According to a new study published in Current Anthropology, an extreme ritual involving bodily mutilation has no detectable long-term harmful effects on participants and actually has a positive effect on psychological well-being. In "Effects of Extreme Ritual Practices of Psychophysiological Well-Being," Dimitris Xygalatas and his team investigate the effects of participation in the kavadi attam, a ritual performed annually by millions of Tamil Hindus around the world, on physical and psychological well-being.

The research is particularly important in the context of developing societies, where biomedical and folk health interventions often co-exist. "Our results stress the importance and utility of traditional cultural practices for health management," he writes. "Although these practices are not meant to substitute biomedical interventions, their complementary utility should not be overlooked, especially in contexts where psychiatric or other medical interventions are not widely available or are associated with stigma."

The kavadi is part of a longer festival of Thaipussam, which involves preparations through fasting and prayer. On the day of the ritual, devotees pierce their bodies with numerous metallic objects, including needles, hooks and rods impaled through both cheeks. Once these piercings are in place, devotees embark on a several-hour-long pilgrimage to the temple of Lord Murugan, the most popular deity among the Tamil Hindus, carrying portable altars on their shoulders. These structures are often over three meters (10ft) tall and can weigh up to 60kg (130lbs).

The study was completed using 37 participants from the Tamil Hindu community in the town of Quatre Bornes in Mauritius, an island nation in the Indian Ocean. For three weekly periods before, during, and after the ritual procedures, participants wore portable monitoring devices that recorded their stress levels, sleep efficiency, and physical activity. Participants' heart rate was recorded on a daily basis during these measuring periods. Clinically and cross-culturally validated surveys were administered before and after the ritual to assess psychological wellbeing. The researchers also recorded the health and socio-economic status of the participants, and examined whether these factors predicted whether a participant chose a low or high-intensity engagement in the ritual.

Results showed that participating in the ritual had no detrimental effects on physiological health, and actually had positive effects on psychological well-being, with those who engaged in a higher number of body piercings experiencing the greatest improvements in perceived health and quality of life. Additionally, people who had been experiencing health problems or were of low socioeconomic status sought more painful levels of engagement.

The authors offer several possible explanations for the observed benefits of performing the kavadi, ranging from neurochemical processes to social factors related to participation. First, there is evidence that the sensory, physiological, and emotional hyperarousal involved in strenuous ordeals can affect the levels of neurotransmitters such as endorphins and endocannabinoids, resulting in feelings of euphoria.

There is also a great deal of evidence that shows that extreme rituals, when performed collectively, strengthen communal bonds and provide a sense of belonging. Additionally, participating in the kavadi allows participants--who are viewed as more devout and trustworthy than non-participants--to improve their social standing within the community. "Multiple lines of research suggest that individuals are strongly motivated to engage in status-seeking efforts, and that there is a strong positive relationship between social rank and subjective well-being," the researchers write. "Indeed, we found that individuals of lower socioeconomic status were more motivated to invest in the painful activities that can function as costly signals of commitment."

Whether the positive psychological effects of kavadi participation are primarily biological, social, or a combination thereof, should be a focus of further research, Xygalatas says. He also suggests expanding study length to include many kavadi events over the course of a lifetime and other possible ways to deepen the understanding of this widespread ritual.

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