Abstract
Theories of healing have attempted to identify general mechanisms that may work across different modalities. These include altering expectations, remoralization, and instilling hope. In this paper, we argue that many forms of healing and psychotherapy may work by inducing positive psychological states marked by flexibility or an enhanced ability to shift cognitive sets. Healing practices may induce these states of cognitive and emotional flexibility through specific symbolic interventions we term “flexibility primers” that can include images, metaphors, music, and other media. The flexibility hypothesis suggests that cognitive and emotional flexibility is represented, elicited, and enacted through multiple modalities in healing rituals. Identifying psychological processes and cultural forms that evoke and support cognitive and emotional flexibility provides a way to understand the cultural specificity and potential efficacy of particular healing practices and can guide the design of interventions that promote resilience and well-being.
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Notes
We use the term “shifters” here in a broader sense than its use for indexicals in linguistics (Silverstein 1976), to denote any symbolic action aimed to evoke a change or transformation in experience.
Depending on the context, healers and participants may be variably aware that inducing flexibility is a function of the healing practice. Certain cultures or traditions may have more explicit imagery and discourse about flexibility as a core value (e.g., the image of the flow of water in Taoism; Allan 1997). However, even when it remains entirely implicit, flexibility may be an important adaptive outcome of healing.
Erickson’s work gave rise to contemporary forms of strategic, family, narrative, and solution-focused therapy (Zeig 1987).
In hypnosis, this type of mirror-and-shift is sometimes called “pacing” and “leading,” a technique often used by Erickson (Haley 1973).
The images need not be plausible to work; indeed, improbable images may have added beneficial effects because they evoke amusement or laughter.
This type of metaphoric transformation is used in many Western methods without an explicit ontology. In progressive muscle relaxation, for example, the release of tension is often matched with the phrase, “just let go of all your problems,” or some other such metaphor; or in hypnosis, the therapist may use statements of this kind when the person exhales. In these cases, the therapeutic metaphor is synchronized with bodily experience, and in addition to the sensory reinforcement of positive affect, this may result in a form of verbal-somatic conditioning so that the metaphor increasingly evokes the bodily state. As another example, in yoga, the act of stretching in an asana may be linked to the statement that one needs to be flexible in one’s life. Visual imagery can be added as well, so that there are three parallel layers encoding flexibility: bodily stretching, verbal statement, and image (e.g., of a leaf moving flexibly in the wind). Of course, in yoga practice, stretching has actual biological effects of muscle relaxation. Thus there may be a sort of associative learning or conditioning strengthening links between the physiological process of relaxation and the cognitive-emotional process of flexibility. This process is naturalized and automatized by the use of metaphors that imply ease or lack of effort.
One might translate “arâm” and “ceut” as “attentional-focus/mood.” So these phrases could be translated as the following: “cutting the ‘attentional-focus/mood’” (gat ceut), “pulling the ‘attentional-focus/mood’” (dâ ceut), and “turning the ‘attentional-focus/mood’” (beunlâp arâm). In these expressions, the role of the attentional focus in generating emotion is emphasized.
Our use of the term “transformagram” and the related theory of healing resembles Dow’s (1986) theory of ritual healing, according to which the patient’s problem is re-cast in terms of a culturally salient and emotionally charged symbol and then that symbol is changed to bring about healing. However, we aim to go beyond Dow’s account in specifying the central role of metaphor in cognitive-affective, sensorial, and social transformation (for a review, see Kirmayer 1993). In symbolic healing, a symptom or emotion may be linked through metaphor to other representational processes and then transformed (Lee et al. 2010).
In instances where a person suffers from recurrent intrusive imagery, a shift to verbal depiction may provide similar benefits by disrupting the arresting image.
So, for instance, contrasting deities are contrasting “patterns” in the broad sense.
Here we use “multi-strand” as a general term to represent the analogue of polyrhythm across sensory domains. As indicated, multi-strands involve patterns, which co-occur either sequentially (one after another) or simultaneously (all at once). And as indicated above, the pattern may be auditory (e.g., a rhythm), visual (e.g., clothing patterns), or involve other sensory modalities (e.g., olfaction or taste). In addition, a multi-strand may be the co-occurrence, either sequentially or simultaneously, of different modes of consciousness or experiencing.
We use the term “icon” here to indicate that some quality of that represented is present in the symbol, establishing a relationship of “iconicity,” rather than pure abstraction (Roseman 1988).
We use the term state here in the broad sense of a nexus of process and experience that includes the mode of being-in-the-world, which encompasses physiological, psychological, and socially marked states of identity. Although the aim in healing may be consonance between these different facets of state, in any given case they may be only partially aligned and their tensions or contradictions will be part of the full analysis of states of affliction and healing trajectories.
Csordas (1994) uses the term “modulation” to capture a similar concept, but though modulation in respect to music means a change in key, when used more generally as a kind of metaphor, it normally has the meaning of a slight change or adjustment rather than the radical shift indicated here.
For this effect to occur, the person may not need to be conscious of the shifting, and may not be aware of the attentional “choice” of strand and shift from one to the other. Instead, these shifts may have their own cumulative effect, creating a sense of flexibility. The meta-message of flexibility can be conveyed through other sensory domains as well.
By experiencing a shift from A to B, the person is experiencing profound shift, which opens up the possibility of change in other experiential domains.
In many cases, the ritual seems to highly represent the idea of flexibility to promote a shift from state A to state B. Whether this flexibility emphasis simply serves as a way to move the person to state B or whether it helps to open up to the possibility of change are distinct issues. In addition, processes that promote a shift from state A to state B may not involve flexibility, but they are flexibility primers in the sense they create a sense of shift and further ways of being-in-the-world. In this sense, “shifters” are a broader category.
Friedson (1996:169) remarks that a key aspect of the healing ritual is a doubling of consciousness in which there is normal consciousness and the new consciousness that occurs through possession, with each deity associated with a specific rhythm, story, and manner of dance. He sees the three-against-two rhythm as facilitating an openness to shift, to doubling of consciousness; that is, sees it as acting as a musical shifter, or an analogue of doubling. While he does not explain why this doubling is therapeutic, we argue that it is by promoting a more general psychological flexibility and a sense of transformative shift.
Adding to the complexity, a compound duple meter has a strong inherent threeness in it because of the cluster of three pulses per beat.
Friedson’s main point is that there is playing of three-against-two in different instruments (hand clapping as also an instrument) and shifting in a particular instrument from a twoness to a threeness and back again.
In which each of the three beats is two pulses long.
There is a profound transformation with each deity associated with a certain story, mannerisms, dance motions, and rhythmic pattern (Friedson 1996). And normally the person is possessed by more than one deity.
There is vertical hemiola, meaning co-present 3-pulse and 2-pulse beats, and sequential hemiola, meaning one instrument changing from a 3-pulse to a 2-pulse beat or visa versa: 1 2 3/1 2 3 to 1 2/1 2/1 2 (Brandel 1961).
In possession by a demonic force, there is again a dual self or two registers of being, but the goal is expulsion.
To make the key component of the kaen, the tubes, one must do the following: cut off ââ tubes (a bamboo-like reed that grows in clumps); puncture with a rod each tube’s inner partitions (which are located at the level of the joints); cut a small hole (about an inch long) at the side of each tube about half the way up its length; and place a metal-tongue-containing small rectangle over that hole (the metal has been cut to form a metal tongue that swivels on its base). To form the kaen, two rows of eight tubes prepared in this way are placed inside a “wind chest,” with the part of the tubes holding the metal tongues placed in that wind chest; the wind chest has a mouthpiece through which one blows to move the metal tongues to create sound.
The player’s fingers lie parallel to the pipes––jointed fingers alongside jointed ââ tubes. If one includes the two rows of ââ tubes (eight in a row), one has an impressive number of juxtaposed jointed columns: two rows of vertically aligned, jointed columnar shapes. Looking at this in terms of layers, one discerns a five-fingered hand, then a row of eight tubes, then another row of eight tubes, and finally a hand of five fingers. And each of these rows has multiple “joints”—the three joints of each finger.
As described above, each tube of the kaen has been notched (this part of the tube is hidden within the wind chest) so as to create a one-half by one-inch hole (the one-inch length laying along the long axis of the tube). The maker slides a square sheet of metal into this hole in the ââ tube. In the middle of this square sheet of metal, the maker previously cut a tapering column of sorts, this now attached to the metal sheet only at its base. Hence, this tapering column can swing back-and-forth within the metal sheet, analogous to the manner in which a piece of bamboo might swing back-and-forth pivoting at its base. This tapering metal column is called the “tongue of the kaen” (lin kaen). As the player blows, if he fingers a particular hole, then air rushes down that tube, and the metal piece inserted on the side of that particular tube must flexibly bend back-and-forth in order for sound to be created.
Because metaphor provides the cross-modal links in human conceptual activity, thinking about these different modes of symbolizing in terms of metaphor may capture much of their cognitive effect (Danesi 2013). In different sensory zones there may be icons of flexibility, with icon here meant in the Peircean sense of a sign that bears a likeness to what it represents. Thus, images of something pliable moving or multiple shifting rhythmic patterns can convey flexibility. It may be that such icons actually activate biological systems related to flexibility, for example, those related to attention, and directly promote cognition based on shifting gestalts. But how participants in a culture think about and enact these images is key.
One key process involves metaphoric cognition, here considered in the broad sense of resonating icons or images that structure domains (e.g., abstract encoders of shift ability such as shifting pattern and the flexile element, which act as metaphors of change ability), key conceptual metaphors (e.g., that of “flexibility), and the process of using metaphor to bring about shift (e.g., transformagrams).
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Hinton, D.E., Kirmayer, L.J. The Flexibility Hypothesis of Healing. Cult Med Psychiatry 41, 3–34 (2017). https://doi.org/10.1007/s11013-016-9493-8
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DOI: https://doi.org/10.1007/s11013-016-9493-8