Is There Medicine in Magical Thinking?

January 6, 2021

Until I researched “magical thinking,” I had mistakenly relegated all of it to naivety and irrational thinking. After doing a little study of it, I’ve come to understand it as a “reflexive,” sometimes learned response to anticipating uncertainty or an adverse outcome. As my views shifted, my capacity to respond with more empathy for myself and others expanded. Birth story listeners can benefit from learning about the evolution, function, and conscious calibration of magical thinking and how it plays a role in reducing anxiety. 

 MAGICAL THINKING” refers to a belief that one’s wishes, thoughts, or actions cause or prevent an outcome from happening. In various ways, everyone has practiced magical thinking, beginning in childhood to their most recent unwished-for moment or anticipation of a threat to their security, well-being, or survival. In the last century, where evidence-based information and reductionistic thinking is increasingly revered, the eternal human yen to have control over the uncontrollable, to grasp the unknowable, and embrace the sacred through magic and personal rituals may be met with an eye-rolling dismissal, dismissing the possibility that magical thinking and personal rituals play any positive role in coping and participating with the uncertainties of day-to-day life.

Anxiety is our emotional, behavioral, and intellectual response to anticipating a future aversive event and uncertainty about whether we can avoid or mitigate the physical or psychological threat. It is triggered when we feel we have little or no control over novel, stressful, unpredictable situations, especially those we perceive as threats to our survival.⁵  Anticipatory anxiety is pervasive in modern obstetrics (for parents and caregivers); an inevitable consequence of continuous diagnostic screening, vague predictions and forewarnings of potential outcomes and future management. Overly active imaginations ruminate about worst-case scenarios, but the anxiety that follows isn’t imaginary; it is genuinely physiological and psychological. Anxiety manifests physiologically through a release of a flood of stress hormones: the heart races, breathing is uneven, the gut churns, mobilizing us to act. A well-calibrated level of anxiety allows us to assess the probability and severity of an anticipated threat, and to be solution-minded in preparing to effectively avoid or respond to the threat. On the other hand, over-estimating the probability or severity of a threat and not being prepared or capable of responding in some way creates excessive anxiety, and interferes with psychological and physiological well-being.¹

MANAGEABLE and UNMANAGEABLE  EVENTS or THREATS

A manageable risk or threat is when an individual has enough knowledge about the threat to respond logically and effectively. For example, someone in a field during a lightning storm who knows that lightning tends to strike the highest point in an area can reason that the next best thing to do is find a ditch to lie in or get as low to the ground as possible for the duration of the storm. Knowing what to do reduces the threat and anticipatory anxiety caused by the potential threat.⁶ 

Consider a manageable event or threat related to childbirth, such as cesarean surgery, from the parents’ perspective: For many reasons, some parents feel anticipatory anxiety about cesarean birth. However, parents who learn what they can do to decrease the likelihood of cesarean, what to expect during cesarean surgery, and a few things they can do to make the experience more personal and less stressful, have a lower level of anticipatory anxiety-stress.

In the absence of childbirth mentoring, parents try to navigate self-preparation or accept advice from people who may be inexperienced or leaning toward magical thinking, e.g., discouraging preparation in favor of simply: “trust birth.” Magical thinking may momentarily feel assuring and lower anxiety, but when it interferes with solution-minded preparation, in the long run, parents often experience a surge of anxiety during the surgery for which they are not prepared.

Learning what to do in a lightning storm does not influence the chance of being in a field during a lightning storm any more than learning about cesarean surgery increases the likelihood of having one.

The lion’s share of high-stress and anxiety comes from unmanageable threats that cannot be influenced by logical thought or human behavior; these situations are uniquely responsive to magical thinking, which mitigates anxiety- stress in a way that logical thinking cannot.⁷  Long ago, humans discovered that, when facing unmanageable threats, magical, repetitious, rigid ritual behaviors reduced anxiety and improved their ability to cope and survive. Not-knowing “why” or “why me?” contributes to feeling vulnerable and anxious in a random world. ­­­­­But, imagining a causal link, reason, lesson, or purpose allows humans to believe they “know why,” and therefore, have control in bringing about or avoiding this unwished-for event in the future. Magical thinking evolved to reduce anxiety even when it has no effect on the outcome. 

Consider the following example of an unmanageable outcome:

Char, a young doula, attended an extremely preterm labor. When the doctor counseled the parents their 23-week-old baby would not survive, the doula could not accept the predicted outcome. She believed the doctors were not “doing enough.” So, the doula decided to do everything in her power to make the baby survive, beginning with calling a friend who did aura energy work. Her friend told Char to turn the cell phone toward the mother while she “sent positive energy” to the mother and baby.

Long ago, faith in obstetric science eclipsed space for the sacred and excluded personal rituals during preparation, the ordeal, and return. For some people, trusting medical “rituals” is enough to reduce their anxiety. For others, passive waiting raises anxiety. In the absence of existing spiritual and social rituals for the many thresholds and uncertainties of childbirth, people often create their own out of necessity. The fetus could not have survived outside the womb, so, from the medical perspective, the only thing left to do was to attend to the mother’s physical well-being (following highly structured rituals of medical care, see below).

Facing this unmanageable, unchangeable outcome, the parents, baby, and doula in our story needed a personal ritual to contain their entwined, invisible inner journey. The doula hoped calling for additional support from an aura energy healer— even when it would come from a distance, through a phone—would change the outcome. Even though this transmission of positive-energy could not change the course of labor, it could meet the trio’s emotional and spiritual needs. While many would associate this mediation with innocence, might it also be a quality of the resourceful, empathic Warrior, one who acts for the benefit of others? 

Psychologist Jean Piaget was the first to study how children think differently from adults. When he developed the four stages of childhood development (1936), he realized that children younger than eight years old do not understand cause and effect, and can’t distinguish fantasy from reality. Every child two- to ten-year-old believes that their thoughts or feelings can make or prevent things from happening to others or in the world and that proximity in the timing of two events might mean one caused the other.²

When I was six years old, my father drove away one day, never to return, and for many years I believed I made him leave because I hid his cigarette lighter under my bed (to help him stop smoking). I missed my dad and felt guilty for making him go away, so another magical thought followed: I could make him come back if I did not misbehave again.

Some say magical thinking dissipates by pubescence, but that’s not been my observation. In a variety of ways, adults engage in magical thinking every day, and have done since the beginning of organized culture. To this day, even in a world increasingly dominated by science and technology, every human on the planet engages in magical thinking now and again because “even for the clear scientific mind, the subject of magic has a special attraction,” explained Polish anthropologist Bronislav Malinowski, “partly because magic stirs up in everyone some hidden mental forces, some lingering hopes in the miraculous, some dormant belief in [human’s] mysterious possibilities.”³

When Malinowski studied the primitive Melanesian Islanders (1954), he was the first to discover that magical thinking was associated with anxiety. He observed the Melanesians had two ways of thinking: They relied on rational thinking in matters where they had mastery and knowledge, such as in the meticulous construction of their sailboats’, sailing, fishing in familiar waters, or gardening. But, when it came to facing the inexplicable moods of Mother Nature over which they had no control, such as the uncertainties of wind, rough weather, deep-sea sailing or diving—they relied on magic rituals and magical thinking. His conclusion: magical thinking has a function: it decreases anxiety and increases confidence to function in uncertainty.⁴  Stress and anxiety also diminish performance, memory, our ability to think and react quickly, and our ability to heal.

MEDICAL RITUALS

Predictable and repetitive clinical routines, i.e., medical rituals, bring order and structure to circumstances and environments that feel chaotic and full of uncertainty.⁸  Labor and obstetrics are synonymous with uncertainty,⁹ so the birthplace is a breeding ground for various rituals: sacred, personal, and medical. Contemporary health care utilizes ritual to define relationships, legitimatize authority, reinforce social order, and contain anxiety in high-stress work environments. Doctors, nurses, and midwives unwittingly interact with patients in a highly ritualized manner.

“What is the magic of rituals? The quick answer is less about magic and more about science.

“The defining features of rituals are repetitive and rigid movements and behavior. This rigid routine “buffers against uncertainty by evoking a sense of personal control and orderliness. The very act of engaging in a scripted sequence of ritualistic movements tricks the brain into thinking that it’s experiencing the pleasant state of predictability and stability.”                                                                        —Nick Hobson ¹⁰

Medical and religious rituals influence meaning to the experience and influence expectancy for outcomes from a treatment; this also mobilizes beneficial placebo effects.¹¹  Medical ritual behavior may be evident or invisible to the degree to which we have become accustomed to them; in part, we accept them even when a part of us may question or resist them. Examples of ritual behavior include: wearing the “seven mehda“ unique to obstetric caregivers (white coats, scrubs, uniforms, caps, booties, gloves, official name badges); the use of a special language, terms and jargon;  While rigid adherence to protocols establishes and maintains efficiency in clinical settings, it may inhibit progress and change.¹²

IN SEARCH OF MEANING & THE SACRED

Mythology, magic, magical thinking, and religion have restored peace of mind by constructing meaning when things seem pointless. When people feel uneasy, powerless, unprepared, or alone—like the doula and parents in a labor that came too early—many seek a higher power or a connection with someone with knowledge or resources they don’t have.  Personal and shared rituals invite active participation in the mystery and instill a sense of belonging, caring, and control. As birth story mentors, we can be instrumental in reviving and validating our storytellers’ innate creativity for personal rituals.

Unasked-for, undeserved reverses in life are unbearable without meaning. Therefore, humans seek and give meaning and purpose to adversity and betrayals. When we are not sure there was any purpose in the terrifying ordeal we survived, we quiet our unease by telling ourselves, “Everything happens for a reason,” or “for the best,” then imagine the reason. Finding similar experiences with mythic heroes gives personal meaning to our mythic journeys. Mythology and the ancient map of the heroic journey are the most potent tinctures in the birth story mentor’s Story Medicine Cabinet.

Without mythology, magic, and shared ritual, how would ancient initiates or patients have navigated and made sense of their initiations, ordeals, and transformations? The Victim and Hero archetypes are two sides of the same coin. So, without the ancient map of the heroic journey, think about it: Who (which part of the storyteller, Victim or Hero) would tell and give meaning to their story? Their Victim. How would humanity have progressed if the Victim story had been the dominant teaching story? But that is not what happened. Wisdom prevailed. For centuries, storyteller-mentors imprinted heroic journey myths on humanity; it is our internal map, the one that to this day helps us awaken our Huntress-Warrior to find new meaning after our Ordeals.

Birth Story Medicine includes empathic acknowledgment, a solution-focused dialogue exploring beliefs, positive intentions, personal rituals, and reliance on other resources.

BIRTH STORY MENTOR MASTERY

Part of being human is to cope with uncertainty and unmanageable threats with magical thinking and ritual behavior. It is neither good nor bad; it does not have to be replaced with rational thinking, nor can it be entirely because magical thinking arises unconsciously in response to anxiety and the need to restore order, to be connected to others or the divine, and to participate in chaos rather than be passive.

Begin Within: Self-Awareness:

In the past few weeks, as I observed my conflicted attitudes and relationship with magical thinking, my own and others. I discovered that depending on whether anxiety is mild or intense, magical thinking responds in kind: subtle to dramatic. It comes in a variety of flavors, e.g.: If I don’t think about, or read about ___, it won’t happen to me, or I won’t attract it to me.”; Wishful thinking; “If only…,” or, “Things happen for a reason,” or “This happened because I thought ____, (usually a negative thought), or “Because I did or didn’t do _____,” to name a few! And as much as I tried to be rational, sometimes magical thinking does bring hope and restores peace of mind and calmness.

I also discovered balance when a sprinkle of magical thinking was combined with solution-seeking-action. On my drive-about, on the afternoon of New Year’s Eve, driving “blind” through a mountain pass on I-75 toward Lexington, through a fog so dense it could only be called a white out. I would not see a car (especially when their lights were not on) until I practically drove into it. It was an unmanageable situation in that I could not change the fog, how other people drove, there was no shoulder to pull over on and no exits—even if there were an exit I would not have seen the sign until I was passing it!  Holding a protective amulet with positive associations might be calming,  but survival also depended on negotiating the fog without an accident. A calmer state of mind aided solution-seeking and right action:  following a semi with lots of red lights that I could see even in the fog.

Do This:  Begin noticing when you engage magical thinking, are you feeling uncertainty? Or, notice when you feel anxious do you engage magical thinking, and which forms of magical thinking are your go-to? Then notice what follows, do you feel more peace of mind, better able to cope, or still powerless? Are you able to engage magical thinking and solution-minded action together? If so, what follows?

You will encounter many storytellers whose stories include elements of magical thinking and spontaneous rituals.Thoughtfully consider if the storyteller is in their Innocent, naïve, or leans toward magical thinking versus critical thinking. Perhaps if someone relies predominantly on magical thinking, they are in a constant state of anxiety or feeling out of control.

See the whole storyteller, not just the chosen moment: consider their life experience, education, and capacity for discernment and critical thinking versus naivety and irrational optimism resulting in the storyteller (parent or caregiver) endangering themselves or others.  People exclusively relying on magical thinking may forego life-saving testing, medication, or treatment, causing harm to themselves or others.  For example:

Ignoring an abnormal NST at 42 weeks, a home birth midwife (and perhaps her clients) wanted more guidance about whether or when to transfer her client to the hospital for an induction; a Tarot card informed her to “wait” (another two weeks). Unfortunately, the cards did not foretell what the consequences would be.

Mentoring is about taking the storyteller to the next step in their understanding and journey. Find out where they are, what they are seeking, what’s working, what’s not, and what their next step is. Birth Story Medicine, the Process, includes:

•    Empathic acknowledgment and inquiry about the unmanageable risk or threat that induced anxiety

•    A solution-focused dialogue to explore their beliefs, positive intentions, personal rituals, and other resources.

•    If a ritual intervention was used, whose idea was it? Was the ritual part of their life before this event, or spontaneous in response to what was happening?

•    Be curious about whether their beliefs and rituals help them cope or strengthen their relationship with others.

As birth story listeners, may we find the Medicine in magical thinking,

Pam

CITATIONS