The Social Life of Placebos is an interdisciplinary study of the evolution of placebogenic responses – beneficial ones activated by psychosocial triggers -- and their elicitation in Asante medical contexts. Based on an extensive literature review in social, cultural, and medical studies and over 26 months of intensive research in rural Ghana, West Africa, it examines the therapeutic efficacy of Asante medical encounters by analyzing rites of care-giving within an evolutionary framework. Section 1 investigates why evolutionary processes appear to have made human physiology susceptible to psychosocial manipulation, what the health consequences of that susceptibility are in modern environments, and how culturally specific expectations and healing rituals might dampen or amplify that susceptibility. Because of key transitions in human evolution, the fitness consequences of sociality have increased rapidly and created the conditions whereby endogenous mechanisms have become responsive to sociocultural conditions. This explanation helps us better understand why culturally specific rituals can elicit powerful beneficial (placebo) and adverse (nocebo) physiological responses.
Using a mixed methodology of physiological data and ethnographic case studies collected from hundreds of Asante medical encounters, Section 2 illuminates evolutionary and proximate processes in Asante contexts of care-giving and healing rituals in detailed chapters on pain, emotion, and stress. It examines the social and cultural resources and techniques that Asante health practitioners rely on for pain management in contexts where no pain medication is available. It analyzes the biocultural interactions that can take place when healers modify patient perceptions, emotions, and expectations. The dissertation concludes with biometric evidence that Asante indigenous ritual healing ceremonies actually promote significant entrainment and relaxation effects
