This paper analyses the relation of processes of socio- economic differentiation and change to the well-being and health of families within highland Maya communities and to the lived experience of emotional suffering, as defined by local categories of mental illness. We specifically analyze how highland Maya Indians of central Chiapas, Mexico, experience the contradictions of a rapidly changing economy, social relations, politics, and culture in conjunction with chawaj (chuvaj),3 one of the major Tzeltal and Tzotzil native categories of mental illness (Castille 1996; Fabrega et al. 1970).