Much of what Western medicine classifies as psychiatric illness is understood by Tibetan thought as associated with imbalance of rlung (wind, breath). Rlung has a dual origin in Indian thought, combining elements from Ayurvedic medicine and Tantric Buddhism. Tibetan theories of rlung seem to correspond in significant ways with Western concepts of the autonomic nervous system (ANS), and Western medicine too has associated psychiatric issues with ANS problems. But what is involved in relating Tibetan ideas of rlung to Western ideas of the emotions and the ANS? The article presents elements of the two systems and then explores similarities and differences between them. It asks whether the similarities could be the basis for a productive encounter between Tibetan and Western modes of understanding and treating psychiatric illness. What could Western psychiatry learn from Tibetan approaches in this area?