In Tamil Nadu, a cult of devotees of the goddess Amman believe in subjecting their body to acts of torture in order to pledge their devotion, fulfil their vows and seek boons. These devotees pierce their cheeks and arms or their backs with hooks or with the weapon of their deity, which is often the trident.

Often, carts bearing images of the deity are drawn by people with hooks attached to their skin. They believe the piercings will be completely healed by their goddess in 24 hours.

This phenomenon is visible at the four-century-old Chithirai Festival in Madurai, Tamil Nadu, held annually at the famous Meenakshi Amman Temple. Lakhs of people attend the festival each year, and the Tamil Nadu government has officially declared the festival a tourist attraction.