The usual practices of so-called “medicine men” shall be considered “Indian offenses” cognizable by the court of Indian offenses, and whenever it shall be proven to the satisfaction of the court that the influence or practice of a so-called “medicine man” operates as a hindrance to the civilization of a tribe, or that said “medicine man” resorts to any artifice or device to keep the Indians under his influence, or shall adopt any means to prevent the attendance of children at the agency schools, or shall use any of the arts of a conjurer to prevent the Indians from abandoning their heathenish rites and customs, he shall be adjudged guilty of an Indian offense, and shall be confined in the agency guardhouse for a term not less than ten days, or until such time as he shall produce evidence satisfactory to the court, and approved by the agent, that he will forever abandon all practices styled Indian offenses under this rule.
—Regulations of the Indian Office
April 1, 1904
It’s 180 degrees, and I’m lying naked on a cedar bench. Peeking out from behind his handlebar mustache, a man in a pointy green hat and a loincloth beats me with a bouquet of flowers. Petals and pollen break apart on impact and drift down to the wet floor. I open my eyes between the lashings to see my wife, Laura, also nude and drenched in sweat, on a bench opposite mine. Birch leaves, sticks and yellow flowers form a pile on her head and chest.
We are dressed like salads. We marinate like steaks.
A woman in a felt hat and a loose nightgown pours water onto a bed of glowing coals in the corner. A column of steam erupts upward, and she deftly waves a branch of spruce leaves like a fan sending a hot cloud cascading down on Laura’s prone body. The hot vapor drenches her feet, calves, thighs, stomach, breasts and head.
Laura whimpers.
I make out her pleading whisper. It’s too hot. It’s too much. Then, just when my wife is about to break, the gnomish woman dips her bundle of branches into a pail of cold water on the floor and shakes it, letting loose a torrent of cold water. The burst of contrast—hot to cold and cold to hot—brings Laura back from the brink.
A cloud of steam obscures my view, and I have to remind myself that this is not a fever dream. This is medicine. This is the Wedge.
And I’ll admit, the whole situation is strange and otherworldly.
Laura and I have come to this isolated spot to learn how indigenous medicine differs from the targeted drug prescriptions and discreet physical interventions that are so familiar back home. The fey couple running the ritual uses the contrast between hot and cold to seesaw our bodies into surrender—ultimately helping to build up resilience to emotional and physical stress. They’re feeling the same heat we are, which means that we’re all working the Wedge together, communally reaching our breaking points and then walking it back. It’s a team effort.
The sauna is tucked away in a dark pine forest about forty kilometers from the post-Soviet capital city of Latvia, roughly ten degrees of latitude south of the Arctic Circle and sandwiched between Estonia, Lithuania, Belarus and Russia. The sauna itself is a fancy affair: half hobbit hole, half upscale spa. Most of the building is tucked into the belly of a hill, but its floor-to-ceiling windows look out on a placid pond.
I can’t say exactly what I expected when I signed up for a five-hour ritual of contrasting sensations. All I knew was that this is an old tradition that harks back to a time when people were more connected to the natural world, when conditions were brutal and death was much more present. Most indigenous medicine traditions I know of use sensation and stress as entry points to manipulate the body and build on the principles behind the Wedge long before I ever came along. Still, I figured that the skills I’ve learned in other parts of my journey would apply in some way to enduring heat. And though I can’t say where this is going, I do expect it to be profound.
The people in pointy hats are pirtnieks, or, in English, “sauna masters,” trained in the art of using contrasting sensations to stimulate psychological and physical changes through intense heat. In ordinary life, the woman, Ivita Picukane, is a nurse at a local hospital. Her partner, Vilnis Lejnieks, is a reiki healer. But right now, they’re shamans acting as conduits between nature’s energy and the people on their cedar benches.6 While Latvia is ostensibly a Christian country, and the home of the very first Christmas tree, most people I meet here consider themselves part of a pagan tradition that goes back thousands of years. Latvians grow up foraging for mushrooms with their families in the forest and celebrating the solstice with much more enthusiasm than anything you might find in a church. It’s probably one of the last stands for Europe’s old nature-loving traditions.
Neither Picukane nor Lejnieks speaks more than a handful of English words, but they’re communicating through their actions and the tools of the ritual. Under ordinary circumstances, the temperature and humidity in this room wouldn’t only be unbearable; it could be lethal without the sauna masters’ tricks. They perform a sort of dance with the heat, hitting us with steam and the ambient temperature until we reach the very edge of tolerance, where it feels like we’re suffocating, and then they walk us backward from the edge with a splash of cold water, a torrent of sound or the slap of their branches. The goal seems to be to keep us as close to our red line as possible without pushing us over.
The stress is all in service of their goal of pushing us past the emotional and physical limits that we arrived with. And if I’m being honest, the limits they’re working on really aren’t things that I’ve pushed too hard on before. Everything is context, and I simply don’t have occasion to think about my breaking point with heat all that much. I don’t know what passive associations I’ve locked into my psyche by not trying to push up the thermometer’s mercury. This is the tricky thing with any new Wedge experience. I simply don’t know where it will go. I’m trying to feel how my reaction to heat defines who I am, and how facing it makes me more human.
And to really understand what I’m doing and how it informs my understanding of the Wedge, I need to take a step back to try to reconsider what medicine is in the first place. The medicine served in hospitals and doctor’s offices back home concentrates on eliminating the symptoms of disease. It’s a laudable science that can deliver specific cures to well-defined conditions. In its most ideal form, Western medicine is mechanical, objective and repeatable. But Western medicine’s specificity doesn’t always account for the vast range of human subjective experience. Western doctors rarely care about how you feel; sensations don’t much matter to them. At the end of the day, all they see is pathology.
However, while underlying pathology can certainly cause you to feel bad, you don’t go to the doctor to make a mechanical change; you go because you want to feel better. You go because your senses are telling you something is wrong. And sometimes, being myopically focused on pathology can obscure the true causes of illness.
Medicine isn’t exclusively a human domain. Every living creature on Earth struggles against the threat of disease. The grinding process of evolution has given us a bewildering array of tools to help keep infections at bay—from cell walls and skin that form barriers to the environment, to highly advanced immune systems that can adapt and respond to danger without any conscious input. But it’s also important to realize that many animals take an active role in their own recoveries. They use things they find in the environment to provoke physical responses. Cats and dogs both eat certain grasses to induce vomiting when they feel sick. Chimps, bonobos and gorillas eat tree bark to rid themselves of parasites and reduce fever, moths lay eggs in anti-parasitic milkweed to protect their offspring, and bees brew antibacterial honey and can raise and lower the temperature of their hives to make it less hospitable to invaders. These actions are based on the sensory interactions of the Wedge. The animals don’t have a specific plan to alter mechanical processes the way a scientist might; they just somehow know that taking a particular action changes how they feel. And sometimes—especially with chronic conditions—our sensory system has more information to draw on than any medical diagnostic.
Indeed, Western medical interventions—cocktails of drugs, surgeries, etc.—are an often too-narrow way of addressing how the human body heals and recovers. By putting sensation first, indigenous traditions around the world offer other perspectives on chronic illness that in many cases can be more effective than treatments in hospitals and doctor’s offices at home. The breadth of indigenous treatments is too vast for a chapter, a book, or, for that matter, the entire field of medical anthropology. However, many practices build on the same foundation as the Wedge as they skillfully manipulate sensory pathways to coax the body into healing itself.
Just about every circumpolar indigenous community has its own sauna tradition that employs extreme heat to usher in transcendental experiences, to heal, to build community, and to foster resilience in the environment. Cold, prayer and psychedelic plants all play a role in many native medicine systems. However, traditions that manipulate heat stress are unique not only because of how our bodies respond to the upper end of the temperature scale, but because of how a skilled practitioner can use those temperature reactions to alter the way another person feels the stress. The doctors of the indigenous world wield the Wedge like a scalpel.
In North America, Lakota sweat lodges, called inipi, are sacred spaces where the community comes together for ceremonies, and as a form of indigenous psychotherapy. When I started to research heat training, my first instinct was to sit down with the Lakota, but a violent history of genocide, oppression and bad-faith treaties makes reporting on Native American traditions contentious for an outsider like me. Up until the late 1970s, merely setting up a sweat lodge could land an Indian medicine man in jail. Today there’s a well-founded concern about cultural appropriation of their ancient traditions. I approached several tribal groups asking for permission to write about inipi, and was pointedly but politely asked to look elsewhere.
The same week that I gave up on the tribes near home, I got an invitation from a man named Maris Zunda, who was trying to organize the first biohacking conference in Latvia. In Scandinavia, the Baltic states and Russia, saunas remain a mainstay of social life. Zunda asked me to deliver a lecture on the principles behind the Wedge and what I’d learned from controlling my body in ice water. He sweetened the deal by saying he could help me experience one of the oldest continuous pagan rituals in the world: pirts, the Latvian sauna ritual. That, in short, is how my wife and I ended up at the mercy of two wood elves halfway across the world.
…
Let’s jump back in time, to when we arrive at the sauna and meet Picukane and Lejnieks, with Maris Zunda in tow. The pirtnieks take us into a small tea room, and Zunda acts as translator. They say that the sauna is a special place in Latvia, not recreation, and that we need to take it seriously. They are, after all, masters. A traditional pirts takes at least five hours. That’s a long time to be on the razor’s edge of tolerance. They warn me that it will go from pleasurable to grueling and then back again, but we should trust that they’re in control.
“Our tool is feeling the same heat that you do,” says Lejnieks.
They tell us to stand in a circle and set an intention for the ceremony. I focus on the darkness behind my eyelids and concentrate on health, strength and bounty for the people closest to me. Maris and my wife are close to me, and I can feel everyone’s presence echo on my skin. The ritual begins when the shamans start to walk in a circle around our small group while playing what seem like improvised instruments. Since I can’t see them, my imagination paints the stage. One shakes a branch of dried leaves in my ear so that it sounds like the patter of a gentle rain. The other starts a steady rhythm on a hand drum. Someone whistles. And the cacophony of sound only grows weirder over time, as I imagine the shamans are dancing around us. The rain morphs into the high-pitched plink of someone running their fingers over the hard tines of a pinecone. I hear the whistle of wind through trees and the scent of pine fills my nose. Just as I start to feel like I am weathering a storm in a forest, the unmistakable notes of Beethoven’s Für Elise come through what must be the plinking mental prongs of a child’s music box.
It’s not really a song. I can’t even say that it all hangs together. I’m not sure that I can identify what instruments are playing or where the smells are actually coming from. And yet because of all the discordance, I miss one critical thing. Sometime at the beginning of the impromptu nature concert, one of the shamans snuck off and opened the door to the sauna. It must have been more than 200 degrees inside. Over the course of five minutes, heat that had been trapped in the adjacent room filled this one. It’s only when I open my eyes that I notice we’re in a pine-heated oven and I start to sweat inside my clothes.
Outside of the array of branches and tools at the shamans’ disposal, they’ve just shown me the first technique that underpins the entire five-hour experience. There’s no English term for it that I can determine, but it’s definitely a wedge. I’ll call it distraction. In the opening of the ceremony, they flood my sensory pathways with unexpected stimuli—sounds, smells and vibrations—so that I’m not actually aware of how my environment is changing. It’s like sleight of hand for my nervous system—tricking my sensory pathways by making me focus on the incidental noises they make so that my mind isn’t aware of the general context.
After the sound circle, the shamans close the door to the sauna, Zunda excuses himself, and Laura and I sit down at a wooden table. There’s a small meal of different teas, waters, honey and a loaf of dark bread in front of us. Over the last few weeks and months, Picukane infused each treat with herbs that she’s collected from around Latvia. I try the tea first. It’s a deep and astringent yellow brew distilled from wormwood. It puckers my face into a screw. The honey tastes of pine needles, and, indeed, when I look closely, I can see flecks of green floating in it. The bread smells of lavender. Every taste is familiar but out of place. It feels deliciously exotic, like something out of a fairy tale.
After the meal, we strip off our clothes and head into the sauna, where Picukane has arranged for us to meet all those ingredients again in a different way. Maybe it’s an American thing, but Laura and I are both a little embarrassed about the idea of getting naked in front of total strangers. I feel vulnerable and exposed. But the pirtnieks don’t bat a lash. They have us take spots on cedar benches. In a matter of minutes, we’re drenched in sweat. The pirtnieks start rubbing the same herbs that we just consumed onto our skin and into our hair, then use dried switches of them to beat our bodies. The plants suffuse every sensory portal.
When Lejnieks rubs a spruce frond on my chest, the taste of spruce comes up through my esophagus and floats in the back of my palate. When Picukane puts a bouquet of yellow wormwood under my nose, the smell connects to my stomach. I can feel its astringence in my bloodstream. The ritual induces a sort of synesthesia. I feel smell as one pirtniek grinds a flower blossom into my skin. I smell sound when the shamans shake the flower in my ears. I mull over what to call this second wedge, and I settle on the word bonding.
The shamans manipulate neural symbols in ways that I had never really considered possible. The strangeness of the ritual heightens my attention, but there are simply so many sensations to pay attention to at once. Neither I nor my body have a baseline to work from. Instead of emotions linking to sensations the way it normally works with neural symbols, the pirtnieks’ bond sensations to sensations. This sensory witchcraft wedges space between what my senses are supposed to tell me and how I actually feel in the increasingly difficult environment. Stressors that I’m used to experiencing in one way—like the taste of tea made from wormwood—I now experience in sound and touch. It’s hard to tell exactly why my body starts to mix the signals; perhaps it only happens while also fighting the stress from heat. And all the while, I’m slowly heating up without noticing that the room is more than three-quarters of the way to the boiling point of water.
My senses are occupied well enough that I don’t realize I’m withstanding brutally hot temperatures. And yet I know that some part of my brain must sense the temperature. Those areas of my brain stem exist below conscious thought. And I guess that it would have raised alarm bells much earlier if it had known where to pay attention. But the periods of relief between sweltering heat and brief baths of intervening cold keep changing the overall baseline. Before I know it, I breach the point where I should have broken, but instead ascend into uncharted territory. And then, before my senses can catch up, the shaman gently brings me back down. This pattern of subtle expansion and retreat is altering my relationship with heat—and, to some degree, stress in general.
Most people associate warmth with love, safety and well-being. At higher intensities, heat gets insufferable. The body responds with a sense of claustrophobia as a sensation that urges the conscious mind to take action and find a safer, cooler environment. This is the way most neural symbols are supposed to work. Claustrophobia conveys bad feelings about the environment and demands that the conscious mind come up with a solution. The conscious mind can override the sensation until the sensory system decides to make itself unbearable. It becomes a conversation between consciousness and sensory-ness. And this is an insight into comfort and homeostasis.
Warmth feels good because our bodies don’t need to work to maintain their core temperatures. Heat feels bad when our bodies have to alter the way they function in order to dump excess energy. When we’re hot, our central nervous system triggers autonomic programming that relaxes arteries to increase blood flow to the extremities. It lowers the metabolic rate and increases the rate of perspiration. For the most part, you can’t feel any of that happening. It’s only that sense of claustrophobia that signals our conscious minds to take action or risk cooking our insides.
In ice baths and cold immersions, the sensation we think of as “cold”—that shivering, clenching feeling that seems to start in the shoulders and arcs across the skin—corresponds to autonomic changes in our metabolism and vascular system. Those contrasting sensations between temperatures begin whenever we stray from that narrow band of stasis, where our bodies are in equilibrium with the environment. The discomfort is a signal that your body is doing work that it would rather not have to.
In the modern world, where changing environments is as easy as pressing a button, homeostasis is also an addiction. When we appease our internal sense of comfort by changing environments, over time we feel comfortable in an ever-decreasing range of external conditions. The cycle continues until everything feels uncomfortable. Cold training allows a person to develop resilience at low temperatures. Heat training in saunas is one way to extend comfort’s upper limit. This gentle seesaw between hot and cold in the pirts exercises autonomic processes that foster adaptation to temperature variation and increase our overall resilience.
I’m grateful that my wife and I have the advantage of having two guides carefully lead us through increasingly difficult temperatures. They keep us right on the cusp of danger and then skillfully bring us back into the realm of tolerance. Their manipulations help us maintain our own mental orientation to the heat. We’re getting stronger with their help.
But I have to remember that training with heat is potentially more dangerous than training in the cold. It’s far easier to heat a person up who has been in an ice bath too long than it is to bring their body temperature down from beyond the redline. Frostbite and hypothermia occur far below most people’s comfort thresholds, but danger is closer at hand in a sauna. Overheating can sneak up on you. Proteins begin to unwind if your body temperature arcs above 104° Fahrenheit (40° Celsius) for an extended time. At that temperature, the brain starts to cook and you might well die. It’s happened before.
In 2009, two people died and 18 ended up in the hospital at an ill-fated sweat lodge run by Law of Attraction self-help guru James Arthur Ray. They’d spent several hours in a sauna ritual meant to push the limits of human endurance. Ray and the other men urged each other to stay in a little longer until a few of them cooked from the inside. And while their deaths could have been prevented by toning down the macho vibes, it also sounds at least a little similar to what I’m doing here in Latvia. With all this distraction and bonding going on, how am I supposed to know when I’ve gone too far?
Across the room, one of the sauna masters pours a ladle full of water on the pile of hot stones in the corner. Steam erupts upward like it’s charging out from a volcanic vent. The 50-ish man places his hand on my feet to check my temperature; even though both our bodies are surely already running high fevers, the way people feel sensation is relative. If I feel hot to his touch, then it means that my body temperature at that point of contact must be higher than his. This is the gauge he uses for how I must be feeling.
Pirtnieks know that heat is a great leveler and that everyone feels the same sensations when they’ve had too much of it. Everyone, eventually, will feel the need to get out; everyone gets claustrophobic. It’s the pirtniek’s job to keep me right on the edge of tolerance and then get me out when I’m hotter than he is. This is what he meant when he said that the heat was his tool. He grabs a fan made out of willow branches and waves it above my head. I feel the steam push down on me like high tide rolling in on a beach. He wafts the steam down my body and past my toes. I open my eyes and my vision narrows, like I’m looking down a tunnel with hazy red outlines in my periphery. My back begins to strain, and he puts his hand on my feet again and nods.
“It’s time,” he says struggling with his English. “Get up.”
I’m unstable on my feet. He takes me through the tea room and stark naked into the brisk April air. He is watching me closely to be sure I don’t fall down. With his guidance, I walk into the still pond in front of the pirts, sending waves across its flawless surface. Steam wafts upward off my body, and I slowly submerge.
Relief.
…
Even with the potential dangers of overheating, actual sauna fatalities are extremely rare. We know this because a series of exhaustive demographic studies out of Finland over the past few decades on the benefits of sauna therapy reported that fewer than two people out of every million regular users die during exposure. Similar to Latvians, most Finns keep saunas in their homes and use them at least once a week. They’re sauna evangelists. The medical data that Finnish scientists publish show how regular use can radically improve people’s health over the baseline. One study tracked 2,315 middle-aged men in eastern Finland over the course of 20 years. The most frequent users, who sat in saunas four to seven times a week, demonstrated a 40% decline in heart attacks and cardiovascular disease as compared with people who sat in one just once a week. Other studies indicate that regular sauna use helps dementia, strokes, Alzheimer’s and, as one article put it, improves on “all-cause mortality events.”
Yeah, that’s right. As far as the cutting edge of Finnish science is concerned, saunas keep death at bay.
This makes intuitive sense to me. If saunas stress the cardiovascular system by dilating arterioles and sweating out whatever toxins build up in the body over time, it stands to reason that it helps anything that afflicts the 60,000 miles or so of tubing in our bodies. Heat stress exercises the entire unconscious biology, and thus has a generalized effect on human health. And it’s not just circumpolar scientists who extol the clinical benefits of heat. Researchers in America are increasingly excited about the potential of high temperatures to fundamentally change depression and anxiety, too.
…
Let’s go back in time to early April. I’m sitting in a large conference room full of doctors, neurologists and full-time researchers at one of the largest mental hospitals in Oklahoma. This is the same trip where I have a chance to see Feinstein’s float set up. We’ve taken a short break from the tubs in order to peek in on grand rounds at the hospital. There’s a lecture that he thinks I absolutely have to see. In fact, the whole institute is on tenterhooks.
Charles Raison, a professor of psychiatry and evolution at the University of Wisconsin-Madison, stands at the front of the room wearing a tweed jacket with patches on the elbows—a nod to the stuffy academic halls that he’s used to lecturing in. He’s discussing the relevance of ancient medicinal practices in 21st-century psychiatry. And he starts with a simple supposition: Until the modern world, energy was always at a premium, and humans—not to mention every other living thing on Earth—need energy to survive. The first challenge for any living thing is to find a way to produce, store or share heat.
Raison’s slideshow settles for a moment on a picture of penguins huddled together on an Antarctic ice sheet. It’s a shot that you’ve probably seen in any polar documentary of tens of thousands of flightless birds in black tuxedos massed in an impossibly large group. They stay like this for months in order to resist the brutally cold weather. “If they didn’t have each other, they’d all be dead,” he says. Kleptothermy, or the practice of sharing body heat, does more than help the penguins survive the ice; it organizes the species’ entire social behavior. While it’s obvious in penguins, Raison says, temperature affects human psychology just as much.
“One characteristic that most people suffering from depression share is that they run higher temperatures than non-depressed folks. And if you treat their depression, their temperature returns to normal. Not only that, but depressed people typically don’t sweat,” he says. It’s a bombshell of a statement, because if it’s true, then Raison is essentially arguing that depression stems from bad thermoregulation as much as from any other factor. I have to admit, it’s a statement that I have some trouble accepting on face value. So as he speaks, I open my laptop and log in to an academic database that I have access to. I find a 2003 article in the journal Neuropsychobiology by a team of psychiatrists at the Veterans Administration in Georgia that shows that people with major depression tend to average about a half-degree higher body temperature than non-depressed people. The data on sweating is a little more difficult to parse out, because about 80% of depressed people also suffer from anxiety, a condition that causes excessive perspiration. A careful analysis of psychobiological literature by Raison’s team indicated that if you isolate your sample so that it includes people who are depressed but not anxious, then they barely sweat at all.7 Perhaps even more interesting is that sweating is one of the most common side effects of antidepressant drugs. There’s a connection. I’m a little surprised.
One way to think about inflammation is that it’s heat building up in the body. At a basic physiological level, it’s a primary immune response that stabilizes tissue, heats it up, and isolates pathogens from circulating freely. Inflammation isn’t bad in its own right—it helped us survive our long evolutionary journey—but it damages tissue in the process. In the world of our ancestors before antibiotics and critical medical care, inflammation could be the difference between life or death. But it was also a sign that a person was sick. Raison knows that he is building up to something big, and he smirks as he suggests that inflammation sends ancient signals to our unconscious minds to prepare ourselves for death. While inflammation doesn’t correlate with mortal danger in the same way that it once did, our bodies don’t have any way to know that. In other words, just as too much heat signals claustrophobia and too much cold triggers clenching up, inflammation causes system-wide depression.
Raison’s argument inverts the normal discussion that we have about depression in the Western world. Therapies usually target chemical imbalances in the brain or fractured social relationships, but Raison thinks that maybe treating inflammation would be just as effective. “Is it any surprise that just about every ancient culture in the world has some sort of sweat lodge tradition?” he asks.
Think back to those emperor penguins on an ice sheet: They’re sharing heat, and their combined thermoregulation means that the entire community will survive. Heat is life. Indeed, Raison points out, in lieu of pharmaceuticals, indigenous communities around the globe use sensory and environmental stimuli to treat their sick. He flashes a list of techniques culled from ethnographic accounts and ancient texts on the screen: sensory deprivation, breathing, fasting, extreme exercise, meditation, hyperthermia, hypothermia, and psychedelic plant medicines. All of these interventions aim to wedge space between the way we experience stress and how our bodies respond to difficult environments.
Someone should write a book! I think to myself.
Most people today rarely reflect on the subtle ways that the environment frames their mental state. If we’re depressed or angry or anxious, we tend to look first for events around us as a trigger. Maybe we’re off-kilter because of an argument with a friend or an awkward comment or misstep in etiquette. We’re less aware of things that don’t change rapidly—unaware of our breathing, for example, or the million environmental signals that reinforce how we feel. Outside of a sauna or an ice bath, when was the last time you noticed how the environment altered your mental state?
As Raison writes in one of his many articles, “It would seem that the most important cause of [any mental condition] is not the normal evolved brain response to the environmental stimulus, but the stimulus itself.” This is the Wedge in action as it separates stimulus from response. The brain is the environment. Evolutionary programming matters, but context matters more because human physiology knows how to adapt. Raison does more than just philosophize about depression and heat; he designed an experiment to test the hypothesis.
He flips through slides and shows an image of the basement of a hospital in Switzerland where he found an abandoned 70-year-old infrared sauna from an era when the idea of environmental medicine was more in vogue. The machine was essentially a human-sized box of water-cooled infrared lights with a hole cut out at the top so that the patient’s head would stick out. This setup allowed doctors to heat up someone’s body without worrying about boiling their brains. It was a revolutionary treatment at the time and garnered acclaim for managing a wide variety of psychiatric conditions. However, in the intervening decades, the pharmaceutical approach to psychiatry became more popular, and the sauna ended up gathering dust in the basement. Raison resurrected and refurbished the device, then made an identical copy with one key difference. Instead of infrared bulbs, he used ordinary incandescent ones that didn’t give off much heat. He reasoned that this sham device wouldn’t heat up nearly as much as the real one, but might provide a convincing enough placebo for a clinical control.
Raison deposited two groups of depressed patients in the different saunas and heated the active group for almost 90 minutes until their core temperatures hit 101.3° F (38.5° C)—the equivalent of a mild fever—then cooled them off for 60 minutes. The patients in the sham device heard the same sounds and saw the same colored lights, and completed a questionnaire whose answers showed that 10 out of 14 of them believed they were getting the real treatment. Clinicians assessed both groups’ levels of depression over the next six weeks, and astonishingly, the people who had the real sauna showed significant improvement compared to the folks in the sham setup. The effect was so powerful that it matched treatment with ketamine, one of the most promising therapies for depression.
Simply heating up someone’s body was enough to make depression go away.
A few weeks after meeting Raison, I ask one of his co-authors on the paper, a neuroscientist at the University of Colorado Boulder named Chris Lowry, why he thought the heat therapy was so promising. “At the largest level, depression is all about a person pulling inward, so that they only think about what’s happening inside their own minds, usually in negative ways. But external stimuli like heat and cold force a person to reckon with their environment. It pulls you out of yourself,” he explains. The heat is a wedge that interrupts the things that reinforce feelings of depression. And maybe that is all a depressed person needs: to have a reason to look outward.
…
Back to the present, and underwater somewhere in the Latvian wilderness just a few steps away from the sauna-hobbit hole. I blow out a small stream of bubbles and feel them roll upward past my nose and forehead on their way to the surface of the pond. The water is brisk, maybe 50 degrees, but I’ve been in the blistering sauna for the past couple of hours, and the cold water feels like coming home. I stay under the surface for a few more seconds, and my skin cools rapidly. My core temperature is still high, though, and I have no idea what sort of fever I’m running.
When I come up for air, Laura is naked next to me, her head below the water. I dunk under again. The man and woman in felt hats motion for us to go under a third time. When we’re up again, a small frog pops its head out of the water between us and blinks. The woman smiles and says it’s good luck. Then they usher us back to land and point to two small mats outdoors. They’re stuffed full of local grasses and herbs and crunch pleasantly beneath our weight. The shamans then cover us up with blankets. The man wraps a towel around my head so that the only thing touching the outside air are my mouth and nose through a little hole. He tells us to get up only when we start to feel cold.
So to recap: I’ve been steamed like a potato, then blanched in cold water. It’s a procedure similar to the one that chefs use to remove the skin from tomatoes. The quick underwater dunk was too brief for the laws of thermodynamics to allow my core to cool. At best, the blanching just sealed the heat in as my veins constricted around my hot core. Even so, my skin is icy to the touch. I close my eyes and try to focus in the way that I would at the end of a long Hof breathing session—at a point between my eyes where I often see colors. My mind is unusually clear, but my body is confused. I feel a shiver rock up my spine and out through my arms. I have a few short convulsions, but it’s not because I feel cold. I’m shivering from the heat.
Synesthesia again.
The contrasting temperatures have confused whatever software my body uses to control thermoregulation. It’s trying to dump heat from my core into my hands and feet, but my extremities are pulling inward. Up is down and down is up. The two opposite bodily reactions bring the taste of pine from the branches or honey that I’d eaten earlier into my mouth. I feel clean inside and out. Soft convulsions rock my body for a few minutes before Lejnieks puts his hand on my shoulder and asks if I’m okay.
I am. In fact, I feel great.
Despite the contradictory sensations and physical responses, I feel connected and grounded in my body in a way that I haven’t for a long time. The sensation is similar to the diminished brain functions from intense breathwork in Elee’s class that helped me connect to that feeling of universal consciousness. My body is so confused that my mind has nowhere to go but inward...and, paradoxically, outward at the same time.
I lie there for a few more minutes before I feel ready to go inside and start another round of heat. Laura is already on a chair inside, wrapped in a brown sheet. She’s sipping a cup of bitter wormwood tea out of a clear glass.
The secret is in the contrast between hot and cold, between sound and silence, taste and smell. When they confuse and alter the sensory pathways, the pirtnieks aren’t really sauna masters: they’re contrast masters.
For thousands of years, philosophers have argued among themselves whether or not it’s possible for two people to experience the world in the same way. While we can agree on words—it’s not controversial to say that bananas are yellow, for instance—how do we know that all people experience that color in the same way? What looks yellow to you might well be red to me if I saw it through your eyes. How you answer this question ultimately depends on how much you trust your senses and the existence of an objective reality.
Pirtnieks don’t struggle with such arcane questions, because they know from the experience of a thousand saunas that everyone feels the claustrophobia and panic from extreme heat in the same way. They know that cold brings relief to people on the edge. For them, the ultimate question isn’t about the nature of hot or cold, but is perhaps better understood as the contrast between opposing sensations. In this superheated chamber, they don’t need language to communicate with the two Americans on their cedar benches. Sensation is everything. They’re shamans because they feel what we feel.
…
Three years before I came to this sauna, I ran a race in England called the Tough Guy that was supposed to be the coldest obstacle-course race in the world, yet I ran it wearing just a bathing suit. Most everyone else on the field that day wore neoprene wetsuits. After the first few minutes on the course, I felt hot. While I was far from the fastest person in the lineup, every picture that course photographers shot of me caught me wearing an ear-to-ear grin. I’d practiced the Wim Hof Method for months before the race and was conditioned to the cold. But why was I so happy? When I started to run over obstacles and dunk nearly naked into muddy pits of water, I felt the sensations of frigid cold on my skin, but I was also having an absolute blast. At some point I told myself that it wasn’t cold that I was feeling on my skin; the muscle-tensing sensation caused by my environment was joy itself. This mental trick transmuted the entire experience. I consciously assigned a meaning to my sensations, and that alone made me more resilient.
Somehow I’d managed not only to maintain my body temperature through my training, but I’d also triggered a change in the emotional valiance of the cold and reprogrammed the sensation as a full-body experience of happiness.
There’s an anatomical explanation for how that works. When we sense heat, the signal first comes in through the skin, and the nervous system sends the information from the outside world through the thalamus, where it branches off into two main directions. First into the rostral insula, an area in our gray matter on the periphery of our brain that deals with the intensity of a sensation. The second path heads to the anterior cingulate, a brain region that assesses the quality of a sensation. The anterior cingulate is the part of the limbic system that controls the emotional resonance of the signal as well as other higher brain functions. I believe that when I chose to focus on the joy of running the race instead of the pain of cold on my skin, I allowed my brain to give preference to one neural symbol over the other. This split in the sensory pathways creates an opportunity to change how we react to environmental sensations. I’d created a new neural symbol in the moment of stress.
The same technique works in the sauna. When the intensity gets too high, I can focus my mind on the thrill of the challenge instead of the walls closing in around me. And the shaman can help when I start to lose control.
Back in my position lying face down on the cedar bench, I’m doing something similar to what I did when running the Tough Guy. The man in the felt hat starts beating me again with willow branches. These are the same sticks infusing the tea in my stomach and the branches I laid on outside. The sensations from the natural world are all around me. And I can’t tell if the lashing is pleasurable or painful. I realize that, just as when I was running the race three years ago, my reaction to the branches, to the funnily dressed sauna masters, to the heat, the food and the cold, are all a choice. I can be embarrassed by my nakedness. I can cringe at the heat or retract from the branches. Or I can embrace the experience and realize how unique and special it all is. My mindset is a choice where I get to decide what my sensations mean.
Someone pours another cup of water on the scalding stones, and steam erupts again throughout the room. The shaman is bringing me to the edge of tolerance, but it’s my choice as to when I feel that limit. Even though the pirtnieks are doing the physical work, Laura and I can manipulate our reactions. We’re letting the heat flow through us like water and trusting that nothing here is going to push past any hard limits—past the so-called redline, where we’ll start to hurt ourselves. The Wedge is our ability to surf that sensation, and the pirtnieks aid our journey by redirecting our attention away from the most difficult sensations.
Perception is key. Whatever heat tolerance I build in this moment also stretches into more mundane stresses once this is all over. It’s the same concept of resilience that Mackenzie finds when using parasympathetic breathing during high-intensity workouts. I’m learning a new way to be comfortable in uncomfortable surroundings.
The pirts slowly winds down over the next hour. The contrasting sensations level out into our normal ranges, and I feel a full-body sensation of happiness. I’m also exhausted. The sauna was difficult and deeply rewarding. I’ve connected in my body how sensation can manipulate my mental state, and I’m eager to apply that knowledge to other aspects of my life.
I notice one change almost immediately. Normally I keep the temperature of my house pretty cold in the winter, below 60 degrees. This forces my body to increase its metabolic rate and switch to burning fat. This is what I call slow cold (in contrast to the fast cold, when you jump into ice water and feel the contrast immediately). The problem with slow cold is that it can make you feel achy and tired over time—maybe even a little depressed. But brief bouts in a sauna change the game. Now, instead of only being cold, I give myself some variation of extreme heat. So I when I came home, I bought a sauna. I’ve never been happier.
If heat can alleviate depression, then maybe there are other sensations that trigger beneficial changes to human health. Maybe in our search for ever more efficient medicinal chemicals, we’ve left other healing pathways off the table.
And this is how a trip to a Latvian sauna made me question a fundamental process of human healing that functions in the background of all medical research and medical miracles. While indigenous traditions use sensations to manipulate the body, Western medicine aims to treat the body as an object without any subjectivity of its own. The two systems are at odds. But lurking underneath every drug, every diagnostic technique and in the back of the mind of every doctor is the fact that most of the time, the body knows how to heal itself. And the most derided words in medicine might just be the key to shifting our medical paradigm to accept the Wedge: the placebo effect.
6 The word “shaman” originates from Tunguskic religious healers who enter into trances to communicate with the spirit world. Anthropologists like me use the term to speak about similar indigenous spiritual healers on every continent who usually have gone through years of training to attain the title. This can be confusing, because in recent years, the term has grown in popularity and has also lost its specificity. Today it has come to mean any priest of a New Age order.
7 In that article, titled “Somatic influences of subjective well-being and affective disorders: the convergence of thermosensory and central serotonergic systems,” in Frontiers in Psychology, Raison and his five co-authors pull from literature dating back to 1890 that correlates decreased skin conductivity with depression. The article lays theoretical groundwork that suggests that not only does temperature affect depression, but that external stimuli in general can generate natural antidepressant effects that are potentially more powerful than current antidepressants—and that one sign that a depressed patient is recovering is if they start sweating more.