CHAPTER 5. SEMIOTICS OF BODY

5.1. Secondary meaning of intraceptive sensations

As we have tried to show, the generation of a separate specific somatic sensation cannot be derived from the present situation and, as a subjective phenomenon, goes far beyond a simple reflex act. Becoming a phenomenon of consciousness, the elementary sense includes a hidden categorical network, only in the cells of which it acquires its subjective existence. In this case, of course, it also accepts all the inconsistencies in the design of this network, which imposes fundamental restrictions on perception and serves as a source of specific errors. Despite the fact that this complication, at first glance, multiplies the number of possible distortions, this price must be paid for the birth of subjectivity, which allows one to free oneself from the unnecessary abundance of particular manifestations of reality, distinguishing universal principles in them, and dramatically increasing the adaptive capabilities of the individual.

However, in reality, the situation is even more complicated and the system of intraceptive meanings is not the only source of influence on the perception of bodily manifestations. The meaning of individual sensory qualities can occur not only at the level of perceptual universals, the latter themselves can serve as material for meaning.

Thus, physicality in the context of the disease has a special quality: painful sensations mean not only themselves, but also that, in principle, they are not affected - a disease. They are deployed not only inward, i.e. they represent not just sensory tissue, which has received the meaning in terms of the bodily space of internal organs, modalities, intensity gradations, etc., but also without the disease. Although the unfolding of bodily sensations outside does not always occur only in categories of illness, they can be interpreted in a different way (even pain can be assessed as a sign of special note, a special state, for example in religious rites), we will focus on the problem of the connection between bodily sensations and diseases. Such an assumption, without changing, in my opinion, the content of the situation, will allow us to consider it more clearly.

The secondary meaning is generally similar to what was usually described as the intellectual level of the internal picture of the disease, the evaluation stage of its formation and is well described in the patho psychology. The formation of a secondary designation of bodily sensations is associated with the assimilation of views on diseases that exist in culture, their causes, mechanisms, and the resulting treatment methods. Ethnography and the history of medicine demonstrate various forms of such representations. Despite their archaic nature, the lack of a logical substantiation in them, from a modern viewpoint, they are structurally little different from natural scientific explanatory principles typical of the modern European culture.

From a semiotic point of view, the concepts of diseases can be interpreted as classical myths described by R. Bar Tom on sign models (1989). Consider the semiotic approach in more detail.

Its use for the analysis of physicality is possible because the values ​​are studied in it, regardless of their content. In accordance with the tradition that goes from F. de Saussure, the sign is not reduced to the language system, navigation signals, gestures of politeness, ceremony, fashion, etc., are also semiotic systems, where the main principle is the relationship between the signified and the signifying. R. Barth specifically emphasizes that although it is usually said that the signifier expresses what is meant, in reality the situation is somewhat more complicated - in each semiotic system there are not two, but three different elements. These three elements, respectively, are the signifier, the signified and the proper sign, which is the result of the connection of the first two elements. The signifier becomes the sign of the signified, entering into the seven otic relationship with the latter. Some confusion of the problem lies in the fact that there is really (substantively) only one element - the signifier. However, by participating in the act of naming and becoming familiar, it acquires new meaningful functions.

For greater clarity, we turn to any of the examples of R. Barth. Take a simple dark stone. There are many ways to make it meaningful. One thing is significant - it is worth giving it a definite signified (for example, it would mean a death sentence by secret ballot), as a stone becomes not a mere stone, but a sign. In terms of analysis, three elements can be distinguished: a “pebbled-down” death stone can with good reason be decomposed into stone and death; both of these phenomena existed separately before uniting and forming a third object, the sign. The difficulty lies in the fact that this sign is essentially the same stone, but you cannot mix stone as a signifier and a stone as a sign: “the signifier itself is devoid of content, the sign is informative, it bears meaning” (Barth, 1989, .77). Transformation into a sign completely transforms the signified, but this transformation is carried out in the semiotic sphere, from the physico-chemical point of view nothing happens to the signified.

This formal scheme is universal and can be filled with various contents. In our case, it can describe the relationship between an individual sensory sensation (or sensory tissue) and a bodily construct. For example, in a certain way localized modal specific sensation means pain in the heart.

The most important thing is that the relation of the signifier and the signified can be transformed in a special way, giving rise to a secondary semiological system, named by R. Barth mythological. “In the myth we find the same three-element system ... But the myth is a special system and this feature consists in the fact that it is created on the basis of some sequence of signs that exists before it; the myth is a secondary semiological system. The sign ... of the first system becomes only signifying in the second system. ... Material carriers of the mythical message (the language itself, photo graphy, painting, advertising, rituals, any objects, etc.), no matter how different they may be in themselves, as soon as they become an integral part of the myth, are reduced to the function of denotation; all of them are only the source material for the construction of the myth; their unity lies in the fact that they are all endowed with the status of language means. Whether it is a sequence of letters or a drawing, for myth they represent

sign unity, global sign, final result, or the third element of the primary semiological system. This third element becomes the first, i.e. part of the system that the myth builds over the primary system. There is a kind of shift of the formal system of primary values ​​by one scale mark ” {Barth, 1989, p. 78).

Thus, in a myth, two semiotic systems coexist in parallel, one of which is partially built into the other. Firstly, it is a language system (or other means of representation) that plays the role of an object language, and secondly, the myth itself, which can be called a metalanguage and which the object-language arrives at. The myth is understood by R. Bart, not as a thing, a concept, or a specific idea, but as a universal method of secondary meaning. The substantial form of the myth does not matter at all, it is not the subject of the message itself that is important, but how it is communicated. Although later in connection with the criticism of his understanding of the myth from many semiotics R. Barth refused to reduce it only to the secondary semiotic system and interpret it as a metalanguage, nevertheless, in my opinion, this concept is well applicable to understanding the specifics of the secondary meaning playing in the structure of everyday consciousness, the principal role (Ulybina, 1998), and therefore, with certain reservations, we will adhere to the terminology of R. Barth in this text.

Analyzing the metalanguage, one can, in principle, not be very interested in the exact structure of the object language, in this case only its role in the construction of the myth is important. Therefore, it is right to use this approach to any object language (written text, verbal language, music, painting, or, in our case, physicality). It is important that it is a sign system, ready to build a myth. The essence of the myth is not determined by what it narrates, nor by its material carrier (see: Barth, 1989, p. 79).

Re-formulating the proposed model to the problem of physicality, one can modify the Bart scheme of the “mythological” as shown in Figure 2. Here the sign (the said bodily sensation), which is an association of sensory tissue and the bodily construct, becomes meaningful in the mythological scheme of disease and, turning outward, turns into symptom 1.

-1 It should be stipulated that this is not an objective symptom that cannot be reduced to subjective sensations for modern medicine, namely, a subjective phenomenon — a sensation that means illness and has become its sign, i.e. a symptom.

Consider a simple situation as an example: a patient coming to the doctor says that he has a stomach ache. This message is not as simple as it seems at first glance and, at least, ambiguous. First, the patient reports a certain sensation of a certain intensity and modality, more or less localized in his body. In addition, the fact of going to a doctor suggests that this feeling means not only itself — a painful sensation in a certain part of the body — as well as the fact that it is not a normal state, that it has a certain reason and must be affected. . A “sick stomach” is a message not only about the definition of a patient's feeling at a given time and place, but also a message that something is going on with a patient that goes beyond a known fact.

In different cultures and epochs, the volume and prevalence of the myths of the “disease” change significantly, but as soon as we go beyond the primary semiotic system, considering a specific body sensation as meaning something more general, we instantly fall into the sphere of myth. At the same time, the objective fidelity of the myth is not significant: the term “myth” does not fit any assessment in the semiological approach, characterizing only the method of communication between constructs of different levels. From this point of view, the scientific explanation itself is also a version of the myth ( Malinowski , 1926; Lotman, 1965; Meletinsky, 1976; Golosovker, 1987). The mythological structure is especially characteristic of everyday consciousness, and in emotionally significant areas, it is human nature to think more mythologically than rationally. In my opinion, psychology in general hypertrophies rational knowledge (in its pure form is actually observed only in special laboratory conditions or in specific scientific activity), without noticing that in ordinary life a person is a being far from rational. Inconsistency, combination of opposites, ambiguity, logic of desire are errors that should not only be recognized as inevitable imperfection or ignored, but rather made the subject of psychological research itself, for error speaks about the essence of mankind often more than any formally correct performance. Everyday consciousness is more like a multi-layered structure that unfolds in parallel in many layers and, in the absence of necessary contradictions, does not require unambiguous output, paradoxically smoothing recurring contradictions in the most fantastic way. At the mythological level of everyday consciousness, a person resolves contradictions at the level of “bricolage”, a kind of “homemade” well described by C. Levi-Strauss (1983). “Bricolier” is similar to an ordinary person in that it adapts all means at hand to the resolution of that different situation, taking little care of the purity of the style, but trying to recreate a consistent picture of the world. Elements of scientific knowledge coexist with the most fantastic and ridiculous ideas, logic - with elements of magic, participation, metaphor, external similarity, and science-like theories can actually be nothing but scientific or medical folklore, science - fiction (Ulybina, 1998 ).

5.2. Effect of secondary signage on intraceptive sensations

The most significant thing in all this is that the secondary meaning is not indifferent to the primary sensations on which it is built and parasitic. Having become a symptom, the bodily sensation does not change outwardly only; it is built according to other laws and contains within itself what is inaccessible to it naturally. Being meaningful in myth, it is two-faced: on the one hand, it is a bodily sensation, filled with concrete experiences, and on the other, it is a hollow form — a sensation deprived of its own history, which means the concept of illness. In its first quality it can be felt, felt, it has a sensual reality, has its own value and content, which, in principle, are self-sufficient. It already contains a ready-made meaning, suggests some “own history”, correlation with experience, categorical decision, etc.

In the second quality, as meaning in the mythological system, it turns into a hollow parasitic form. By becoming a symptom, the bodily sensation loses its spontaneity, it becomes depleted. The wealth of specific content is relegated to the background, subject to the logic of the myth of the disease. As its element, the bodily sensation loses its own significance, but does not die, but, by necessity, exists, nourishing a myth. It remains for the myth to be something like a repository of specific events, which can always be borrowed, so that the myth (the concept of the disease) can “put roots” in real physicality and, having absorbed it, take on the appearance of nature in its concrete “indisputability”.

The myth of the disease deforms the natural side of bodily sensation, not destroying it, but cutting back, alienating it. Meaning in the myth of the disease is open in two directions, it is the result of the primary meaning of the sensory fabric and the beginning of the myth. This leads to duality and constant “flickering” of the form and background of the sensation-symptom, demonstrating alternately rational and sensual, mediated and direct, arbitrary and natural. It is impossible to confront the mythical and the real in body sensation, because it is the single point for them in which they never find themselves at the same time. As a result, the question of the truth, the “corroboration” by the physical reality of the conceptual myth of the disease is extremely confused. The myth is very difficult to “verify” from the point of view of truth, “... nothing prevents it from maintaining an eternal alibi; the presence of two sides of the signifier always allows him to be in another place ” {Bart, 1989, p. 89). Body sensation is always on hand to become meaningful to a myth; the signifier is always here to “obscure” a particular bodily sensation. Trying to catch the myth, we find only the result of the combination of the signifier and the signified - the bodily sensation that has become a symptom, and taking it as a natural given, we do not notice the transition to the area of ​​mythological.

The trick is that the mythology of corporeality is hidden from the simple-minded observer: the myth appears in the guise of reality, but on closer examination this reality turns out to be false, borrowed.

However, losses in spontaneity are partially offset by the inclusion of physicality through the concept of the disease in the accumulated public experience. The concept introduces a “new event”, time, epoch, people, history, principles of the structure of the world.

and so on. In this sense, the myth is an open system that constantly catches everything new that appears in the public consciousness. Another thing is that the mythical concepts are unstable and do not always represent what they look like. Many scientific medical ideas in the ordinary consciousness are refracted into absolutely incredible fantastic theories, and the new-fangled "Indian medicine" is closer to the ballet "La Bayadere" than to the real India. “... When moving from meaning to form (in our case, from a specific bodily sensation to a signifying symptom. - A. T.), the image loses some amount of knowledge, but instead absorbs the knowledge contained in the concept. In fact, the ideas contained in the mythological concept are vague knowledge, formed on the basis of weak, fuzzy associations ... this is in no way an abstract, sterile essence, but rather a condensate of unformed, unstable, obscure associations; their unity and coherence depend primarily on the function of the concept ” {Bart, 1989, p. 84).

Incorporating into the secondary semiotic system of myth, feelings can either change their quality or be generated from above by the myth itself, which needs sensory reinforcement and orienting itself to the search for suitable sensations. Модификация и по рождение необходимых для подтверждения мифа ощущений осуществляются прежде всего через выбор или усвоение соответствующих означаемых первичной семиотической системы, т.е. телесных конст руктов. Так как ощущение, становясь содержанием сознания, с не обходимостью отливается в форму соответствующих категорий, то их актуальный набор, зависящий от предположений и ожиданий субъекта, будет определять качество переживания телесных ощу щений.

Целые медицинские направления или методы, сохранившиеся до наших дней, такие как, например, аюведическая, антропософ ская и тибетская медицины, натуропатия или акупунктура основа ны на весьма своеобразных представлениях об устройстве организма и выявляют у своих адептов соответствующие этим представлениям симптомы (Эберман, 1925; Чаттопахьяя, 1961; Капур, 1982; Хи-гель, 1983; Базаром, 1984; История китайской философии, 1989). Существует большое количество этнографической литературы, по священной описанию разнообразных мифологических моделей и конструкций тела {Антонович, 1877; Robbins , 1959; Healing , Magic and Religion , 1985; Carry , Feher , 1980). Важно, что независимо от степени соответствия этих моделей реальности, они всегда подтверждаются субъективными телесными ощущениями. Доказатель ство этого — культурно-исторический патоморфоз симптомов, доминирование в клинике истерии, неврозов и ипохондрических синдромов жалоб, соответствующих господствующим медицинским теориям.

В качестве более современных примеров можно назвать болезни студентов-медиков 3 курса, демонстрирующих симптомы изучае мых ими форм патологии, или феномен ятрогении. Многие болез ни, никак не проявлявшие себя, после установления диагноза начинают обрастать чувственной тканью. Так, при случайном вы явлении опухолевых образований у больных появляются опреде ленным образом локализованные болезненные ощущения. Стабиль ность таких ощущений связана с уже отмечавшимися трудностями их проверки и коррекции. Богатейшая феноменология вторичного порождения телесных ощущений в рамках сверхценных идей и пер вичного ипохондрического бреда описана в психиатрии ( Huber , 1957; Ротштейн 1961; Ladee , 1966; Lopez - Ibor , 1972; Эглитес, 1977; Смулевич, 1987). Не столь вычурные, но также весьма яркие случаи встречаются и у психически здоровых людей. Для иллюстрации приведем два клинических наблюдения.

Больная К.А.Е., 47 лет, диагноз: рак тела матки, состояние пос ле комбинированного лечения. Больная поступила в онкологический центр с жалобами на непереносимые неприятные ощущения в брюш ной полости, связанные, по мнению больной, с прогрессированием онкологического заболевания.

При объективном исследовании никаких патологических изме нений не выявлено. Отмечается анатомический вариант располо жения брюшной аорты близко от брюшной стенки. Прощупав пуль сацию аорты, больная решила, что это метастатическое поражение каких-то сосудов. Возник страх разрыва сосудов, сопровождавшийся появлением непереносимых болезненных ощущений в области живота.

Больной О.А.О., 23 года, практически здоров. Больной поступил в онкологический центр с жалобами на боли в животе слева, ирради-ирующие вниз живота по прямой кишке и вверх, в сердце. Проекция болей не соответствует анатомическому расположению органов. Счи тает себя больным около 5 лет, когда после обильной еды появились болезненные ощущения в животе. Незадолго до этого от рака прямой кишки умер отец больного, что по его (больного) мнению служило доказательством наследственного онкологического заболевания у него самого. При обследовании выявлен ускоренный пассаж пищи в тонкой кишке, послуживший, видимо, источником интрацептивных ощущений.

Эти случаи показывают, насколько под воздействием усвоен ной концепции болезни могут быть развиты самые невинные и мимолетные интрацептивные ощущения. Несмотря на отсутствие каких-либо объективных оснований, эти больные на протяжении мно гих лет были убеждены в своем смертельно опасном заболевании, вводя в заблуждение многочисленных врачей.

Интересный случай такого же рода приведен в книге Э.Б.Тайлора «Первобытная культура»: «Не одно только зрение приводит к обманчивой реализации мечты, грезы, фантастического образа. Для подтверждения их все внешние чувства как будто вступают в заго вор. Укажем следующий поразительный пример. Существует раздра жающая кожная болезнь, постепенно покрывающая тело лишаем, точно поясом. Нетрудно понять работу воображения, которое эту болезнь приписывает какой-то извивающейся змее, и я помню случай в Корнуэлльсе, где семейство заболевшей девушки с ужасом наблюдало, будет ли она вся опоясана этим гадом, так как на основании поверья больной должен умереть, если голова и хвост змеи сойдутся. Но значение этого фантастического представления отра жается еще полнее в сообщенном д-ром Бастианом случае, когда один врач страдал чрезвычайно мучительной болезнью, причем ему казалось, будто змея обвилась вокруг него, и эта идея дошла в уме его до такой реальности, что в минуту чрезмерных страданий он мог видеть змею и ощупывать руками ее твердую чешую» {Тайлор, 1989, с. 143).

5.3. Семиотическое опосредствование интрацептивных ощущений на модели медицинского ритуала

Особенно ярко влияние концепта болезни на телесные ощущения проявляется в особом феномене — ритуальном лечении. Ритуальность — настолько характерная черта народной медицины, что невозможно найти ни одной медицинской системы, где бы она от сутствовала. Феномен ритуального лечения демонстрирует влияние символического действия, объективно не связанного с причинно- следственными характеристиками заболевания и объединенного с последними лишь в сознании индивида. Тем не менее, это дейст вие, лишенное непосредственной целесообразности и служащее лишь обозначением определенных семиотических отношений, при водит к субъективному, а иногда и объективному улучшению сос тояния больных. Этот эффект очевиден даже для тех, кто скепти чески относится к ненаучным медицинским системам, и если бы его не было, то магические приемы не имели бы такого распростра нения во все времена и на всех континентах.

Пытаясь снять это противоречие, научная медицина искала в ритуалах естественно-материалистическую основу. При этом под разумевалось, что лечит, конечно, не сам ритуал (это невозмож но), а те конкретные материальные действия (фитотерапия, физи ческие методы), которые с ним связаны. Собственно магическая часть при таком понимании — это вздор, недостаточность логичес кого мышления, отсталость и либо не имеет практической ценнос ти вообще, либо, в лучшем случае, несет не вполне ясные психоте рапевтические функции успокоения пациента.

Определенный смысл в таком подходе есть, но, к сожалению, он не решает проблемы до конца. Эффективность «естественного» лечения, вырванного из ритуального контекста, значительно сни жается, тогда как одно магическое действие отчетливо улучшает состояние пациента. «Во всех... случаях терапия (насколько известно, часто действенная) трудно поддается объяснению: когда она направ лена на больной орган, она слишком груба и конкретна (обычно это чистый обман), чтобы оказать какое-либо действие на внутрен ние органы, а когда она состоит в повторении ритуальных обрядов, зачастую весьма абстрактных, остается неясным, на чем основано ее лечащее действие. Обычно, чтобы избавиться от трудностей, связанных с объяснением этого воздействия, говорят, что речь идет о психологическом лечении. Но этот термин остается лишенным со держания до тех пор, пока мы не поймем, каким образом опреде ленные психологические представления могут положительно вли ять на строго определенные физические расстройства» (Леви-Строс, 1983, с. 170).

Трудно с большей очевидностью показать, что решение этой проблемы возможно только на психологическом уровне. Эффектив ность ритуального лечения останется загадкой, если считать болезнь, симптом и телесное ощущение натуральными физиологическими процессами, и превратится в решаемую проблему, если их понимать как сложные семиотические образования.

Обратимся к конкретному примеру ритуального лечения, при веденному К. Леви-Стросом в его работе «Колдун и его магия» (Там же). Это ритуальное исполнение особого песнопения шаманом в момент трудных родов. В песнопении описывается путешествие по телу больной неких маленьких существ, являющихся причиной бо лезни, которое заканчивается победой над ними шамана. Это чисто психологический способ лечения, так как шаман не прикасается к телу больной и не дает ей никаких лекарств, но в то же время явно и прямо говорит о патологическом состоянии и о том, чем оно вы зывается. Смысл этого песнопения заключается в следующем: оно переводит неопределенные ощущения больной в четко локализован-

understandable and, by giving her the language, turns an affectively charged situation into a safe, non-threatening situation. “... The song represents a kind of psychological manipulation of the diseased organ and ... recovery is expected from this manipulation” {Ibid., P. 170). This is a concrete example of the influence of myth on the primary sensory tissue, modifying which, the shaman greatly facilitates the sickness of the patient.

However, having understood their torments, the patient not only resigns herself, she recovers. This can be easily explained in cases of functional diseases, when any psychological factors act as the primary cause of the disease. But diseases, although numerous, do not exhaust all cases of pathology. There are no fewer organic diseases with a primary lesion of the material substrate. In this case, the treatment with ritual can be understood only by recognizing that the disease, at least in humans, is not just a disease of any organ, but above all its reflection in the consciousness of the subject. In other words, it cannot be presented to him except as an inner picture of the disease. In the logic of the development of the disease, two sides should be distinguished: the objective, subordinate to the natural laws, and the subjective, associated with the laws of the mental. Only in the abstract limit do they completely coincide, in reality, they can diverge quite significantly. So, even with an objective progression of the disease, patients who believe in the effectiveness of the treatment they are conducting (often completely inadequate) can feel subjective improvement for a long time. (I had to observe this phenomenon quite often in oncological patients.) The limits of such a disagreement are truly amazing: fanatical followers of therapeutic starvation, despite an obvious threat to health and life, nevertheless sometimes feel a continuous improvement, even in lethal outcomes. Religious rites are very painful actions are not perceived as such.

On the contrary, if some condition is signified as a disease, and the treatment is perceived as impossible or insufficient, then even with an objective cure, the patient will continue to consider himself ill. This can happen if the disease really did not exist at all. The "evil eye", "spell" associated in the mind of the subject with the disease, cause the corresponding somatic sensations. The extreme expression of such a connection is Wood — death, resulting from a spell, witchcraft, or breaking taboos (Reikovsky, 1979; Levi-Strauss, 1983). A person who considers himself an object of witchcraft charms, is convinced, in full accordance with traditional beliefs, that it is doomed and really dies soon. Cases of recovery from Voodoo-death with the help of European medicine methods are possible only if the patient considers the magic of the white man to be the strongest.

Objective fidelity of the myth underlying the treatment method is not of fundamental importance. The most fantastic and ridiculous medical techniques find their dedicated followers. This is precisely the non-specific factor that provides any therapeutic (including psychotherapeutic) definition of success, especially in terms of immediate results. As in the case with the shaman: “the fact that the shaman’s mythology does not correspond to reality is irrelevant: the patient believes in her and is a member of a society that believes in her. Evil spirits and helper spirits, supernatural monsters and magical animals are part of a coherent system on which Aboriginal ideas about the universe are based. The patient accepts their existence or, more precisely, never questioned him. What it cannot reconcile with, is the suffering that falls out of the system, seem arbitrary, something alien. The shaman, with the help of myth, recreates a harmonious system, having found an appropriate place for this suffering ”( Levi-Strauss, 1983, p. 176). The success of any psychotherapist is largely determined not by the “truth” of the theory he uses, but by completely different qualities: authority, persuasiveness, artistry, subtle “patient feeling”, ability to make him turn into the myth he proposes. The healer’s fame itself is a ready-made myth that helps to give persuasiveness to the proposed treatment, and, in a certain sense, the “great healer” is great not because his method helps better than others, but rather, on the contrary, the method cures precisely because the healer considered "great."

Of great importance is also the readiness of the public consciousness to perceive myths of a certain kind, the conformity of the myth of the patient and the myth of the doctor. Even K. Levi-Strauss noted that the birth of psychoanalysis and the consolidation of its position as a scientifically based method of treatment led to the formation of a special “psychoanalytic” culture in the European public consciousness of the beginning of the century, the emergence of a “psychoanalytic patient” articulating his complaints “psychoanalytic” in a way. Psychoanalysis is akin to shamanic practice: “in both cases, the goal is to bring internal conflicts and hindrances that until then were unconscious, either because they were suppressed by other psychic forces, or because (as in the case of childbirth), in both cases, that the processes taking place, by their nature, are not mental, but organic or even mechanical. Similarly, in both cases, internal conflicts and internal hindrances disappear not because of the fact that the patient gradually acquires real or supposed knowledge of them, but because this knowledge makes it possible for a special kind of experience in which conflicts are realized in such a sequence and in such a plane that contributes to their unhindered flow and resolution ... From the fact that the shaman does not analyze the psyche of his patient, it can be concluded that the search for lost time, which is sometimes they are triple as a basis for the therapy of psychoanalysis, they are only modifications (the value of which cannot be neglected) of the basic method. The definition of this method must be independent of the origin of the myth, individual or collective, since the mythical form prevails over the content of the prose ” (Levi-Strauss, 1983, p. 176, 182). Not surprising in this connection are the equal successes of countless psychoanalytic (and other psychotherapeutic) schools.

On the other hand, the lack of assimilation of the proposed myth, such as the underdevelopment of the natural-science paradigm in traditional societies, leads to a significant decrease in the effectiveness of European medicine in them (Kapur, 1982; How a traditional healer ..., 1982; Hegel, 1983; Coppo, 1983) . As a result, in Nigeria, for example, 70% of patients continue to use the services of folk healers, even with the possibility of accessing scientific medicine ( Chiwuzie et al., 1988). In these cultures, the treatment offered by European medicine has no basis for the formation of an adequate myth.

Understanding this point allows you to avoid many misunderstandings associated with the interpretation of the role of objective factors in various therapeutic procedures. A doctor who takes the mythological reality as the true reality risks fighting “in the wrong field”. This relatively innocent fallacy becomes serious when the immediate positive subjective effect of treatment hides long-term results, and patients lose the time needed for pathogenetic treatment. The danger of such confusion is great because, having received confirmation of his method by improving the patient's subjective condition, the doctor begins to believe in the objective nature of the method, misleading both himself and the sick, and numerous scientific institutions. This misunderstanding is even more expensive for the researcher. So, until recently the actual idea of ​​studying the mythological television treatment is quite obvious A. M. Kashpirovsky objective methods recalls an attempt to explain the effect of the Bible on believers by the chemical properties of the paper on which it is printed.

A classic example demonstrating the influence of myth on those forest sensations is the placebo effect. In essence, this is nothing but a variant of ritual action: the preservation of all attributes of treatment according to the scheme of natural science medicine (taking a dummy under the form and in the form of a drug, the patient has more or less developed ideas about the essence of the drugs, experience their use) in the absence of the most important - the actual drug. The ritual of placebo treatment is interesting in that it can be modeled under experimental conditions, allowing you to isolate and evaluate the various factors involved in its formation. However, before we start discussing the results of such studies, let us consider in more detail the mythological schemes related to the concepts of health and disease. This will make it possible to move from speculation to concrete facts and will enable us to detect a logical pattern in their diversity.

5.4. Classic and modern myths of illness and health

The mythology of the disease varies greatly throughout human history. But it is rather a substantial historical and ethnographic diversity, in which stable structural archetypes can be distinguished.

Myths about illness and death are among the most common and ancient. At the center of such myths is the fundamental idea of ​​diseases as something external and alien. The explanation is built on the contrary. The disease is opposed to a normal healthy state as something that is not peculiar to man, introduced from outside and does not depend on it. The first people did not get sick and did not die until any divine ordinances were violated or sins were committed. In the biblical tradition, this is the fall of Adam and Eve; in Indian mythology, death is created by Brahma in order to break the world from overpopulation.

Alien disease is an uncontrollable phenomenon with its own activity independent of the person. Objectification of a disease is a natural psychological consequence of a violation of the normal, automated course of any processes or the impossibility of arbitrary regulation of activity. A person becomes sick when he cannot cope with his condition and needs help. At the same time, this impossibility allows us to distinguish the disease from being creative, licentiousness or bad habits. In the last three cases, the person does not want to “pull himself together,” and in the first case he can not do this.

In ancient and modern folk medicine, natural causes of disease are extremely rare and even in these cases they are far from etiological. Traditional healers in Zaire explain various diseases of pregnant women by the fact that the worm, which is wound up in the body, gnaws the fruit, and in the opinion of the Mali doctors, any disease is an imbalance between heat and cold (How does a traditional healer ..., 1982; Koppo 1983). Although these are very specific and realistic reasons, they are nothing more than imaginary. Only a small circle of diseases was due to natural causes and rational methods, as a rule, treated only minor injuries and skin lesions. The natural explanation was understood to be simpler, and surgeons dealing with such "visible" diseases referred to the lower castes of the medical class (Foucault, 1998). Diseases that have no obvious visual signs (diseases of internal organs or mental diseases) were explained irrationally {Yangni-Angate, 1982; Baro , 1990). The causes of such diseases are the action of evil spirits, witchcraft, the penetration of anthropomorphic and zoomorphic creatures into the organism. The personalized incarnations of the disease include Nav and Morin in Slavic mythology, Sabdag in Tibetan, Kutys in Udmurt, Giltina in Lithuanian, and thousands of other deities or spirits.

This view follows from the general ideas of the ancient man about the structure of the world, originally filled with living beings, which are the cause of everything that happens. The concept of the living precedes the concept of the dead, and for the primitive consciousness of the dead nature does not exist, and the course of events is determined by the actions of these creatures. Causality is understood as the result of someone's will, not “how”, but “who”, and it does not expect the discovery of a universal impersonal law (Frankfort et al., 1984).

The new time has significantly modified the idea of ​​the causality and personification of the disease, leaving their rudiments and giving rise to new myths. In mechanistic materialism, ideas about the human body appeared as a complex mechanical device, and the disease began to be understood as its clogging or malfunction. It is interesting that the complexity and structure of such a mechanism were directly borrowed from the most common mechanical devices of their time. In the XVIII - XIX centuries. Mannequins, watches were the favorite analogues, and in our time - automobile motor, which served as a model for “pollution”, “accumulation of slags”, “overpressing”, “obstacles”, etc. Plumbing and hydraulic explanations of the body's work are extremely popular. . One should expect the appearance of analogs with computers, nuclear reactors and other new equipment. The first examples of this kind have already appeared as a method of “coding” from alcoholism according to A.R. Dovzhenko. The idea, which was absolutely incredible in its absurdity, nevertheless fell on the ground prepared in everyday consciousness, giving rise to numerous followers who extended the idea to “coding” from trouble and grief. The success of the method generated from its authors (exactly the same as in the case of the Levi-Strosovsky shaman Kvesalid 2) the conviction of its truth, and in accordance with the traditions of objectivism - the desire for theoretical justification from the standpoint of neurophysiology.

Samples of such a plumbing understanding of the body's work have found a place in the regular publications of the journal Svet. Man and Nature ”, offering its readers a variety of options for healing and“ cleansing the body ”: from“ grounding ”to“ dry starvation ”.

As an example of this kind of myth, one can consider Arinchin’s small publication “Gomokibernetika”, published in 1990 with 200,000 copies under the signature of the Ministry of Health of the BSSR. It differs from other similar ones only by lapidary and special straightforward presentation. "Gomokibert netik", by definition, the author, "is the art of management

-2 This is a passage from the native biography of a native named Kvesalid in Kwakiutl, recorded by Franz Boas ( Boas , 1930). Questalid did not believe in the power of the sorcerers and, prompted by the desire to reveal their deception, achieved initiation into shamans. He was taught to feign fainting, nervous seizures, induce vomiting, sing magic songs, use the "seer", i.e. spies who are obliged to eavesdrop on private conversations and secretly report to the shaman information about the source and symptoms of the diseases with which one or another tribesman suffered. Having established himself in his worst suspicions, Kvesalid decides to continue his investigation, but unexpectedly faces the fact that his deceitful methods bring the obvious therapeutic effect and the loud glory of the great shaman, which causes him to rethink his attitude towards witchcraft (Levi-Strauss, 1983).

health and longevity, based on new scientific data on the role of skeletal muscles in the human presence and blood circulation ". The main cause of the disease is that due to the fact that the person became erect, the inflow of venous blood from the capillaries of the lower extremities was disrupted. As the author points out, “... as a result of the research, the muscles turned out to be primarily suction-injection micropumps — independent peripheral microheart”. The goal of homo-cybernetics is “to make all assistants of the heart work,” since they rested during sleep, and the heart continued to work. In the process of sleep, the blood supply to the organs is reduced, and the formed elements of the blood, red blood cells and white blood cells, are deposited in the liver and spleen. The blood becomes thinner, and it is easier for the heart to push it through the vessels. After awakening, it is necessary to transfer the blood cells stored in the “depot” into the bloodstream, “rinse”, “massify” the internal organs, put the “heart helpers” into operation. It is terrible to even imagine what a mass of new intraceptual sensations await a person who decided to follow these tips!

Creation in the XIX century. Virchow's cellular theory and Pasteur's work in the field of microbiology have opened to the ordinary mind a new kind of zoomorphic creatures: bacteria, microbes, viruses. Described L.N. Толстым в «Плодах просвещения» мифологичес кое понимание микробиологических теорий сохранилось до наших дней: обычному человеку кажется, что избавление от болезней лежит в тотальной стерилизации организма, представления о «нор мальной», «патогенной» и «условно патогенной» флоры непопу лярны и понятны лишь лицам, имеющим медицинское образование. Природные силы, ранее персонифицированные в виде божественных существ, в последнее время были «реинкарнированы » в виде «биополя», «кармы», «чакр», «жизненных сил», пони маемых во вполне мифологически-механистическом духе.

Близко к мифологическим представлениям о болезнях находится и их естественное дополнение: представления о здоровье. Отожде ствление здоровья с реальным конкретным предметом проявилось в широко распространенных мифах о существовании объекта — носителя здоровья. Эта связь понималась чисто материалистически: трудно представить себе большего материалиста, чем древний чело век, полагавший, что, съев сердце льва, можно приобрести его храбрость. Главный герой киргизского эпоса «Манас» пьет для этих целей кровь убитого врага. Гильгамеш — герой шумерского эпоса — получает вечную жизнь, съедая плод «растения жизни». Добывание «жизненной силы» служило причиной «охоты за головами», как местом ее пребывания, у индейцев Нага (Шинкарев, 1988). Можно назвать также «живую воду» и «молодильные яблоки» в славянских сказках, «яблоки Индунн» — в Младшей Эдде, «яблоки Гесперид» и «амброзию» — в греческой мифологии, «амриту» и «мандрагору» — в индийской, «яблоки Нартского сада» — в нартском эпосе, «активную воду» — у экстрасенсов, витамины, микроэлементы, бифидобактерии и «проникающие в самые корни питательные вещества» — в современной рекламе.

Конкретные носители здоровья часто материализовывались в виде лекарств, содержащих в себе либо само здоровье, либо некую активную субстанцию, побеждающую болезнь. Элементы этих ве рований можно проследить от «панацеи» древних до современных «стимуляторов иммунитета».

Субстанциональные или персонифицированные представления о болезнях и здоровье настолько широко распространены, что та кую форму можно рассматривать как особенность человеческого сознания. Одна из возможных причин этого заключается в сущест вовании различных «призраков языка» — ловушек речевого мыш ления. Л. Витгенштейном этот феномен связывался с влиянием «грамматического гипноза». В нем проявляется грамматическая практика фиксации в существительных функциональных реалий, рождающая ложные представления об их природе ( Wittgenstein , 1964). Существительные же побуждают искать определенные предметы, нечто субстанциональное ( Ryle , 1949; Козлова, 1989).

Непосредственная причина заболевания вытекала из общих представлений о причинности. Если болезнью управляют высшие существа, то они насылают ее, когда необходимо за что-либо покарать человека. Конкретная вина может быть разной: оскорбление богов, нарушение табу, неповиновение, невыполнение каких-либо обязательств или, наконец, просто плохой характер божественных существ, отвечающих за болезнь. Батонеби — группа духов в грузинской мифологии — приносят инфекционные болезни, когда к ним относятся без должного уважения, поэтому в семьях, где есть больные, необходимо приготовить для них угощение и подарки. Ведь-ава — хозяйка воды в мордовской мифологии — может на слать болезни, и чтобы откупиться от нее, нужно бросить в воду деньги или зерно. Идоменей — внук греческого царя Миноса — после похода на Трою попал в бурю и дал обет Посейдону при нести в жертву первого встречного. Этим человеком оказался его сын. Разгневанные боги наслали моровую язву. Насылание «моровой язвы», чумы, холеры, проказы как кары за грехи является сквозной темой многих мифологий.

С пониманием причинности как безличного закона в Новое вре мя резко сокращаются теории «кары», расплаты за вину. Болезни включаются в стихийные события, никем и ничем целенаправленно не управляемые. Их течение не зависит от человека и все, что ему остается сделать, — это постараться их избежать. Стихией нельзя управлять прямо, но можно принять меры предосторож ности. Параллельно остаются осколки веры в