This article provides an introduction to the thematic issue of Transcultural Psychiatry on local responses to trauma. To illustrate how local responses to trauma may be therapeutic, we consider the multiple dimensions or domains that may be targeted by healing rituals and interventions. We then outline a theoretical model of the generation of trauma-related symptoms and distress. We present the multiplex model of symptom generation which posits multiple cognitive, social, and physiological mechanisms by which various triggers can lead to severe distress among trauma victims in acute episodes, and which may be targeted in treatment. More persistent forms of distress can be explained in terms of the effects of persistent mood states and associated modes of cognitive processing and behavior that render individuals vulnerable to chronic symptoms and acute exacerbations. The beneficial effects of healing rituals and interventions may occur, in part, by inducing positive affective states associated with a flexible mindset. We conclude by summarizing some of the contributions of the papers in this issue to understanding local therapeutic processes of healing.Keywords affect, flexibility, healing, mood, PTSD, psychotherapy, ritual, symptom amplification, trauma This issue of Transcultural Psychiatry examines local attempts to cope with and recover from trauma. In every cultural context and community, there will be particular ways to respond to the effects of trauma, some more effective than others. Clinically, these responses, practices and techniques are important to assess for Corresponding author: Devon E. Hinton, Harvard University, 15 Parkman Street, WACC 812, Boston, MA 02114, USA. Email: devon_hinton@hms.harvard.edu several reasons. First, they provide a view of how trauma and its effects are understood in specific socio-cultural contexts, which is important for clinical engagement and diagnosis. Second, attention to local approaches to trauma can provide guidance on how to adapt Western treatment interventions to support local modes of coping, strength, and resilience. Finally, the diversity of responses can provide key insights into therapeutic processes and universal aspects of healing that may have applicability across cultural groups.Although the contributors to this issue consider a broad range of local responses to trauma that include interpretive practices based on local ethnopsychologies, for many the focus is on ritual healing and religious practices. There are several theories of how ritual may bring about healing (