Historical Trauma and Unresolved
Grief: Implications for Indigenous
Healing and Research
Maria Yellow Horse Brave Heart, PhD
Associate Professor of Psychiatry/Director,
Native American & Disparities Research
Center for Rural & Community Behavioral Health
mbraveheart@salud.unm.edu
© Maria Yellow Horse Brave Heart, PhD
Omniciye Woiyaksape: Sharing
Wisdom Council Project
It is our way to mourn for one year when one of
our relations enters the Spirit World. Tradition is
to wear black while mourning our lost one,
tradition is not to be happy, not to sing and
dance and enjoy life’s beauty during mourning
time. Tradition is to suffer with the remembering
of our lost one, and to give away much of what
we own and to cut our hair short….Chief Sitting
Bull was more than a relation….He represented
an entire people: our freedom, our way of life -all that we were. And for one hundred years we
as a people have mourned our great leader.
© Maria Yellow Horse Brave Heart, PhD
Omniciye Woiyaksape
We have followed tradition in our mourning. We
have not been happy, have not enjoyed life’s
beauty, have not danced or sung as a proud
nation. We have suffered remembering our great
Chief and have given away much of what was
ours…. blackness has been around us for a
hundred years. During this time the heartbeat of
our people has been weak, and our life style has
deteriorated to a devastating degree. Our people
now suffer from the highest rates of
unemployment, poverty, alcoholism, and suicide
in the country.
Traditional Hunkpapa Lakota Elders Council (Blackcloud, 1990)
© Maria Yellow Horse Brave Heart, PhD
Intergenerational Parental Trauma
I never bonded with any parental figures in my
home. At seven years old, I could be gone for
days at a time and no one would look for
me….I’ve never been to a boarding school....all
of the abuse we’ve talked about happened in my
home. If it had happened by strangers, it
wouldn’t have been so bad- the sexual abuse,
the neglect. Then, I could blame it all on another
race….And, yes, they [my parents] went to
boarding school.
A Lakota Parent in Recovery
(Brave Heart, 2000, pp. 254-255)
© Maria Yellow Horse Brave Heart, PhD
Multiple Losses and Trauma
Exposure
• Death of five family members killed in a collision by a
drunk driver on a reservation road
• One month earlier, death of a diabetic relative
• Following month, adolescent cousin’s suicide and the
death of another relative from a heart attack
• Surviving family members include individuals who are
descendants of massacre survivors & abuse in boarding
schools
• Many community members comment that they feel they
are always in a state of mourning and constantly
attending funerals.
© Maria Yellow Horse Brave Heart, PhD
Presentation Overview
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•
•
•
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Historical trauma theory
The HTUG Intervention: A Tribal Best Practice
HTUG and gender differences
HTUG components and parenting study
Preliminary research on perceived mental health
and substance use problems and prevalence
• Indigenous Peoples Survey development
• Challenges in Native Research
• Celebration of Survival
© Maria Yellow Horse Brave Heart, PhD
The Development of Historical
Trauma Theory and Interventions
• Motivated by desire & commitment to reduce the
suffering of Indigenous Peoples (1978);
informed by clinical, cultural/spiritual immersion
• By 1992 – the first Native historical trauma
intervention; presentations across the US &
Canada
• 1996 – 2004 - Designed the first Lakota/Native
parenting curriculum incorporating historical
trauma; number of SAMHSA grants
• 2009 – HTUG selected as a Tribal Best Practice
by First Nations Behavioral Health Association,
Pacific Substance Abuse & Mental Health
Collaborating Council, and SAMHSA
Maria Yellow Horse Brave Heart, PhD
Historical Trauma and Unresolved Grief
• Historical trauma is cumulative emotional
and psychological wounding over the
lifespan and across generations,
emanating from massive group trauma
(1985-88)
• Historical unresolved grief accompanies
that trauma
(Brave Heart, 1998, 1999, 2000)
© Maria Yellow Horse Brave Heart, PhD
Historical Trauma Response
• The historical trauma response (HTR) is
a constellation of features in reaction to
massive group trauma
• This response is observed among Lakota
and other Native populations, Jewish
Holocaust survivors and descendants,
Japanese American internment camp
survivors and descendants.
(Brave Heart, 1998, 1999, 2000)
© Maria Yellow Horse Brave Heart, PhD
Historical Trauma Response Features
• Survivor guilt
• Depression
• Sometimes PTSD
symptoms
• Psychic numbing
• Fixation to trauma
• Somatic (physical)
symptoms
• Low self-esteem
• Victim Identity
• Anger
• Self-destructive
behavior including
substance abuse
• Suicidal ideation
• Hypervigilance
• Intense fear
• Dissociation
• Compensatory
fantasies
• Poor affect
(emotion) tolerance
© Maria Yellow Horse Brave Heart, PhD
Historical Trauma Response
Features
• Death identity –
fantasies of
reunification with the
deceased; cheated
death
• Preoccupation with
trauma, with death
• Dreams of
massacres, historical
trauma content
• Loyalty to ancestral
suffering & the
deceased
• Internalization of
ancestral suffering
• Vitality in own life
seen as a betrayal to
ancestors who
suffered so much
© Maria Yellow Horse Brave Heart, PhD
Identification & Self-Hatred
• Identification with the aggressor (A. Freud)
& internalized oppression (Freire)
• Identification with the oppressor’s view of
Natives, resulting in self-hatred
• Self-destructive behavior (i.e. SA) to avoid
pain and to act out the self-hatred
• Identifying with parents’ trauma response
patterns
© Maria Yellow Horse Brave Heart, PhD
The Takini Network
The Takini (Survivor) Network is a Native
non-profit organization (formed in 1992)
designed to address healing from
historical trauma and historical
unresolved grief among the Lakota as
well as other Native people through
therapeutic work, prevention, research,
publication and community education.
© Maria Yellow Horse Brave Heart, PhD
Background: Genocide
• Native history meets UN 1948 Geneva
Convention definition of genocide
• Congressional genocidal policy: no further
recognition of their rights to the land over which
they roam; go upon said reservations…chose
between this policy of the government and
extermination; wards of the government,
controlled and managed at its discretion
• BIA Education Division called “Civilization
Division”
• Congressional policy of forced separation of
children from family and tribe; militaristic
• Gender roles and relationships impaired by
boarding schools
© Maria Yellow Horse Brave Heart, PhD
Boarding School Era
• This bill provides for the utilization of
vacant military posts and barracks for the
industrial education of nomadic youth and
the employment of officers of the army as
teachers or to be otherwise detailed by the
Department of War. Education as a means
of civilizing and elevating the savage has
ceased to be experimental. Best results
are obtained with the removal of children
from all tribal influence (US Congress,
1879).
Maria Yellow Horse Brave Heart, PhD
Background: HT Theory, Trauma
Exposure
• 2/3 of American Indian youth affirm
multiple traumas (Manson et al., 1996)
• American Indians 15-54 years had a trauma
exposure rate of 62.4% to 69.8% to at least one
traumatic event; a substantial proportion of these
entail death of a loved one (Manson, Beals,
Klein, Croy, & AI-SUPERPFP Team, 2005)
• American Indian males and females have
similar trauma exposure rates in contrast
with gender differences in the general
population; AI women have greater rates
than other women (Manson, et al., 2005)
Maria Yellow Horse Brave Heart, PhD
HT Theory & Symptoms of Depression,
PTSD, Complicated/Prolonged Grief
• Suicidal behaviors were associated with
depressive disorders, PTSD, & substance
abuse/dependence (LeMaster, et al., 2004)
• Lifetime prevalence of 44%, 86% of these
having major depression, were found in Native
women (mean age 29.8 years) where 41% had
attended Indian boarding schools (Duran et al.,
2004 AmJPH); later study (2004 ChA&N),
boarding school attendance not significantly
associated with PTSD but did not assess quality
of experience
© Maria Yellow Horse Brave Heart, PhD
HT Theory & Symptoms of Depression,
PTSD, Complicated/Prolonged Grief
• CG/PG: sadness, separation distress including strong
yearnings, longing for and preoccupation with thoughts
of the deceased, and intrusive images, psychic
numbness, guilt, extreme difficulty moving on with life,
and a sense of the part of the self having died (Boelen &
Prigerson, 2007; Shear et al., 2005). CG may also cooccur with PTSD (20-50%); prevalence unclear for
American Indians/Alaska Natives.
• Historical unresolved grief includes these but also
yearning, pining, preoccupation with thoughts of
ancestors lost in massacres, loyalty to ancestors with a
focus on their suffering, as if to not suffer is to not honor
them, to forget them
• Intrusive images often come in massacre dreams, as if
one is living in the 1800s and often dying tragically with
ancestors (like transposition – Kestenberg)
© Maria Yellow Horse Brave Heart, PhD
Prolonged or Complicated Grief
• Tribes may also be at high risk for CG/PG
related to the impact of genocide across
generations and frequent deaths of attachment
figures, due to high morbidity and mortality rates,
& generational boarding school trauma.
• Rather than ambivalent relationships, some CG
researchers think that close attachments may
predispose CG development; AI/AN attachment
styles may be closer and more intense as a
cultural norm
© Maria Yellow Horse Brave Heart, PhD
HT Theory & Symptoms of Depression,
PTSD, Prolonged Grief
• Native mourning resolution is distinct from
European American grief
• Loss of close relative experienced as loss of part
of self, exhibited by cutting the hair
• Natives maintain active relationship with
ancestor spirits
• Massive group trauma (genocide) impairs
normative grief; extent & quality of losses
(trauma exposure) limit time for culturally
congruent mourning resolution; history of
prohibition of bereavement ceremonies
© Maria Yellow Horse Brave Heart, PhD
HT Theory, Depression, PTSD, Trauma
Exposure, & Prolonged Grief
• American Indian males 15-54 years old have greater
prevalence of any lifetime depressive disorder, PTSD, or
any anxiety disorder than general population
• For PTSD, American Indian male prevalence is 12.8% in
SW and 11.5% in NP
• For any anxiety disorder, it is 15.9% and 13.1%
compared to 8.6% among males in general population
• American Indian female rates are higher than American
Indian males and than females in general population
(females in general have higher rates of anxiety and
depression)
(Beals, et al., 2005)
Maria Yellow Horse Brave Heart, PhD
HT Theory, Depression, PTSD, Trauma
Exposure, & Prolonged Grief
• American Indian males have noninterpersonal trauma exposure rates of
25.2% in SW and 36.4% in NP, including
natural disasters, life-threatening
accidents (Manson, et al., 2005)
• Interpersonal trauma exposure rates
(assault, rape, abuse, combat) – 25.5% in
SW and 31% in NP for Native men
• Witness to trauma – 46.7% SW & 46.3%
NP
Maria Yellow Horse Brave Heart, PhD
Cultural Context & Grief
• Native mourning resolution is distinct from
European American grief
• Loss of close relative experienced as loss of part
of self, exhibited by cutting the hair
• Natives maintain active relationship with
ancestor spirits
• Culturally, AI men more relational than white
males, more similar styles of attachment to AI
women
• Massive group trauma (genocide) impairs
normative grief; extent & quality of losses
(trauma exposure) limit time for culturally
congruent mourning resolution
Maria Yellow Horse Brave Heart, PhD
Impact Upon Indian Parenting
• Many boarding school survivor parents
report traumatic, negative experiences
including physical & sexual abuse
• Boarding school survivor parents report a
sense of self as being wounded and
impaired in their competence as parents
• Descendants of boarding school survivors
frequently report abuse and/or neglect in
their own childhoods
• Need to examine regional, tribal, and
generational differences
© Maria Yellow Horse Brave Heart, PhD
More HT Impact on Parents & on
Gender Roles and Relationships
• Traditional gender roles and relationships impaired –
women & children were never the property of men,
sacredness of children lost, & men lost traditional
parenting roles as well as roles of warriors and
protectors
• Native men targeted for greater genocide – seen as
more of a threat, higher bounties for male scalps,
prohibition of long hair in past, impairment of traditional
hunting and ways for men to express their Native
manhood
• Many Native men internalized white male values,
including the view of women & children as property due
to forced socialization in boarding schools
Maria Yellow Horse Brave Heart, PhD
More HT Impact on Parents & on
Gender Roles and Relationships
• Older study found that Lakota women with
greater degrees of traditional lifestyle, blood,
and language fluency were healthier than less
traditional women but more white-acculturated
men were healthier than traditional males (Han,
Hagel, Welty, Ross, Leonardson, & Keckler,
1994)
• Although study concluded that acculturation was
more stressful for women, also implication that
the pressures for traditional Native men seems
greater
Maria Yellow Horse Brave Heart, PhD
Young Native Men
• Often lack clear concepts of what it means to be
Indigenous, what their roles should be in their
communities
• Many carry distortions regarding the
responsibility of being a true warrior
• Confusion stems from the early genocide and
erosion of Native culture, resulting in violence,
abuse, and oppression of peers, self-hatred, and
self-destruction
• Rape on the Reservation - Vanguard TV series
www. currenttv.com
• Evidence of internalized oppression
Maria Yellow Horse Brave Heart, PhD
The Historical Trauma &
Unresolved Grief
Intervention:
A Tribal Best Practice for
Intergenerational Healing
Maria Yellow Horse Brave Heart, PhD
Historical Trauma & Unresolved
Grief Intervention:
A Tribal Best Practice
• Psychoeducation about genocide, boarding
school losses, & oppression
• Use of audiovisual materials to stimulate
memories and to educate participants about the
traumatic historical context
• Small & large group processing and in dyads
(pairs); exercises
• Focus as well on lifespan trauma
• Cathartic, traditional cultural experiences
© Maria Yellow Horse Brave Heart, PhD
Historical Trauma Intervention:
Four Major Intervention
Components
• Confronting historical trauma and
embracing our history
• Understanding the trauma
• Releasing our pain
• Transcending the trauma
© Maria Yellow Horse Brave Heart, PhD
The First HT Intervention1992
• Quasi-experimental study, 45 Lakota, on
effectiveness of group intervention on collective
group trauma & grief
• Traditional culture & ceremonies throughout
facilitated cathartic release of emotions
• Psychoeducation; narratives & trauma testimony
• Delivered over 4 days; random assignment to
small process groups with the trained Native
facilitators
Maria Yellow Horse Brave Heart, PhD
Return to the Sacred Path
Study (1992)
• Mean age of study population was 43
• 72.1% attended boarding school; mean age 8.9 years;
38.7% attended before 6 yrs, 48.4% before 7 yrs; mean
distance from home 123.1 mi, mode 300 miles
• Physical abuse (58.1%) & sexual abuse (22.6%) by staff
• Sexual abuse higher in male participants
• 90.7% reported parental boarding school attendance
• 50% reported death of a close relative in past year,
100% in the past two years
• Statistically significant differences on all scales of
projective measures
Maria Yellow Horse Brave Heart, PhD
Historical Trauma Intervention
Research & Evaluation (1992 - 2003)
• Reduction in sense of feeling responsible
to undo painful historical past
• Decrease in guilt, shame, stigma, anger, &
sadness
• Increase in joy and hope
• Improved valuation of true self and of tribe
• Increased sense of personal power
Maria Yellow Horse Brave Heart, PhD
Changes on the Lakota GEQ
[Statistical significance achieved for 7 items
including these (Brave Heart, 1995, 1998)]
Concept
M (T1)
M (T2)
P
Shame
3.21
2.67
.004 p<.01
Stigma
2.92
2.31
.001 p<.01
Anger
3.15
2.87
.012 p<.05
Obsessive
thoughts
3.38
2.79
.007 p<.01
Feeling
responsible for
undoing the pain
of the past
3.04
2.46
.023 p<.05
© Maria Yellow Horse Brave Heart, PhD
Significance
Semantic Differential Results:
Changes Over Time
• Evaluation Scale
– My True Self (P=.004, p<.01)
– Anger (P=.032, p<.05)
– The Past (P=.004, p<.01)
– Wasicu (P=.001, p<.01)
© Maria Yellow Horse Brave Heart, PhD
Semantic Differential Results:
Changes Over Time
• Potency Scale
- My True Self (P=.035, p<.05)
- Wasicu (P=.002, p<.01)
- The American Indian Holocaust (P=.000,
p<.0001)
© Maria Yellow Horse Brave Heart, PhD
Semantic Differential Results:
Changes Over Time
• Activity Scale
- The American Indian Holocaust
(P=.012, p<.05)
- The Past (P=.001, p<.01)
- My People (P=.006, p<.01)
© Maria Yellow Horse Brave Heart, PhD
Table 11: Gender Differences for Affects Experienced Often Before,
During and After the Intervention
Before
Female/Male
During
Female/Male
After
Female/Male
Anger
70.6%
73.3% 41.2% 66.7%
Sadness
70.6%
66.7% 100.0% 80.0% 5.9%
33.3%
Guilt
70.6%
53.3% 29.4%
33.3% 0.0%
13.3%
Shame
64.7%
60.0% 5.9%
40.0%
13.3%
Joy
58.8%
33.3% 64.7%
66.7% 70.6%
© Maria Yellow Horse Brave Heart, PhD
11.8%
0.0%
26.7%
86.7%
Return to the Sacred Path
Study (1992): Results for Men
• Men experienced greater degree of boarding
school trauma including assault from staff for
speaking Native language and sexual abuse
• Men had less conscious emotional experience of
historical trauma yet reported more traumatic
events in boarding schools
• Gender may have interacted with greater Indian
phenotype (skin color & features) to place men
at greater risk for lifespan trauma exposure
• Men may have used avoidance (common in
PTSD and prolonged grief) to defend against
their emotional pain, hence less awareness
Maria Yellow Horse Brave Heart, PhD
Return to the Sacred Path
Study (1992): Results for Men
• Men’s grief scores differed from women’s
– they may have been in an earlier stage
of grief resolution
• Men, however, were more conscious of
survivor guilt than women
• For Lakota men in the intervention, guilt
about the Wounded Knee Massacre was
one probable explanation for differences
before the intervention
Maria Yellow Horse Brave Heart, PhD
Return to the Sacred Path
Study (1992): Results for Men
• Men’s historical inability to enact their traditional
roles as protectors during the Wounded Knee
Massacre may have heightened initial (T1)
defensive denial of shame and general guilt (as
opposed to survivor guilt) and lessened
conscious awareness of the Lakota historical
trauma and its impact
• At T2, men reported increase in survivor guilt &
shame as well as joy, suggesting an increase in
affect (emotion) tolerance and a decrease in
psychic numbing as well as greater
consciousness of trauma response features
Maria Yellow Horse Brave Heart, PhD
Gender Differences: Boarding
School Experiences
Experiences
Attended boarding school
Hit at boarding school
Punished for speaking
Racism in boarding school
Sexually abused at school
%Men
82.4%
85.7%
57.1%
85.7%
28.6%
%Women
65.4%
35.3%
20.0%
58.8%
17.7%
(Brave Heart, 1999. Gender differences in the historical
trauma response, J of Health & Social Policy, 10(4), 121)
Maria Yellow Horse Brave Heart, PhD
Wakanheja (Sacred Children)
Lakota Parenting Curriculum
• Content includes emphasis on traditional values,
traditional parenting styles (pre-boarding school
days) & traditional protective factors
• Includes review of risk & protective factors for
effective parenting
• Includes the Historical Trauma & Unresolved
Grief Intervention key components (HTUG)
Includes the Woope Sakowin (Seven Laws) as a
guide for parenting & effective parenting skills
Maria Yellow Horse Brave Heart, PhD
Traditional Protective Factors:
Woope Sakowin
(7 Laws of the Lakota)
•
•
•
•
•
Wacante Ognake - Generosity
Wowaunsila – Compassion
Wowayuonihan – Respect
Wowacin Tanka - To Have a Great Mind
Wowahwala – Humility, State of Silence,
To be humble
• Woohitike – Courage, Bravery, Principal,
Discipline
• Woksape – Wisdom, Understanding
Maria Yellow Horse Brave Heart, PhD
Themes from Qualitative
Evaluation of Parental Responses
(1996-2004)
• Increased sense of parental competence
• Increase in use of traditional language
• Increased communication with own
parents and grandparents about HT
• Improved relationships with children,
parents, grandparents, and extended
kinship network
• Increased pride in being Lakota and
valuing own culture, i.e. Seven Laws
Maria Yellow Horse Brave Heart, PhD
Indigenous Driven Research: Direct
Descendants of HT Event
• Community sample of 486 urban AI/AN adults
• Direct descendants (DD) had higher perceived
mental health problems, depression, PTSD,
alcohol/drug problems, thought more about
collective HT, followed by Don’t Knows (DK); Chi
square showed significant differences
• DD had greater guilt and feeling responsible to
undo pain of past collective trauma, followed by
DK
• DD were more proud, more Native language
comprehension, practiced traditional spirituality
more, and felt more connected
© Maria Yellow Horse Brave Heart, PhD
Direct Descendants of HT Event in
Western Urban Sample
• Limitations – preliminary data – logistic regression
analysis in process
• Implications – DD may also have come from more
traditional family lineage and those who were “hostiles” –
who resisted the cavalry
• DD may have had more trauma exposure and higher
degree of Indian blood/more full-blood phenotype (skin
color and features); could be older (checking)
• DK interesting – something about no knowing that is
emotionally challenging
• Tribal differences suggested; some tribes may have had
greater or more recent HT exposure, more DD in specific
tribes; cultural differences in coping and grief resolutions
© Maria Yellow Horse Brave Heart, PhD
Direct Descendants of HT Event in
Western Urban Sample
• Trauma of boarding schools among direct descendants
could have resulted in “fight” rather than “flight” –
defiance, holding onto the language (oral testimony of
refusal to cry during a beating)
• Admission of perceived mental health problem, including
alcoholism, may be related to less stigma with sobriety
movement and also participation in traditional
ceremonies where cathartic release and openness are
the norms; ceremonies role-model affect tolerance and
expression
•
(Brave Heart, Elkins, Carliner, in preparation)
© Maria Yellow Horse Brave Heart, PhD
Indigenous Peoples of the Americas
Survey (IPS)
• Funded by UNM RWJF Center for Health Policy
• Refine and pilot test an Indigenous Peoples
Survey (IPS) instrument with 40 Indigenous
adults living in Albuquerque; interest from tribal
communities in different regions
• Sections for Indigenous Peoples from US &
Canada; section for Indigenous Peoples from
Mexico, Central, and South America
© Maria Yellow Horse Brave Heart, PhD
Indigenous Peoples of the
Americas - Definition
• Indigenous Peoples of the Americas are a diverse
population, with over 500 federally recognized tribes in
the United States and over 400 in Latin America.
Indigenous Peoples have experienced pervasive and
cataclysmic collective, intergenerational massive group
trauma and compounding discrimination, racism, and
oppression. Indigenous Peoples of the Americas,
terminology adopted by the United Nations Permanent
Forum on Indigenous Issues, refers to the descendants
of the original inhabitants of Canada [First Nations], the
United States [American Indians/Alaska Natives],
Mexico, Central and South America.
© Maria Yellow Horse Brave Heart, PhD
IPS Content
•
•
•
•
•
•
•
Inventory of Complicated Grief
Trauma History Inventory/HTQ
PTSD Checklist-Civilian Version
Historical Loss Scale (Whitbeck)
Center for Epidemiologic Studies Depression Scale
Duke-UNC Functional Social Support Questionnaire
Items from the Lakota Grief Experience
Questionnaire (Experimental) and the Return to the
Sacred Path Study (PI-constructed)
• Experiences of racism and discrimination
• Identity
© Maria Yellow Horse Brave Heart, PhD
IPS
• Provides preliminary data on the
psychometric properties
• Finalize for research use by tribal
communities who have identified a need
for such an instrument
• Preliminary data on the nature and
prevalence of the emotional challenges
(depression, collective trauma exposure,
interpersonal losses, and unresolved grief)
© Maria Yellow Horse Brave Heart, PhD
Current HT Research
Development
• Combine HTUG key components with culturally
adapted evidence based practices or empirically
supported treatments
• HTUG framed as treatment engagement
• HTUG reduces stigma and empowers American
Indian/Alaska Native and First Nations
communities through acknowledging the
collective trauma across generations
• Pilot combined intervention with urban and
reservation American Indians in NM and SD
© Maria Yellow Horse Brave Heart, PhD
Research Challenges for Native
Communities
• Lack of data on Native Peoples – limited
inclusion of Natives in research on EBT/EBP
• Not fitting into the box
• Culturally responsive and Indigenous-lead
research often innovative and doesn’t easily fit
framework or process of standard funded
research
• Traditional consensus and tribal politics;
attending to alliances in the community, barriers
from institutions e.g. gift cards, ss#, mistrust
© Maria Yellow Horse Brave Heart, PhD
Case Examples
• 15 year old American Indian girl with recovering
boarding school survivor parents attempts
suicide
• 43 year old recovering alcoholic, with history of
physical abuse and neglect by alcoholic
boarding school survivor parents, experiencing
suicidal impulses, depressed and unable to cry;
placed on anti-depressants and in mainstream
psychotherapy but symptoms are not alleviated
© Maria Yellow Horse Brave Heart, PhD
Celebration of Survival
Video Presentation:
A Celebration of Survival: The Takini
Network (supported by CSAT)
– includes historic boarding school slides
– summarizes historical trauma intervention
theory and approach
– describes historic 2001 Models for Healing
Indigenous Survivors Conference
Follow up conferences held in 2003 and 2004
(CMHS and CSAT funded)
© Maria Yellow Horse Brave Heart, PhD
Website
• www.historicaltrauma.com
• Developed by Raymond Daw (Dine’)
© Maria Yellow Horse Brave Heart, PhD
References
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•
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Brave Heart, M.Y.H., DeBruyn, L.M., Crazy Thunder,
D., Rodriguez, B., & Grube, K. (2005). . This is
hallowed ground: Native Voices From Ground Zero, In
Danieli, Y. & Dingman, R. (Eds) On the Ground After
September 11: Mental Health Responses and Practical
Knowledge Gained. New York: Haworth Press.
Brave Heart, M.Y.H. (2003) The Historical Trauma
Response Among Natives and Its Relationship with
Substance Abuse: A Lakota Illustration, Journal of
Psychoactive Drugs, 35 (1), 7-13.
Brave Heart, MYH (1998). The return to the sacred
path: Healing the historical trauma response among
the Lakota. Smith College Studies in Social Work,
68(3), 287-305
© Maria Yellow Horse Brave Heart, PhD
References
•
Brave Heart, M.Y.H. (1999) Oyate Ptayela: Rebuilding the Lakota
Nation through addressing historical trauma among Lakota
parents. Journal of Human Behavior and the Social Environment,
2(1/2), 109-126.
•
Brave Heart, M.Y.H. (2000) Wakiksuyapi: Carrying the
historical trauma of the Lakota. Tulane Studies in
Social Welfare, 21-22, 245-266.
Brave Heart, M.Y.H. (2001) Clinical assessment with
American Indians. In R.Fong & S. Furuto (Eds),
Cultural competent social work practice: Practice skills,
interventions, and evaluation (pp. 163-177). Reading,
MA: Longman Publishers.
Brave Heart, M.Y.H. (2001) Clinical interventions with
American Indians. In R. Fong & S. Furuto (Eds).
Cultural competent social work practice: Practice skills,
interventions, and evaluation (pp. 285-298). Reading,
MA: Longman Publishers.
•
•
© Maria Yellow Horse Brave Heart, PhD
References
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Beals, J., Manson, S., Whitesell, N. Spicer, P., Novins, D. &
Mitchell, C. (2005). Prevalence of DSM-IV disorders and
attendant help-seeking in 2 American Indian reservation
populations. Archives of General Psychiatry, 162, 99-108.
Beristain, C., Paez, D. & Gonzalez, J. (2000). Rituals, social
sharing, silence, emotions and collective memory claims in the
case of the Guatemalan genocide. Psicothema, 12(Supl.), 117130.
Duran, BM, Sanders, M, Skipper, B, Waitzkin, H, Malcoe, LH,
Paine, S, & Yager, J. (2004). Prevalence & correlates of mental
disorders among Native American women in primary care.
American Journal of Public Health, 94(1), 71-77.
Huang, B., Grant, BF., Dawson, DA.,Stinson, FS., Chou, SP,
Saha, TD, Goldstein, RB, Smith, S.M. , Ruan, WJ, & Pickering,
RP. (2006). Race-ethnicity & the prevalence & co-occurrence of
Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition, alcohol and drug use disorders and Axis I and II
disorders: United States, 2001 to 2002. Comprehensive
Psychiatry, 47, 252-257.
© Maria Yellow Horse Brave Heart, PhD
References
•
•
•
•
•
Indian Health Service (2001). Trends in Indian Health 2000-2001.
Washington, DC: U.S. Department of Health & Human Services.
Legters, L.H. (1988). The American genocide. Policy Studies
Journal, 16 (4), 768-777.
Lewis-Fernandez, R. & Diaz, N. (2002). The cultural formulation:
A method for assessing cultural factors affecting the clinical
encounter. Psychiatric Quarterly, 73(4), 271-295.
Manson, S., Beals, J., O’Nell, T., Piasecki, J., Bechtold, D.,
Keane, E., & Jones, M. (1996). Wounded spirits, ailing hearts:
PTSD and related disorders among American Indians. In A.
Marsella, M. Friedman, E. Gerrity, & R. Scurfield (Eds),
Ethnocultural aspects of Posttraumatic Stress Disorder (pp. 255283). Washington DC: American Psychological Association.
Robin, R.W., Chester, B., & Goldman, D. (1996). Cumulative
trauma and PTSD in American Indian communities (pp. 239-253).
In Marsella, A.J., Friedman, M.J., Gerrity, E.T., & Scurfield, R.M.
(Eds), Ethnocultural aspects of Post-traumatic Stress Disorder.
Washington, DC: American Psychological Press
© Maria Yellow Horse Brave Heart, PhD
References
• Robin, R., Chester, B., Rasmussen, J.,
Jaranson, J. & Goldman, D. (1997). Prevalence
and characteristics of trauma and posttraumatic
stress disorder in a southwestern American
Indian community. American Journal of
Psychiatry, 154(11), 1582–1588.
• Shear, K., Frank, E., Houck, P.R., and Reynolds,
C.F. Treatment of complicated grief: A
randomized controlled trial, 2005, JAMA, 293
(21), 2601-2608.
• US Senate Miscellaneous Document, #1, 40th
Congress, 2nd Session, 1868, [1319]
© Maria Yellow Horse Brave Heart, PhD
References
• Brave Heart, M.Y.H. (1999) Gender differences in the
historical trauma response among the Lakota. Journal of
Health and Social Policy, 10(4), 1-21.
• Brave Heart, M.Y.H. & Spicer, P. (1999). The
sociocultural context of American Indian Infant Mental
Health. World Association of Infant Mental Health
Handbook of Infant Mental Health. J.D. Osofsky & H.E.
Fitzgerald (Eds.). John Wiley & Sons.
• Brave Heart, M.Y.H., & De Bruyn, L. (1998). The
American holocaust: Historical unresolved grief among
native American Indians. National Center for American
Indian and Alaska Native Mental Health Research
Journal, 8(2), 56-78.
© Maria Yellow Horse Brave Heart, PhD
Additonal References
• Boelen & Prigerson, 2007 on Prolonged
Grief
• Duran, B. (2004) CA/N article
• Manson, Beals, Klein, Croy 2005
• Walters, K. (2004) Presentation at HT
conference, New Mexico, December, 2004
© Maria Yellow Horse Brave Heart, PhD