Historical Trauma Among Indigenous Peoples of the Americas PDF

Journal of Psychoactive Drugs, 43 (4), 282–290, 2011 Copyright © Taylor & Francis Group, LLC ISSN: 0279-1072 print / 2159-9777 online DOI: 10.1080/02791072.2011.628913 Historical Trauma Among Indigenous Peoples of the Americas: Concepts, Research, and Clinical Considerations Maria Yel...

Journal of Psychoactive Drugs, 43 (4), 282–290, 2011 Copyright © Taylor & Francis Group, LLC ISSN: 0279-1072 print / 2159-9777 online DOI: 10.1080/02791072.2011.628913 Historical Trauma Among Indigenous Peoples of the Americas: Concepts, Research, and Clinical Considerations Maria Yellow Horse Brave Heart, Ph.D.a ; Josephine Chase, Ph.D.b ; Jennifer Elkins, Ph.D.c & Deborah B. Altschul, Ph.D.d Abstract —Indigenous Peoples of the Americas have experienced devastating collective, intergenerational massive group trauma and compounding discrimination, racism, and oppres- sion. There is increasing evidence of emotional responses to collective trauma and losses among Indigenous Peoples, which may help to inform ways of alleviating psychological suffering and unresolved grief. Tribal cultural and regional differences exist which may impact how the wounding across generations and within an individual’s lifespan are experienced and addressed. This article will review the conceptual framework of historical trauma, current efforts to measure the impact of historical trauma upon emotional distress, and research as well as clinical innovations aimed at addressing historical trauma among American Indians/Alaska Natives and other Indigenous Peoples of the Americas. We will discuss assessment of historical trauma and implications for research and clinical as well as community interventions, and conclude with recommendations. Keywords — American Indians, grief, historical trauma, Indigenous Peoples, mental health Indigenous Peoples of the Americas1 are a diverse trauma and losses among Indigenous Peoples and how best population, with over 500 federally recognized tribes in the to intervene in order to alleviate psychological suffering United States and over 400 in Latin America. Indigenous and unresolved grief. A long-term goal of historical trauma Peoples have experienced pervasive and cataclysmic col- intervention practice is to reduce emotional suffering lective, intergenerational massive group trauma and com- among Indigenous Peoples of the Americas by developing pounding discrimination, racism, and oppression. There culturally responsive interventions driven by the commu- is insufficient data on emotional responses to collective nity to improve behavioral health. American Indians and Alaska Natives2 are one seg- a Associate Professor of Psychiatry, University of New Mexico ment of the Indigenous Peoples of the Americas. American Health Sciences Center, Center for Rural and Community Behavioral Indians/Alaska Natives rank higher in health dispari- Health, Albuquerque, NM. b Social Work Faculty, Oglala Lakota College, Kyle, SD. ties than any other racial or ethnic group in the United c Assistant Professor, School of Social Work, University of Georgia, States. American Indians face emotional challenges such Athens, GA. as depression, substance abuse, collective trauma expo- d Assistant Professor of Psychiatry, University of New Mexico Health Sciences Center, Center for Rural and Community Behavioral sure, interpersonal losses and unresolved grief, and related Health, Albuquerque, NM. problems within the lifespan and across generations (Beals Please address correspondence to Maria Yellow Horse Brave Heart, et al. 2005; Manson et al. 2005, 1996; Whitbeck et al. Ph.D., Associate Professor of Psychiatry, University of New Mexico Health Sciences Center, Center for Rural and Community Behavioral 2004a, b; Brave Heart 2003, 1998). Although there is Health, MSC09 5030, 1 UNM, Albuquerque, NM 87131-0001, email: a paucity of research among Indigenous Peoples living [email protected]. within the United States, some studies indicate elevated Journal of Psychoactive Drugs 282 Volume 43 (4), October – December 2011 Brave Heart et al. Historical Trauma Among Indigenous Peoples of the Americas levels of PTSD and depression among both American research and clinical as well as community interventions, Indians and Alaska Natives (Manson et al. 2005) and and conclude with recommendations. Indigenous Peoples from Latin America (Sabin et al. 2003). In addition, substance abuse is a significant prob- CONCEPTUAL FRAMEWORK OF HISTORICAL lem (Walters 2004), with death from alcohol-related causes TRAUMA AND HISTORICAL TRAUMA being five times more likely for American Indians than RESPONSE for White Americans. Additionally, suicide rates are 50% higher than the national average (US DHHS 2001). Thus, Primm and colleagues (2010) note the importance of there is an urgent need to reduce racial and ethnic taking a public health approach to addressing mental health health disparities, which have a significant public health disparities for racial/ethnic minorities, specifically exam- impact, through designing effective interventions with ining the prevalence rates, diagnoses, access to care and American Indians/Alaska Natives (Wallerstein & Duran sources of care. Collective, communal, and generational 2010). In order to develop culturally resonant interven- trauma for massively traumatized Indigenous Peoples, as tions for Indigenous Peoples, more information is needed well as ongoing racism, oppression, and discrimination, regarding collective as well as individual lifespan trauma, have been described in the literature in relation to their grief, and loss in this diverse population who have faced impact on the prevalence of psychiatric disorders among histories of genocide, colonization, forced assimilation, American Indians/Alaska Natives (Duran & Walters 2004; and exclusion that undermine intergenerational health and Duran et al. 1998). Elevated chronic trauma exposure and well-being. the high prevalence of DSM IV-TR disorders (including Despite the array of tribal cultural practices, many both mental health and substance abuse disorders) have Indigenous Peoples share historical and contemporary been found among large samples of American Indian adults experiences, intertribal organizations, and often congru- living on reservations (Beals et al. 2005; Manson et al. ent worldviews and values. With increasing migration to 2005; Robin et al. 1997a, b). urban areas, approximately 60% of American Indians live Historical trauma (HT) is defined as cumulative emo- in cities rather than on reservations (US Census Bureau tional and psychological wounding across generations, 2006). Trauma among American Indians/Alaska Natives including the lifespan, which emanates from massive group is pervasive, often related to the mass genocide docu- trauma (Brave Heart 2003, 1998). To our knowledge, mented in the literature (Jaimes 1992; Stannard 1992; the concept of historical trauma among American Indians Hoxie 1989; Legters 1988; Thornton 1987; Prucha 1984; first appeared in the clinical literature in 1995 (Brave Tanner 1982; Brown 1970). The subsequent communal Heart 1998). Historical trauma theory frames lifespan suffering, cumulative trauma, and prevalence of PTSD in trauma in the collective, historical context, which empow- some American Indian communities have been addressed ers Indigenous survivors of both communal and individual by a few studies and clinical articles (Beals et al. 2005; trauma by reducing the sense of stigma and isolation. Manson et al. 2005, 1996; Robin et al. 1997a, b; Robin, Historical loss is a term utilized by Whitbeck and col- Chester & Goldman 1996). For instance, Whitbeck and leagues (2004a) in a measure of historical trauma. colleagues (2004a) found evidence of the impact of his- The historical trauma response (HTR) has been con- torical loss on risks for alcohol abuse among American ceptualized as a constellation of features associated with Indians. The collective traumatic past of American Indians a reaction to massive group trauma. Historical unresolved and Alaska Natives and subsequent responses merit consid- grief , a component of this response, is the profound unset- eration in the design and delivery of clinical interventions tled bereavement resulting from cumulative devastating and research with these populations. Although alcohol losses, compounded by the prohibition and interruption remains the most prevalent substance abused by American of Indigenous burial practices and ceremonies. Whitbeck Indians/Alaska Natives, there is increasing abuse of drugs and colleagues (2004a) found that thinking about historical such as methamphetamines, IV drug use and risks of trauma is associated with emotional distress, specifically needle sharing resulting in devastating illnesses such as depression and anger. These researchers raised additional HIV/AIDS and hepatitis C. Thus, there is a need to tar- important questions for consideration such as: what are get all substance abuse prevention and early intervention the psychological characteristics of people with high lev- efforts for this population. els of perceived loss and what tribal differences contribute This article will review the conceptual framework of to responses to historical trauma. Further considerations historical trauma, current efforts to measure the impact of include diversity in responses related to being a direct historical trauma upon emotional distress, and research as descendant of a historically traumatic event or more recent well as clinical innovations aimed at addressing histori- collective trauma. For example, some boarding schools cal trauma among American Indians/Alaska Natives and were reportedly more traumatic and attendance was more other Indigenous Peoples of the Americas. We will dis- widespread in some tribal communities. Additionally there cuss assessment of historical trauma and implications for may be regional and cultural tribal factors that impact the Journal of Psychoactive Drugs 283 Volume 43 (4), October – December 2011 Brave Heart et al. Historical Trauma Among Indigenous Peoples of the Americas magnitude of historically traumatic events and responses importance for conceptualizing Indigenous bereavement to them (e.g., there are some regions where tribes may and providing effective strategies for coping with loss not currently be experiencing higher degrees of discrimination only in the lifespan but across generations. For example, a and oppression and there is a need to understand how tradition in some tribal groups is to cut the hair when a close this impacts HTR). Thus, studies are needed to deter- relative dies, a manifestation of the degree of attachment mine the prevalence of HTR and the diversity among and a sense of a loss of part of oneself. Addressing grief and tribal groups regarding historical trauma exposure. There loss must incorporate an understanding of traditional nor- has been a groundswell of positive reactions to the con- mative grief resolution along with modern practices within cept of historical trauma (Whitbeck et al. 2004a) as evi- each tribal community. denced by significant requests for workshops and train- The degree of interpersonal losses and trauma expo- ing on this topic across tribes throughout the United sure in a number of American Indian/Alaska Native com- States and Canada, the number of “hits” on the website munities has been documented (Manson et al. 2005). More www.historicaltrauma.com, an increase in literature on this research is needed regarding the relationship between this topic, and local as well as national and international con- trauma exposure and risk factors for PTSD, prolonged ferences about historical trauma and related topic areas. grief, substance abuse, and depression, to elucidate some Research is needed about the prevalence and characteristics of these relationships and to facilitate development of inter- of HTR as well as the effectiveness of the HT intervention ventions to address root causes of behavioral health needs. strategies now in use. To date, interventions that reframe symptoms in terms of collective responses have been observed to alleviate a RELATIONSHIP OF CURRENT BEREAVEMENT number of the symptoms at least on a short-term basis AND HISTORICAL TRAUMA: CLINICAL (Brave Heart 2003, 1998). Such interventions also focus on IMPLICATIONS the cumulative generational impact of compulsory Indian boarding schools which may negatively influence the qual- Many Indigenous communities experience multiple ity of parental interaction with children, and contribute to traumatic deaths with great frequency due to elevated mor- unresolved or prolonged grief, depression, substance abuse, bidity and mortality rates, lowered life expectancy, and and other behavioral health issues (Whitbeck et al. 2004b; high accidental death rates. Most grief research focuses on Brave Heart 2003, 1998). Addressing parental trauma and marital bereavement (Sanders 1989) rather than the exten- generational boarding school issues for parents may help to sive premature and traumatic losses faced by Indigenous improve parenting skills and reduce behavioral health risks Peoples. Brave Heart’s conceptual model is that HT and for children. HTR are strongly related to the experience of lifetime traumatic events and that both are related to a series of psy- Relationship Between PTSD, Depression and chological outcomes for individuals including unresolved Historical Trauma grief, complicated/prolonged grief, PTSD and depression, In their studies on PTSD among a Southwestern all of which are often comorbid with substance abuse. The tribe, Robin, Chester and Goldman (1996) asserted the major mechanisms for ameliorating these results include need to describe the collective and communal trauma of developing functional support systems and returning the American Indians related to the historical past and ongoing individual to a sacred path as defined by their particu- impact of oppression and racism. Manson and colleagues lar tribal culture. The hope is to demonstrate that this (1996) posit that American Indian youth may demonstrate relationship exists and then develop interventions to alter higher thresholds for trauma and PTSD due to chronic and functional support systems and increase the individual’s severe trauma exposure, cultural manifestations of trauma participation in traditional culture. The eventual outcome responses that may be different, and/or PTSD assessment will be reductions in behavioral health consequences. instruments that may be biased. Although this study found Traditional American Indian/Alaska Native mourning a lower prevalence of PTSD than expected for American practices and cultural protective factors were impaired due Indian boarding school adolescents, other studies have to the federal prohibition around 1883 against the prac- found elevated rates of PTSD among American Indians tice of traditional ceremonies, which lasted until the 1978 (Beals et al. 2005). American Indian Religious Freedom Act. However, parts of The original intent of HT was to frame current Indigenous practices related to traditional burials are still trauma exposure within the context of historical trauma to not permitted. Importantly, when members of Indigenous reduce stigma about emotional distress and responses to communities experience death of close attachment figures, individual trauma, as well as highlight intergenerational the intense positive attachment to the deceased may be collective trauma. The intent of HT and HTR is to foster a risk factor for complicated or prolonged grief (Shear healing by providing a context for the extreme emotional et al. 2011). For American Indian/Alaska Natives, the qual- distress found in American Indian and Alaskan Native ity and intensity of interpersonal attachment is of great communities. Journal of Psychoactive Drugs 284 Volume 43 (4), October – December 2011 Brave Heart et al. Historical Trauma Among Indigenous Peoples of the Americas HISTORICAL TRAUMA MEASURES TO INFORM and experience cathartic relief and support. In clinically CLINICAL AND COMMUNITY-BASED informed intervention research, more specific questions PRACTICES may facilitate increased tailoring of healing approaches. Whitbeck and colleagues (2004a) developed the Indigenous Peoples of the Americas Survey Historical Loss Scale (HLS) and the Historical Loss and The Indigenous Peoples of the Americas Survey (IPS) Associated Symptoms Scale (HLAS) and moved the field is an instrument in development, which is designed to forward in terms of empirical evidence demonstrating a inform clinical practice and research on the effectiveness link between the trauma of a collective historical past of interventions incorporating historical trauma and unre- and the emotional experiences of the HTR, compounded solved grief. It is also intended to explore tribal diversity by lifespan trauma. HLS assesses the frequency with in the experiences of HT and HTR so that healing can which people think about the historically traumatic events be tailored to fit a variety of tribal communities. IPS is and losses, and HLAS is designed to capture emotional an effort to fill some of the gaps and answer some of responses to these losses. Whitbeck and colleagues (2004a) the questions raised in previous sections of this article. found that the higher the score was for perceived histor- With service providers in mind and the kind of information ical loss, the more likely was the report of depression needed for clinical intervention, treatment, and counseling, and anger associated with the thoughts about that histor- the IPS consolidates other structured measures and assess- ical loss. Broader use of HLS and HLAS with different ment tools into a survey (giving credit to and citing these tribal groups would increase our knowledge of the preva- measures), including the HLS and HLAS, and also adds lence of HT consciousness and HTR among American items that provide more detail about tribal identity, trau- Indians/Alaska Natives. matic experiences, depressive symptoms, PTSD symptoms, and Indigenous identity. Further, the IPS asks for more Moving Research Forward: Development of the detailed trauma history (both lifespan and collective his- Indigenous Peoples of the Americas Survey torical trauma), looks at tribal similarities and differences The collective, intergenerational massive group trauma in the experience, and may be useful in clinical settings and compounding discrimination, racism, and oppression for treatment planning and intervention. IPS will also pro- among American Indians (Whitbeck et al. 2002) as well vide a better sense of the prevalence of HTR and symptoms as unresolved grief and loss (Whitbeck et al. 2004a; Brave across multiple tribal populations. Identifying constructs Heart 1998) are increasingly a focus of attention in the lit- that may be generalizable to numerous tribal groups would erature, in the field, and in tribal communities. Whitbeck be helpful in informing the design of culturally responsive and colleagues (2004b) examined the impact of discrimi- clinical practice for this traditionally underserved popula- nation on the collective issues facing a northern Midwest tion. The authors, as clinicians and clinical and services reservation group and identified that perceived historical researchers in tribal communities, are concerned with the loss affected American Indian adolescent depression in application of HT concepts to intervention work. The IPS that tribal community (Whitbeck et al. 2011). Importantly, asks about specific losses the individual has experienced neither the HLS nor the HLAS include a full measure themselves as well as the collective past and unresolved, of depressive symptoms or PTSD. Additionally, the HLS prolonged grief. and HLAS both examine perceived loss of family ties as IPS will also provide preliminary data on the nature a consequence of boarding schools but do not ask the and prevalence of the emotional challenges (depression, individual respondent about their own specific boarding collective trauma exposure, interpersonal losses, and unre- school trauma or particular family history related to board- solved grief) facing Indigenous parents, which is useful ing school attendance. Research would be strengthened by in informing the development of an intervention designed adding these areas. to improve behavioral well-being, parental competence, In the Return to the Sacred Path intervention (Brave and relationships with children. Earlier versions of the IPS Heart 1998), the first Historical Trauma and Unresolved were reviewed by Indigenous clinical graduate students and Grief Intervention (HTUG), information was collected Indigenous providers. Currently, the IPS is in the process of from participants regarding their own boarding school review by an Indigenous advisory panel and will be piloted attendance, generational boarding school family history, and then refined. Preliminary development of the IPS was and rating of the quality of these experiences. Additional grounded in prior work, including a qualitative study on the questions included the distance of the boarding school from experience of HT and manifestations of HTR (Brave Heart the home tribal community and the frequency of visits 2000). home per year as well as traumatic experiences such as The precedent for designing the IPS was to examine physical and sexual abuse at the school. Such information collective trauma and commonalities, while simultaneously was useful in helping participants to process their trau- respecting diversity among Indigenous Peoples across the matic experiences within the historical collective context Americas. This precedent emerged from an orientation Journal of Psychoactive Drugs 285 Volume 43 (4), October – December 2011 Brave Heart et al. Historical Trauma Among Indigenous Peoples of the Americas that we are relatives, and is consistent with a variety emotionally present for their children and being able to of Indigenous organizations that have developed linkages absorb parenting skill training. across the Canada-United States border and extended into HTUG has been utilized primarily with reservation- Mexico, and Central and South America. These associa- based American Indians/Alaska Natives across the U.S. tions include the International Indian Treaty Council and and Canada but little work has been evaluated with urban the Inter-American Indian Institute in Mexico City, as well communities or with Indigenous Peoples of Latin America. as global Indigenous organizations and conferences, (e.g. The intent of the IPS is to collect data on multiple tribal the Healing Our Spirit Worldwide Conference, and the communities in both reservation and urban settings in order United Nations Permanent Forum on Indigenous Issues). to increase further understanding of the impact of collective In addition to the work of the National Aboriginal group trauma and lifespan trauma exposure on behavioral Health Organization in Canada on residential (boarding) health symptoms, and to inform culturally responsive inter- school trauma, there has been some research on Indigenous ventions with greater scientific rigor. A modification of the Peoples of Latin American related to historical trauma, Harvard Trauma Questionnaire (HTQ) has been utilized including the impact of unresolved grief, collective trauma, with Maya genocide survivors, including translation into and behavioral health issues among Maya survivors and local Spanish dialect and Maya (Sabin et al. 2003). The descendants of genocide in Guatemala and parts of Mexico HTQ items are incorporated into the IPS. (Sabin et al. 2003; Beristain, Paez & Gonzalez 2000). To our knowledge, the only intervention study reported There is a need for further study to inform interventions in the literature that specifically focuses on the HTR with these underserved Indigenous populations (Gone & among an Indigenous population in the United States was Alcantara 2007). Similarly, Maya Indians from Guatemala a study of the Historical Trauma and Unresolved Grief and Chiapas in Mexico have been found to suffer from Intervention (Brave Heart 1999a, b, 1998). However, a collective and ongoing trauma and prolonged grief symp- number of prevention studies incorporate some consid- toms (Sabin et al. 2003; Beristain, Paez & Gonzalez 2000). eration of HT in the intervention design. For instance, The IPS will contribute to increased knowledge across one tribal-specific prevention intervention includes cul- Indigenous communities and the sharing of clinical healing turally specific assessment, recognizes historical and cul- approaches. tural contextual factors, and allows for traditional healing approaches (Fisher & Ball 2002). Healing intergenera- THE HISTORICAL TRAUMA AND UNRESOLVED tional pain is perceived as one way to prevent suicide GRIEF INTERVENTION (Strickland, Walsh & Cooper 2006) and one small qual- itative study explored perceptions of effective traditional Historical Trauma and Unresolved Grief Intervention healing components among Indigenous Peoples in Canada (HTUG) is a short-term, culturally congruent intervention (McCabe 2007). These studies point to the importance of for grief resolution and trauma mastery that has been shown incorporating HT and HTR into treatment and prevention to be effective among a small segment of the American interventions. Indian population with elevated psychosocial issues (Brave Incorporation of Indigenous customs and tradi- Heart 1998). Measures include an experimental Lakota tional healing approaches when developing interventions Grief Experience Questionnaire (LGEQ) and an instrument with Indigenous Peoples are increasingly advocated by exploring respondent’s traumatic experiences including Indigenous scholars, clinicians, and prevention special- boarding school attendance and a self-report assessment of ists. Some of the tenets of Indigenous healing practices that experience, as well as projective measures. HTUG was (Struthers, Eschiti & Patchell 2004) may be congruent selected as a Tribal Best Practice in 2009 by First Nations with some methods of evidence-based treatments which Behavioral Health Association and the Substance Abuse could be adapted for application to diverse populations, and Mental Health Services Administration (SAMHSA), (e.g. Interpersonal Psychotherapy; Markowitz et al. 2009). and has been incorporated as part of a Lakota parenting Thus, incorporation of indigenous customs and traditional prevention intervention and used with Lakota parents on healing approaches is also indicated. the reservation (Brave Heart 1999b). Qualitative results revealed that self-perceptions of competency in parenting CURRENT PRACTICE CONCERNS increased after the intervention as did improved relation- ships with children, parents, grandparents, and extended Current Practice Concerns: Addressing Shared kinship networks. Increased use of traditional language Experiences and enhanced valuing of the tribal culture were also found Although there are tribal differences in the degree in this study. The intervention was structured around the of collective generational trauma exposure there is also view that parents are wounded by HT, specifically the a similarity among Indigenous Peoples and an emphasis generational impact of boarding schools. Thus, parents on shared values and traditions. Certainly tribes share a need support to address their own trauma before being history of colonization, genocide, oppression and racism. Journal of Psychoactive Drugs 286 Volume 43 (4), October – December 2011 Brave Heart et al. Historical Trauma Among Indigenous Peoples of the Americas However, some tribal groups have suffered greater numbers Evans-Campbell (2008) has articulated the need for of traumatic events. Unifying bodies (e.g. the United multilevel assessment and intervention strategies to address Nations Permanent Forum on Indigenous Issues) confer- HT at individual, family, and community levels. The inter- ences and associations that span across borders seek to relationship of these levels has significant implications for transcend tribal differences. However, research and inter- clinical approaches to healing. A major challenge among ventions must simultaneously respect this collective phi- clinicians and researchers is the ability to not only discern losophy and worldview as well as tribal cultural distinc- detrimental effects but also identify and maximize areas of tiveness and differing degrees of trauma exposure. The key strengths and resilience. to effective intervention development is to develop inter- ventions models that may be generalizable to many tribal Current Practice Concerns: Need for Family and groups and, at the same time, adaptable for tribal cultural Community Level Interventions and historical specificity. Boarding school attendance affected entire family sys- Although there are numerous linguistic and cultural tems; individual and family relationships; family, commu- differences within Indigenous populations there are some nity, and cultural attachments; and interpersonal communi- common cultural features that might inform intervention cation (Abadian 2008; Barnard 2007; Mooradian, Cross & design, including: focus on a collectivist culture; indi- Stutzky 2007; Grandbois 2005; Schafor, Horejsi & Horejsi rect communication styles; focus on harmony and balance; 1997; Mannes 1995; Morrissette 1994). Chase (2011) shared traditional beliefs in the existence of animal spir- found that students who experienced harsh parenting both its as guides, ancestor spirits, and feeding the spirits; at home and at boarding schools reported continued dif- and attachment to all of creation, (Brave Heart 2001 a, ficulty with trust, relationship building, parenting, and b; Rousseau, Morales & Foxen 2001; Beristain, Paez & communication. Poor parenting fell on a continuum from Gonzalez 2000). Thus, interventions must be developed lack of involvement to neglectful to abusive. It appears with the involvement of the Indigenous community. that parents who experienced harshness at boarding schools but felt loved at home were either indulgent with their Current Practice Concerns: Multilevel or Systemic own children in reaction to their own childhood expe- Assessment riences, or they were more balanced in their care and Historical trauma is a meaningful concept that res- supervision as parents. Likewise, some students who had onates with Indigenous communities. There is a need difficult home situations but positive experiences at board- for attention to communal oppression, collective trauma, ing school had the experience of “family” with the other and cultural distinctions in understanding and measuring students and care from school staff. However, most students trauma responses and unresolved grief (Robin, Chester & failed to develop appropriate nurturing and discipline skills. Goldman 1996; Lykes 1994; Zur 1994). While group inter- Clearly, clinical interventions are needed at the family level ventions show great promise, there is also a need to develop to address parenting issues that arose from the boarding individual and family interventions. Steps to doing this school experience. would involve gathering more exploratory data, design- Similar to findings in earlier studies, Chase (2011) ing interventions in partnership with Indigenous commu- found that individuals first identify historical traumatic nity members as consultants and advisors, testing these events, including boarding school, as important factors in interventions, refining them, and then researching these the deterioration of American Indian/Alaska Native values. interventions. Earlier studies also found that individuals recognize the Another part of the process in alleviating the emotional validity of traditional Indigenous culture and practices for a suffering of Indigenous Peoples is validating the existence path to healing and recovery. Several researchers and prac- of not only the traumatic history but the continuing oppres- titioners have written about the consideration of intergener- sion. The Lakota, for instance, share the challenges of ational effects of historical events and historical trauma on mourning mass graves, of the lack of proper burials, of American Indian families. For instance, with sibling groups massive collective traumatic losses, and of ongoing oppres- attending boarding school together, older siblings often sion and discrimination. Other tribal groups deal with took on parental and protective roles for younger siblings traumatic histories as well (e.g., the Sand Creek Massacre and relatives, and this relationship continued after boarding of the Cheyenne, the Long Walk of the Navajo, and the school departure. In addition, being separated from parents Trail of Tears of the Cherokee). The United States was the and other siblings often negatively affected relations with last member of the United Nations to acknowledge human family members when students returned home (Child 1998; rights violations through the signing of the UN Declaration Adams 1995; Hultgren & Fairbanks 1994), resulting in on the Rights of Indigenous Peoples (adopted in 2007). alienation and detachment between boarding school alumni Official recognition of genocide is thought to be an impor- and their home community. However, the strong bonds of tant part of the healing process, and should be incorporated kinship, the resilience of the individual students and cul- in multilevel interventions. ture most often supported the adjustment and reintegration Journal of Psychoactive Drugs 287 Volume 43 (4), October – December 2011 Brave Heart et al. Historical Trauma Among Indigenous Peoples of the Americas of boarding school alumni. This was due to the fact that the community to improve the quality of life, specifically individuals perceived their relationships with parents and behavioral health and well-being. Our aim is to restore siblings to have changed during their tenure at boarding and empower Indigenous Peoples, to reclaim our traditional school (Chase 2011). selves, our traditional knowledge, and our right to be who Future research should include the examination of the we are and should be as healthy, vital, and vibrant commu- spectrum of trauma in communities, and distinguish his- nities, unencumbered by depression, overwhelming grief, toric events that affect individuals, families, and commu- substance abuse, and traumatic responses. In essence, we nities, and the array of responses to those events. Cultural strive to transcend our collective traumatic past. groups that have experienced collective trauma, oppression, We recommend increased research on the effects of and racism are recognizing the intergenerational effects historical trauma in diverse tribal cultural regions, and of trauma, and that healing must begin within a culture- that such research be driven by Indigenous Peoples and specific context both at the family and community levels be culturally-informed. Further, we advocate for contin- (Schafor, Horejsi & Horejsi 1997; Williams & Ellison ued development and evaluation of healing intervention 1996; Xuequin, Toubbeh, Cline, & Chisholm, 1998). Thus, models, grounded in Indigenous worldviews, which aim it is important to consider culturally appropriate approaches to ameliorate the emotional distress emerging from the to engaging communities and gaining community buy- legacy of trauma and grief. HT and HTR appear to resonate in and ownership when developing interventions that can well with communities. The next step is to determine the impact communities at the macro level. empirical effectiveness of related interventions in healing individuals and communities. CONCLUSIONS AND RECOMMENDATIONS NOTES American Indians/Alaska Natives have experi- enced devastating collective, intergenerational massive 1. Indigenous Peoples is the term endorsed by the group trauma and compounding discrimination, racism, United Nations Permanent Forum on Indigenous Issues. and oppression. There is increasing evidence of emo- For the purposes of this article, the term Indigenous Peoples tional responses to collective trauma and losses among of the Americas refers to the original inhabitants of the land Indigenous Peoples, which may help to inform ways area now known as the United States as well as Canada, of alleviating psychological suffering and unresolved Mexico, Central, and South America, and their descen- grief. Tribal cultural and regional differences exist which dants. American Indians and Alaska Natives are included may impact how the wounding across generations and in this larger collective terminology when used. within an individual’s lifespan are experienced and 2. American Indian and Alaska Native are the only addressed. 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However, users may print, download, or email articles for individual use. Copyright of Journal of Psychoactive Drugs is the property of Haight Ashbury Publications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.