Shamans work with the spirit or the soul and they work with energy. In the case of shamanic extraction they are working with misplaced energy. No energy is truly bad from a shamanic perspective. If energy is misplaced or it isn’t in accord with the environment (the human body, or the body of land…) it will bring illness. Shamanic extraction is the removal of displaced energy, sometimes called intrusions. This is energy that does not belong in the body and may cause illness. Where does misplaced energy come from?
We all are aware that emotional states can affect health. Stress is acknowledged to cause backaches and ulcers. Shamans believe that your emotion takes the form of energy and can be stored throughout the body and eventually lead to illness. So you store your stress, fear or anger in your stomach, or you get angry and send your anger out at someone. We can see this if you can remember a time when someone’s anger or sadness seemed to have an effect on a room: "her anger hit me like a blow" "you could cut the tension with a knife." The energy that can be stored in the body does not have to be from anger but could be from other reasons as well. In the shamanic mind there is no distinction made based on where the energy came from. The shaman sees that the energy does not belong there and removes it. Other types of misplaced energy could be the energy left behind from an injury. Someone sprains his/her ankle and an energetic injury may remain which could perpetuate weakness in that location. Organ transplants are sometimes an instance where shamanic extraction is needed.
Shamanically everything has a soul, so the heart transplanted from another may still contain energy from the organ donor. This energy may or may not be compatible with the heart transplant recipient. If it’s not, the shaman would remove the ‘displaced’ energy that is adding to the body’s rejection of the heart so that the rejection will be less severe.