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The ‘placebo effect’ in highland Laos: insights from Akha medicine and shamanism into the problem of ritual efficacy

Ongaro, Giulio (2019) The ‘placebo effect’ in highland Laos: insights from Akha medicine and shamanism into the problem of ritual efficacy. PhD thesis, London School of Economics and Political Science.

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Identification Number: 10.21953/lse.00004232


This thesis examines the phenomenon of healing efficacy among the Akha of highland Laos, in light of the science of ‘placebo effects.’ Swidden farmers of Tibeto-Burman language origin, the Akha have a rich ancestral system of oral customs, centred on animism and a robust shamanic tradition. Based on 18 months of ethnographic fieldwork in a remote village, the first part of the dissertation is a detailed investigation of the whole gamut of Akha therapeutic practices. Among its key findings is that rituals for spirit affliction challenge a number of assumptions about healing performances that are widespread in medical anthropology. Specifically, the analysis shows that only few of these rituals engage the sick person’s senses in a way that harness ‘placebo effects’, as prevailing theories would predict. It is argued, however, that the most compelling aspect of efficacy lies at the level of Akha aetiology. The ways of explaining illness and healing – through a distinction between naturalistic and personalistic causes – reveal intriguing parallels with the aetiological picture of symptom perception that is borne out of placebo science. Overall, Akha thought is shown to capture something fundamental about the nature of illness and healing. The final part of the dissertation dwells on the implications of this finding. The material analysed invites a shift in focus from the narrow domain of the patient-healer interaction to the wider social and conceptual framework that underpins the phenomenon of health. It also has direct bearings on the understanding of the ‘placebo effect’, a notion that captures a nexus of contradictions central to modern naturalism. Espousing a kind of anthropology that looks at the ‘other’ for insights into one’s own culture and the human condition, the thesis examines how Akha resolve these contradictions, and what we can learn from them.

Item Type: Thesis (PhD)
Additional Information: © 2019 Giulio Ongaro
Library of Congress subject classification: G Geography. Anthropology. Recreation > GN Anthropology
Sets: Departments > Anthropology
Supervisor: Astuti, Rita and Allerton, Catherine

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