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The following notes were taken from National Geographic documentary: Taboo: Spirit World, October 4, 2007.

Devotion is tested by extreme acts of physical endurance.  

In Malaysia, Hindu worshipers partake in a ceremony, Tai Bo San, requiring their bodies are pierced with metal hooks and skewers, which they endure while climbing 272 steps, ascending to heaven. The participants pray and enter a trance state prior to undertaking the ordeal.  The trance state eliminates the pain and the wounds do not bleed. Once on top, devotees emerge from their trance state.

Self mutilation ceremonies are often a negotiation with the Divine Spirit, an agreement to undertake pain in exchange for favor.

In India, Hindu worshippers seek radical cures to rid loved ones of demons. Exorcisms may take hours or days to rid victims of their unwanted passengers.  The physical manifestations of possession vary from tumors or headaches, to weakened mental states, such as depression.   Spirits may lash out and resist the exorcist’s efforts; physical resistance is met with equal physical force, the inflicted are beaten in a last hope for the damned. The spirits are urged to talk, to explain what they want.  The spirit world has had a place in all ancient cultures. The Catholic Church still reserves the exorcism ceremony to rid followers of demonic possession.

Outside of Havana Cuba, believers prove their devotion by crawling on hands and knees to the Church of St Lazarus.  Santeria is a mysterious religious sect that believes saints of the Catholic Church are reincarnations of African spirits.  St Lazarus is also Babalu Aye, the god of good health. Spirits are invited into the home using blood sacrifices to lure them forward.  Each spirit must be fed or they will become angry and bring trouble to the home. There is great reward and risk associated with inviting spirits into your home.  Each spirit is said to have their own preference, and if they are displeased with the quality of the sacrifice they may curse rather than bless the participants.

It is not easy to fulfill promises made. This is the key to sacrifice in the name of faith. You must keep going, to pay your dues for favors received.