Shamanism: psychopathology and psychotherapy

The cross-cultural practice of shamanism reflects an innate capacity for altered states of consciousness (ASC's) that are elicited by stress, deliberately sought in shamanic rituals, and associated with psychopathology. Shamanic sickness, animal transformation, and death-rebirth experiences specifically resemble psychotic experiences. The triggers of shamanic and psychotic experiences are also related, but while psychotic experiences endure and intensify under uncontrollable circumstances, shamanic sickness is ameliorated by ritualized and controlled engagement of ASC. Shamanic vocation, when and where it is culturally accepted, does not lead to progressive deterioration or dysfunction but rather to an increased functional capacity as expert healer, teacher, and ritual guide. Shamanic training methods, or other controlled and ritual methods of engaging ASC, may inform strategies for promoting mental well-being.