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Psychic Surgery: A Second Look

Psychic surgeon Tony Agpaoa feels for an intestinal growth.

“Psychic Surgery” refers to a form of healing practiced in the Philippines wherein the healer appears to perform a surgery upon a conscious patient with no instruments or anesthesia, apparently opening the patient’s body and removing diseased material with bare hands, and then closing the wound leaving no trace of the incision remaining.

        This practice was first publicly introduced to the United States in April 1960 by FATE, a magazine dealing exclusively with so-called ‘paranormal’ phenomena, events believed to be scientifically unexplainable. As the subject of “bloodless surgery” (as the practice was first called by the magazine) carried a certain amount of gore appeal, it became popular among other magazines with a similar interest in unexplained phenomena; renamed "Psychic Surgery1," the topic became reasonably well-known among those interested in paranormal theories in the United States and Europe… but it also became well-known among a particular grouping of American and European citizens with a vested interest in a certain type of paranormal phenomena: miraculous cures.

        Science, despite its own press, has limitations; the most painful of these is in the medical sciences. It has become an accepted -- almost expected -- ritual for doctors dealing with chronically or terminally ill patients to inform these patients of when biomedical science can no longer offer them either treatment or hope. Not surprisingly, there are some patients that do not accept this as the final declaration that most doctors feel it is and, instead of preparing to die, make every effort to explore other possible cures. Stories of miraculous cures offer patients beyond biomedical hope the possibility of a complete and immediate recovery. The United States has a history of such patients traveling the world looking for miracles; so the stories of miraculous healings in the Philippines found a ready audience as they were spread by the paranormal phenomena magazines.

        At first, there were many reports of amazing cures taking place as a wave of American and European patients sought out the healers named in the articles they had read. As the number of these stories about the healing and healers increased, and as foreign patients returned with stories of their own miraculous recoveries and films showing the bizarre surgeries, more and more people from Europe and the United States started to go to the healers in the Philippines with their own chronic and/or terminal problems. By 1966, there was enough interest in the topic that a book -- Wonder Healers of the Philippines, by Harold Sherman -- was released in the United States and England on the topic, which advertised and supported the stories of the miracle cures; but also by 1966, the first accusations of fraud were being made as skeptics noted that the very appearance of the operations could be imitated convincingly by stage magicians using sleight-of-hand.

        By 1970, it was no longer just people with no biomedical hope of living going to the Philippines; many patients were traveling to the psychic healers before trying biomedical treatments for their problems, some even before a biomedical diagnosis of their problems had been sought. So many people were going, in fact, that tour packages to the psychic healers began to be offered by a variety of travel agencies. There were enough people trusting the Filipino healers with their lives that the American Medical Association (AMA) composed a form letter to discourage interest in the topic among both doctors and any patients that inquired.

        At the height of the interest -- about 1972-1973 -- it was estimated that as many as 7,000 to 9,000 foreigners per month were visiting the Philippines specifically to visit the psychic healers. By this time, however, several damning truths had become apparent. Although some abnormal healings had initially been reported among the foreigners going to the Filipino healers, it was clear to the AMA that most of the patients returning were not being cured of organic diseases, and that many were becoming sicker -- or dying -- because they were ignoring or delaying biomedical treatment.

        Most damning of all was something that even supporters of the paranormal nature of the surgery had to admit... that many, if not all, of the Filipino healers had by this time been caught faking their “psychic” surgeries, using the aforementioned slight-of-hand tricks to introduce animal blood and tissue as if it was tissue removed from the patients. Soon, professional magicians were displaying on national TV in both Britain and the United States that they could fully imitate every reported detail of the so-called ‘psychic’ surgeries. Also influential was Healing: A Doctor in Search of Miracles, a book by American doctor William Nolen released in 1974, which chronicled 18 months he spent investigating the psychic surgeons of the Philippines. Nolen’s conclusion after this trip was that he saw absolutely nothing that he didn’t feel could be explained by trickery and gullibility. This conclusion officially sounded the death knell for American interest -- and likely European interest -- in the topic of psychic surgery.

        After the techniques of the Filipino healers were exposed, the AMA characterized the healers as con men out to merely bilk sick and desperate foreigners. Fewer and fewer foreigners went to the Filipino healers for help, and those patients who had previously reported miracle cures began to qualify those cures and then to disbelieve them. By 1980, American interest in psychic surgery as an alternative treatment had largely waned. Psychic surgery is currently a relatively unknown topic in the United States, even among enthusiasts of paranormal phenomena.

        But was this a fair assessment of the situation? The conclusions of both the supporters and the skeptics regarding the Filipino “psychic surgery” were reached outside of knowledge of the history, use, and beliefs regarding the techniques within the country of their origin; and the conclusions also ignored a larger question... namely, did anomalous healings actually occur that appeared to be due to the Filipino healing techniques?

The Techniques of Psychic Surgery

        The techniques of psychic surgery are very old in the Philippines and, previous to foreign interest in them, very different from the gory show that attracted worldwide media attention. Originally, the healers were farmers who did healing on the side; they would heal their neighbors, and payment was not expected. When the healer performed a ‘surgery’, they would apparently pull any of a variety of odd objects from their patients -- pieces of coconut, bits of glass, tobacco, rope, etc. -- which were generally called “witchcraft items”, as it was believed that they had been inserted into the patients' bodies by means of witchcraft to start with. These items each had (and still have) symbolic values that abstractly identified them with the illnesses that brought the patient to the healer to begin with, and so represented the disease being removed from the patient’s body. As late as 1973, a Filipino healer was observed by a foreigner to appear to pull "several, large, flat leaves" from a patient who was said to be a victim of witchcraft, and a different healer was observed removing coins from a patient's belly.

        Foreign interest in psychic surgery is said to have started as early as 1948 or 1950, and it appears likely that it was sometime around or after 1960 -- when the FATE Magazine article on “bloodless surgery” was published -- when a Filipino healer first appeared to pull blood and tissue from one of these new foreign patients. When asked at a much later date why this started to happen, a healer stated that his “spirit guide” said it was so the foreigners would believe they had been cured, and he acknowledged that they responded better to the gore than to the traditional “witchcraft items”.

        The reason foreigners responded better to the gore was likely due to a cultural difference in what was expected from medical treatments. While the native Filipinos held beliefs that made sense of strange objects -- the “witchcraft items” -- in their bodies as an explanation of illness, the foreigners -- mainly from Europe and the United States, though later many from China and Japan as well -- believed in a biomedical explanation for illness, and thus conceived of illness in their bodies as being malignant or damaged tissues and blood... and this was what they expected to see if the healer was actually pulling disease related materials from their bodies. This biomedical expectation grew in the Filipino population over time as well, maybe partly due to the foreigners who were attending the healers, but more likely because of the industrialization of the larger cities and the introduction of biomedicine in these places as the primary source of medical care. The shift is clear; by 1966, the healers that were observed by foreigners were pulling gore from most of their native patients as well as from their foreign patients.

        At first, it was believed by these foreign patients that the blood and tissue that appeared to be pulled from their bodies was indeed from inside of their bodies, often despite any evidence that the healers may be using sleight-of-hand tricks to introduce foreign matter. This belief was started and supported by both the fact that the healers told their foreign patients that the tissue had come from within their bodies (much as they told native patients that the “witchcraft items” also came from within their bodies), and because the biomedical expectations of the foreign patients regarding surgery in general was that it involved removing diseased tissue from their bodies. The later wave of foreign patients also had this impression reinforced by the sensational press coverage that told them about the “psychic surgeries”, which stressed the paranormal nature of the healings by insisting that the tissue was being “psychically” transported out of the patient’s bodies and was indeed their own diseased tissue.

        This claim was easily challenged by both skeptics (who wished to generally disprove paranormal beliefs) and the AMA (who had become alarmed at the number of foreign patients who were neglecting proper biomedical treatments while seeking miracle cures in the Philippines) because both the American and Filipino believers had to admit that they had at some time or another caught the healers using sleight-of-hand tricks to present foreign tissue as if it had been magically extracted from their patients.

        So the Filipino healers were telling their patients that the material was coming from inside the patients’ bodies, but all critical examination said it was not. That this fact would be interpreted as signs of fraud by most of the foreigners is not a surprise; in biomedical beliefs of the time, if no physical change had actually been made within a patient’s body, then there had been no action on the part of the healer that could possibly lead to any sort of cure. And the reaction of most foreigners to stories of fraudulent practices among some of the healers was that it simply meant that all of the healers were frauds, a belief that was reinforced by skeptical television programs in the United States and Europe, as well as the aforementioned book by William Nolen, and which inevitably led to the general loss of foreign interest in the Filipino healings.

Other Mis-Communications

        Initial foreign interest in the Filipino psychic surgery grew slowly at first, and was mostly spread by word of mouth and later by vacation films of the surgeries that foreigners would show to friends. It was a vacation film that led to the FATE article on psychic surgery being written, which, as stated above, led to the topic being advertised to those Americans and Europeans who were looking for miracle cures. This in turn led to a massive increase in the number of foreigners traveling to the Philippines to see the healers; and with this new crowd of foreigners came a number of new problems for, and unreasonable expectations of, the Filipino healers.

        Right off the bat, with the foreigners came their money. Though the earlier farmer/healers did not charge for their services, many Filipinos later became full-time healers that supported themselves mainly by asking for voluntary donations to their “churches”. I have been unable to determine if full-time healers developed before or after the foreigners started to visit the healers; but what is clear is that from the start of foreign interests, the visitors from America and Europe tended to be very generous with their donations if happy with their treatments. These “generous” donations were still many times less than the cost would be for treating the same illnesses with biomedical techniques at home. So due to this difference in affluence between the foreign patients and the native healers, these donations which were relatively cheap by the foreigners’ standards of living were a massive windfall by the healers’ standards.

        In addition, when the later foreign patients went to the Philippines for the first time each had generally tried to locate the same healers that they had either been told of or read about; so, over time, only a small number of healers -- about 30 -- came to handle almost all the foreigners coming to the Philippines (remember that at the height of foreign interest in psychic surgery, foreigners were arriving at a rate of 7,000 to 9,000 patients per month).

        The generosity mentioned above created competition among both ambitious healers and ambitious con men to attract the foreign patients to themselves; and the foreigners’ habit of seeking out whoever they had heard of led to both the healers and con men finding ways to advertise themselves in the United States and Europe2. These two factors also led to the creation of “psychic surgery tour packages” on the parts of some travel agencies to take advantage of the situation, at an average cost in the United States of from two-thousand to three-thousand dollars per person for a week-long trip.

        The later foreign patients also brought unreasonable expectations with them. Due to the impressions of “miracle cures” created by the sensational presentations of the healings shown outside of the Philippines, these later foreign patients commonly had illnesses that had already been declared biomedically untreatable -- advanced or complicated cancers being the most common -- which they fully expected the Filipino healers to be able to completely cure in just one or two visits. Later, the Filipino healers also started to receive patients who saw them as a relatively cheaper and faster way to treat illnesses compared to the known costs and treatments available biomedically; some of these patients simply could not afford the treatments recommended by their foreign doctors.

        When the Filipino healers performed their psychic surgeries for these foreign patients, most patients left convinced they had indeed been healed as they had hoped to be. As many of these patients in the months afterwards started to realize their physical complaints had not actually gone away, and in some cases had worsened, their opinions regarding the Filipino healers also bottomed out, and they as well as the AMA began to characterize all the healers as con men (which some were) and the whole practice of psychic surgery as a fraud designed to draw in tourist dollars, a claim that the available tour packages made believable. Clearly though, this claim was a massive simplification of a complicated interaction in which foreigners were largely responsible for the initial misrepresentation and advertising of a native Filipino healing practice; it also nicely covered up one last major cultural difference between the medical beliefs of the Philippines and medical beliefs of biomedicine.

Psychic Surgery and "Anomalous" Healing

        Strange though it may sound after all the indications that the Filipino psychic surgery doesn’t do anything biomedically, many people still actually did experience unusual cures for their illnesses. However, these cures were largely ignored by scientists and doctors when evaluating the evidence regarding psychic surgery, an action made easier by the believers focusing too much attention on the supposed paranormal nature of the Filipino healers' techniques rather than on the anomalous healings themselves. The fact that some of the foreign patients actually experienced healings due to the attentions of the Filipino healers is noted not only in the literature of the believers, but also in the literature of the skeptics... and yet this evidence was quietly ignored. The reasons why constitute the last major cultural difference I mentioned above.

        The Filipino “psychic surgery” is a form of treatment that can be classified as part of a larger grouping of healing techniques referred to as "faith healing"; faith healing, in some form or another, exists pretty much worldwide. The basic concept and approach behind faith healing techniques are the same: the healer must convince their patients that they have been cured of their ailments and that they will become better. This is done on the assumption that if a patient believes they have been healed then they often do get better. The actual techniques used to convince a patient that their problems have been taken care of varies – it can be a evangelical priest "driving the evils" out of protestants in the American 'Bible Belt', or an entranced !Kung healer pulling invisible sicknesses from people attending a dance in Africa, or, in the Philippines, a healer apparently pulling either symbolic items or bloody tissue magically from a patient's body -- but the important point of the techniques is to engender in the patient the belief they have been cured. Belief is the whole key to all faith healing; and it is the reason why Filipino healers eventually started to pull gore from their foreign patients, and why they always tell their patients the gore comes from their bodies; the Filipino healers were trying to engender the same sort of faith in the foreigners who came to them as they were capable of engendering in their native patients.

        That the techniques chosen by faith healers are not in themselves what cause patients to get better has been demonstrated many times. One of the best documents proving this is the autobiography of Quesalid, a Kwakiutl Indian from the Vancouver region of Canada, first collected by Franz Boas in the early 1900's. What makes this account intriguing is that Quesalid initially learned to be a shaman for the purpose of discovering what their tricks were and exposing them. His suspicions were confirmed when his training showed him that all the shamans' healing techniques were essentially just a show to trick patients into thinking they had been healed; the biggest display in this show was when the shaman would spit a piece of bloody fur, hidden in the shaman's mouth previous to the ritual, into their hand and then tell the patient that it was the illness the shaman had removed from their body.

        However, when Quesalid was forced to perform the tricks himself for a patient that dreamed Quesalid could heal him, the patient was actually cured, much to Quesalid's immediate confusion. Clearly, the beliefs of the healer did not matter in this case, as Quesalid only later came to believe in the powers of the shaman as more and more people were cured by his tricks; thus, at the time he concluded that the patient healed simply because he had a strong belief that he would be if Quesalid was his healer. In addition to this bit of evidence, a later encounter with a band of shamen that used a different technique... one that seemed even faker to Quesalid than the technique he was using... showed that the very techniques themselves were not necessarily important to the healing process.

        The techniques of these other shamen were essentially the same as Quesalid's own with one large difference; instead of the bloody fur as evidence of the removed illness, these shamen were simply spitting into their hands and telling their patients that the spit itself was evidence of the removed illness. The technique still worked as often as Quesalid's own. Out of curiosity, Quesalid requested permission to try his own technique to heal a woman who failed to be healed by these other shamen; his healing cured her, and at the same time demonstrated that the very techniques themselves were not as important to the healing process as that the patient believes in their own healing.

        It's interesting to note that when European magicians wanted to tour psychic healing churches in the Philippines with the intent of showing the healers and patients that they could mimic the healer’s techniques, they were asked by their native guide if they also intended to imitate the actual cures. Faced with this intriguing question, and the possibility of facing the same dilemma as Quesalid before them, the magicians decided to skip the proposed tour.

        So the question is: can belief alone cure illnesses? Surprisingly, in some cases it can. To explain this point, you must first know that biomedicine recognizes three large categories into which bodily complaints can be grouped: autonomic diseases, psychosomatic diseases, and organic diseases.

        Autonomic diseases result from miscommunications in the human body's autonomic nervous system, which runs body functions that must be constantly regulated: obvious examples would be breathing and heartbeat, but far more is also controlled by this system... tissue growth and repair, hormone levels, the immune system, and hundreds of other body functions that are normally run completely separate from an individual's awareness or control. When a miscommunication occurs in this system a large variety of physical ailments can develop, such as loss of hair, fever, irregular heartbeat, heartburn, ulcers, bloating, diarrhea, colitis, impotency, migraines, menstrual disorders, high blood pressure, etc.

        The second category of diseases, psychosomatic diseases, refers to illnesses caused by the individual's own mind. A basic example would an individual that has convinced themselves they feel pain from a particular point in their body; between a real pain and the imagined pain, there is no perceptible difference to the individual. But far more complex -- and physical -- problems can occur from such a state of mind, due to the autonomic system responding to a situation in the body that does not actually exist.

        The last category of diseases, organic diseases, is where biomedicine places the lion's share of its resources and attentions. Organic diseases are diseases that either started as or became an impairment in the body's structure or tissue; the best known such disease is cancer, which is an uncontrolled tissue growth caused by a wide variety of influences. Other examples of organic diseases mentioned in the psychic surgery literature are multiple sclerosis, and diverticulitis.

        Of the three categories, biomedicine is at its best when dealing with organic diseases, and at its worst when dealing with psychosomatic diseases; this is because organic diseases can be cured solely by treating the patient's body. This is science at its best; mere physical cause and effect, with no need to talk to the patient to determine either what is wrong or what needs to be done about it.

        In comparison, faith healing (including psychic surgery) is at its best when dealing with psychosomatic diseases and at its worst when dealing with organic diseases; this is because psychosomatic diseases can be cured solely by treating the patient's mind.

        Although psychosomatic diseases can result in physical manifestations, treating the physical symptoms does nothing to cure the problems that initially caused them, so the physical problems often become chronic. In these cases, convincing the patient that the problem they believe exists does not actually exist will generally effect a cure; and because many autonomic disorders are just the physical expressions of a psychosomatic disease, the same techniques can often help or cure autonomic diseases as well. That this is the modus operandi behind psychic surgery is made clear by the healers themselves when they say that the actual illness is in their patients' minds, not their bodies, and when they demand absolute faith from their patients to effect the best results.

        Biomedical culture in America and Europe tends to ignore and/or belittle problems caused by psychosomatic and autonomic agencies, focusing all attention on what it is strongest at handling: the organic diseases. The knowledge that patients can sometimes become healthier just by having a positive view of their own health -- known as the "placebo effect" in biomedicine -- once was more readily acknowledged by biomedical practitioners. But the introduction of controlled investigation of the effects of drugs in the 1950's created a situation in which the placebo effect was in the way of new medicines proving their effectiveness. In the context of testing a new drug, the placebo effect was a negative factor that had to be eliminated to prove new drugs actually had a physical effect separate from just encouraging the patient to feel better. This testing, of course, ignored the implication that the placebo effect alone was as effective as many of the drugs being tested… but pharmaceutical companies can't sell placebos, which is the key reason the effect was quietly ignored.

        By 1975, the placebo effect had become redefined as simply any medicine or procedure with no intrinsic healing value, used solely for testing new medicines and procedures. Even more recently, skeptics have described the apparent healing action of the placebo effect as simply being due to the hopeful patient taking better care of themselves because they think they will get better, thus completely separating the placebo effect from the body itself by making it merely a behavioral change on the patient's part.

        So American and European biomedicine already had a presupposition in place that patients could not be healed by faith and belief alone before the topic of “psychic surgery” became a situation that had to be addressed.

        Nolen’s book on psychic surgery and faith healing (mentioned above) lays out the biomedical point of view on the matter perfectly. After summing up the general results of his trip to the Philippines, Nolen then presents three separate chapters to explain and sum up the results for faith healing vs. each of the three categories of disease above -- autonomic disorders, psychosomatic disease, and organic disease. Even though he had seen himself and cited other evidence of various forms of faith healing as actually curing most psychosomatic disorders and a large number of autonomic disorders, he states with no uncertainty that both faith healing in general and psychic surgery in particular is completely incapable of curing organic diseases... and in Nolen’s assessment this is equivalent to being completely medically useless. In short, the fact that psychic surgery and faith healing proved effective against autonomic disorders and psychosomatic diseases was simply not important when it came time for the good doctor to judge the matter3.

Questionable Ethics, Here and There

        To be fair, it must be noted that Nolen witnessed many people with organic diseases hurt themselves terribly by trusting the faith healers. Here is the ethical line that has been stepped over time and again; faith healers appear to be completely incapable of curing organic diseases, but most seem to be either completely unaware of this, or uncaring about it. The argument that has been largely framed by skeptics and biomedical practitioners is that faith healers, by their nature, are practicing in an unethical and harmful way and therefore should not be allowed to practice. This is, of course, mostly aimed at faith healers whose practices affect patients that would usually be claimed by biomedical practitioners.

        These accusations do have some merit. Faith healers in general, and psychic surgeons in particular, are not trained at universities to have the skills necessary to recognize the differences between the organic diseases and the psychosomatic and autonomic diseases. Faith healers are also unlikely to turn away patients for two reasons: first, most healers truly believe they can help with any illness, and second, a healer that turns away patients as incurable chances losing the faith of the patients they can help. Another problem is that healings engendered by belief are not predictable in their effectiveness because they depend so much on the patients themselves, each of which is different. Even if the faith healers correctly identified just those patients with diseases they could affect, there would still be no guarantee of a cure for every patient. Under these circumstances, even the most honest of faith healers takes the chance of being accused of fraud simply because their techniques will not work on every patient.

        This last reason is why most of the Filipino healers do not formally charge a fee for their treatments; making a donation to them is optional, and the nature and size of the donation dependent on the patients themselves. One of the first reports of psychic surgery, published in Britain in 1963, recounted the fact that when the author tried to give money to the Filipino healer who had treated him, the healer was surprised and insulted. Even at the height of the foreign interest in psychic surgery, there was at least one healer that still refused all money from patients, continuing to support himself as a farmer instead. Very few of the healers became rich due to their practices, though there were definitely a number of greedy healers and flat out con men who did try to get rich at the height of foreign interest in the 1970's.

        But is biomedicine applied in a purely ethical way, that its practitioners can sinlessly cast stones on other medical beliefs? Biomedicine is built around money and profit, and the doctor's ability to diagnose the difference between psychosomatic diseases and organic diseases is not much better than the faith healer's. This diagnosis relies heavily on expensive laboratory tests and equipment impossible for faith healers to afford or access. Doctors only rarely inform patients that they cannot be helped by biomedical services somehow; and when the doctors inform a patient that they can't be helped by them, it is usually phrased as a death sentence, for which the patient is charged. Even biomedically approved medicines and surgical techniques don't work on every patient... but, again, every patient is charged for the attempt.

        Consider the following: one of the American patients that was unable to be helped by the Filipino healers and that Nolen chose to present as a typical case of a failed healing in his book, initially went to the Philippines because biomedical treatments for a minor ailment triggered a rare side-effect in her that destroyed her bladder. True, the Filipino healers were unable to restore or help her destroyed bladder... but it was her American doctors that both destroyed it and then told her they could only fix it by giving her an artificial bladder. So who is more unethical in this case: the Filipino healers that the patient herself sought out but that couldn't help, or the American healers that harmed the patient in the first place? A further thought... Nolen neglects to mention who was paying for both the artificial replacement and the ongoing medical care the patient would require. Clearly, different expectations and criteria exist for judging the ethical values of faith healing and biomedicine.

        Given biomedicine's focus on organic diseases and general disdain for the placebo effect as a healing agency, how are psychosomatic diseases treated when encountered? If the psychosomatic disease has a physical expression of some sort, then this expression is generally treated as if it were an organic disease, with no attempt made to diagnose a possible psychosomatic cause; standard treatments for the physical complaint are applied, and if these do not make the physical complaint go away -- which it often won't with a psychosomatic disease -- then the nature of the treatments applied by doctors slowly become more intrusive and dangerous as only the physical symptom of the disease is targeted.

Last Thoughts

        Can a happy middle ground be found? Admittedly, the idea of doctors recommending patients to AMA approved faith healers sounds a bit unlikely... but this extreme may not be necessary. Remember, the techniques of faith healing don't matter so much as does the patient's own belief in the healing; and ways can be found to engender this belief without resorting to new techniques that are alien to both doctors and patients.

        A practical solution would be to finally re-examine the old scientific and biomedical assumption of a separation between mind and body, and at the same time consider if ending the separation between biomedicine and psychology would not be a better approach to medicine in general. This would require changes in how patients are currently treated, changes that have been recommended before; office visits need to become more personal again, and physicians need to be more willing to listen to patients... really listen, in the way that psychologists do.

        By treating patients like people rather than as just bodies, doctors can relearn how to engender the same sort of belief and trust that helps cure psychosomatic diseases worldwide.