In contemporary Okinawa shamanism and psychiatry are both employed by Okinawans to bring relief from what are understood to be godly or psychiatric interventions in their lives. This paper examines some of the reasons that shamanism is still popular and well-patronized in a society that is part of one of the world's most developed nations. By situating the role of shamans within a historical context, it becomes clear that repression of these women has taken place at a number of junctures in Okinawan history, mainly because they were seen as "backward," "primitive," or "too" Okinawan. In other words, their primary identity as Okinawans led those in political power to attempt to remove them from being socially acceptable, forcing them underground as the state reinvented itself to suit broader political strategies. Notwithstanding almost four centuries of discrimination and attempted repression, shamans continue to prosper in contemporary society, using markers of Okinawan identity (in particular ancestor worship) to legitimate their roles as therapists and healers. Patients, too, hybridize both systems today in informed and idiosyncratic ways, moving comfortably between treatment regimes. Both shamans and psychiatrists are perceived as therapists in this article.