Hmong shamanism

Hmong peoples and their migrations

EthnoMed, a cultural-health resource run by Harborview Medical Center and UW Medicine, states that the Hmong trace their origins to northern central Asia and moved south into China over centuries. In the 1800s many settled in the mountains of Burma, Thailand, Laos and Vietnam. After the 1975 communist takeover in Laos, many Hmong fled to refugee camps in Thailand, and the first refugees reached the United States later that year. The Minnesota Historical Society likewise describes the Hmong as a distinct ethnic group with ancient roots in China and dates the start of arrivals in Minnesota to 1975.

Traditional religion and the shaman's role

A profile on the Religions in Minnesota site, authored in 2015 by a group that includes people with Hmong names, says the term Hmong shamanism is most often used for Hmong traditional religion, while noting debate over the name. It describes the religion as animistic and spirit-based, with ancestor veneration and belief in reincarnation. The profile recounts an origin account in which the deity Saub empowered a figure named Siv Yis to act as a healer, and presents shamans as people chosen by healing spirits rather than people who elect the role.

The Hmong Museum in Minnesota, in an educational resource for schools, describes shamans as people who travel between three worlds and are chosen by spirits or ancestors. It situates the tradition in Hmong life before the mid-20th century, when missionaries and French colonialism reached Hmong settlements. The sources reviewed here do not give a dated account of the tradition's earlier history, and written histories of Hmong religion are limited in what was reviewed.

Resettlement, Christianity and continuity

A 2002 Minnesota Medicine article based on interviews with 11 shamans and 32 patients reported that, after about 25 years of Hmong acculturation in the United States and conversion to Christianity, shamanism maintained its traditional role in health and healing. The Religions in Minnesota profile gives a rough estimate that up to half of Hmong people in the United States are Christian and says Hmong Christians may still practice ancestor veneration and shamanic healing. It also states that most Hmong people still value the life-cycle ceremonies of the tradition. These figures are estimates and vary by community.

The Hmong Cultural Center in Saint Paul, a community organization, states in its 2015 Hmong 101 presentation that about two thirds of Hmong in the United States continue to practice the traditional animist religion and shamanism, and about one third are Christian. This is the organization's own estimate and differs from the rough Christian share of up to half in the Religions in Minnesota exhibit, so the proportions are best read as uncertain.

Names for the tradition and its practitioners

Hmong shamanism is the English phrase most often used by outside scholars and some community-authored resources, and the Religions in Minnesota profile notes that the name is debated; the same exhibit also uses Hmong religiosity. Within the tradition the shaman is called txiv neeb. The Hmong Museum's resource gives niam neeb for female shamans and a male form written txis neeb, while a California Health Care Foundation article uses txiv neeb for any certified shaman and the 2002 Minnesota Medicine article uses tu txiv neeb. Spellings vary between sources, and this page uses txiv neeb.

Terms for souls, ceremonies and other healers

Sources describing the community's terms give ntsuj plig for the human spirit, said to number 37 in the Hmong Museum resource, and poob plig for a lost or fallen spirit. Ua neeb is the shaman's trance or ceremony, hu plig is soul calling, and khi tes or khi hlua is the tying of red and white strings on the wrist. Mob neeb is described by the Hmong Museum as shaman sickness. A published case study of a ceremony uses the term ua neeb khu for a healing ceremony for spiritually focused concerns.

Shamans are distinguished from other healers. The Religions in Minnesota profile lists kws tshuaj (herbalists, who work with helping spirits called dab tshuaj) and kws khawv koob (healers who use chants with water, metal and incense). EthnoMed notes that traditional care in Hmong communities also includes home remedies and folk medicine doctors. The 2002 Minnesota Medicine article observes that Western biomedicine has no equivalent to the shaman.

Becoming a txiv neeb

The Hmong Museum resource says spirits or ancestors choose the shaman, who may regard the calling as a blessing or a burden, and may first experience shaman sickness that Western medicine does not explain. It states that only other shamans can confirm a person's spirit guides, after which the person decides whether to accept the role. The Religions in Minnesota profile likewise says one cannot decide to become a shaman. Both sources describe a role of social standing in clan life, and neither is a substitute for the account of an individual shaman or lineage.

Ceremonies and how they are described

Adherents describe a txiv neeb as a mediator between the visible world and the spirit world who diagnoses spiritual causes of illness while in trance, calls back lost souls, and performs rituals for healing and divination. Scholars note that ordinary men and women can learn certain rituals, such as returning frightened souls, without being shamans. This page names the ceremonies but does not set out how they are carried out, and the ritual detail in the sources is a matter for the shamans and families who hold it.

A published ethnographic case study of one ceremony, performed for an elderly man in a Midwestern city and filmed and then reviewed with the shaman, analyzed its symbolic meanings as a reciprocal exchange between the living and the spirit world. The authors of the study drew on the shaman's own explanations. Practices with their own Machipedia pages that overlap in theme include Shamanic Healing and Soul Retrieval, though those pages describe other traditions and should not be read as equivalent to Hmong practice.

Reasons people consult a txiv neeb

A study in a Central Valley, California, Hmong community collected 924 patient contact forms completed by 36 shamans over 18 months. Patients sought shamanic help for physical, emotional and psychological complaints, which shamans frequently attributed to soul loss or to bad spirits. The authors concluded that the data suggest a continuing need for spiritual healing within the community and that the rituals affirmed and strengthened connections to family, culture and community. The shamans' own records are the data, so the outcomes are shamans' perceptions rather than independent measurements.

A 2018 study of 20 shamans in Fresno, California, reported that shamans continue to train and practice there, that older patients still use them, and that young adults had become the fastest-growing group of users. Interview-based studies of older Hmong Americans with chronic illness in Minnesota found that most continued to use shamanic ceremonies together with biomedicine, and that reliance increased when biomedicine was seen as limited or when a spiritual cause was suspected.

How the tradition describes its purpose

The Hmong Museum resource says a hu plig ceremony is held when trauma or strong emotion is believed to have led to loss of one or more ntsuj plig, and that families hold a version of the ceremony at the Hmong New Year. It describes shamans as healers and keepers of spiritual harmony. The 2002 Minnesota Medicine article reported that many Hmong consider shamanism effective care, irrespective of age, gender or degree of acculturation, which is a finding about belief and use rather than a test of outcomes.

What the literature consists of

PubMed searches run on 2026-10-12 combining Hmong with shaman, shamanism and traditional-healer terms returned 20 records. The 15 records examined were qualitative studies, case studies, interview series, surveys and an erratum; none was a controlled trial or systematic review of shamanic ritual. A second search on Hmong soul loss and spiritual healing outcomes returned one record, the contact-form study described above. The sources reviewed therefore do not support any statement that Hmong shamanic rituals do or do not change clinical outcomes.

Shamans as research participants

A 2026 study in Psycho-Oncology interviewed 15 Hmong shamans in the United States, Thailand and Laos between 2018 and 2020. Fourteen linked cancer to soul loss, while others pointed to factors such as processed food, inactivity or heredity. Five reported having referred patients to Western providers when spiritual healing was ineffective, three had collaborated with such providers, nine were willing to do so and six were reluctant. The authors note that the lead author is a Hmong shaman, which may have influenced data collection and interpretation, and that most participants were older with limited formal schooling.

Hospital accommodation and cross-cultural care

A 2020 California Health Care Foundation article describes Mercy Medical Center in Merced, California, where any patient can ask for a visit from a certified txiv neeb, who may perform nine hospital-approved ceremonies in the patient's room. The article reports a 40-hour certification course covering Western medicine topics such as germ theory, vaccines and prescription drugs, more than 150 shamans trained according to a hospital official, and adoption of the arrangement as formal hospital policy. The claim that this is the only such program nationally is the article's own statement from 2020 and was not independently checked. It also reports earlier clashes over string tying during surgery.

EthnoMed offers provider-facing guidance, last reviewed in 2007, advising that many Hmong patients use traditional healing first, that trust and family involvement in decisions are central, and that interpreters be used for limited English. A 2022 qualitative study of Hmong patients with diabetes and their caregivers in Wisconsin found reliance on herbs and shamans linked to distrust of Western medicine and recommended family involvement and culturally informed dietary advice. It was a small pilot using snowball sampling and did not interview older patients themselves.

Documented concerns about care and timing

A California survey of 417 Hmong parents and caregivers found that use of shamans or herbalists, alone or with Western care, was associated with higher perceived barriers to childhood immunization; 9.4 percent used traditional care only and 7.7 percent used both. The design was cross-sectional with a convenience sample, so the association should not be read as showing that shaman use causes lower vaccination. In the cancer study, 11 of 15 shamans reported difficulty diagnosing or treating cancer, often because it did not appear clearly in their diagnostic readings. Conventional medical care should not be delayed or replaced on the basis of spiritual diagnosis alone.

The sources reviewed describe interactions between ritual and hospital care as an area needing communication rather than as a source of injury. The Merced article reports shamans guiding patients toward physicians, for example for symptoms of diabetes, and the Minnesota Medicine article suggests clinicians ask patients about their beliefs. None of the sources reviewed reports physical harm caused by the shamanic ceremonies themselves.

Cultural attribution and who speaks

Authority to speak for the tradition rests with its practitioners and the Hmong families and clans who work with them. Both community-authored resources reviewed state that shamans are chosen by spirits and that spirit guides are confirmed by other shamans, so people outside this process cannot claim the role. Clan and household customs differ, and the Hmong Museum and Religions in Minnesota resources are educational summaries rather than authoritative statements for all Hmong communities. Most research reviewed here comes from the United States, so Thai, Lao, Vietnamese and Chinese Hmong practice may differ.

Ritual detail that families and shamans hold privately is not reproduced on this page, and readers seeking a ceremony should approach Hmong community organizations and shamans directly. Several sources are older than a decade, and the EthnoMed guidance dates from 2007.

Community organizations speak for Hmong culture and health, but the sources reviewed do not show them speaking for ritual. The Hmong Cultural Center says its Hmong 101 workshops can cover Hmong beliefs about health and medicine. The Minnesota Historical Society's encyclopedia entry describes the Hmong Health Care Professionals Coalition, founded in 1995, as working through health fairs, surveys and provider conferences to build trust between Hmong patients and doctors. Neither source sets out a position on shamanic practice.