An extreme ritual involving temporary body piercings and dancing induced altered states of consciousness in both pierced dancers and non-pierced participants, as measured by tests of transient hypofrontality and flow. Both groups reported decreases in negative affect and psychological stress and increases in intimacy from before to after the ritual. However, physiological responses differed: pierced dancers showed increases in the stress hormone cortisol, while non-pierced participants showed decreases during the ritual. The ritual produced similar psychological effects but different physiological effects across participant roles.