Magical thinking is by no means limited to “preliterate societies.” Supernatural explanations are no less common in developed nations than in developing ones when people are confronted by unexpected personal disasters such as flood, fire, death of a spouse or child, or sudden illness. This paper is concerned not with how illness affects individuals, but their attempts to explain why: Why them? Why then? The focus of concern is the very widespread system of beliefs that attributes behavior disturbance to malign magic—a hex or spell perpetrated by one individual on another whose success he envies and resents. The characteristics of beliefs shared by many people within two cultural groups are considered, Liberians and black Americans. The two systems of beliefs, strikingly similar in many ways, are usually called “witchcraft” in Liberia and “rootwork” in America. Data are presented from the author's 2 years experience as director of the only psychiatric facility in Liberia, and from a study of patients treated during the past 2 years at the University of Connecticut-McCook Hospital in Hartford. Case history material of 4 patients is included to illustrate the principal features of the belief systems as well as the range of behavior disturbances associated with witchcraft and rootwork beliefs. The report concludes with a discussion of how professionals can utilize a knowledge of these belief systems to diagnose and treat patients more effectively who are convinced of their importance.