Keele Research Repository

Extreme ritual practices involving pain and suffering pose significant risks such as injury, trauma, or infection. Nonetheless, they are performed by millions of people around the world, and are often culturally prescribed remedies for a variety of maladies, especially related to mental health. What is the observable impact of these practices on health? Combining ethnographic observations and psycho-physiological monitoring, we investigated outcomes of participation in one of the world’s most extreme rituals, involving bodily mutilation and prolonged suffering. Performance of this physically demanding ordeal had no detrimental effects on physiological health and was associated with subjective health improvements, and those improvements were greater for those who engaged in more intense forms of participation. Moreover, individuals who experienced health problems and/or were of low socioeconomic status sought more painful levels of engagement. We suggest two potential mechanisms for these effects: a bottom-up process triggered by neurological responses to pain; and a top-down process related to increased social support and self-enhancement. These mechanisms may buffer stress-induced pressures and positively impact quality of life. Our results stress the importance of traditional cultural practices for coping with adversity, especially in contexts where psychiatric or other medical interventions are not widely available.