Karma is a traditional Eastern concept, mirrored in Western analytical psychology as individuation. These notions about how meaning is made are concepts near the top of the hierarchy of ideas in their respective traditions: both are theories about connections between a time-bound part of the mind, which analytical psychologists call ego, and a time-free, transcendent experience, which we call self. The concept complex describes both a structure and a process: repetitive patterns of thought and behaviour create suffering. From stillness and clarity, self unfolds into unresolvable oscillations; its developmental spiral is arrested, forming instead a strange attractor, ever circling and never reaching its archetypal core in the psyche. Jung saw individuation as task involving working through complexes, a project for second half of life, requiring a stable identity and persona. His classical view, emphasizing the role of archetypes and the collective unconscious in the individuation process, contrasts with that of Michael Fordham and the developmental school. The latter are close to Eastern ideas both see self as a gradual unfolding from potential to actual throughout the whole of a life. This paper explores karma and individuation, through the work I did with Yukio, a young Japanese man born with severe bilateral cleft palate. Overwhelmed by shame, he believed himself beyond help due to bad karma. Repeated emotional traumas hindered identity formation, producing deep problems in forming symbols and relation to others. Born with a malformed face, he felt fated continually to lose face. As a new sense of identity emerged, with it came the courage to have a new face. The enactment, gaining face by plastic surgery, was a counterpoint to our work.