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Living with a Skin Disease: a Shamanic Journey

Silvia Camastral

The Itch of Creation

In the beginning there was silence
vastness of quiet then–a spark
a charm, an electric impulse–the itch!
The universe convulsed itself
dynamic electric explosions
firing of neurons contracting and convulsing
the universe body enchantment
new creation!

The itch
A sudden whirling contraction
at its core an impetus
total attention drawn into itself
the cosmic body
a dynamic impulse release
as new creation emerges.


This article offers a sharing of some my personal experiences of living with Atopic Dermatitis (AD). It aims to convey some of my personal story of living with a chronic illness as a mythical journey–a life-long shamanic journey with symptoms as my spirit guides. The first part provides a brief account of how process work has helped me discover the mythical and symbolically shamanistic aspects of my journey which includes personal experiences and ways of working with my symptoms. Next follows a short overview of Atopic Dermatitis (AD) in western medical terms. Finally, I wish to show how both my particular experiences of AD and skin processes in general are often marginalized by cultures and societies that idealize white, western mainstream cultural values.

Individuals and peoples who have skin that is visually different from white mainstream norms often experience painful discrimination and marginalization. At the same time, the individuals who suffer this rejection are often additionally repressed by a process of victim-blaming. I am seeking to extrapolate some of my experiences from aspects of skin “beauty” dictated by social and cultural expectations and attitudes that disavow diversity of skin types, textures and colors. My experience of chronic skin disease has been recontextualized by the privilege of my involvement with process work. I wish to particularly thank my teachers for the opportunity to broaden my experience of victimhood by connecting to the myth, or deeper meaning of my life. I have come to understand painful experiences of skin and beauty norms in part as a need to challenge white, western mainstream social and cultural expectations and attitudes.

In this article I will use both a linear approach to writing and organizing my story as well as weaving in my underlying non-linear, personal creative style. This follows the patterning found in my symptoms, which tend to suddenly appear and disappear in irrational and often untraceable ways as though my skin is suddenly moved by a creative spirit that makes weird and wonderful textures and experiences, suggesting more impulsive and potentially creative ways of living and expressing myself.

The marriage of these linear and non-linear approaches immediately gives rise to an internal debate between two sides of myself. On the one hand, I would like to convey the suffering and physical torture of daily living with chronically itchy and irritating skin. On the other hand, I want to go beyond the suffering and show how a chronic illness is an initiation into a shamanic journey that offers a source of creativity and wealth of experience.

Process work

Process work postulates that challenges to the identity are part of the organizing field or spirit providing messages that want to be lived through us. This view is supported by Jung’s discovery that chronic illness has a mythical aspect, which if understood and grappled with over the years, will lead to a transformation and individuation towards the self or wholeness. This belief is carried to the collective in shamanism.

A shaman is a healer who has the ability to travel to other worlds and have contact with the spirits. She then brings back otherworldly messages that are relevant to the community. I see shamanism as a symbol for working with the symptoms of chronic illness using the tools of process work. By entering into the deep sensory-grounded experience of symptoms, one travels into another world and finds messages that can bring deeper awareness into our everyday consciousness.

Some experiences may be lived through purely altered states, so the transformation of this short-term experience of sensory-grounded information, or dreaming process, is not translated into everyday lifestyle consciousness. For example, I remember working on my skin symptoms and seeing a Native American warrior dancing. I ended up in a trance-like state, dancing his dance for hours in my apartment in Zurich. There was no immediate integration and transformation into my life at that time, but just letting myself be in that internal trance gave me access to more freedom than I had previously experienced. Allowing oneself to enter the world of immediate experience of the body and perceiving its magic is potentially healing. Being strange and unpadded, following my irrational, sometimes explosive, sometimes isolated trance-like states has provided an inner healing much needed to compensate for my more adaptive and socially controlled lifestyle.

I get into a similar state when I am painting, drawing or being creative in other ways. These states are often hard to follow in my regular life. I first struggle, have body symptoms, feel irritated and crazy with impulses, then rigid and attached to what I think I should be focusing on. I often end up in a furious and angry outburst about myself and my inner struggle. I call this my creative fury. I start out feeling restless. My mind searches for something, although I don’t know what. I feel like a wild animal stalking prey. I don’t exactly know what I am hunting, yet there is a physical sensation, like an itch in the pit of my stomach, an appetite that wants to be satisfied. I pace the house wondering what to do. I start this and that and can’t settle with anything. I feel possessed, crazed, and furious. After my fury, I can usually let myself get immersed in the spirit of creation through drawing, painting, writing, or creating in other ways. It is a relief to immerse myself and be enveloped by this energy. I find myself in a slightly dizzy state where I momentarily step out of my usual identity and step into another world. A generative madness takes hold of me, captivating all my attention. My whole consciousness is centered on what I am creating. I am possessed. There is no destructive self-criticism, no judgment, just a state of wild immersion–a dance with the spirit. These creative fits match the intensity of my experience of my itching fits and wild scratching attacks. The same energy that is locked in my experience of my skin can often be expressed through the creative process.

Illness as a symbolically shamanic process

A shaman has the ability to go beyond everyday reality by living and expressing messages from other realms. Going into the depths of physical experiences and contacting the energy within symptoms is a way of going beyond everyday reality. This requires momentarily losing one’s known world, or identity, in order to live the message of the symptom’s energy. Like the shaman, the person processing their symptom in this way brings back treasures of information from previously unknown realms.

Those who have contacted the energy of a symptom often share the treasures of this transformative experience with the community. Sharing might happen in relationship with individuals, groups, a community or the larger world. It may involve the transformation of a momentary sensory-grounded experience into a longer-term identity shift. In other words, a momentary experience focused on with awareness of its energetic and informative nature can become a symbolic vessel for a previously unknown realm needed by the individual and his or her community.

Chronic illness is a challenge to the sufferer and offers a chance to develop depth and contact with less known realms. Such realms can contain treasure that opens, questions and develops our deepest beliefs or spiritual attitudes to life. This sort of work necessitates persistence and tenacity for finding connections to the underlying energetic realms of information that want to come through. Getting in touch with the energy of the symptom and living its shamanic journey involves courage and constant renewal of identity. It has taken me many years of warriorship to value my chronic illness as a spiritual path and on many days I lose sight of this attitude and sink into depressed victimhood. Increasingly, though, I see my symptoms as a chance to lose personal history and identity. Although I constantly struggle with this, I sometimes find the freedom to really follow the actual experience of my symptoms to receive a meaningful message that matches my experience. It has taken a long time and I’m still struggling, but over the years I have become more fluid with diving into my physical experiences in order to find the messages and momentary transformation.

Today I can say that I am eternally grateful to my fate, the spirits or higher spirit, whatever force is organizing our existence, for providing me with such an enriching and challenging journey. Some days are full of guided, shamanic treasures gained through dealing with my symptoms. Then come days when living with a chronically irritated and irritating, itchy skin is a painful, enormously frustrating, exhausting and energy-consuming business. Although not life threatening, the constant irritation, inflammation and consumption of energy can bring one to suicidal fantasies. I know of people who have actually chosen that path over a life of painfully tantalizing itchiness. Besides the constant struggle and irritation, the visible marks and stigma affect the whole person in many ways.

I have suffered from skin disease and related symptoms all my life. I had a severe crisis in my late twenties and I now see this as an initiation to a huge internal and external life change. My journey of transformation has not been a smooth ride, but a constant battle and challenge–a vision quest and test in all areas of my personality. Although many of my illness experiences have been very painful and I am still victim to them on those exhausting days, they have become a teacher and guide in my life. My skin has become an ally that makes me aware when I am not in contact with the spirit, or deeper meaning and direction of my life myth.

Chronic illness as initiation

Constantly dealing with my illness through working with or suffering from body symptoms helps me stay in contact with life’s alchemical and mercurial transformation and growth process. Constantly itching skin offers a doorway to this process, just as any long-term illness can offer initiation into new areas that are needed by both individual and community.

Looking back to the beginning of my illness, I can see a strong calling for a change in my life–an initiation to a new lifestyle. Although painful and challenging, I am grateful to this opportunity for transformation of my life! Initiation processes, as outlined by Eliade (1939), often require a descent into hell, into the dark of life before one can reappear as a renewed person. This archetypal pattern of death and rebirth takes different forms and usually involves a grappling with fear and physical and psychic limitations. The normal identity gets challenged, or “dismembered” and sheds its skin in painful and scary ways.

Mindell also describes this process. “Chronic illness, feelings of being torn asunder by opposing forces and near death experiences frequently have a goal of cleansing you from your own self and refilling you with nothingness or with pure nature” (1993: 48).

Becoming pure nature, losing one’s personal history, following the Tao or another spiritual path, shedding the skin of identity–all describe a life-long challenging process. One of the earliest textual references to skin disease is found in the Old Testament when the spirit of Job was tried by Yahweh for his humility and faith in God. Yahweh struck Job down with malignant ulcers from the sole of his foot to the top of his head (Job 2). Job describes his sufferings in the following manner: “Lying in bed I wonder when will it be day? Risen I think how slowly evening comes! Restlessly I fret till twilight falls. Vermin cover my flesh and loathsome scabs, my skin is cracked and oozes pus (Job 7: 4-5). And further, Strangling I would welcome rather, and death itself than these sufferings (Job 7: 15)

I remember a period similar to Job’s suffering, during the worst episodes of skin disease during my late twenties. It was the beginning of an illness crisis that would last for several years. I wrote in my diary at that time:

Dark murky smells of fear arise from the underworld and envelop my brain with a numb haze. I am panicked and fight to keep afloat. I feel in danger of being pulled down into the cloudy swamps of gloom. I suffer from insomnia. I spend endless nights in a half wakeful state. I itch and sweat constantly. The nights are filled with the darkest worries, huge shadows of somber threats. I toss and turn. I tear at my body, helplessly. I cannot find peace. I am thirsty, irritable, scared. I am scared of death, unconsciously though. I am anxious about not being able to function in the world anymore. I am afraid of losing my job, my relationship and livelihood–my life. My symptoms have flared up in the most incredible ways. My skin reacts violently to just about anything. I am allergic to even the smallest grain of dust, a breath of wind, any internal or external push, a critical or harsh word, the smallest sense of intrusion. My skin flares up in a wild uproar of violent flames. It feels scorched and seething hot. It itches and burns as if I am being swallowed up as by a fiery wild beast. Endless fits of scratching and I am left feeling helpless, injured and sore. Recovering means waiting for the next bout.

Mircea Eliade (1980) says that initiations give us a glimpse of death to make us stronger and connect us to our spirit. By being exposed to challenging and sometimes life threatening situations, an old identity dies and gives way to a new one. Achterberg (1985) describes a case of a shamanic initiation where the shaman to be had been stricken with small pox and survived. He took an imaginary journey to hell and lost all his limbs. His journey eventually involved reassembling again and subsequent performance of shamanism for his tribe.

As earlier described, shamanism involves a journey into different realms. Many tribes use induced bodily processes to go beyond the known world. Dismemberment, scratching and scarring of the skin, tattooing, and piercing of body parts are used to mark death and heroism. These external marks are signs of initiatory mutilation and symbolize death and resurrection. Some shamanic cultures and cults use whipping and rubbing with stinging leaves and nettles to create intense itchiness to symbolize the death of an old identity. I have experienced that initiatory challenge of the spirit many times. Eczema as reported by Maguire derives from a Greek term that means “to cook” (1991: 73). My journey with atopic dermatitis is an ongoing journey of being cooked in the skin, a symbolically alchemical or shamanic transformational process.

What is Atopic Dermatitis? A linear view and reaction

For many years, I did not know that all my strange symptoms belonged to the syndrome of Atopic Dermatitis (AD). I thought that all the symptoms belonged to my personality, and that I was somehow to blame, bad, weird and strange. To really acknowledge that I had an illness was painful and created a lot of rebellion in me. I didn’t want to be labeled sick because I wanted to feel good and strong and didn’t want to be different from other kids and later on adults. It took me a long time to be able to read medical and psychosomatic articles about my symptoms because of inner and outer judgements about chronic disease.

Atopic Dermatitis is a chronic inflammatory dermatitis that usually starts in early childhood. It is known by various names such as atopic eczema, allergic eczema, and neurodermatitis. It usually appears together with asthma and hay fever and is also called the eczema-asthma-hay fever complex.

The term atopic comes from the Latin “atopy” meaning out of place or strange. It refers to a hereditary tendency to develop allergies to food and inhaled substances with resulting eczema and hay fever. Usually one or more other family members suffer from asthma, allergies, or dermatitis. The course of AD is totally unpredictable. It has been widely researched, but no specific linear cause has been found.

There are some characteristics typical in AD sufferers. The atopic person has a constitution with unusual immunologic characteristics that interfere with the white blood cells’ defense function in the tissues and blood, which thus makes the body prone to certain viral and bacterial infections. There is generally a heightened immunoglobulin type E (IgE) level in the sufferer’s blood serum, which is viewed as the trigger for sudden allergic reactions in the blood and tissues of people with AD.

Broda & Barnes (1976) link AD to thyroid deficiency. Hypothyroidism is thought to be a medical cause for several kinds of skin diseases including eczema. In AD symptoms of itching are emphasized. It is not always clear if the itching causes the scratching or vice versa. The complicated biochemical process of itching in the body has been widely researched and is still not fully understood. In chronic dermatoses the nerve endings can be damaged, which then creates itching. Montague emphasizes the importance of the skin and says that skin and the nervous system arise out of the same embryonic layer, the ectoderm. One could say that the skin is the external part of the nervous system (1971: 5). In a person with AD, the external nervous system is constantly irritated, disturbed and overwhelmed. This matches my personal experience of feeling overwhelmed by nervous tickles like constant prickles of a thistle all over my body, relentlessly and restlessly invaded day and night.

In an allergic reaction, histamines are released into the body tissue, causing allergic symptoms such as hives, itching, inflammation of the skin, hay fever symptoms and asthma. This hypersensitivity of the immune system causes constant stress on the person’s body. The allergic constitution of the AD sufferer makes it hard to test allergens. The mere scratching of the skin for the allergy test can cause an inflammation that makes it difficult to recognize what the person is really allergic to.

Not only are the allergic substances (or combinations of them) unpredictable for the person with AD–the reactions they cause are also unpredictable. It might be an asthmatic, skin, or hay fever reaction. I have endlessly tried to find what creates specific itching/scratching attacks, but have hardly ever come up with directly traceable reactions, which has often made me feel crazy. One time I connected an allergic skin reaction to eating butter and the next day I had absolutely no reaction to butter at all. This constant detective game has brought little direct result except that I have learned to track my proprioceptive sensitivity and according to my physical feedback, learned to monitor what I can allow myself to eat or drink on a certain day. I’ve learned to sense my tolerance to substances and situations that might tend to create allergic reactions. I have become somewhat of an internal hunter and tracker of previously unknown and unpredictably changeable realms, somewhat like the shaman who travels to other worlds to track treasures.

Marginalization through illness and symptoms

Experiences of being stared at because of my red inflamed skin, swollen eyes and rough leathery hands have been painful and made me feel marginalized. I have been asked by a woman with whom I shared a hotel room if my skin condition was contagious. She kept her towel strictly by her bedside and scrubbed the bathtub after I had a shower. This hurt me deeply and made me even shyer about physical contact. I have heard some horrendous stories from people with chronic skin diseases who were teased and treated like outcasts. Some of them totally withdrew from society as a result of feeling marginalized by mainstream norms.

Others who look different from the mainstream norm also suffer from discrimination. For example, people who are physically large are stared at and may be turned down for jobs because of their weight. People with disabilities and AIDS also reveal similarly painful experience of discrimination based on appearance. As a white western person, my experiences of marginalization, discrimination and feeling excluded provide a small taste of what many people of color experience. Those in the white western mainstream who suffer such experiences get a small hint of what it must be like for those outside the mainstream who visibly differ from its racist norms.

When I was at the Dead Sea in Israel, a healing place for skin diseases, I heard patients relate painful stories of loneliness and isolation. I was shocked in particular by an elderly woman who had been hiding her psoriasis (a scaly patchy skin disease) from her husband for 15 years. Her whole body was covered by the disease. She avoided undressing in front of him and they had no physical contact for many years, although they slept in the same bed. Imagine what pains and troubles she must have experienced hiding her skin over that length of time. What loneliness! What deprivation of physical contact! A television speaker who had been hiding his psoriasis under long hair and a beard found liberation when he shaved off his hair and beard to expose his skin to the sun. Back on TV after the 4-week cure, he remarked on his radical external change and his skin condition. I was so happy to hear this story. He had actually used his position as a public figure to speak out openly about his skin, formerly a place of shame and vulnerability. Katherina Jung (1991) says that whoever manages to talk about the difficulty with their skin has already jumped out of the loneliness of suffering and is on the path of healing.

Skin symptoms and the relationship channel

The skin is a contact and therefore a relationship organ–touch and body contact are crucial in relationship. The moment we shake hands, we touch each other’s skin. We express our relationships with one another through touch or lack of touch. We say things like “I’m touched,” or “This doesn’t touch me.” We comment, “I feel touchy” or “It’s a touchy subject.” How about “I’m saving my skin here,” or “I wouldn’t want to be in her skin!” We’re “thick-skinned” or “thin-skinned,” or feel vulnerable, like we have “no skin.” We’re irritated when something or somebody gets “under our skin!”

If the skin is disturbed, i.e., looks different or is highly sensitive, relationship interactions become problematic. The skin is the surface of the body; it is our largest organ and the most exposed to the environment. If a person’s boundaries have been invaded and she didn’t have the ability to defend herself, the skin has been known to express a reaction or some sort of a defense mechanism that wasn’t available to the person at the time of invasion. It might get inflamed, hard, scaly, or shell-like as in protective shield. The skin may reacts in an inflammatory or rough way for a person who is not able to express a reaction. Some form of abuse story is often found when working on skin disease.

I have often heard people describe their ill skin as a highly sensitive surface; it may feel sore and unprotected as if there were no skin, or as if one had been skinned alive. Skin disease sometimes involve feelings of being continuously invaded, be it by looks-ism, lack of touch or unwelcome touch, or overwhelming relationship and worldly expectations, criticism and judgments. Societal attitudes about beauty and appearance create judgmental attitudes towards skin that looks and feels different from the skin in advertisements on beauty care. Visible marks on the skin invite everybody’s judgment, ideas and reactions. The skin is an intimate and at the same time very public organ. Shaming and negative attitudes that one-sidedly favor a consensus reality value of smooth flawless skin over a more rugged or different appearance create continue external and hence internal abuse. Having been shamed and stared at creates internalization of those negative attitudes, which then can result in painful isolation.

Recently I worked with a woman on her AD. Her experience of her skin was very thick and rough. I had her look at her skin and imagine it was a natural phenomenon. After she meditated on her skin for a while, she suddenly said that she saw a walnut, with an outer and an inner shell. Within the two skins there was a tender kernel. She laughed and said that it would be a relief to have a hard walnut shell around her, like a protective shield. She often felt vulnerable and invaded by others. She was a very loving and open woman who needed to grow a thicker skin. She was more open to being at everyone’s disposal than to taking care of her own needs.

The experiences within skin symptoms can sometimes indicate more earthy, scratchy and wild behavior in relationships and in the world. I remember working with a young man with a skin symptom that made his hands and the soles of his feet itchy, scaly, rough and hot. As we amplified the experience of his symptoms he became hyena-like, wild and raspy in his relationship interactions. His normal identity was shy and quiet, but his feet were rough and hot. The wild animal symbolically living in his experience of his hands and feet may have been helpful to him and his community’s relationships.

The following story indicates how exploring skin irritations may reveal a relationship process. In a seminar with Arnold Mindell, I chose to work on both a body symptom and relationship problem. I chose my itchy skin as a body symptom, which I experienced as: “It itches and tickles and does not give me any peace. I constantly have to scratch. It’s really horrible!” Arny suggested a role-play. He played me relating to my friend, who was also present with me in the middle of the seminar. My role was to be the spirit that gives me the itch. As I tickled and created the itch in Arny I said: “Hey, wake up, don’t be so stiff… Loosen up, come on! You don’t show all of your feeling for Marie! You are too stiff!” I then took my own role again and started relating to my friend using the itching tickling energy in relationship to her. We ended up whirling around and expressing our feelings of friendship to each other. The “itch” here was a contact maker that would deepen the friendship if allowed to emerge.

I am looking at my hands as I am typing these words, and I notice that they are rough. Meditating briefly on my skin, I see the dryness and the leathery quality of my hands. These visual qualities remind me of a lizard. I imagine having this skin all over my body. I feel somehow tough and rough. I might be able to use this quality in some of my relationships. If I were to relate in this lizard way, I would be more detached from being concerned about other people’s needs and expectations and be more direct about asking for what I want and need.

Body symptoms often express marginalized parts of ourselves, or unpopular positions or values from our culture (Mindell, 1990). Experiences that are in opposition to mainstream norms are often repressed by individuals, and therefore may only gain notice when they appear in the body. The person suffering from a body symptom is the carrier of this unlived and under-represented experience. As the carrier of a message for the culture that a sufferer lives in, she is a potential healer for the culture.

The process of marginalizing experiences happens at both the world and the internal individual levels. The more I favor smooth pale skin, the more I marginalize experiences that are rougher and more inflammatory. This is actually a form of prejudice or racism on the internal level. Externally, society also favors non-inflammatory and non-conspicuous behavior and projects wilder disavowed behavior onto minority groups. Skin symptoms often challenge this bias against conspicuousness by being very visible. The deeper messages of such symptoms may be about wildness and impulsive, fiery behavior that wants to be expressed and lived. Such behavior counters a person’s usual identity and culturally accepted norms.

For example, I remember a woman who worked on her problems with acne. She hated the way the pimples looked on her face, but as we processed the boils we found that they contained power, impulsiveness, fun and outrageous creative energy that wanted to pop out of her. She started dance and giggle, laugh and express passionate feelings. She talked about wanting to be more sexy, outrageous and irreverent in her life, and about how inappropriate she often felt. She feared that if she were her real self, she would be called too much, or seen as a slut. She had been holding herself back because of societal attitudes against sexy, confident and expressive women. As a woman, especially a woman from a European country, she flouts social and cultural rules by being loud and outspoken. Society and traditional roles for women favor being gentle and friendly, rather than loud and wild. This message is repeatedly reinforced by movies, magazines and television commercials. From a skin perspective, women should not have pimples, or should at least hide them under makeup in order to be desirable. Skin symptoms represent minority attitudes within society and often are carriers of a underrepresented and unlived role for the larger field. In this case, the loud outspoken and unredeemed behavior is needed to be lived and expressed for all women.

In a society where advertisements favor only smooth skin, it is difficult to overcome a bias toward soft smooth skin over rough, wrinkly, or different-looking skin. Despite this difficulty, I would like to invite everybody to go beyond bias and find meaning within different appearances.

I see visible skin marks as messages that need to be seen, noticed and experienced by the onlooker, that is, by society. If I notice a skin ailment–or any other visible trait in another person and I have a reaction of any kind to it–it could be part of myself that I need to notice more.


Skin is a relationship organ, and many relationship channel experiences are indicated in symptoms of the skin. Behaviors such as being direct, unadapted, irrational, earthy, or wild often appear when skin symptoms are processed. These sorts of unlived experiences are relevant for both individuals and cultures that suppress such states because of their unpopularity with dominant norms. Skin symptoms may therefore be important as messengers for whole societies, which might need the messages that the skin’s visible marks express. Skin symptoms need to be seen by the world, not hidden away as imperfections. All of us have marks of one sort or another, but those with skin symptoms cannot hide the marks and their accompanying pain

Pain and suffering due to skin differences, be they skin diseases, damage, or skin that does not fit the white mainstream result from racist norms that need to be challenged. Showing this suffering can be a way of challenging those norms; optimally, judgements about skin that does not fit the ideal displayed in advertisement will be challenged by those whose skin is not different from the norm. (Of course, we all have differences; some of us just have the privilege of being able to hide the ways in which we are different from the norm.) Entering into unknown realms to discover and share these insights is a symbolically shamanistic journey that all of us can do.

Finally, I would like to encourage everyone to catch moments when we are critical about our own skin. Try thinking that the skin ailment–be it a rash, a pimple, or a skin cancer–could be a symptom that is also meant for the world in some way. Find out how it is meant for you and your community’s learning. Try and go beyond mainstream attitudes about appearance and find out your experience of this ailment. You might think about how you might like to hide your symptom, and what it means to have the privilege to hide. To explore this further, you might start talking about something private, something that you have the privilege to hide. You might also talk about something that you cannot hide, some visible thing that you wish that other people did not notice but you fear they do. This is working on the shedding of skin and the shedding of racist societal norms. We remake cultural ideas and expectations when we go beyond the surface to share personal ways of being in each moment. The stripping of cultural and societal expectations can be a shamanic journey valuable for the whole community. Living with a skin disease is but one heightened experience of this.


I would like to thank Jane Martin for all her help in editing this paper as well as making helpful suggestions and additions. Many thanks to Leslie Heizer and Kate Jobe for their useful editorial advice.

Silvia Camastral Ph.D. is a certified process worker. She lives in Brisbane, Australia where she works in private practice and teaches process work. Her special interest is in helping people explore creativity within their body symptoms.