Death by curse: The mystery of voodoo death in 20th century mind-body medicine

In recent history, the healing powers of the mind-body connection in medicine have become increasingly renowned. Although the original skepticism of scientific and medical communities prevented the acceptance of the mind-body connection into the realm of mainstream medicine, today it is ever more acknowledged that one’s psychological convictions can affect the physiological to create an impressive force for the improvement of health, and even the conquest and prevention of such severe illnesses as cancer and heart disease. Indeed, the “power of positive thinking” has inspired a revolution of “miracles” in health care; today, hope is considered a fundamental and necessary principle of medical practice. 

Nevertheless, a dark and sinister aspect of the mind-body connection exists as well: negative thoughts or convictions can cause damage to one’s health. The puzzling and mysterious phenomenon of voodoo death is a case study for the “power of negative thinking” in the history of mind-body medicine. The first article on the neuro-physiological mechanisms of voodoo death appeared in the American Anthropologist in 1942 by Walter Bradford Cannon (1871-1945), an American physiologist celebrated for his laboratory studies on the effect of emotions on the body, particularly the sympathetic and parasympathetic nervous systems and the “fight-or-flight” response. Professor Cannon pioneered the concept of homeostasis, the regulation of an organism’s internal environment through adjustments of physiological equilibriums. Cannon’s article “‘Voodoo’ Death” sought to account for the inexplicable deaths of the primitive peoples and natives of South America, Africa, Australia, New Zealand, and the Pacific Islands. Anthropologists who had visited these places have claimed that such deaths resulted from the superstitions and convictions that one had become cursed. Cannon’s conclusions on the nature of voodoo death reinforced his previous laboratory findings; he rationalized that in response to the sensation of fright, the body experiences changes via the sympathetic nervous system in preparation for “the intense struggle” involving the “instincts to attack or to escape,” including acceleration of the heart, contraction of blood vessels, and the discharge of adrenaline from the adrenal medulla. He concluded that voodoo death resulted from the reduction of the volume of circulating blood due to an increase in adrenaline, causing an insufficient supply of oxygen to the essential organs of the body.

Despite Cannon’s scientific explanation, a conflict existed over the reality of the voodoo death phenomenon between ethnologists and anthropologists on the one hand, and physiologists and physicians on the other. As expected, the supporters of biomedicine and laboratory science became the most stubborn skeptics of the reality of voodoo death. In 1957, the scientist Curt P. Richter provided an alternative explanation for the underlying mechanisms of sudden unexplained death in man. In Richter’s experiments, he placed rats in a confined environment — specifically, glass jars filled with water — and then trimmed their whiskers with metal clippers, noting that “all of the fierce, aggressive, wild rats die promptly on immersion.” EKG measurements demonstrated that these ill-fated subjects suffered from an extreme reduction in heart rate, a process that Richter attributed to the hyperactivity of the parasympathetic nervous system — not the sympathetic nervous system that Cannon’s theory had asserted. Richter explained the experiment’s relevance to understanding voodoo death: like the condemned primitive man, “the situation of these rats scarcely seems one demanding fight or flight — it is rather one of hopelessness; whether they are restrained in the hand or confined in a swimming jar, the rats are in a situation against which they have no defense.” According to Richter, the mentality of hopelessness is enough to shut down the physical processes of the body and cause death. 

The concept of hopelessness likewise appeared in David Lester’s more psychologically based explanation for the phenomenon of voodoo death — the so-called “death by suggestion.” In his article “Voodoo Death: Some New Thoughts on an Old Phenomenon,” Lester based his own hypothesis upon G.L. Engel’s “giving up — given up complex.” According to Engel, an affected individual experiences psychological helplessness, inadequacy, and worthlessness, and disease can invade because of the reduced defenses against infectious agents. Even though the “giving up — given up complex” localized “the cause of voodoo death in the psychological state of the individual,” Lester recognized that ultimately the diminished physical defenses of the immune system facilitated the deterioration of the individual’s health to the point of death. Similarly, Harry D. Eastwell embraced Engel’s mentality of “giving up — given up.”  Eastwell argued that the mysterious mechanism behind voodoo death is dehydration, because one’s increasing hopelessness becomes sufficient “to suppress the physiological drive for fluids” and inhibit efforts to actively obtain liquids. Nevertheless, no medical evidence has been found to date to indicate that voodoo death is caused by bacteria, viruses, other such microorganisms or poison.

Such inquiries into voodoo death as pioneered by Cannon became representative of the increasing interest of scientists in the cultural practices of other societies. Throughout the 20th century, an emerging curiosity in cultural practices such as Zen Buddhism or Yogic medication stimulated “psychological research which (examined) behavior not ordinarily found in Western subjects.” Perhaps the inquiries of Western science into Eastern medical and healing practices had been influenced by Cannon’s previous explorations into the native traditions of non-United States societies. Indeed, the revival of research into the neurological and physiological aspects of voodoo death into the 1970s and beyond, coincided with the New York Times journalist James Reston’s “Now Let Me Tell You About My Appendectomy in Peking” in 1971; Robert Keith Wallace’s dissertation on the physiological changes due to meditation, appearing in Science in 1974; and the development and publication of Herbert Benson’s “relaxation response” from his studies on the interactions of transcendentalist meditation and stress reduction in 1976.

Medical anthropologists Robert A. Hahn and Arthur Kleinman have reinforced the notion that the mind and the body are not separate, but connected. Their concept of nocebo effect, derived from the Latin word noceo (“I hurt”), stands in direct opposition to the more commonly known “placebo.” Nocebo distinguished the “noxious or distressing effects of a placebo.”

Today, the nocebo phenomenon continues to be studied by researchers exploring the “adverse, non-specific side effects that are not a direct result of the specific pharmacological action” of active medications. Arthur J. Barsky and his colleagues at Brigham and Women’s Hospital in Boston, argue that such side effects can cause distress, heighten the burden of illness, and increase the cost of health care; in addition, these side effects encourage “non-adherence” to “an otherwise appropriate therapy,” causing physicians to discontinue potentially necessary treatments or prescribe additional medications in response.  Although Barsky and his colleagues never exactly addressed “voodoo death,” the notion that an individual’s expectation of an adverse side effect — from headaches to fatigue and even death — becomes more than enough to transform the expectation into a reality.    

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Angela Marie Simmen graduated from Harvard College (2007) with a Bachelor of Arts (History and Science) degree. She is currently based in San Francisco and will be entering medical school in Florida this August. This article is excerpted from a History of Science writing assignment for her BA degree. In 2006, she traveled to the Philippines to work with Drs. Lourdes Cruz and Yasmyne Castillo-Ronquillo on her Honor’s thesis about the Aetas of Morong, Bataan. E-mail her at [email protected]