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Biology in Yoga and Shamanism

A comprehensive review of the available literature in the natural sciences on yoga and shamanism, up to 2015.

Biology in Yoga and Shamanism David Alexander Plessy BIOL 4950 Due date: July 28, 2015 2 Biology in Yoga and Shamanism I. Introduction II. Yoga a. Yoga Epistemology: Its Origins and Spread from East to West b. Scientific Perspectives on Yoga: Physiological Effects of Asana and Pranayama c. Scientific Perspectives on Yoga: Cancer, Quality of Life and Psychological WellBeing d. Scientific Perspectives on Yoga: Additional Research on Stress, Low Back Pain, Depression, and Other Conditions. III. Shamanism a. Epistemology of Shamanism: Uses of the Word and Related Practices b. Using Altered States of Consciousness in Healing Ceremonies c. Using Heat: Sweat Lodge and Other Ceremonies d. Physical and Sensory Deprivation e. Using Sacred Plants to Reach Altered States of Consciousness f. Monotony in Ceremony: Repetition Leads to Concentration IV. Conclusion V. References 3 I. Introduction Interest in alternative medicine has grown steadily since its efficacy has been supported by scientific evidence. Yoga and shamanism have shown empirical evidence of health benefits regarding specific components of cancer, cluster headaches, addiction intervention, stress, depression, and a number of other health-related conditions (Labate and Cavnar, 2013; Song et al., 1980; Uebelacker et al., 2010; Streeter et al., 2012; Moadel et al., 2007; McEwen, 2008; Lin et al., 2011). Many studies in the past have shown promise, but lacked adequate methodology. Research is also made difficult by prohibition and restrictions on certain plants that are associated with shamanic healing. In some cases, the spread of yoga has been met with resistance in the west (Mohler , 2010). With the increasing emphasis on proper methodology, more adequate studies are being performed. Improvements on research methods are expanding some of the established theories of how these systems work, and continuing to find new evidence for the mechanisms of their efficacy. A reasonable body of literature exists to date that supports yoga and shamanism as effective forms of therapy under certain conditions. As methodology improves and setbacks to research decrease in number and severity, we may expect to see great potential for these forms of alternative medicine in the 21st century. 4 II. Yoga Yoga Epistemology: Its Origins and Spread from East to West Yoga can be a difficult concept to define. In the west, yoga had become increasingly identified with exercise and gym activities. At its roots, Yoga was developed as an ancient Indian science and way of life (Telles and Naveen, 1997). Archaeological artifacts suggest that yogic postures were associated with religious deities as early as Indus Valley cultural tradition, ca. 2600 BCE to 1900 BCE (Samuel, 2008). Contemplations on what sorts of phenomena led to well-being and longevity were attributed to religious beliefs since the beginning of the Vedic age, ca. 2000 BCE – 1500 BCE, from the Indo-Aryan culture (Crangle, 1994). According to White (2011), the earliest systematic account of yoga came about in the Upanishad texts, dating from about the third century BCE. This is the first text to describe a yogic philosophy of the hierarchy of mind-body constituents. One of the earlier Upanishad texts describes a six-fold yoga method, which helps to define the goal of yoga and the means by which to achieve this goal. This six-fold system consists of breath control (pranayama), introspective withdrawal of senses (pratyahara), meditation (dhyana), mind concentration (dharana), philosophical inquiry/creative reasoning (tarka), and spiritual union (samadhi) (Deussen, 1997). As the practice of yoga became more systematic and developed, its systematization was culminated in the Yoga Sutras of Patanjali, ca. 400 CE (Werner, 1998). The Yoga Sutras derive its contents from different schools of thought, and emphasize the importance of introspection, contemplation, and meditation in order to achieve an altered state of awareness. It is in Patanjali’s Yoga Sutras that yoga is defined in a way that it is most accepted today, as the inhibitions of the modifications of the mind. This is usually interpreted as a state of awareness of 5 one’s own consciousness and nature, without any mixing or confusion of any attachments to material objects. Patanjali’s writing is the basis for eight-limbed yoga, which specify the philosophies and practices required in order to obtain the goal of a pure, undistracted mind (Bryant and Patañjali, 2009). Of the eight limbs proposed by Patanjali, three are seen most prevalently studied in a scientific setting. These three limbs are asanas (physical postures, developed into hatha yoga), pranayama (breath control), and meditation, which is described as the continuous flow of cognition toward a single object or thing, usually the breath. Most of the other limbs are philosophical or life-style related, and can be difficult to study in a scientific setting. The Yoga Sutras have stood as one of the most influential, foundational texts in the development of almost all schools of yoga today. A number of other impactful yoga texts were authored after the Yoga Sutras, but none have been as systematic and referenced since. It is important to consider these historical steps in the formation of hatha yoga (ca. 900 CE), which has become the most commonly practiced type of yoga in the West. Hatha yoga is sometimes cognized to be yoga in its totality by those who have not been exposed to the roots of its formation. According to Chaudhary and Sen (2015), hatha yoga synthesizes elements of Patanjali's Yoga Sutras with posture and breathing exercises. Patanjali had mentioned asana (posture) practice as one of the eight essential limbs of yoga, but the details of asana were described only as a steady, comfortable posture, presumably for meditation (Satchidananda, 2012) . The compilation of Hatha Yoga Pradipika (ca. 15th century CE) served to elaborate on the practice of hatha yoga as purification of the physical body, which leads to the purification of the mind and vital energy. According to the Hatha Yoga Pradipika, these goals are achieved by the practice of asanas, or full body-postures. These full-body postures are what have become 6 commonly thought of as “yoga”. But yoga was not initially introduced to the West as a practice of physical postures (Turlington, 2002). The spread of yoga and Hindu philosophy in the West is initially attributed to Swami Vivekananda in the 1890’s (Nikhilananda, 1957). Swami Vivekananda emphasized yogic and Hindu philosophy, and mostly attracted the interest of intellectuals, especially New England Transcendentalists. Scientific Perspectives on Yoga: Physiological Effects of Asana and Pranayama One of the first scientific publications that attempted to establish a connection between yoga and modern medicine came from N.C. Paul, and Indian scientist. Paul’s 1850 publication Treatise on Yoga Philosophy made physiological links between yoga and sleep, and Paul was the first to point out that yoga can induce hypercapnia, or increased CO2 levels (Broad, 2012). Hypercapnia may result from certain yogic practices, but the opposite effect can be obtained by other yogic practices. Modern studies show that a common yogic breathing technique, known as Ujjayi breath, can increase oxygen saturation in the blood without increasing heart rate or ventilation (Mason et al., 2013). Mason et al. also found slow breathing with similar inspiration and expiration times to increases cardiac-vagal baroreflex sensitivity, improve oxygen saturation, lower blood pressure, and reduce anxiety. Another landmark step in the study of yoga as a science came from the establishment of Swami Kuvalayananda’s Kaivalyadhama Health and Yoga Research Center, which attracted Western medical researchers in the early 20th century (Alter, 2010). Throughout the 20th century, the United States witnessed the growing influence of Hatha Yoga practitioners. 7 Interest in yoga as it relates to health increased greatly after Dean Ornish connected yoga to heart health in the 1980’s (Shaw, 2010). Ornish (1983) studied the effects of stress management training combined with an essentially vegan diet (with the exception of yogurt) in healthy individuals. The stress management techniques consisted of stretching/relaxation exercises, meditation with focus on breathing, and visualization meditation. The results of Ornish’s study showed that participants of the stress management training greatly increased in their exercise tolerance, as well as an overall 20.5% reduction in plasma cholesterol levels when compared with a control group. Participants of the training also showed almost a tenfold decrease in frequency of angina episodes (chest pains) on a weekly basis, and an increase in the ejection fraction of the left ventricle. Scientific Perspectives on Yoga: Cancer, Quality of Life and Psychological Well-Being Practice of full body postures may be regarded as beneficial to health as any equivalent form of physical exercise, but the key to understanding the healing potential of yoga lies in its other components, and how each component is related. The effects of yoga on psychological well-being and quality of life has been the topic of many research projects in the last decade, especially with an emphasis on how it effects cancer patients. Lin et al. (2011) discuss the effects of yoga on psychological health, quality of life, and physical health of patients with cancer. Physical health is generally easier to measure directly, and although psychological health and quality of life are relatively subjective, they have definite effects on physical health. The effects of stress alone can cause chemical and morphological changes in certain regions of the brain (McEwen, 2008). Lin et al. (2011) searched seven electronic databases for ten of the most legitimate articles concerning the effects of yoga on anxiety, depression, stress, and other 8 indications of psychological health in cancer patients. The meta-analysis found significant improvements in these areas of psychological health of patients that participated in yoga programs. None of the articles found provided solid data on the benefits of yoga towards physical health. Lin et al. noted that few systematic and comprehensive reviews of scientific research on yoga for patients with cancer have been published, and none with quantitative magnitude of the identified effects. More recent studies have shown greater success in identifying the effects of physical health on cancer patients (see Kiecolt-Glaser et al., 2014). Another cancer-related study comes from Cohen et al. (2004). This study focuses on a type of yoga from the Tibetan tradition, and how it effects sleep in cancer patients. The Tibetan Yoga program emphasizes regulated breathing, visual imagery, and meditation as well as various other postures. The findings of this study suggest that a Tibetan Yoga program is a feasible medication for sleep quality, sleep latency, and sleep duration in cancer patients. It was also shown to be effective at reducing the amount of sleep medications required by patients. Any benefits to the physical health of the cancer patients was outside the scope of this study, but general benefits of sleep can be inferred from the wide range of physiological effects that come from sleep deprivation, such as depression, increased blood pressure, increased stress hormones etc. (Samkoff and Jacques, 1991). Scientific ambitions to discover direct physical benefits of yoga in cancer patients have been met with inconclusive results in the past, but its effectiveness as a therapy for quality of life and psychological well-being has become evident. Moadel et al. (2007) examine the impacts of yoga on quality of life, fatigue, distressed mood, and spiritual well-being among a multiethnic sample of breast cancer patients. Components of yoga in this study included physical poses, breathing, and meditation exercises. The results of the study suggest that yoga is associated with 9 beneficial effects on social functioning, including enhanced emotional well-being and mood. These effects may serve to buffer deterioration in both overall and specific domains of quality of living. The authors note the potential impact of mind-body programs on quality of living among under-served and ethnic minority populations. Yoga appealed to those with a desire gain more control over their own medical care, especially using non-toxic healing techniques. Although this study did not address any of the effects of yoga on the physical health of cancer patients, it supports the hypothesis that yoga may benefits the psychological well-being and quality of life of cancer patients, which may have associated effects on physical health. Smith and Pukall (2009) conducted an evidence-based review of yoga as a complementary intervention for patients with cancer. They surveyed the literature published between May 2007 and April 2008, and included ten studies in their final analysis. Promising results were found for the benefits of yoga on the quality of life of cancer patients, but the authors point out the drawbacks of variability in different studies and methodologies, and the variability in different yogic techniques employed. Many different traditions fall under the classification of yoga, and there are many different components within just the Hindu/Indian tradition. Smith and Pukall point out that future research should examine what components of yoga are most beneficial, and what types of patients receive the greatest benefit from yoga. Kiecolt-Glaser et al. (2014) conducted a study which showed a reduction in cancerrelated biomarkers from regular hatha yoga practice. Two hundred breast cancer survivors were assigned to either twelve weeks of bi-weekly hatha yoga practice, or a waitlist control group. The main outcome of the study was a reduction in the lipopolysaccharide-stimulated production of proinflammatory cytokines interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and interleukin-1β (IL-1β). These biomarkers are involved in tumor microenvironment regulation, 10 regulation of immune cells, and autoinflammatory syndromes (Masters et al., 2009; Li et al., 2012). Additional benefits of cancer survivors who were administered in the hatha yoga program included an increase in short-term and long-term vitality, and a long-term decrease in fatigue, as well as a decrease of inflammation, which effectively prevents frailty and disability. KiecoltGlaser et al. (2014) conclude that regular practice could have substantial health benefits. Uebelacker et al. (2010) searched through related literature and examined eight clinical trials of yoga-based therapy for depression. The results of these studies were described as encouraging, and the authors suggested that there are several reasons to consider constructing careful research on yoga for depression, mainly listing three reasons. First, it was pointed out that current strategies for treating depression are not sufficient for many individuals, and patients have several concerns about existing treatments. Second, aspects of yoga-including mindfulness promotion and exercise-are thought to be "active ingredients" of other successful treatments for depression. Third, there are plausible biological, psychological, and behavioral mechanisms by which yoga may have an impact on depression. Scientific Perspectives on Yoga: Additional Research on Stress, Low Back Pain, Depression, and Other Conditions. Several studies have been published in regards to the efficacy of yoga as a therapy for stress-related disorders. Streeter et al. (2012) reviewed the hypothesized effects of stress on the nervous system, the primary inhibitory neurotransmitter system, and increased allostatic load. Stress is believed to increase sympathetic nervous system response and decrease parasympathetic nervous system response (PNS). Stress can also reduce activity of the gamma amino-butyric acid 11 (GABA) primary inhibitory neurotransmitter system. This system naturally has relaxing, antianxiety, and anti-convulsive effects, and interfering with it can be problematic (Foster and Kemp, 2006). Allostatic load translates to wear and tear on the body by means of heightened neuroendocrine response that results from repeated or chronic stress (Ogden, 2007). Streeter et al. (2012) hypothesized that yoga-based practices correct underactivity of the PNS and GABA systems in part through stimulation of the vagus nerves, the main peripheral pathway of the PNS, and reduce allostatic load. The authors recount that treatment resistant cases of epilepsy and depression respond to vagal nerve stimulation, and that the integration of yoga-based practices has far-reaching potential for a broad array of disorders exacerbated by stress. In a study on chronic low back pain, it was shown that Iyengar yoga, one of the more popular forms of hatha yoga, 24 weeks of biweekly classes significantly reduced functional disability and pain intensity. Many subjects reported clinical improvements at both 12 and 24 weeks, as well as a reduced tendency to use pain medication, and reductions in depression (Williams et al., 2009). According to Patil et al. (2014), yoga is an effective means to reduce oxidative stress and to improve antioxidant defense in elderly hypertensive individuals. Yoga practice for three months showed significantly reduced malondialdehyde (a marker of oxidative stress), and enhanced antioxidants level such as superoxide dismutase, glutathione, and vitamin C. Several different health conditions have been studied in regards to the potential for yoga as therapy, including high blood pressure, epilepsy, menopause-related symptoms, pediatric conditions, rheumatic disease, and sports related physical health. Inconsistency and inadequacy in methodology seem to be the major drawbacks in health-related studies of yoga. It is unclear what aspects of yoga may be beneficial towards physical health, and which approaches would be 12 most effectively employed in different cases. Several other studies have been performed regarding the effects of yoga on psychological health and other measures of well-being (Streeter et al., 2012). As yoga-related studies continue to grow in number and quality of methodology, more benefits are being discovered. Yoga has been shown to decrease depression, anxiety, sleep disturbance and back and leg pain in prenatally depressed women (Field et al., 2012; Field et al., 2013). The potential health benefits of yoga have been demonstrated in the field of psychological health, and, to a lesser extent, physiological health. The biggest drawback of most studies examining yoga lies in their methodology. It can be very difficult to account for the multitude of variables involved in mind-body techniques, and there are many different traditions and specific practices that fall under the heading of yoga. Nevertheless, researchers are becoming increasingly focused on specific health indicators that yield quantitative data about the health benefits of yoga. Research is also being directed at some of the peripheral components of health (stress, sleep, biomarkers, etc.) which are associated with identifiable effects of yoga practice. As methodology continues to improve, it would not come as a surprise to see more scientific data on the health benefits of yoga. 13 III. Shamanism Epistemology of Shamanism: Uses of the Word and Related Practices The word shamanism is used to describe a religious practice in which the practitioner reaches altered states of consciousness in order to perceive and interact with a spirit world, usually in order to facilitate healing for individuals or a community (Hoppal, 1987; Walsh, 1990). The word itself did not reach the English language until 1698. It was used to describe the magico-religious practices of group of people native to Siberia (Laufer, 1917). Since then, the word has been used to describe the magico-religious practices of many different cultures. It is important to realize the variance between cultural complexes, their ecological contexts, and the details of their ritual forms of healing. The term “shamanism” could really be used as an umbrella term to describe the magico-religious healing rituals of a multitude of different cultures. With that being said, the term is somewhat loosely used in cross-cultural contexts to describe the specific phenomena of a practitioner contacting the spirit world while in an altered state of consciousness (Hoppal, 1987; Walsh, 1990). This differs from other forms of magico-religious healing in that the shaman must go through an initiatory period in which he must achieve control over the spirits that he interacts with. A shaman may also be defined from a social perspective, in which he takes on the role of creating order and reestablish balance between social groups and their respective roles in a given culture (Nicholson, 2014). Using Altered States of Consciousness in Healing Ceremonies Rituals are used by shamans to reach an altered states of consciousness, which allows them to do their healing work. Almost anything that has ever been used to achieve an altered 14 state of consciousness has most likely been included in a shamanic ritual at some point in time. Some examples are intensive temperature conditions, physical or sensory deprivation, the use of sacred plants, and auditory aides to name a few. It is also important to note that using altered states of consciousness to perform magico-religious healings are just one specialty of the shaman. The healing techniques of a shaman have always existed in coordination with applied medicine. If a patient has an arrow sticking out of them, the shaman would not likely order up altered states of consciousness unless the intrusion was removed. Available medicines are then used to prevent infection and to stop the bleeding (Achterberg, 2013). Using Heat: Sweat Lodge and Other Ceremonies The sweat lodge ceremony is a traditional healing ritual with firm foundations in both Native American and some European cultures. During a sweat lodge ceremony, rocks are heated and brought into the lodge, and water is poured over the rocks to transfer the heat into steam. From a physical standpoint, there is a biochemical component of high body temperatures during fevers that reflects the natural reaction to toxins, and correlates to the immune system in action. Increasing the body temperature may also have act as a sterilization procedure, killing bacteria, viruses, and other organisms that thrive at body temperature, but are susceptible to heat (Achterberg, 2013). In addition to this, the growth of cancerous tumors may be inhibited when core body temperature is significantly elevated (Song et al., 1980). Several studies in the 1980’s showed the potential for heat as an effective therapy against tumors. When exposed to hyperthermic conditions of 42-45 °C, normal tissue was able to increase blood flow and dissipate heat much more effectively than tumors. This caused more damage to tumors than surrounding tissue. The naturally acidic intratumor environment also 15 became more acidic upon heating, which further accentuated the thermal damage to tumor cells (Song et al., 1984). This was probably due to the increase in the contents of acidic metabolities, and the inefficient drainage of them that was being caused by vascular damage. The increased acidity in the heated tumors may inhibit the repair of thermal damage and make the surviving tumor cells more vulnerable to subsequent heating, radiation, and chemotherapy (Rhee et al., 1984; Achterberg, 2013). Aside from sweat lodges, the ability to self-generate internal heat is typically regarded as necessary for shamanistic healing. Some advanced Tibetan yogins, who claim many of the same abilities as a shaman, are said to be able to produce psychic heat that renders them impervious to temperature extremes. Such yogins display their ability to generate heat by means of a competition during the winter months in the Himalayan mountains of Tibet. Those who are being initiated must sit on the ground, cross-legged and naked, while sheets are dipped in icy water and wrapped around them. Each man must generate enough heat to dry the sheet that has been wrapped around him, then dip it again in the water, and wrap it around his body to be dried as before. This goes on until daybreak, and a participant must dry at least three sheets in order to bear an insignia of proficiency. Similar tests of one’s ability to generate heat are measured by the quantity of snow melted around him (Evans-Wentz, 2000). The degree of control that such shamans and yogins have over their own physiological functions becomes more apparent when compared with other studies of increased body temperature. Besides shivering/muscular activity, the only known way to increase body temperature is to increase cellular metabolism. External temperature can also be raised by diverting internal body heat to the periphery through an increased rate of blood flow in the skin. This has been documented in biofeedback literature, and has been achieved by mental techniques 16 such as imagery and relaxation. Such procedures have actually been successful in treating some circulatory disorders, but would cause a fatal decrease in the core temperature of a shaman or yogin who is enduring extreme cold. So yogins and shamans have apparently found a means to continue an indefinite heat exchange, which means they have the ability to regenerate the lost chemicals involved, for a long time (Evans-Wentz, 2000). Physical and Sensory Deprivation Physical or sensory deprivation can take many forms, and is not unique to shamanistic cultures. Physical deprivation may include fasting before difficult work, going without sleep for several nights, periods of celibacy, or even blindfolding during healing ceremonies. The different culturally sanctioned methods of deprivation aid the shaman in reaching an altered state of consciousness. The mechanisms by which these techniques alter consciousness have been postulated as electrolyte imbalances, hypoglycemia, dehydration, sleeplessness, and loss of sensory input. Some may say that shamans are willing to push their bodies to the physiological limits in order to awaken their minds (Achterberg, 2013). Using Sacred Plants to Reach Altered States of Consciousness The use of sacred plants to induce hallucinations are perhaps the most commonly known technique. It can help facilitate the shamanic healing tradition, but it is not actually essential for shamanic work. Some see sacred plants as only an intermediate step, and consider them to be unnecessary for an advanced practitioner. It is also notable that not all sacred plants are used to induce hallucinations. Many are used simply to treat skin conditions, bacterial infection, or to promote general well-being (Achterberg, 2013). 17 Anthropologists have performed a great deal of work documenting sacred plants since the heightening awareness of drugs in the 1960s. Many medicinal plants have been examined, sometimes with specific active compounds being indentified (Phurailatpam et al. 2014). The use of certain species of mushrooms (fly-agaric, Psilocybin) has also been widely documented. Besides being used in shamanic healing rituals, psilocybin mushrooms have been shown to be an effective treatment for cluster headaches (Sewell et al., 2006). Cluster headaches can be so severe that they have become alternatively known as “suicide headaches,” and a biomedical approach to cure the condition has yet to be successful (Labate and Cavnar, 2013). Perhaps the most auspicious part of psychedelic medicine is in its potential to treat intractable health problems, such as posttraumatic stress disorder, obsessive-compulsive disorders, wasting syndromes, and addictions. Although double-blind clinical trials have been few in number, this may not be due to a lack of efficacy, but rather administrative prohibitions that have restricted clinical research (Labate and Cavnar, 2013). The use of peyote has become well known amongst members of the Native American Church as part of a humanistic ceremony (Achterberg, 2013). The cactus is often used in large quantities during ceremony, and shows significantly less adverse effects when compared with similar quantities of other drugs. This is probably due to the ritual beliefs and religious intentions surrounding the ceremony (Bergman, 1971). Use of peyote in the Native American Church has shown effectiveness in treating alcoholism and other addictions (Albaugh and Anderson, 1974; Winkelman, 2014). Evidence suggests that the use of peyote, inogaine and ayahuasca assist in the recovery of drug dependency in part by acting on the serotonin neurotransmitter system (Winkelman, 2014). 18 One of the more common sacred plants of South and Central America is the Banisteriopsis vine, also known as ayahuasca. The plant is used by Sharanahua Indians of eastern Peru, as well as many other indigenous groups to help diagnose and cure illness (Achterberg, 2013). Ayahuasca has been examined in laboratory, clinical, and medicinal studies for its potentials to contribute to modern medicine. The plant has shown great therapeutic potential in the fields of addictions treatment and depression (Labate and Cavnar, 2013). A number of studies have shown promise for the treatment of Parkinson’s disease using ayahuasca. According to Serrano-Dueñas et al. (2001), a single dose of extract from the Banisteriopsis caapi plant (ayahuasca) resulted in beneficial behavioral effects in Parkinson’s patients. The authors identify the compound harmaline from the extract, and note evidence of harmaline binding to N-MethylD-Aspartate receptors. This binding mimics the action of glutamate, which is postulated to play a central role in the restoration of loss of motor function in Parkinson’s patients. More recent studies have noted the inhibitory effects of Banisteriopsis caapi extract on monoamine oxidases (MAO), and how this may be used treat Parkinson’s disease. The inhibitory effect of Banisteriopsis caapi extract, as well as pure harmine, on MAO-A increased release of dopamine. Additional evidence of MAO-B inhibition suggests the potential of harmine and harmaline as providing protection against neurodegeneration. Furthermore, potent antioxidant compounds epicatechin and procyanidin B2 were identified in ayahuasca. Oxidative stress is associated with pathogenesis in neurodegenerative disorders, and the powerful antioxidative compounds in ayahuasca may protect neuronal cells that are damaged by oxidative free radicals (Samoylenko et al., 2010). 19 Monotony in Ceremony: Repetition Leads to Concentration Monotony in song, drumming, dance, and rhythmic movements also appears to play a role in many forms of shamanism, and can in some cases induce hallucinations (Nordland, 2014). These repeated, monotonous stimulation changes the focus of awareness. Shamans usually induce monotonous sounds using chants, drums, rattles, sticks, or other percussion instruments. Several physiological facts support the role of sound in the induction of concentration, resolve, and deep trance (Achterberg, 2013). The auditory tracts pass directly into the reticulate activating system of the brain net, which coordinates sensory input and motor tone, and to alert the cortex to incoming information. As sound travels along these pathways, it is capable of activating the entire brain (Guyton, 1982). The strong, repetitive neuronal firing caused by the drums could compete successfully for cognitive awareness, which could filter out ordinary reality, including pain (Achterberg, 2013). According to Melzack and Wall (2013), pain messages travel on small, relatively sluggish fibers. This means that the perception of pain can be effectively blocked by other incoming stimuli traveling on more rapid conducting fibers. Repetitive, monotonous drumming could act a faster, more competitive stimulation (Achterberg, 2013). Stress and metabolic imbalances have been shown to enhance susceptibility to rhythmic stimulation (Neher, 1961; Grumet, 1977). Meditation-based evidence shows that an external auditory stimulus may not even be necessary to bring about a significant physiological change, and that repetition of a word or sound, or even simple visualization may induce identical effects as monotonous drumming. Some of the physiological responses that have been reported from using these techniques include decreased heart rate, blood pressure and muscle tension, and increased alpha and theta activity on an electroencephalogram (Benson and Klipper, 2000). 20 The rapid loss of indigenous knowledge due to modernization has caused the irretrievable loss of many traditional health systems. As many cultures strive to maintain their customs, efforts at preservation have been met with success in some groups, such as the Saraguro community in southern Ecuador. This group has been able to maintain their ancient healing heritage and survive as a community, despite strong external pressure. The Saraguro are just one example of many cultures that struggle to sustain the collective knowledge of countless generations of ancestors (Armijos et al., 2014). IV. Conclusion As empirical data and evidence-based studies of alternative medicine continue to grow and develop, both yoga and shamanism show promise as effective forms of healing for certain health conditions. Alternative medicine studies in the past have shown inadequacies in their methodologies, but improvements in research methods allow for greater certainty in the efficacy of these healing systems. Humans have faced selective pressures for hundreds of thousands of years. We have evolved and adapted successfully, despite countless odds. Ancient healing systems have been around for thousands of years, and it is unlikely that such practices would exist and be maintained if they did not play some role in our survival. Doubtless, many aspects of traditional healing systems are based on subjective, psychological paradigms that may never be understood— but as our understanding of health becomes more holistic, and as we continue to see the benefits of subjective approaches to health, it may be wise to consider the contributions of ancient customs, which are at least partially 21 composed of the cumulative knowledge of many generations of people dedicated to understanding what works and allows humans to survive and thrive. 22 VI. References Achterberg, J. 2013. Imagery in Healing: Shamanism and Modern Medicine. Shambhala Publications. Albaugh, B.J., and P.O. Anderson. 1974. Peyote in the Treatment of Alcoholism Among American Indians. AJP. 131: 1247–1250. Alter, J.S. 2010. Yoga in Modern India: The Body Between Science and Philosophy. New Delhi: New Age Books. Armijos, C., Cota, I., and S. González. 2014. 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