When a person dies, it is possible for their soul/spirit to stay present around familiar surroundings, family members, or friends. Under some circumstances, these spirits do not know they are dead and without a physical body. For the next stage of spiritual evolution to unfold, it is felt that at a minimum, spirits need to be aware of their situation. Ideally, spirits will migrate to special regions of the Lower or Upper worlds where evolution guided by the compassionate helping spirits can occur. The shamanic practitioner can assist those spirits who are stuck in the Middle world to realize their state and move on to their next stage of evolution. If a loved one who has passed on is felt to be present in some way among those who knew them, a psychopomp healing is recommended.
Further complexities arise when a suffering being – the spirit of someone who is stuck in the Middle world – attaches themselves to a living person. This can happen when the living person has suffered some loss of power and/or has experienced deep trauma, and is somehow attractive to the suffering being due to a prior relationship or other compatibility. A series of special and carefully guided healing sessions are needed to help the disembodied spirit differentiate from the spirit of the live person, then through conversations facilitated by the compassionate spirits of the practitioner, aided in understanding their situation and the positive aspects of migrating to the Upper or Lower world. When the suffering being is ready, the practitioner can convey them to the compassionate region of their choice – aided by their own helping spirits.