1. Historical Trauma and Implications for Elders University of Oklahoma School of Social Work Master’s Advanced Curriculum Project Dr. Lisa Byers (Cherokee) Supported By:

2. Social Work Objectives KNOWLEDGE Provide definitions of concepts Provide examples of historical trauma MEASURES Review existing measures of historical trauma INTERVENTION RELEVANCE TO SOCIAL WORK Specific work with Native elders

3. Critical Terms The “cumulative emotional and psychological wounding over the lifespan and across generations, emanating from massive group trauma experiences” (Brave Heart, 2003, p. 7). “Constellation of features in reaction to this trauma” (Brave Heart, 2003, p. 7). Depression Anxiety Low self esteem Grief response that is impaired, delayed Anger Substance abuse Difficulty with emotional identification and expression HISTORICAL TRAUMA RESPONSE 1,2 HISTORICAL UNRESOLVED GRIEF 1,2,3 HISTORICAL TRAUMA 1,2

4. Historical Trauma Examples Wounded Knee Massacre Lakota Jewish Holocaust

5. Wounded Knee The Memorial Website http://www.woundedkneemuseum.org/main_menu.html An interactive website with pictures, interviews, and videos related to the Wounded Knee Massacre, the Memorial Ride, and the contemporary Lakota Nation.

6. Origins of Historical Trauma Concept 3 First Generation Offspring Symptoms Over-dependent, difficulty expressing emotion, particularly anger, depressed, sense of damage based on parental experience WWII Holocaust Survivors Symptoms Denial, depersonalization, isolation, somatization, memory loss agitation, anxiety, guilt, depression, intrusive thoughts, nightmares psychic numbing, survivor guilt PARENTING BEHAVIOR

7. Similarities  Imprisonment  Forced Relocation  Death  Abuse Indigenous Experience Holocaust  Imprisonment  Forced Relocation  Death  Abuse

8. Differences Unacknowledged U.S. laws forbade the practice of tribal religions. Religious ceremonies that would have addressed the trauma, allowed grief expression, and permitted healing were denied. Length of trauma Losses were felt across tribal nations over 500 year period There was no end to ethnic cleansing (ongoing and legal) No place to go Relocated to areas with no economic value where leaving was illegal Dependent on U.S. Government for rations Daily reminders Loss of land, loss of languages, spirituality, healing traditions Highly traumatized group in present Lower live expectancies, higher rates of violent victimization

9. Length of Traumatic Loss  But if you do not [submit]…we shall take you, and your wives, and your children, and shall make slaves of them…and we shall take away your goods and shall do you all the harm and damage we can.  Requerimiento, read by Priests/Spanish Conquistadors, 1500s (as cited in Josephy, 1994, p. 140) 4  I would withhold from [the Indian adults] rations and supplies…and when every other means was exhausted…I would send a troop of United States soldiers, not to seize them, but simply to present as an expression of the power of the government. Then I would say to these people, “Put your children in school”, and they would do it.  Indian Commissioner, Thomas Jefferson Morgan, 1889 (as cited in Josephy, 1994, p. 432) 4  State child custody laws, to which tribes were subject, allowed non- Indian state employees with little understanding of Indian culture to make decision about when to remove children from their families…by 1977, 25 to 35 percent of all Indian children had been taken from their homes by bureaucratic authorization (Jones, 1995) 5.

10. Historical Trauma  The following link highlights historical trauma and it’s connection to health and mental health disparities for American Indian and Alaska Natives. http://www.pbs.org/indiancountry/challenges/trauma.html  Two health care professional, one in Los Angeles and one in North Carolina are interviewed.

11. How Do We Assess Historical Trauma? 3  Range of symptoms that span a number of disorders:  Depression  PTSD  Substance Abuse  Anxiety  What distinguishes historical trauma from the other disorders? What Is It? Distal or Proximal  How does one distinguish historical trauma from the present contexts of trauma?

12. Loss & Reactions Quotes from Elders “I don’t know how to speak Indian. When I was little, my mother, my father didn’t speak it to us…They were beaten for speaking their language at boarding school. So they thought that we would be taken from home and forced to go to boarding school…so they didn’t teach us” “They stole our land, they stole a lot of land, and they killed a lot of people. So what do you expect us to do? Just stand there and take it?” “You go to another town and a white person calls you names. It is shocking so when I see it happening to kids and I think about kids. That is what really triggers the animosity.” “I am trying to teach him (grandchild) not to be angry. I am teaching myself not to be angry anymore, but I have a long way to go.” “When I see all these people doing drugs it makes me wonder when these people are going to wake up… It is more powerful than our culture…” (as cited in Whitbeck, Adams, Hoyt, and Chen, 2004, p. 122-123).

13. Loss and Symptom Scales 3 Loss of :  land, language, and our culture  family ties because of boarding schools,  families from reservation to government relocation,  self respect from poor treatment by government officials,  trust in whites from broken treaties,  respect from our children and grandchildren for Elders,  our people through early death,  respect by our children for traditional ways Often feel:  sadness or depression, anger, anxiety or nervousness,  uncomfortable around white people when you think of these losses,  shame when you think of these losses,  loss of concentration,  feel isolated or distant from other people when you think of these losses,  a loss of sleep,  rage, fearful or distrust the intention of white people,  feel like it is happening again,  feel like avoiding places or people that remind you of these losses Historical Loss Scale Historical Associated Symptom Scale

14. Historical Loss Prevalence of thought in daily life

15. Percentage of Emotional Responses 3

16. Three Factor Model of Historical Trauma and Symptoms 3 Perceived Loss Anxiety Depression Anger Avoidance

17. Implications of Historical Trauma for Elders  Today’s elders are closest to historically traumatic events –They experienced first hand the trauma of boarding schools, government relocation –They are the first generation offspring of historical trauma survivors –Even if not directly experienced the sense of a peoplehood and a group based identity can increase affiliation with historical loss  Elders are traditionally expected to pass on spiritual teachings, cultural knowledge, and language –Some elders may have lost this knowledge due to historical trauma and feel an individual and collective shame  Lack of respect for elders is cited as a historical loss –This indicates that the reverence once accorded to elders has been eroded and created a lack of place for some elders that can be defined as role loss

18. Historical Trauma and Unresolved Grief (HTUG) Intervention 2 Maria Yellow Horse Brave Heart Four Day Psycho-educational Intervention

19. Four Components INTERVENTION COMPONENTS 1) confront our trauma and embrace our history 2) understand that trauma 3) release the pain 4) transcend the trauma OUTCOMES  Adaptable to any tribal culture  Identify communal and individual level trauma  Mourn on communal level  Supports development and internalization of a survivor identity (strength)

20. Tools Individual Journals Written reaction, notes regarding traumatic memories Trauma Graph  Lifeline indicating all trauma and grief experiences throughout individual’s lifespan  Shared with partner then the larger group  Asked about lifespan trauma and its relationship to shared historical trauma

21. Superordinate Themes Trauma Testimony  Wounded Knee  Boarding School  Day School  Boarding School Descendent Transcending Trauma  Coping Strategies  Ideas About Healing  Transforming Past Trauma Response  Trauma Identity  Carrying Trauma  Anger  Impaired Bonding  Transposition  Survivor Guilt  Suicidal Ideation  Multiple Traumas  Somatic Symptoms

22. Preliminary Results  Begin trauma and grief resolution  Decrease in hopelessness  Increase in joy  Increase in positive Lakota identity  Increase in protective factors  Decrease in risk for substance abuse  Perceived improvement in parenting skills, family connections, and sensitivity to one’s children

23. Takini Network, Inc. http://www.ihs.gov/NonMedicalPrograms/HPDP/BPTR/in dex.cfm?module=BestPractices&option=Detail&BPTRSe archID=7272  The Takini Network, Inc. is listed as a best practice with the Indian Health Services Health Promotion and Prevention  Social Service Providers are the target provider  Provides and evaluates substance abuse and mental health interventions and prevention services and programs for Native people.

24. Social Work Implications  Existing research indicates that historical trauma is a viable phenomena for American Indians that needs to be considered in social work interventions  Research needs to continue across tribes to replicated the initial findings related to the Historical Loss Scale and its associated symptom scale  Research needs to commence to identify the short and long term impact of interventions  Social workers that are not trained in trauma and specifically historical trauma should not attempt to create and implement interventions to deal with historical trauma symptoms

25. References 1) Braveheart, 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. 2) 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), 109-26. 3) Whitbeck, L.B., Adams, G.W., Hoyt, D.R., and Chen, X. (2004). Conceptualizing and measuring historical trauma among American Indian people. American Journal of Community Psychology, 33(3/4), 119-130. 4) Josephy, A. M. (1994). 500 nations. New York: Alfred A. Knoph. 5) Jones, B.J. (1995). The Indian child welfare act handbook: A legal guide to the custody and adoption of Native American children. Chicago, IL: American Bar Association.