Chapter 4 shows how the embodied and enacted psychophysiology of metaphor can explain mechanisms of symbolic healing. Recent research on placebo responding and predictive processing or active inference theories in computational neuroscience suggest models for the physiology effects of placebos, imagery, and imaginative enactments. Examples drawn from traditional shamanistic practices illustrate how healing metaphors and images map bodily physiology, cognition, and experience onto metaphoric landscapes or myths. Movement in these landscapes or along an arc then gives rise to corresponding changes in physiology, cognitive, and social relationships or position, which make use of the dynamics of sensory and affective meaning, including processes of abreaction or catharsis and aesthetic distance. Healing rituals involve a hierarchy of cognitive processes that are structured metaphorically, which reaches down to physiological processes and outward to social interactions. Its multiple levels can operate in tandem to reinforce or subvert processes. This leads to a view of symbolic action and healing ritual as involving multiple parallel levels of causality and communication.