1197

DEBORAH C. GLIK

1198

healing. A basic issue of interest. if a social explanation of healing is to be generated. is to show how different forms of spiritual healing encountered may be adapted to the psychological, social, and symbolic needs of the populations who currently seek it out. It may be that spiritual healing has an effect because, like religion, it is “tailormade, projectively, to fit current individual anxieties” [39] of persons involved in it. Analysis of healing systems defined will show how group processes and associated symbols could contribute to their ‘psychohygienic’ [38] effects.

RESEARCH METHODS

Research design Descriptive findings to be reported are based on participant observation by the investigator over a 2 yr period (1981-1983) among members of thirty healing groups in the Baltimore metropolitan area. Studying healing groups and their members appropriately focuses on the social context in which beliefs and behaviors of interest are generated, maintained, and passed on. For here, as in sacred rituals worldwide, initiation into group beliefs and norms for behavior, both for healer and for adherent, are based on tacit transmission of knowledge or ‘grace’ which requires some personal interaction [40]. Concurrent to fieldwork, a survey questionnaire was administered to members of healing groups observed, thus facilitating collection of both qualitative and quantitative data. For arguments presented here, qualitative data are most relevant. Quantitative sociodemographic and illness data will be summarized as they have been reported elsewhere 1351. Sample selection Spiritual healing groups were the primary sampling unit for this study. As the whereabouts of most groups was unpublicized, and directories of healing activities were incomplete, a purposive sampling design was employed. Qualitative methods of indirect key informant and archival data gathering techniques, and direct participation in healing activities allowed entree into numerous groups where access depended on word-of-mouth referrals. Once located, the major criterion for including a group into the study was that members met regularly (weekly or monthly) for the purpose of healing. When 30 groups, I7 CHGs and 13 MHGs, were located they were mapped geographically. Healing rituals were sampled as well: as, on the average, 8-10 such healing rituals were ‘experienced’ for each group, the investigator participated in approx. 250-300 healing rituals over a 2-yr period. Although the sample was purposive, groups selected represent a cross-section of most areas of Baltimore, and for the purpose of social comparisons, the sample is sufficient. Due to logistic constraints and difficulties in gaining entree, black groups were not included. Hence white working and middle class healing groups were over-represented [4l]. The secondary sampling unit for this study was group members. Twenty-three leaders agreed to let members be formally interviewed: MHGs (n = I2

groups) were more cooperative than CHGs (n = I I groups). Interviewees were all volunteers. For MHGs the final sample size was n = 93. for CHGs the final sample size was n = 83 [42]. FINDINGS 4ND ANALYSIS

Social structural and illness comparisons As has been found in other studies of healing in American settings. participants were predominantly middle-aged and female [ 15-17. 201. with members of CHGs being slightly older than MHG members, and a majority of MHG members being single. divorced or widowed. MHG respondents were better educated. and a greater proportion held professional or white collar jobs than CHG respondents. CHG respondents were more likely to be housewives, unemployed, or retired and when employed, held service or blue collar jobs. No differences on income levels were found between groups [35]. Mapping the locations where MHG and CHG meetings were held illustrated social class and sociocultural differences found between CHG and MHG respondents. Group members lived in neighborhoods similar to but not necessarily the same as neighborhoods in which the group met. MHGs were found in newer, white, middle, and upper middle class neighborhoods. CHGs were found in older. white working and middle class neighborhoods. There was little geographic overlap in areas where groups were found. Sociocultural differences between MHGs and CHGs concerned family roles and interactions. CHG members adhered to traditional family patterns of nonworking spouse, and lived near and interacted frequently with relatives and kin. The majority of female MHG respondents worked, and lived further from and interacted less frequently with relatives [35]. Most of illnesses suffered by MHG and CHG respondents were chronic and mild to moderate in severity. Less than 10% of the repondents reported illnesses which were serious or life-threatening, e.g. multiple sclerosis, cancer, heart disease. A number of illnesses reported were ‘nonspecific’, or had to do with psychosomatic, stress, or mental health problems. No significant differences were reported between CHG and MHG members in regards to the severity of illnesses, or in mental health status, which was ‘average’ ]351. Analysis of the social attributes of healing group members within the larger social context of the Baltimore area, suggests a number of convergent themes in regards to group members’ health and social needs: both types of groups had a preponderance of members who were in structurally weak positions. CHG members were older, less educated, often unemployed, and predominantly female; MHG members were single, divorced, or widowed more than married, and also predominantly female. These statuses are typically socially or economically devalued in American culture. Specifically, there was a dearth of persons in these groups who had attained recognized success in secular or community affairs, except those who had done so vicariously through spouses. Also, numerous persons were going through life transitions at school, work, or in family life. A

Spiritual

subset of group members had serious illnesses which kept them from being fully integrated into mainstream lifestyles. Also, among some of the younger members, their ‘spiritual orientation’ made difficult their finding a meaningful role in secular society. also a stress-producing predicament. Hence healing group participants were peculiarly vulnerable to social and economic changes in the larger society, at the same time lacking sufficient social or economic power to change their personal situation. In addition to respondents’ relationships to the social structure, an added ‘sociogenic’ risk factor was the social environment itself. In the case of Baltimore this constituted an aging, industrial city with changing labor market conditions, changing cultural patterns (in- and out-migration), and environmental pollution. At the time of the study Balitmore was experiencing a severe recession. Thus much of the illness and stress that healing group members report may have psychogenic or sociogenic origins [ 19,43,44]. These observations suggest that both needs deprivation and self-actualization issues mediate the fit between persons involved in healing and social, group or symbolic processes of healing. Network comparisons

A system of informal networks tied individuals to groups as well as groups to each other. Individuals found their way into groups most commonly through word-of-mouth referrals. Persons often moved from group to group or communicated information about the existence of one group to participants in another group. However, these networks of referral observed rarely extended beyond the observed boundaries of type of group, charismatic on the one hand, metaphysical on the other. In fact, while group leaders or healers might know about the existence of other types of healing than that which they practised. they generally voiced suspicion, distrust. or derision towards practices or beliefs that they questioned ideologically. While the ethos of the groups seemed to be quite ‘localized’ [44] if not competitive, paradoxically many groups and leaders maintained regional or even national affiliations with like-minded organizations. This reinforced individuals sense of ‘we-tress’ and identification with larger spiritual movements. Among the CHGs there were national churchaffiliated activities as well as newsletters and magazines with material about healing. Christian bookstores stocked numerous titles on spiritual healing and news about visiting healers. MHGs had their national and regional affiliations as well as visiting dignitaries on the lecture circuit whose whereabouts were publicly advertised in the larger groups and in New Age bookstores and health food stores. Among the MHG members attendance at lectures, workshops, and conventions were popular; CHG members preferred retreats. Within groups, linkage with larger spiritual movements was seen to indicate, symbolically, the important role of spiritual groups to ‘usher in the New Age’ (MHGs) or to ‘witness Jesus’ return’ (CHGs). Organizational comparisons

The bulk of spiritual healing activities observed represented a collective, group process carried out

healing

1199

within religious or ideational contexts. Groups were typically organized and led by a healer. Most of the groups observed were small (n = 6-15). some larger groups were found clustered around healing ‘celebrities’-those persons who were well-known in local and sometimes national healing communications networks for their healing abilities. Healing groups had some of the characteristics of families and were informal rather than formally organized. The family-like atmosphere of such groups has been noted in this [44-47] and other cultures [48]. ‘Socialization’ of new members into the healing group included a symbolical recognition and affirmation of their new identity within the ‘spiritual family’ of the group, where the symbolical status or brother or sister was often conferred, and healers were seen as parental figures. As in any family structure, there was ‘sibling rivalry’ for the attention of the leader as well as disaffection and rebellion when conflicts arose. Observed over time, the temporariness of such groups was apparent as attendance and enthusiasm for any given group waxed and waned. Healing groups depended for their existence primarily on a charismatic leader and a community of believers, at best a fragile entity. Healers often had difficulty in forging lasting institutional ties and only those healers with very strong personalities were able to institutionalize groups successfully. Located within institutional settings such as churches, such groups tended to last longer. CHGs were more likely to be church based, whereas MHGs were found in marginal religious groups, growth centers, and New Age study groups [49]. Both CHG or MHG group membership conferred the direct benefits of social support-friendship, mutual aid, love, self-esteem-to members. However the actual organization of CHGs was in direct contrast with MHGs. In CHGs the structure of the organization was authoritarian and stratified, with the leader in control of events. Changes in status or role within the group membership were mediated by the leader: to some degree participants were passive, receptive, obedient to authority. Persons within the group who had ‘gifts of the holy spirit’ such as ‘the gift of prophecy’ had to be legitimated by the leader before they could testify or speak up. This model contrasts with the more democratic, spontaneous, nonscripted rituals of the MHGs, where ‘activated’ participants voluntarily helped in the healing of others, and each person’s contribution to the group was valued. Still, in some MHGs this more democratic style was occasionally sabotaged by the personality of healers who often exhibited controlling tendencies. Comparing group structures and dynamics to the larger society, the organization of the ‘spiritual family’ of CHGs mirrors or is symbolic of working and lower middle class socialization patterns in which obedience to authority is the norm (501. The freewheeling ‘family life’ of MHGs with shared and interchangeable roles, and the ethos of autonomy among different members mirrors socialization processes within middle and upper middle class families [SO]. It can be hypothesized that, in regards to their organization, healing groups reflect the cultural back-

1200

DEBORAH

grounds of their members, hence creating a ‘therapeutic climate’ which is familiar. The general process of identification with the group seen as a surrogate family, within which members were resocialized into new roles with kin (brothers, sisters, parents), was symbolic of healing participants’ attempts to redefine their social and interpersonal relationships generally. This process could be seen to create both empathy [44] and tension within groups observed, necessitating a continual, immediate, perceived need for healing praxis. Leadership comparisons

Healers were individuals who, at some point in their lives, had realized their special ‘gift’, ‘mission’ or ‘calling’ to do healing. Without a leader or healer, the healing group cannot maintain itself. In four groups observed, two MHGs and two CHGs, when leaders moved or were removed, due to personal or church changes, groups quickly disbanded. Healers gave impetus to the activities that attracted and held the membership; persons without sufficient personal charisma who tried to start healing groups generally did not succeed. Within CHG groups most healers were clergy, with lay leaders sometimes in assistance; among MHGs most healers were nonprofessionals, however 3 out of 13 observed had degrees in social work, nursing or medicine. The healer was responsible for orchestrating healing rituals, as well as counseling individuals, or guiding their spiritual development. While a one-toone interaction might occur between a healer and a ‘client’, most healers encouraged group participation among them. In some groups, particularly MHGs, responsibility for the healing role was shared. While the leadership of the group was generally undisputed, there could be any number of ‘regulars’ in varying stages of ‘development’ of becoming a healer. Similar patterns of development have been observed among Spiritualist groups in Mexico [ 18, 19,511, and among Spiritualist Puerto Rican groups in American urban areas [52,53]. Many of those who were in the process of becoming healers had experienced a dramatic healing or improvement in some condition or illness prior to trying to heal others. Healers also reported having suffered from illness or despair and having been healed, often at the hands of a healer-mentor. Sickness of the healer prior to initiation is similar to the process of shamanistic initiation in other cultures [40]. Shared roles and responsibilities had a number of therapeutic effects on participants: they encouraged altruistic behaviors as well as forced seekers to adopt nonsick roles [19]. In ten out of thirteen MHGs, group leaders were women, and considering the family-like nature of healing groups, MHGs can be seen to have ‘matriarchal’ leadership patterns. All except one of the Church-based CHGs were led by men and hence followed a ‘patriarchal’ leadership pattern. Such differences between groups may reflect the historical fact of male leadership in the Church. Matriarchal and patriarchal leadership patterns in groups, while reflective of their traditional (CHGs) and nontraditional (MHGs) orientations, may also have a deeper significance in regards to healing.

C. GLIK Recalling that the healer typically had, prior to their current status, ‘fallen’ (CHGs) or ‘lost the path’ (MHGs) and then been healed, and that act of deviance and social reintegration may have been linked to wounds suffered from sociogenic or psychogenic causes, then the symbol of the healer as similar to the seeker of healing may be important. Following this line of reasoning further, if the wounds suffered by the CHG member are linked to SES and lack of mobility in a stratified social system, then the minister or priest, who has himself suffered by having chosen a spiritual, nonsecular profession. becomes a symbol of hope or inspiration-removed but not completely from the seeker. In MHGs where gender, illness, life situation, or even personality, rather than SES has been the factor that has blocked aspirations or careers or more meaningful social roles, then the symbol of a female healer, with the self-control and the ability to heal herself and others, despite lack of professional credentials, represents an even more radical symbol of ‘healing’ or liberation from the typical pattern of seeking professionally dominated health care. Contrast these symbols to those furnished by conventional medical care-the white, worldly, relatively wealthy, physician, who is often male-a symbol of those who have not lost out in the current social system. If the spiritual healer is a symbol of possible solution for sociogenic or psychogenic stress, then the medical doctor or the psychiatrist are often symbols of the very things that healing group members are not. For stress-related or existential problems of seekers, health professionals may exacerbate these ‘psychic’ wounds. The notion of wounded healer made whole is a powerful one for spiritual healing P41. Ideological comparisons

Shared belief systems held most deeply by the leadership were communicated to followers through sermons, lectures, songs, books, and religious literature. An oral tradition exists in both CHGs and MHGs, however the literature of the healing movements, from which these groups have their ideological roots, needs to be considered to delineate some of the major ideas of either healing system. Christian CHGs have ideologies grounded in the Fundamentalist, Pentecostal, or neo-Pentecostal religious movements. Except for the Catholic CHGs, such groups hold the King James version of the Bible to be the inspired word of God, and interpret it literally. This type of Christianity, was often viewed by participants as an attempt to regain or rediscover Christianity as it was practised at the time of Christ. Thus, members of such CHGs interpreted their life experience in terms of the scriptures, and spoke of living their faith in ‘spirit-filled’ homes and churches. Their ideologies, morals, values were conservative and traditional, their lives made meaningful through numerous, ongoing personal religious experiences. MHGs’ ideologies were much more syncretic than CHGs, having their origins in numerous religious movements. More recent American influences are Spiritualist, ‘New Age’, New Thought, theosophical, occult, or even shamanistic traditions. The nontraditional views held by MHG’s members were said

Spiritual healing to represent the ‘esoteric’ or ‘mystic’ traditions, and in their literature were found writings derived from Buddhist, Kabbalistic, Sufi, Hermeunetic, Gnostic and Yogi doctrines, said to be the basis for all world religious teachings. Such teachings emphasize the primacy of mind over matter, the need for attunement with all life, and the existence of an allpervasive spiritual essence. Here as in CHGs openness to religious and mystical experience gave meaning and validation to ideologies espoused. Certain beliefs about healing cut across ideological differences between the two groups. Most persons involved in healing agreed that the healer did not heal; rather it was God, the forces of nature, or man’s potential for innate healing that was catalyzed by the healer. Second, it was widely believed by many persons within healing groups that healing was not usually instantaneous, but gradual. Third, respondents in both types of groups espoused a belief in the reality of the soul, and that this human attribute survived after death. Ideological differences between groups were evident in definitions of God. In CHGs, God was conceptualized as transcendant; thus salvation through grace and prayer brought relief from suffering and promise of an afterlife. In contrast, MHG members often acknowledge the concept of God transcendent, but stressed that it was God immanent, the God within, that the individual strove to actualize. Hence MHG members spoke of becoming ‘co-creators’ with God, filled with knowledge and understanding. The ‘purification’ or development of self this entails is in contrast to that of CHGs for whom communion with God was conceptualized as complete surrender of one’s will or consciousness to God, or Jesus. Thus among the CHGs God was seen to descend or rescue and give grace; in the MHGs it was the individual’s task to raise consciousness to a level of godliness, a conceptualization typical of Eastern religions [55]. Variation between the two types of groups was observed in members’ beliefs about the causation of illness or disease. Charismatics attributed illness to sin, to lack of faith in God, or to failure to live by the word of God. Metaphysical types tended to attribute illness or disease to lack of harmony with spiritual and natural forces, to ‘wrong’ thinking, to wrong feeling, and to wrong living, and in some cases to ‘karmic debts’ carried over from a previous incarnation. In both groups illness was associated with error (MHGs) or sin (CHGs), but it was also recognized that exposure to forces of evil outside of the self could cause illness-thus references were made to both internal and external causal agents [56]. In neither type of group did belief in spiritual or metaphysical causes of disease negate scientific explanations of disease causation: e.g. a virus could certainly cause cancer, hardening of the arteries was a risk factor for heart disease. However these scientific explanations were framed within a larger schema of cause and effect in which the individuals relationship with God, be that God immanent or God transcendant, was also incorporated into disease-illness paradigms. Thus neither CHG nor MHG members showed hesitation to seek medical care, especially in cases of

1201

clearcut organic disease. Greater variations in attitudes towards secular psychological and psychiatric services were encountered, ranging from very positive to very negative. Partial evidence for this was found in the diagnostic categories used by the respondents to describe their ills. While medical diagnostic categories were used routinely for physical problems, use of psychological categories for emotional problems was less likely. Ignorance of diagnostic categories for psychological problems within lay populations may be a contributing factor. On the other hand, divergence from professional health care in ‘explanatory models’ [23] for emotional problems was also in evidence. For example, within MHGs generalized distress or anxiety was sometimes attributed to the blockage of energy flow, requiring physical or spiritual cleansing in order for healing to occur. This was based on the belief that all living organisms have an electromagnetic dimension which can become depleted or unbalanced, similar to theories in many Oriental healing systems. Alternatively, MHG respondents might believe such a condition was caused by erroneous thinking or a negative attitude, in which case the healing exercise was directed towards the mental transformation of internal states. As an aspect of God is perceived to be within the self, change in affect towards and perception of the self could often open the door to healing. Emotional distress or suffering experienced by members of CHGs might be explained as due to a ‘loss of faith in God’s love’ for the individual, or as a result of allowing oneself to be ‘deceived by the Devil’. In such cases the proper antidote was increased commitment, prayer, surrender to God’s will, giving one’s ‘burdens’ (conscience) to God, and forgiveness of self and others. To quote an appropriate Biblical verse: And the prayer of faith shall save the sick, and the Lord shall raise him up . . . (James 5: IS) In both MHGs and CHGs, complex, opposing symbol systems were linked to ideologies and ritual processes. For example there might be references to symbols of lightness and darkness, higher and lower worlds, concepts of purity and impurity, goodness and evil, unity and separation, wellness and illness, specialness and sameness, and angelic or Satanic forces. Through visualization, conflicts or unresolved tensions suggested by such symbols were often resolved. For example, in CHGs fixation on the image of Jesus surrounded by light ‘protected’ the individual from Satan. In MHGs images of light emanating from and surrounding the self protected from ‘dark forces’ and to some degree transformed self and others. Thus typically in healing rituals, suggestions were made favoring mental concentration on positive symbols, while negative symbols were either pushed away (CHGs) or transformed (MHGs), so that healing could take place. The use of symbols of light (MHGs) or spirit (CHGs) was central in both groups, and became shorthand references for powerful, emotional states experienced within (or outside of) healing rituals. Within cultural systems of healing the meaning of symbols in regards to shared consciousness can be

1202

DEBORAH C. GLIK

seen as external referents to internal events [56]. How symbols are used may refer to processes of psychological, social, or spiritual reintegration [57], that ‘heal’ negative states of anomie, anxiety, or despair linked to life experiences, or to ‘empower’ participants [20]. Symbols used in healing rituals derive from healing myths. Myths are defined here as embodying in parable form collective memories which reflect universal [58] or archetypal [59] life processes. The Christian healing myth, relates the death of Jesus Christ and his subsequent resurrection, and is characteristic of CHGs. This version of the death and rebirth myth is found in many world religions and symbolizes the process of healing seen as rebirth or renewal into spiritual framework. A variant of this myth, characteristic of MHGs, is derived from Eastern traditions and delineates the Soul’s journey towards enlightenment. Ideological characteristics of healing groups offered a response to the sociogenic or psychogenic nature of members’ angst, through use of powerful analogies and metaphors, images and symbols. Not only were symbol systems used to help ‘transform’ internal states [3] in both groups spiritual metaphors for problems of social injustice, personal uncertainty, social change, or lack of community were evident. In regards to perceived lack of community, due to changing neighborhood composition, changing lifestyles, or transitional statuses of members, images and metaphors which represented the notion of building a new community of believers were strong in both groups. In CHGs that metaphor was represented in the notion that the true church is made up of the ‘body of believers’ who were also symbolic of the body of Christ. In MHGs the metaphor was more global with the notion of ‘networks of light’, a worldwide community of believers linked together on metaphysical levels whose collective vibration could help to bring in the ‘New Age’ where peace and brotherhood would reign. In regards to social change, belief in forthcoming apocalyptic changes associated with the end of the millenium, evident in both CHGs and MHGs (221 could be interpreted as a metaphor, or a projection, of sensed social and personal change. It was stressed by some that the very existence of groups and networks of like-minded souls was evidence of coming world catastrophe. Membership in a group of believers was hence a mark of specialness or being chosen, with the promise of personal salvation from (CHGs) or participation in (MHGs) coming world or national crises. Particularly valued were explanations that put a positive interpretation on personal and social change sensed by group members [60]. In regards to social injustice or personal uncertainty many metaphors were used-notions such as one has ‘fallen from grace’ or had an ‘imperfect relationship with God’ but would be ‘lifted up by God’ (CHGs); or that one had erred but could learn to turn weakness into strength (MHGs), could be interpreted as symbolizing both an actual and a desired relationship with the social world: i.e. the CHG member gaining prestige or status or respect of self or community, the MHG members actualizing self within their status group. In both CHGs or

MHGs situations of social injustice or social pathology were also metaphorically alluded to: in images of evil forces, or the Devil-forces or states that, similar to illness, were encountered as ‘tests of faith’ (CHGs) or tests of ‘belief in self’ (MHGs). For the most part these metaphors or collective projections do not challenge the current social order, but suggest a way for individuals to redefine themselves within the current social order in more positive terms. To some extent reassuring ideologies of CHGs suggest a solution based on acceptance and conformity-at least externally-to the current social order, with the promise of future relief through surrender of will to God. MHGs, on the other hand, stressed self-transformtion and empowerment [20] through the acquisition and use of esoteric knowledge. Thus CHGs stressed external controls, MHGs stressed internal controls. Both groups saw life solutions to be at the level of the individual. Symbols and myths in healing groups gave meaning to illness or personal difficulties, seen to be tests of faith, lessons to be learned, or purification processes on the way to Salvation (CHGs) or Enlightenment (MHGs). Within the context of healing groups then, the process of healing has much broader meaning than the healing of illness or disease, and the state of being ill shifts from a purely negative event to one that is only relatively negative and may in fact have a positive value for the individual. In regards to healing, rituals, symbols, and myths serve to shift focus from self to the collectivity, from the particular to the whole, from one series of life events to the whole life, from the unique to the archetypal. The degree to which a participant shares these myths and internalizes healing symbols may determine their therapeutic impact [3,8]. Symbolic metaphors of falling, surrender to God, and rising (CHGs) or of self-transformation through communion with the inner self (MHGs) also anticipate the pschodynamic impact of the rituals themselves, which may have psychobiological correlates [61-641. Ritual comparisons

A final characteristic of healing groups to be described are group processes of healing rituals. Generally CHGs were larger, and rituals more formalized than MHGs. The style of charismatic ritual lent itself well to larger groups, having its origin in the old style religious revivals prevalent in the early part of this century. Origins of the metaphysical style of healing are harder to trace given its syncretic nature. An ordered or structured sequence of activities determined most healing rituals in both types of group. These activities can be seen as a means by which individual participants in groups experienced increasing ‘engagement’-cognitive, affective, and behavioral-in the group process. However there were many differences in ritual healing behaviors between the two types of group. Generally CHG rituals were noisy, dramatic, and expressive. Rituals for cognitive engagement included Bible reading, group pryaer, hymn singing, and sermons lead by the healer or group leader. These were then followed by activities indicative of affective engagement such as personal prayers repeated out loud, affirmations of faith, testimonials, the begin-

Spiritual healing

ning stages of glossalalia (‘speaking in tongues’) and occasional prophetic utterances (‘words of knowledge’). Finally the healing practices themselves, which are mode of behavioral engagement, took center stage. These might have included communion services, gatherings at the altar rail for the laying-onof-hands, annointments with oil by the healer(s) or utterance of intercessory prayers for nonparticipants. Behavioral responses to such stimuli varied, from the muttering of prayers by some to the complete loss of consciousness among others. That is, a good number of participants in charismatic rituals fainted and fell down when touched by the healer. The latter response was known by charismatics as being ‘slain in the Spirit’. This temporary loss of consciousness might be caused by high levels of arousal among the participants during the behavioral engagement stage. While today, old style ‘holy roller’ or convulsive types of reactions among participants may be discouraged, given the high arousal levels of participants, fainting may be an acceptable behavioral ‘releasing mechanism’ among those who lose motor control in such states. Generally these extreme responses occurred in groups where glossalia and prophecy were commonplace. An underlying belief of participants in this style of healing ritual was that, symbolically speaking, such activities enhanced the possibility that God or the Holy Spirit would descend and touch or lift up participants through Grace. In the MHGs a different behavior was encountered in healing rituals. Participants gathered at an appointed time, in a place which was ordinarily not a church. Certain verbal stimuli such as prayers, inspirational lectures, or readings, were used at first to create cognitive engagement. In the mode of affective or behavioral engagement which followed members of MHG’s attempt to ‘tune in’ to a transcendent reality, usually through meditation practice. Through a process of physical hypoarousal combined with continued mental alertness, attention to outward stimuli was stilled, and awareness of other states or levels of consciousness was reported to be achieved. Generally, but not always, behavioral engagement involved, besides the attainment of a meditative state, various forms of healing by touch or laying-on-of hands. Other commonly used techniques in these groups were guided imagery or visualization, chanting, or ‘therapeutic touch’ [65]. The group, as part of its healing meditation might practise remote healing: the names of persons not in attendance who needed or who had requested healing were recorded or called aloud and then the group directed healing ‘energy’ towards such individuals. This practice was also to be found in CHGs but in MHGs the atmosphere was quiet, and the stimuli were internal rather than external, whereas in CHGs external stimuli were the norm. In MHGs emphasis was placed on harmony within the group as a whole, as it was believed that disharmonious or negative thoughts were disruptive. Access to such groups was thus generally limited to persons without sociopathic, borderline, or psychotic disorders. In contrast CHG members did occasionally bring persons with serious mental problems. Rituals described were not static forms; but were emergent processes in which change and innovation s S.M271, I--F

1203

occurred. While there were certain basic implicit rules for healing rituals in all groups, such rituals were seen to evolve over time depending both on the population served and the personality of the healer. Moreover, even in the more nonritualistic of the healing groups, i.e. some of the MHGs, such qualities as drama, mystery, and personal charisma of the healer were highly effective in maintaining group engagement and sense of purpose. Rituals observed can be described using the conceptual framework suggested by Victor Turner [4]. In his analysis of rituals, he saw them to be effective inasmuch as participants who are in a ‘hminal’ or marginal social status are able, through ritual, to experience a ‘communitas’ or collective state. ‘Communitas’ means to share a glimpse of one’s connection or oneness with others or with God, which ultimately, at least in indigenous societies, realigns the individual with a more positive, less liminal social status. A positive personality (the healer) can facilitate the ritual process and the symbols it evokes by drawing on group or collective consciousness. Thus collective processes may create a climate in which healing can take place. Altered states of consciousness have also been linked to ritual participation and healing ‘effects’ [25,61,62,66]. In this study, ritual processes observed did have an impact on behaviors that can be attributed to altered states of consciousness (ASCs) although here too there was variation between CHGs and MHGs. In CHGs, changes in motor behaviors such as glossolalia, shouting, fainting, and reports of tingling, warmth, buzzing in ears, or ‘electric shocks’ to the body suggest ASCs. In MHGs behaviors and reports indicative of ASCs were based on reports of feelings of complete harmony with bodily processes, hearing no outward sounds, having inner voices and visions, feeling a sense of calm, peace, love. Fischer relates such divergent behavioral or affective effects of ASCs to central nervous system activity and delineates two complementary modes of cortical arousal, both of which are correlated with deviations from normal states of consciousness [63,64]. One mode is the ‘perception-hallucination continuum’, in which increasing levels of ergotrophic discharge or hyperarousal induce states of intense creativity, hyperphrenia, or ecstatic trance. This type of arousal characterizes Western, Christian healing systems where prayer, singing, gross motor activity and glossolalia are the norm, thus corresponding to CHGs [63]. The other mode is the ‘perception-meditation continuum’, which refers to states of relaxation and trophotropic hypoarousal, induced through such techniques as relaxation or Eastern meditation practices-this mode corresponds to MHGs [64]. Of interest here is that observed effects of rituals fit desired states espoused by ideologies described thereby showing the linkage between symbolical ideation and psychobiological changes experienced subjectively by participants. In CHGs these ideational symbols are notions of ‘surrender’ and ‘being lifted up’. In MHGs these are notions of ‘control’, ‘inner space’, and ‘centeredness’. In sum, ecstatic (CHGs) or meditative (MHGs) ASCs, experienced within the protective confines of the group and interpreted

DEEIORAHC. GLIK

1204

within ideological frameworks described contribute powerfully to feelings of well-being, connectedness, and being ‘healed’ among healing group participants -a powerful antidote to feelings of ‘demoralization’, anomie, or stress [S]. CONCLUSIONS

This exegetical description of characteristics of spiritual healing groups in a mid-Atlantic city gives primacy to symbols and their hypothesized relationships with the social, psychological, and psychobiological processes observed among participants. Findings as regards the configurations of beliefs, symbols, myths, and rituals that differentiate charismatic from metaphysical healing show them to be distinct and integrated systems [23]. Points of divergence between charismatic and metaphysical healing can be traced to differences in backgrounds of participants which suggest that personal needs and their solutions vary along social class lines. ‘Stratification’ between spiritual healing groups is reflected in the organizational structure of healing groups, gender and affiliative differences in leadership, the nature of beliefs and symbols, and the form and effect of the ritual process itself. Ironically, such differentiation in healing group form and function may be a symptom of the very modernization processes that strain persons’ capacity to adapt and cause them to search for healing [68]. However such differentiation also suggests that these healing forms are culturally adapted enough to be responsive to the needs of their clientele thus making them ‘competitive’ with other healing systems. There were also numerous points of convergence between charismatic and metaphysical healing groups. In both types of group, important processes noted were those of identification of the individual with the group and the healer, role playing, assimilation of belief or mythic systems, and engagement in ritual. In both systems spiritual healing parallels medical or professionally based healing in its focus on individual therapeutic change rather than political change. This analysis of qualitative data is seen as pre-

liminary to building a substantive theoretical model that addresses how social and group processes within healing systems influence healing at the level of the individual [17.20. 23, 361. This is a slightly different approach than comparative studies of the systems themselves [6]. For models of healing that consider psychosocial outcomes as endpoints must include sociocultural factors and social processes as determinants. A general model that includes social and group processes as predictive of healing at the individual level is proposed. This probabilistic model, conceptualized at the level of the individual, does not specify symbols explicitly-an assumption being that mediating and endogenous variables have a large symbolic component that would become explicit in their operational definitions. Thus this model is an heuristic device to stimulate thinking on the subject and to move research in this area from descriptive to empirical modalities (see Fig. 1). By defining spiritual healing as a form of symbolic healing [2, 3,6, 571, it is posited that symbolic characteristics play a large role in healing processes. Within healing systems studied, symbols are ubiquitous-in the mythic structures of religious ideologies espoused, in the persona of the healer, in the family-like nature of the group, in the metaphors which are related to the social and psychological attributes of the persons involved in healing. These are persons whose status with the larger social structure is transitional, vicarious, or tenuous-hence ‘liminal’ [4]. Symbolic systems of healing are most effective if culturally relevant for adherents [3]. Within the divergent types of healing groups studied, symbols are culturally specific, and their evocation and manipulation by the healer within the ritual context of healing is highly effective in suggesting psychological, social, and even psychobiological states or changes in states within participants. Thus symbols using in healing may allow the individual access to unconscious material [2,3, 571 which, if properly framed within a shared system of meaning or ‘mythic structure’ of healing [3], can symbolically connect soma to psyche [I] self to collectively [2,4], or psyche to the ‘world of spirit’ [6] enabling healing to occur. In this

I

I Exogenous

Factors

AGE

Mediathg

Factors

MEMBERSHIP IN NETWORK

SES

Endogenous

TYPE

Factors

Outcome

Factors

OF GROUP

SHARED

IDEOLOGY

RITUAL

ENGAGEMENT

PSYCHOSOCtAL MARITAL STATUS

ILLNESS/

GENDER

ROLE

RACE

PLAYING

IDENTIFICATION WITH

Fig. 1. Theoretical

CHANGE

DISTRESS

model:

social process

GROUP

determinants

of symbolic

healing

1205

Spiritual healing manipulation of symbol systems by the healer (31 is aided and intensified by the use of rituals and the induction of ASCs. Many of the ills that beset persons in postindustrial societies are sociogenic or psychogenic in nature. Such distress cannot always be resolved at the level of friends, family, or professional care. Neither the types of problems found among healing group members, nor the means by which healing takes place, nor the criteria for problem resolution, fit medical paradigms of practice or healing well. Attempts to ‘medicalize’ healing practices by employing them in clinical contexts [65,69] may rob these practices of their effectiveness. Current interest in spiritual healing for adherents may lie in its rich symbolism, dynamic ritual forms, supportive social context, and the possibility of experiencing ‘healing’. view,

Acknowledgemenrs-A version of this paper was presented at the Association for Sociologists of Religion Annual Meeting, August, 1986, New York, where Dr Meredith McGuire provided thoughtful commentary. For help with carrying out this research acknowledgements are made to Dr Margaret Bright. Dr Jerome Frank, and Dr Roland Fischer, of the Johns Hopkins University, Baltimore, Md, Joan Kellogg, Mandala Assessment and Research Institute, and Dr Robert Ness, Medical College of Georgia, gave valuable editorial insights.

REFERENCES 1. Moennan D. E. Anthropology of symbolic healing. Curr. Anthrop. 20, pp. 5966, 1979. 2. Sandner D. Navaho Symbols of Healing. Harcourt, Brace, Johanovich, New York, 1979. 3. Dow J. Universal aspects of symbolic healing: a theoretical synthesis. Am. Anfhrop. 88, 5669, 1986. 4. Turner V. The Rirual Process. Cornell University Press, Ithaca, New York, 1977. 5. Frank J. Persuasion and Healing 2nd edn. The Johns Hopkins University Press, Baltimore. Maryland, 1973. 6. Peacock J. Symbolic and psychological anthropology: the case of pentecostal faith healing. Ethos 12, 37-53, 1984.

I. Nelson G. K. Spiritualism and Society. Schocken Books, New York, N.Y., 1969. 8. Judah J. S. The History and Philosophy of the Metaphysical Movements in America. The Westminster Press, Philadelphia, Penn., 1967. 9. Nichol T. T. Pentecostalism. Harper & Row, New York, 1966. IO. Podmore F. From Mesmer IO Christian Science: A Short Historv of Mental Healing. University Books, New York,.1963. II. Weatherhead L. D. Psychology. Religion, and Healing. Abingdon-Cokesbury, London, England, 1953. 12. Harrell D. E. All Things Are Possible: The Healing and Charismatic Revival in Modern America. University of Indiana Press, Bloomington, Indiana, 1975. 13. Inglis B. The Case for Unorthodox Medicine. Putnam’s, New York, 1965. 14. Ikin A. G. New Concepts of Healing. Association Press, New York, 1956. 15. Wardwell W. Christian Science and spiritual healing. In Religious Systems and Psychotherapy (Edited by Cox R. H.), pp. 72-88. Charles C. Thomas, Springield, Illinois, 1973. 16. Pattison E. M., Nikolajs A. L. and Doerr H. A. Faith healing-A study of personality and function. J. nero. menr. Dis. 157, 394409, 1973. 17. Ness R. C. The impact of indigenous healing activity-

an empirical study of two Fundamentalist churches. Sot. Sci. Med. 14B, 167-409, 1980. 18. Finkler K. Non-medical treatments and their outcomes. Cult. Med. Psvchiat.

4, 271-310,

1980.

19. Finkler K. Non-medical treatments and their outcomes: focus on adherents of Spiritualism. Cult. Med. Psychiat. 5, 65-103,

1981.

20. McGuire M. Words of power: personal empowerment and healine. Cult. Med. Psvchiat. 7. 221-240, 1983. 21. Allen G. and Wallis R. Pentecostalists as a medical minority. In Marginal Medicine (Edited by Wallis R. and Morley P.), pp. 110-137. The Free Press, Glencoe, Illinois, 1978. 22. Levin J. S. and Coreil J. ‘New Age’ healing in the US. Sot. Sci. Med. 23, pp. 889-897, 1986. 23. Kleinman A. Patients and Healers in the Context of Culture. University of California Press, Berkeley, Calif., 1980. 24. Lewis I. M. Ecstatic Religion: An Anthropological Studv of Spirit Possession and Shamanism. Penguin Books, Middlesex, England, 1971. 25. Bourguignon E. Possession and trance in cross-cultural studies of mental health. In Culture-Bound Svndromes, Erhnopsychiatry, and Alternative Therapies (Edited by Lebra W. P.), pp. 47-55. The University Press of Hawaii, Honolulu, Hawaii, 1976. 26. Kiev A. (Ed.) Magic Faith and Healing: Studies in Primitive Psychiatry Today. Free Press, New York, 1964. 27. Bird F. and Reimer 8. Participation in New Religious and para-religious movements. J. Scient. Study Relig. 21, l-14,

1982.

28. Ellwood R. A. Alternative Eastern Spirituality

Altars: Unconventional and in America. University of Chicago

Press, Chicago, Illinois, 1979. 29. Sneck W. Charismatic Spiritual Gifts: A Phenomenological Analysis. University Press of America, Washington, D.C., 1981. 30. Hastings A. C., Fadiman J. and Gordon J. S. Health for the Whole Person: The Complete Guide to Holistic Medicine, Westview Press, Boulder, Cal., 1979.

31. Chapman L. Developing a useful perspective on spiritual health: love, joy, peace and fulfillment. Am. J. Hlth Promotion

2, 12-17,

1987.

32. Peck M. S. The Road Less Travelled. A Touchstone Book, New York, 1978. 33. Boucher F. K. The Cadences of Healing: perceived benefit from treatment among the clientele of psychic healers. (Unpublished doctoral dissertation; University of California, Davis, 1980.) Dissert. Abstr. Inr. 41, 5155A, 1981. 34. Garrison V. Sectarianism and psychosocial adjustment: a controlled comparison of Puerto Rican Pentecostals and Catholics. In Religious Movements in Contemporar.v America (Edited by-Zaretsky I. I. and Leone P.). Princeton University Press, Princeton, N.J., 1974. 35. Glik D. C. Psychos&al wellness among spiritual healing adherents. Sot. Sci. Med. 22, 579-586, 1986. 36. Griffith E., English T. and Mayfield V. Possession, prayer, and testimony: therapeutic aspects of the Wednesday night meeting in a black church. Psychiatry 43, 12&128,

1980.

37 Bourguignon E. (Ed.) Religion, Altered States of Consciousness

and Social

Change.

Ohio

State

University

Press, Columbus, Ohio, 1973. 38. Jilek W. G. Salish Indian Mental Health and Culture Change. Holt, Rinehart & Winston, Toronto, 1974. 39. LaBarre Weston. The Ghost Dance: The Origins of Religion Doubleday, New York, 1970. p. 44. 40. Eliade M. Shamanism, Archaic Techniques of Ecstasy (Translated by Trask W. R.). Bollingen Series LVXXVI, Random House, 1964, p. 27. 41. ‘New Age’ groups excluded from study, as their main

1206

42

43. 44.

45.

46.

47.

48.

49.

50. 51.

52.

DEBORAH C. GLIK

activity was not healing, were: (1) groups practising mainly magic, astrology. or divination, (2) sects of Eastern religious origins, and (3) cults such as Hare Krishna, Scientology, or Divine Light Mission. Groups excluded are ‘counter cultural devotional’ groups, whereas CHGs are ‘Western Devotional’ groups, and MHGs are ‘apprenticeship/discipleship’ groups in Bird and Reimer’s- schema [27]. MHGs use-‘esdteric’ and ‘contemplative’ modes of healing, rather than secular ‘self-betterment’ modalities proposed by Levin and Coreil [22]. The array of healing groups found regionally is dependent on historical, sociocultural factors, e.g. the distribution of groups by type in Baltimore was evenly split between CHG and MHG tvpes. Findings from New Jersey [16], Montreal [23], and California-[23,29] imply that in regards to healing, New Age groups predominated. In the Deep South, there are mainly Pentecostal and charismatic groups [6]. Fishman R. G. Spiritualism in Western New York: a study in ritual healing. Med. Anthrop. 3, l-22, 1979. Skultans 0. Empathy and healing. In Sociul Anrhropology and Medicine (Edited by Landon 1. B.). Academic Press, New York, 1975. Hine V. A. Pentecostal giossolalia-towards a functional interpretation. J. Scienf. Study Relig. 8, 21 l-226, 1969. Galanter M. and Buckley M. B. (1978) Evangelical religion and meditation: psychotherapeutic effects. J. nerv. ment. Dis. 166, 685691. Anthony D. and Robbins T. Spiritual innovation and the crisis of American civil religion. In Religion in America (Edited by Douglas M. and Tipton S.), pp. 229-248. Little Brown, Boston. 1983. Dipojono B. Javanese mystical groups. In Transcullural Research in Mental Health (Edited bv Lebra P.). pp. 267.-281, University of Hawaii Press, Honolulu, 1972. The following affiliations with religious institutions were noted: among CHGs there were 7 Catholic, 2 Episcopal, 2 Pentecostal, 2 Lutheran. 2 nondenominational. 1 Baptist. and 1 Methodist groups; among MHGs there were 1 Methodist. 1 Catholic, 2 Unity, 1 Spiritual Science. I Theosophical. and 7 unaffiliated groups. Kohn M. Class and Conformity. Dorsey Press, Homewood, Ill., 1969. Kearney M. Spiritualist healing in Mexico. In Culture and Curing (Edited by Morley P and Wallis R.), pp. 19-39, University of Pittsburgh Press, Pittsburgh, Penn., 1979. Lubschansky I., Egri G. and Stokes J. Puerto Rican

53. 54. 55. 56.

57.

58. 59.

60.

61.

62.

63

64

65.

66.

67.

68. 69.

Spiritualists view mental illness: the faith healer as para-professional. Am. J. Psychiut. 127, 312-321. 1970. Harwood A. Puerto Rican spiritism. Culr. Med. Psychiar. 1, 135-153, 1977. Nouwen H. M. The Wounded Healer. Image Books, Doubleday, Garden City, New York. 1979. Wilber K. The Spectrum of Consciousness. Quest, Wheaton, Ill., 1979. Young A. Internalizing and externalizing medical belief systems: An Ethiopian example. Sot. Sci. Med. 10, 147-156, 1976. Koss J. D. Symbolic transformations in traditional healing rituals: perspectives from analytical psychology. J. Analyr. Psychol. 31, pp. 341-355, 1986. Campbell J. The Hero wirh n Thousand Faces. Bollingen Series XVII, Pantheon Books, New York, 1949. Jung C. and Kerenyi C. Essays on a Science qfM!rhology (Translated by Hull R. F. C.). Bollingen Series XXII, Pantheon Books, New York. 1949. Victor Turner notes the common configuration of apocalyptic visions, maintained by members of ephemeral ‘cbmmunitas’ groups. Turner-V. (41 p. 153. . Lex B. W. The neurobiology of ritual trance. In The Spectrum of Ritual: A Biogenetic Structural Analysis (Editedby D’Aquili E. G., Laughlin C. D. and McManus J.), pp. 117-151, 1979. Katz R. Holiness ritual fire-handling: ethnographic and psychophysiological considerations. Ethos 10, 344368, 1982. Fischer R. Transformations of Consciousness. A cartography 1. The perception-hallucination continuum. Confna Psychiatrica 18, 221-224, 1975. Fischer R. Transformations of Consciousness. A cartography. II. The perception-meditation continuum. Co&a Psychial. 19, l-23, 1976. Krieger D., Peper E. and Ancoli S. Therapeutic touch: searching for evidence of physiological change. Am. J. Nursing 79, 6-62, 1919. Griffith E. E. H. and Mathewson M. A. Communitas and Charisma in a black church service. J. Nal. Med. Ass. 73, 1023-1027, 1981. Parsons T. Definitions of health and illness in the light of American values and social structure. In Parienfs. Physicians, and Illness (Edited by Jaco E. G.). pp. 165-187. The Free Press, New York. 1958. Berger P. L. From the crisis of religion to the crisis of secularity. Douglas and Tipton, pp. 17-24. Kutz I., Borysenko J. Z. and Benson H. Meditation and Psychotherapy: a rationale for the integration of dynamic psychotherapy, the relaxation response, and mindfulness meditation. Am. J. Psychiar. 142, 1-8, 1985.