Historical trauma for American Indian peoples have encompassed wars, massacres, genocide, imprisonment, reservations, boarding schools and continued oppression and racism. The effects of historical trauma have had a horrific impact on the health and welfare of American Indian peoples for over 500 years – alcoholism and drug addiction, many health (including mental) issues, poor education, and poverty. All of this lands squarely on the shoulders of our children.
In September, 2000, Kevin Gover, Assistant Secretary of Indian Affairs described the effects of the Bureau of Indian Affairs (BIA) handling American Indian boarding schools, “They forbade the speaking of Indian languages prohibited the conduct of traditional religious activities, and made Indian people ashamed of who they were. Worst of all, the BIA committed these acts against children entrusted to its boarding schools, brutalizing them emotionally, psychologically, physically, and spiritually. The trauma of shame, fear and anger has passed from one generation to the next, and manifest itself in the rampant alcoholism, drug abuse and domestic violence that plague Indian country.”
Alcoholism in American Indian communities nationwide is not only a critical health issue, but is the leading cause of death in these communities. In Minnesota between the years 2000 and 2007, according to the State of Minnesota Department of Human Services, 42% of American Indian deaths were related to alcohol abuse. These include motor vehicle accidents, suicide, homicide, alcohol poisoning, and heart and liver disease.
This stark picture has not changed for the past 20 years, and in fact is increasing with each new generation.
Our American Indian experience is the psycho-social impact, depending upon a particular tribe’s geographic location and historical experience, of from one to five hundred years of the most brutal genocide, ethnocide and forced acculturation the world has ever seen. The effect of this holocaustic experience for both the individual and the tribal group is, of course, trauma. The result of this trauma is a condition that has come to be known as Post Traumatic Stress Disorder (PTSD).
PTSD has a generic application and can be either acute or secondary. The secondary form is reactive and can have a major inter-generational effect or it can be passed on to children and grandchildren. Acute PTSD can be defined as the normal human reaction to severe trauma, shock or pain. Acute PTSD can occur within an individual as a result of dramatic environmental change, including involuntary displacement or relocation, or being in a natural disaster; as a result of physical, sexual, emotional or spiritual assault, abuse or neglect; as a result of war-like conditions, including experience in battle, experience as a prison-of-war, civil imprisonment, involuntary subjugation at a boarding school, experience in a concentration camp (which is what our reservations were at first), experience as a hostage (including experience with a violent, dominant spouse or suffering a long-term or terminal illness); or as a result of a loss of a close friend or relative to death.
Secondary PTSD can be defined as the normal human reaction by an individual who is in a close interpersonal relationship with someone who is suffering from acute PTSD. Usually this will include a member of the acutely traumatized individual’s nuclear and/or an extended family, a lover or a close friend.
Secondary PTSD can also have an inter-generational effect, and here is where it is most harmful. Those suffering from the reactive type of secondary PTSD often change their behavior patterns and actions in order to cope with the behavior of the person with acute PTSD. These usually negative reactive behaviors and actions can then become learned by the following generations as “normal” behaviors. People never know that what they have learned was not the way it traditionally was in their tribe. These patterns of behavior and actions are identical to those that are found in families of alcoholics and especially with adult children of alcoholics.
There are a number of phrases that persons go through and they are different for different kinds of trauma. For acute PTSD they include:
1. Impact, shock
2. Withdrawal, repression, submission, resignation, insensibility, emotional numbing
3. Regression, ambivalent anger, acceptance, acquiescence, unrealistic optimism, honeymoon
4. Compliance, anger, ambivalent anger, dependent aggression, disappointment, euphoria, emotional anesthesia
5. Trauma mastery, recovery, reconstruction, reorganization
There are a number of different psychological or behavioral symptoms that a person with acute PTSD will have and which ones they have and how severe the symptoms are depends upon what kind of trauma they experienced and how severe it was. In helping a person to face their experience and begin to heal themselves, you must let them know that some of these behaviors may get worse before they get better. Theirs is a normal reaction and the symptoms include: phobias, guilt, shame, blunted emotions, depression, anxiety, hostility, substance abuse, anger, fear, isolation, acting out, feelings of failure or helplessness, mental or verbal liability, increased or decreased sexual function, increased or decreased work function, paranoia, déjà vu, flashbacks, irritability, disassociation, or inefficiency.
There are also a number of psychophysiological symptoms that a person will experience. These symptoms may also get worse before they get better during the healing process and it is important that you let the person with acute PTSD know that this is normal. These symptoms include: Insomnia, nightmares, night tremors, bedwetting, sleepwalking or sleep talking, skin disorders, trembling, hypertension, hyper-alertness, sexual inhibition, diarrhea, digestive disturbances, back trouble, migraines, restlessness, distorted perceptions, fatigue, verbal-audio-speech disorders, weight loss or gain, anorexia, diaphoresis, or tachycardia.
The process of therapy for the acutely diagnosed individual is much like that done in grief therapy and the individual will follow the same stages of denial, acknowledgement, rage, acceptance and mastery. However, there are some important variables in each individual’s experience that must be considered:
1. Intensity of trauma
2. Type of trauma
3. Length of episode
4. Whether trauma is by human hand
5. Age of onset of trauma
6. Stage of individual’s development
7. Length of time since event
Once an individual is past the denial stage and acknowledges the episode(s) it is important that you validate the pain of the trauma, validate them as a human being and, let them know that is was not their fault and they are not alone. It is also important to remember that the experience of trauma creates a “victim mentality” within the individual that becomes part of their identity. You must always confront the individual’s behavior and thinking regarding this “victim mentality” or they will not heal.
With the secondary form of PTSD that is inter-generational, this “victim mentality” can become a part of the family’s, or overall tribal group’s, identity as well. This is especially true for tribal groups that experienced one or more group traumas or the group experienced a series of individualized traumas over the same period(s).
For the individual and the group it is extremely important to point out that they are not to blame for many of their behaviors, because they were learned from those suffering acute or secondary PTSD. It must also be pointed out that many of their parents and grandparents cannot be blamed for their behaviors because they too, were innocent victims who never received help for their own personal trauma.
At the time that severe trauma was thrust upon our Native peoples the group therapy capabilities of each tribal group was being destroyed as well – and there was nothing to replace these capabilities when they were most needed. This destruction of the healing process only exacerbated an already very wounded psyche by increasing the sense of alienation in a spiritual context.
All of this trauma was external to our Native peoples and we cannot “own” the behavior of those who brought this trauma to us. What we can do is heal ourselves and put the blame where it belongs – on the perpetuators. After all, it is common sense to know that a rape victim cannot be blamed for being raped and our people for many generations have been raped physically, mentally, emotionally, and spiritually.
Because of this holocaustic experience we now suffer daily re-victimized, lack of self-esteem, the highest levels of substance abuse, sexually transmitted diseases and teen pregnancies. We also indulge in many other forms of self-destructive behaviors, including high levels of suicides.
We can successfully treat acute PTSD if therapy begins soon after the onset of the trauma. It is more difficult however, the longer it has been since the onset of trauma.
Much more work is needed to serve the “victim mentality” from the individual’s identity. Secondary PTSD in its primary reactive form is treated much in the same way as acute PTSD. The inter-generational form, however, is much more of a problem for treatment since you are dealing with learned behavior, and although easy to acknowledge, behavior is learned over much of childhood, adolescence and young adulthood – this will take time to learn and relearn new ways of coping and being in the world.
It is suggested that for both individual and group work, a self-empowering form of therapy be used that is culturally reinforcing. The task is a difficult one that we are also in the process of healing our ancestors as we try to heal ourselves.
As we approach the future there remains a great need in addressing the idea of Inter-generational PTSD. The hope is that empirical and theoretical work in this area is encouraged, since presently we have more questions than we have answers – especially in the treatment area.
Western civilization has always assumed that radical change can be brought about by changing the environment. That is why emphasis has always been placed on change in structure. This approach has failed to produce proper results. It has ignored the need to bring about change within men and women themselves and has concentrated on change in the outside world. What is needed, however, is a total change – within American Indian people them-selves, as well as their social environment. The starting point must be the hearts and souls of American Indian men and women, their perception of reality and of their own place and mission in life.