Psychotherapy has often been said to derive from traditional and religious healing patterns (Janet 1919), contemporary illnesses such as hysteria and multiple personality disorder being closely allied to spirit possession states. The efficacy of both Western (‘cosmopolitan’ or ‘biomedical’) medicine and local healing has been argued to be nonspecific (empathy and suggestion: Frank) but others have favoured rather a close ‘symbolic congruence’ between affliction and shared social meanings (Dow, Torrey) or taken the illness as the individual representation of ‘social tensions’ in a pivotal individual (†Turner, I.M.Lewis, Littlewood). *Lévi-Strauss has proposed that whilst shamanic healing deploys communal myths, Western psychotherapy facilitates the development of private myths: recent interest in the political and gender history of psychoanalysis would argue against the latter assertion. Prince has argued that healing is just the systematization of existing coping styles. Phenomenological and semantic anthropologists (Kleinman, Good, Kapferer, Csordas) criticize the *essentialism implicit in a single notion of ‘healing’, and look rather at the particular reconstruction of self and agency in a performance of ritual, together with an interest in how both medical and local therapy can be reconfigured in the other context. Whilst Western psychotherapies are rarely available in developing countries, a number of local practices-shamanism, vision quests, fire walking, acupuncture, meditation, sweat lodges-have been assimilated into the ‘human potential therapies’ of metropolitan North America; whilst ‘spirit possession’ has emerged again as an acceptable diagnosis among evangelical Christian psychiatrists and social workers.