a b s t r a c tThis study, which is based upon ethnographic data collected between 1999 and 2008 in Nepal, examines the connection between the shaman's altered states of consciousness (ASC; i.e., what goes on inside the healer's mind/brain) and therapeutic changes that take place in the patient's mind/body. Unlike other studies that primarily emphasize the shaman's internal psychological state, this article attempts to explain the role of the healer's ASC and elucidate how desired therapeutic changes depend upon patient-healer interactions. This question is explored in the context of a healing ritual highlighting various aspects of the cosmology of Nepalese shamans. k e y w o r d s : symbolic healing, altered states of consciousness, spirit possession, nepal, shamanism & i n t r o d u c t i o n Since 1999 (Figure 1), I have investigated shamanic practices among various ethnic groups and Hindu castes in Nepal (Chhetri, Jirel, Sherpa, R ai, Gurung, and Tamang). What specifically caught my attention while observing numerous shamanic healing rituals were the dynamic interactions that take place between the entranced shaman, the invisible supernatural beings called upon,