Shamanic healing is often described as powerful work with spirit and altered states of consciousness, and precisely because of this intensity, it carries a range of possible risks and side effects. On the psychological level, deep ritual processes can stir up repressed memories, trauma, or powerful emotions that may be difficult to integrate, and in some cases can destabilize existing mental health conditions. Those who already live with psychosis, bipolar disorder, or other serious psychiatric vulnerabilities may be especially at risk when entering strong trance states or visionary experiences. There is also the subtle danger of spiritual bypassing, where spiritual language and ritual are used to avoid rather than address concrete psychological or relational problems. Confusion between visionary experiences and everyday reality can further complicate matters if there is no careful grounding and integration.

Physical and medical dimensions of risk also deserve careful attention. In traditions that employ plant medicines or other entheogens, there can be adverse physical or psychological reactions, including interactions with medications or strain on the heart and nervous system. Even without substances, intense drumming, dancing, fasting, sleep disruption, or prolonged ceremonies may lead to exhaustion, injury, or complications for those with underlying health conditions. When shamanic methods are used as a substitute for appropriate medical or psychological care, there is the added danger of delayed diagnosis, misinterpretation of symptoms, or unsuitable treatment for serious conditions. Temporary physical discomfort, fatigue, or a perceived worsening of symptoms can also arise as part of the process, and may be unsettling without proper explanation and support.

There are further risks that arise in the relational, ethical, and spiritual-energetic dimensions of this work. The shaman or healer is often perceived as having privileged access to hidden realms, which can foster dependency, over-reliance, or vulnerability to exploitation if the practitioner lacks integrity. Financial or emotional manipulation, unreliable or subjective diagnoses, and divinatory messages framed with excessive certainty can all shape life decisions in unhelpful ways. On an energetic or spiritual level, some traditions speak of people feeling overly “opened,” vulnerable, or disturbed after intense sessions, especially when boundaries are not clearly set or closed. Difficulties in integrating powerful experiences into ordinary life may lead to social strain, misunderstanding with family or community, or a sense of isolation.

Traditional cultures that hold shamanic lineages often surround these practices with protocols, community oversight, and clear ethical expectations precisely to minimize such harms. In contemporary settings, similar safeguards are sought through careful screening for medical and psychological vulnerabilities, maintaining access to conventional healthcare, and choosing practitioners who are accountable and embedded in a coherent framework of practice. When approached with discernment, clear boundaries, and respect for both spiritual and psychological realities, the transformative potential of shamanic healing can be engaged while also acknowledging and mitigating its very real risks.