This article describes a case of a 'spiritual attack' in the context of Amazonian ayahuasca ceremonies. These attacks are often assumed to be imaginary, and there is relatively little information available about them. Specifically, there appears to be no documentation about possible mechanisms of action for these attacks. Subjectively, they typically appear as context-dependent visions or somatic sensations that represent disease-inducing or lethal interventions from an external hostile party. Such 'spiritual attacks' could tentatively be conceptualized as subjective mental representations of fundamental disagreements between two parties. 'Defenses' against these attacks might then consist of methods for maintaining stability and resolving the associated negative affects. This discussion could facilitate an improved understanding of this rarely documented, difficult-to-conceptualize phenomenon.