Shamans' training generally includes a "death and rebirth" experience, an initiatory crisis typically involving illness and suffering from attacks by spirits that lead to the experience of death. This is followed by descent to a lower world where spirits and animals attack and destroy the victim's body. The initiate is then reconstructed with the addition of spirit allies that provide powers. The death and rebirth experience reflects processes of self-transformation that occur under conditions of overwhelming stress and conflicts that result in fragmentation of the conscious ego (Walsh, 1990). The experiences are "autosymbolic images" reflecting the breakdown and disintegration of psychological structures (Laughlin, McManus, & d'Aquili, 1992). The death and rebirth cycle reflects a fragmentation of the conscious ego and self, experienced symbolically as death; and their reformation guided by innate drives toward psychological integration. Shamanic ritual processes manipulate symbolic constructs and neurological structures to restructure the ego, producing a new level of self and identity. The restructuring of the ego is promoted by holistic imperatives toward psychointegration (Laughlin et al., 1992), providing a dramatic alleviation of psychosomatic, emotional, and interpersonal problems. This self-transformation is core to the exceptional health of shamans, providing a basis for individuation and self-actualization. Although pathological interpretations of the shaman have been offered, Noll's (1983) application of diagnostic criteria of the Diagnostic and Statistical Manual of the American Psychological Association (DSM) rejects this; nonetheless, the initiatory phase may involve conditions akin to acute psychosis (Walsh, 1990).
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