the return to the sacred path: healing the historical trauma and historical unresolved grief...

This article was downloaded by: [Stony Brook University]On: 21 December 2014, At: 06:24Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House,37-41 Mortimer Street, London W1T 3JH, UK

Smith College Studies in Social WorkPublication details, including instructions for authors and subscription information:http://www.tandfonline.com/loi/wscs20

The return to the sacred path: Healing the historicaltrauma and historical unresolved grief responseamong the lakota through a psychoeducational groupinterventionMaria Yellow Horse Brave Heart Ph.D. a ba Assistant Professor at the Graduate School of Social Work , University of Denver , Denver,COb Director/Co‐Founder of the Takini Network for Lakota Holocaust Survivors ,Published online: 17 Feb 2010.

To cite this article: Maria Yellow Horse Brave Heart Ph.D. (1998) The return to the sacred path: Healing the historical traumaand historical unresolved grief response among the lakota through a psychoeducational group intervention, Smith CollegeStudies in Social Work, 68:3, 287-305, DOI: 10.1080/00377319809517532

To link to this article: http://dx.doi.org/10.1080/00377319809517532

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) containedin the publications on our platform. However, Taylor & Francis, our agents, and our licensors make norepresentations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of theContent. Any opinions and views expressed in this publication are the opinions and views of the authors, andare not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon andshould be independently verified with primary sources of information. Taylor and Francis shall not be liable forany losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoeveror howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use ofthe Content.

This article may be used for research, teaching, and private study purposes. Any substantial or systematicreproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in anyform to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions

http://www.tandfonline.com/loi/wscs20

http://www.tandfonline.com/action/showCitFormats?doi=10.1080/00377319809517532

http://dx.doi.org/10.1080/00377319809517532

http://www.tandfonline.com/page/terms-and-conditions

http://www.tandfonline.com/page/terms-and-conditions

THE RETURN TO THE SACRED PATH:HEALING THE HISTORICAL TRAUMA AND

HISTORICAL UNRESOLVED GRIEF RESPONSEAMONG THE LAKOTA THROUGH A

PSYCHOEDUCATIONAL

GROUP INTERVENTION

Maria Yellow Horse Brave Heart, Ph.D.*

ABSTRACTThis article, based on research conducted with Lakota human

service providers, concludes that the Lakota (Teton Sioux) sufferfrom impaired grief of an enduring and pervasive quality. Impairedgrief results from massive cumulative trauma associated with suchcataclysmic events as the assassination of Sitting Bull, the WoundedKnee Massacre, and the forced removal of Lakota children toboarding schools.

The research studied a culturally syntonic four-daypsychoeducational intervention designed to initiate a grief resolu-tion process for a group of 45 Lakota human service providers. Themethodology included assessment at three intervals: (a)apre- andpost-test, utilizing a Lakota Grief Experience Questionnaire andthesemantic differential, (b) a self report evaluation instrument at theend of the intervention, and (c) a six-week follow-up questionnaire.

The results confirmed the hypotheses that: (a) education abouthistorical trauma would lead to increased awareness of the impactand associated grief related affects of the traumatic Lakota history,(b) sharing these affects with other Lakota in a traditional contextwould provide cathartic relief, and (c) grief resolution would beinitiated, including a reduction in grief affects, more positiveidentity, and a commitment to individual and community healing.

The historical trauma and historical unresolved grief response amongthe Lakota (Teton Sioux) emanates from massive cumulative trauma

* Maria Yellow Horse Brave Heart, Ph.D. is Assistant Professor at the University ofDenver Graduate School of Social Work, Denver, CO and is Director/Co-Founder of theTakini Network for Lakota Holocaust Survivors.

Smith College Studies in Social Work, 68(3), June 1998.

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14

288 MARIA YELLOW HORSE BRAVE HEART

across generations. This study advances theoretical understanding of thisphenomenon, and demonstrates that a psycho-educational group inter-vention incorporating affective experience of the cumulative traumawithin a traditional Lakota context can facilitate grief resolution.

As a Lakota I have been examining multi-generational trauma as acontributing factor in the development of psychosocial pathology since1978. In 1988, independently of Prince (1975/1985), I developedtheoretical constructs describing historical unresolved grief, historicaltrauma, and historical trauma response. Building on years of confirma-tory experience with my people, I designed a psychoeducational curricu-lum to address the unresolved grief and trauma response among theLakota. In 1992,1 conducted a more systematic study of this modelintervention for facilitating the resolution of Lakota cumulative historicaltrauma and grief.

Historical trauma is defined as cumulative trauma — collective andcompounding emotional and psychic wounding (Niederland, 1989) —both over the life span and across generations. The historical traumaresponse involves the constellation of features identified in the literatureon Post-Traumatic Stress Disorder (PTSD) and psychic trauma (Krystal,1984; van der Kolk, 1987). It is associated with the reaction to massivegenerational group trauma such as has been identified for Jewish Holo-caust descendants (Fogelman, 1988;Kestenberg, 1982/1990). For Ameri-can Indians, historical unresolved grief involves the profound, unsettledbereavement that results from generations of devastating losses whichhave been disqualified (Doka, 1989) by prohibiting indigenous ceremo-nies and by the larger society's denial of the magnitude of its genocidalpolicies.

The Lakota experience of its pervasively traumatic and cataclysmichistory has been enduring (Brave Heart-Jordan, 1995). Extensive litera-ture confirms genocide intent and actions against American Indians(Legters, 1988; Stannard, 1992; Thornton; 1987). For example, Tanner(1982) argues that the United States had not intended the long-termsurvival of the Lakota but concluded that treaties were cheaper alterna-tives to war against such formidable opponents. Genocidal policies areevident in congressional documents: "[Indians] are to go upon saidreservations .... they are to have no alternative but to choose between thispolicy of the government and extermination" (U.S. Senate MiscellaneousDocument No. 1,40th Congress, 2nd Session, 1868, [1319]).

This article will first review literature illustrating the impairment ofLakota mourning rituals and the manifestations of unresolved grief.

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14

HISTORICAL TRAUMA AMONG THE LAKOTA 289

Next, a description of the Lakota historical unresolved grief and historicaltrauma response will include a summary review of the literature onpathological grief arid trauma. Elucidation of the etiology andintergenerational transmission of Lakota unresolved grief and trauma, anintervention model designed to address Lakota unresolved grief andtrauma, and the research methodology and findings will follow. Thepaper will conclude with a discussion of the efficacy of the interventionmodel.

Manifestations of Impairment in Traditional Modes of GriefTraditional Lakota ceremonies effectively afforded grief manage-

ment. The prohibition of indigenous spiritual practices, however, miti-gated culturally syntonic modes of working through normative grief, andprevented the resolution of traumatic grief resulting from cataclysmicevents such as: (a) the assassination, in 1890, ofTatankalyotake (Sitting .Bull) who personified Lakota resistance and traditional leadership (Ves-tal, 1932/1957), (b) the Wounded Knee Massacre in which hundreds ofLakota were killed and their bodies thrown into a mass grave (LakotaTimes, 1990), (c) the forced removal of children to boarding schoolswhere youngsters experienced abuses such as being shackled and chainedto bedposts for weeks at a time, starvation, and tragic death (Tanner,1982), and (d) the overcrowding and deficient health standards at board-ing schools that fueled a tuberculosis epidemic which contributed to atuberculosis death rate seven times the national average (Hoxie, 1989),and which, between 1936 and 1941, resulted in the death of more thanone-third of the Lakota population over the age of one year (Tanner,1982).

The rapidity and severity of these traumatic losses, now extended byhigh death rates from psychosocial and health problems, has complicatedLakota grief. Psychosocial pathology of the Lakota has been describedfor at least the past 50 years (Erikson, 1963; Macgregor, 1946/1975;Sack, Beiser,CIarke,&Redshirt, 1987). Forexample, the suicide attemptrate on one unspecified Lakota reservation was almost seven times thatof the general United States population (Claymore, 1988). Indian HealthService ( 1995) statistics confirm serious problems among the Lakota: analcoholism death rate 13 times the national average, a suicide rate twicethe national average, and high rates of coronary heart disease, hyperten-sion, and accidental death. Physical health has been a problem among theLakota since the inception of the reservation era in 1871 (Tanner, 1982).Moreover, at the time this study was conducted, unemployment rates onmost Lakota reservations averaged 50-90%, and approximately 50% of

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


the Lakota were living in poverty (Bureau of Indian Affairs, 1990). Theresearch study reported here was based on the hypothesis that thesestatistics manifest unresolved grief and trauma as well as compoundingpsychosocial problems.

Traditional Grief PracticesThe tiospaye, the Lakota extended family kinship network, expands

relationships beyond the European American family system and subse-quently extends grief. The extent of the Lakota grief experience, theimportance of relationship, and the degree of attachment to the lost objectare apparent in traditional mourning practices. Outward visible signs ofgrief for a close relative involve cutting one's hair and at times one'sbody, symbolizing the psychic pain of the bereaved and the experience ofloss of part of oneself. Accordingly, the bereaved, readily identifiable bytheir short hair, are treated respectfully during their mourning period. Thebereaved give away possessions and abstain from dancing and celebra-tions during mourning. Spirit keeping ceremonies allow the bereaved tomourn, usually for a year after the death while keeping the soul of thedeceased. A "releasing of the spirit ceremony" is held at the end of themourning period along with a "wiping of the tears ceremony" to resolvegrief and to welcome the bereaved back into full participation in society.

With the 1881 federal ban on traditional burials, spirit keeping, and thewiping of the tears ceremony, Lakota grief was inhibited and com-pounded. Further, normative Lakota grief resolution differs from thatdescribed by Freud (1917/1957) and Pollock (1961/1989a). The degreeof decathexis is qualitatively different because the Lakota seek continuedinvolvement with the spiritual world after the death of loved ones.Without their indigenous, culturally syntonic mourning rituals, the Lakotaare further predisposed to the development of pathological grief, as evenpartial decathexis is limited.

Lakota Historical Unresolved Grief and Historical Trauma ResponseThe inordinate potential for grief impairment among the Lakota is

evident upon examination of the massive traumatic losses. The magni-tude of the loss during the Wounded Knee Massacre may have intensifiedthe acute grief observed during the 1890 Wanagi Wacipi (Ghost Dance),a spiritual movement that spread among the Lakota during a time of greatlosses and massive starvation. Manifestations of traumatic grief areobservable in the features of the Wanagi Wacipi which incorporated ayearning for the return of the past and sought visions of deceased relatives(see Black Elk & Neihardt, 1932/1972). The Lakota children who

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


psychically escaped into the past in Macgregor's study (1946/1975), alsorevealed characteristics congruent with traumatic grief. Unresolved griefresponses included (a) obsessive rumination about the deceased (Sand-ers, 1989), (b) searching and pining for the lost object with fantasies ofreunification (Parkes, 1972), (c) coping strategies such as fantasies aboutthe reappearance of deceased relatives and about transcending immediateexperience by projecting oneself into the past or future (Berger, 1988;Rustin, 1988), and (d) pseudo-hallucinatory experiences of the lost object(Sanders, 1989). Additionally, both Erikson (1963) and Macgregor(1946/1975; 1970) report substantiating evidence of trauma responsefeatures including: (a) withdrawal and psychic numbing, (b) anxiety andhypervigilance, (c) guilt, (d) identification with ancestral pain and death,and (e) chronic sadness and depression (seeFogelman, 1988; Kestenberg,1982/1990; Lifton, 1968).

The Lakota currently display unresolved grief in: (a) somatization(Indian Health Service, 1995), (b) depression (Shore, Manson, Bloom,Keepers, & Neligh, 1987), and (c) substance abuse (Indian HeallthService, 1995), all of which have been viewed as manifestations ofimpaired bereavement (Jacobs, 1993). The elevated Lakota suicide ratesare a manifestation of the self-destructiveness in delayed or distortedgrief (Jacobs, 1993), and of a pathological identification with the dead inwhich the bereaved are unconsciously motivated to join the deceased(Lifton, 1988; Pollock, 1972/1989b).

The Etiology and Intergenerational Transmissionof Lakota Unresolved Grief And Trauma

The Lakota collective ego identity as bereaved, victimized, andtraumatized is anchored in the historical and cultural past (Erikson,1959). It is transmitted through the intergenerational experience ofunresolved grief and trauma, a phenomenon that has been observed withotherpopulations (Nagata, 199 l;Sigal& Weinfeld, 1989). For example,studies demonstrate significant differences between the children ofHolocaust survivors and control groups (Felsen & Erlich, 1990). For theLakota, transposition — the introjection of and obligation to ancestorswhile living concurrently in the past and present (see Kestenberg, 1982/1990,1989) — may be culturally induced through spiritual contact withthe deceased, and the expansiveness of kinship lineage.

Studies of other survivor populations confirm that the Lakota memoryof historical trauma linked with a collective, victimized ego identitycould be inherited. Under such circumstances, contemporary lifespantrauma could be reinforced through a physiologically based addiction to

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


traumatic experiences (Brave Heart-Jordan, 1995; van der Kolk, 1987).Holocaust and Japanese internment descendants have developed internalpsychic representations of generational trauma which have becomeorganizing constructs in their lives, perpetuating continued transmissionacross generations (Danieli, 1989; Nagata, 1991).

The perpetuation of suffering and victim identifications results fromloyalty to the deceased as well as identification with parental suffering(Fogelman, 1991). For the Lakota, loyalty to the tiospaye (extendedfamily) is preeminent and is enacted through the maintenance of sufferingand a collective victim ego identity. Lakota transposition and historicalgrief are apparent in the following dream of a massacre:

In my dream I had been going back into another life. I saw tipisand Indians camping... and then, suddenly, I saw white soldiersriding into camp, killing women and children, raping, cuttingthroats. It was so real... sights I did not want to see, but had tosee against my will; the screaming of children thatl did not wantto hear.... And the only thing I could do was cry....

For a long time after that dream, I felt depressed, as if all life hadbeen drained from me. I was still going to school, too young tobear such dreams. And I grieved because we had to live a life wewere not put on this earth for. (Crow Dog & Erdoes, 1990, p. 97)

Due to the inherent cultural emphasis on ancestor spirits and theimpairment in traditional bereavement, many Lakota have a proclivity forbecoming wakiksuyapi (memorial people) — my name for the Lakotaequivalent of Wardi's (1990/1992) concept of "memorial candles."Memorial candles are children of Holocaust survivors who (a) carry theburden of internalized ancestral trauma and grief, (b) possess a coreidentification with deceased ancestors and a sense of self as being dead,(c) manifest chronic mourning or depression, (d) assume a family rolefocused on emotional healing and Holocaust testimony (Wardi, 1990/1992), and (e) have superior cultural sensitivity compared with controlgroups (Heller, 1982). Broader than Wardi's conceptualization of therole of a memorial candle in a family, wakiksuyapi may include entirefamily groups or bands that shoulder this role for the Lakota Nation.

The Return to Study of the Sacred PathThe research reported here examined the effectiveness of an originally

designed, culturally syntonic, four-day psychoeducational interventiondesigned to initiate a grief and trauma resolution process for a group of45 Lakota human service providers. The study methodology included

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


assessment at three intervals: (a) a pre- and post-test utilizing a LakotaGrief Experience Questionnaire and the semantic differential, (b) a self-report evaluation instrument at the end of the intervention, and (c) a six-week follow-up questionnaire. The study was based on the followinghypotheses:

1) Education about historical trauma leads to increased awarenessabout the trauma, its impact, and the grief-related affects it evokes.

2) The process of sharing these affects with others of similar back-ground within a traditional Lakota context leads to a cathartic sense ofrelief.

3) Psychoeducation initiates a healing and mourning process whichresults in a reduction of grief affects, an experience of more positivegroup identity, and an increased commitment to continuing healing workboth for individuals and the community.

METHODDescription of the Intervention

The intervention took place in the sacred Paha Sapa (the Black Hills)at Sylvan Lake near Harney Peak, the center of the Lakota universe. Thisis the place where Sitting Bull had a guiding vision about protecting theLakota, a vision to which he dedicated his life (Vestal, 1932/1957). Theintervention incorporated traditional Lakota culture, language, and cer-emonies. Forty-five primarily Lakota service providers and communityleaders responded to a brochure advertising a training/healing interven-tion focused on historical unresolved grief. All applicants were admittedto the four-day psychoeducational group experience which included (a)didactic and videotape stimulus material on Lakota trauma, (b) a reviewof the dynamics of unresolved grief and trauma, (c) small group exercisesand sharing, co-facilitated by a Lakota male and female pair whosetrauma experiences were similar to the participants', and (d) the oinikage/inipi (Lakota purification) ceremony and a traditional wiping of the tearsceremony.

Traumatic memories were stimulated through videotapes about theWounded Knee Massacre and boarding school traumas, followed bysmall group processing. In one exercise, participants diagrammed alifeline of their traumatic experiences which they shared with partnersand in small groups. The four-day process ended with the Lakota wipingof the tears ceremony with the mourners in a circular formation.

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


Intervention Strategy and IntentThe intervention was intended to provide culturally congruent be-

reavement, decathexis of death and victim identities, and cathexis totraditional Lakota philosophy and values. The design aimed to fostercollective mourning, facilitate integration of affects and cognitions abouthistorical trauma, and promote awareness of the intergenerational trans-mission of trauma. Opportunities for abreaction, catharsis, sharing, andgroup identification, as well as for modeling affect tolerance, self-regulation, and mastery were provided through the use of videos andgroup processing. Videotapes were used to facilitate more adaptivemanagement and mastery of grief affects. Utilizing the proclivity forpeergroup formation among individuals who have been traumatized aschildren, particularly relevant for the Lakota, the intervention wasdesigned to stimulate the perception of merging within the group andthereby to facilitate disclosure and rapid cohesiveness (Fogelman &Savran, 1979; van der Kolk, 1987), bonding and mutual identification,and symptom normalization (Koller, Marmar, & Kansas, 1992).

Another aim was to facilitate integration and consolidation of Lakotaidentity through the incorporation of traditional Lakota culture, lan-guage, ritual, and memorialization which also offered vehicles forabreaction. For example, the oinikage (a) permits cathartic self-disclo-sure of previously repressed material as part of an ego-enhancing expe-rience in which individuals are connected to others in a group context, (b)replaces depression and identity diffusion with experiences that encour-age reformation of the self, (c) enhances collectively and bonding, (d)transmits expectations of healing, and (e) encourages strength throughpeer role modeling of self-disclosure through prayer (Silver & Wilson,1988). The Lakota intervention model utilized in this study attempted toincrease awareness of death identity while simultaneously fosteringpositive identification with ancestors, thereby promoting a healthy senseof connection with lost relatives (see Fogelman, 1991; Wardi, 1990/1992). Facilitation of communal support and connection, based on theLakota concept of tiospaye was afforded to the study participants throughceremonies and collective cathartic memorialization.

Data Collection and AnalysisResponses to the intervention were examined through self-report

measures taken at three intervals. Data collection instruments includeda demographic and trauma history questionnaire given prior to theintervention (Tl); a Lakota Grief Experience Questionnaire adaptedfrom Barrett and Scott (1989), given both at Tl and at the end of the

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


intervention (T2) ; the semantic differential (Osgood, Suci, & Tannenbaum,1957/1978)givenatTl and T2; an evaluation form given at T2 ; and a six-week follow-up measure (T3).

The data were analyzed for each instrument using measures of centraltendency, frequency, as well as descriptive statistics. The semanticdifferential was examined using paired t-tests and t-tests for independentsamples.

FINDINGSDescription of Sample

The mean age of the study population was 43 years with womenmaking up 59.1 percent of the participants. The population was reserva-tion based with 73.8% indicating that their reservation was the primaryresidence for most of their lives. More than 97% were currently living,or had lived on their reservation. Indian phenotype was confirmed by83.8% of the sample. Although the vast majority of the sample areChristian (97.7%), more than half (65.9%) practice traditional Indianspirituality, in contrast to only 27.3% of their parents and 56.8% ofgrandparents.

More than a third of the participants had entered boarding school by 6years of age, and their average age at entrance was 8.9 years. For 72% ofthe participants boarding schools were at a mean distance of 123.1 milesand a modal distance of 300 miles from home. A majority of participantsrated their boarding school experience as negative (54.8%) or mixed; i.e.,both negative and positive (6.5%). Parental boarding school experiencewas attested to by 90.7% of the sample.

Hypertension was reported by 50% of respondents. Alcohol abuse wasaffirmed by 81.8% of respondents, with 76.7% reporting they had beenin alcohol recovery or counseling. Half of the sample (50%) hadexperienced a death within the past year and 100% had experienced onewithin the past two years.

Of the 45 participants ,97.8% completed the entire process. The resultsinclude the evaluation instrument findings (T2), comparison of signifi-cant pre-test (Tl) with post-test (T2) scores on the Lakota Grief Experi-ence Questionnaire, and significant changes over time on the semanticdifferential and the six-week follow-up evaluation outcome (T3).

Evaluation Results (T2)There was a 75% valid response rate at T2 on the evaluation of the

experimental intervention. One hundred per cent (100%) of respondents

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


reported (a) increased awareness of historical trauma and improvedunderstanding of the survivor complex after intervention, (b) that theintervention helped them resolve grief reactions, (c) that the interventionhelped them feel more positive about being Lakota, and (d) feeling betterabout themselves after the intervention. Most of the participants, 97.0 %,found that sharing their feelings was helpful. Ninety seven percent alsofelt they could now make a constructive commitment to the memory ofancestors. A commitment to community grief work was expressed withhigh agreement by 72.7%.

The Lakota Grief Experience Questionnaire ResultsIn response to questions about affects experienced before, during, and

after the intervention, the participants indicated that most grief-relatedaffects, with the exception of anger, increased as predicted during theintervention, and all decreased after the intervention. Table 1 illustratesthe change in affects over time for all respondents.

Table 1 : Affects Experienced Often Over TimeBefore, During, and After the Intervention

SadnessGriefPrideAngerHopelessnessShameHelplessnessJoyGuilt

Before

66.7%54.551569.745.560.654.545.560.6

During

90.0%78.854.551.512.121.230.363.630.3

After

18.2%27.381.818.20.06.10.0

75.86.1

The overall Lakota Grief Experience Questionnaire score diminishedbetween Tl and T2, from a mean of 2.99 to 2.82. The grief componentsand items which reflect a significant change between Tl and T2 arereported in Table 2.

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


Table 2 : Changes on the Lakota Grief Experience Questionnaire from Tlto T2for Grief Components and Items

ShameStigmatizationAnger at U.S.Obsessive thoughtsFeeling blamed for

Wounded KneeMassacre

M(T1)

3.212.923.153.38

2.63

Feeling responsible forundoing the pain ofour people's past

Feeling self-consciousaround Caucasians

3.04

3.21

M(T2)

2.672.312.872.79

1.96

2.46

2.67

P

.004

.001

.012

.007

.023

.004

.004

Significance

p<.01p<.01p<.05

P<m

p<.05

p<.05

p<.0\

Results on the Semantic DifferentialT-tests for paired samples were conducted to analyze change

over time on the semantic differential instrument for seven concepts: TheAmerican Indian Holocaust, My People, My True Self, Wasicu [TheWhite Man], Anger, The Past, and The Future. The most positive ratingson each scale — those for evaluation, potency, and activity — areprovided. They will be followed by a presentation of statisticallysignificant results for each scale.

Evaluation Scale. The most positive rating at Tl was for the conceptMy People (M=2.10,1.00 being most positive). At T2,however,My TrueSelf (Af=l .92) was rated most positive. Statistically significant changesin a positive direction occurred between Tl and T2 for the followingconcepts: My True Self (P=.OO4, p<.0l), Anger (P=.O32, p<.05), ThePast (P=.004,p<.01), and Wasicu (P=.001,p<.01).

Potency Scale. The Future was the most potent concept at Tl(M=3.14). At T2, however, My True Self was the most potent (M=3.08).The concepts that changed significantly over time, in a more potentdirection, were: My True Self (P=.035,p<.05), Wasicu (P=.002,p<.01),and The American Indian Holocaust (P=.000,p<.0001). This was themost significant change in all the data.

Activity Scale. The Future was the most active concept at both Tl(M=2.88) and T2 (M=2.78). It was more active at T2 although it did notachieve significance. All concepts were rated as more active at T2 withthe exception of Anger. Three concepts were experienced as more active

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


at a statistically significant level: The American Indian Holocaust(P=.O12, p<.05), The Past (P=.OO1, p<.01), and My People (P=.OO6,

Six-Week Follow- Up Evaluation ResultsOf the initial 45 participants, 44 responded to the data collection

instruments (97.8%). Approximately 35 individuals (77.8%) completedmost items on all the T2 instruments, and 28 (62.2%) returned thecompleted the six-week follow-up evaluation (T3). The return rate on thefollow-up evaluation for those who completed all the data collectioninstruments at T2 was 28 of 35, or 80.0%. Responses were fairly even bygender, with 13 men and 15 women responding.

The follow-up evaluation revealed that 89.3% of respondents foundthe intervention very helpful in resolving their historical unresolved grief.One hundred percent said the intervention would impact their work withclients or communities. The majority, 64.3%, responded that they foundnothing unhelpful about the intervention. Unhelpful experiences identi-fied were intra-group conflict, insufficient process time, and processdisruption due to some participants who arrived late or left early. Threerespondents, all women, reported leaving early, one on Day Three andtwo on the last day, because of family emergencies. One participant didnot wish to participate in the final ceremony because of her Christiandenomination.

Gender DifferencesGender differences were evident in the study findings. Although

deliberation about gender disparity is beyond the scope of this article, theresults indicate that the men — more fullblood Lakota in appearance andlanguage — experienced greater trauma in boarding schools and experi-enced greater sadness, guilt, and shame as well as joy at T2 (Brave Heart-Jordan, 1995).

DISCUSSIONThe study hypotheses were overwhelmingly supported by the find-

ings. The first hypothesis that education about historical trauma wouldheighten awareness about its impact and the associated grief affects wasaffirmed by 100% of the respondents on the follow-up questionnaire.This hypothesis was also supported by the evaluation results. Furthersupport for this hypothesis was clearly evident on the semantic differen-tial; enhanced potency and activity of Lakota traumatic history corrobo-rated the prominence of historical trauma as a component of currently

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


experienced grief and psychic pain among the Lakota.The second hypothesis, that sharing these grief affects with other

Lakota in a culturally traditional context, would lead to cathartic reliefwas unquestionably demonstrated, with 97.0% finding the interventionhelpful. The semantic differential results also revealed a decrease innegative evaluations of trauma concepts despite their increase in potencyand activity, suggesting that cathartic release reduces negativity. Addi-tionally, the evaluation measure reported an affective crescendo with anoverall decrease in negative affects and an increase in positive affectsover the course of the intervention. This finding, also substantiatescatharsis. The Lakota ceremonies incorporated throughout the interven-tion provided a safe, culturally syntonic milieu for eliciting catharticresponses.

The third and final hypothesis was that the intervention would facili-tate a grief resolution process leading to a reduction in grief affects anda more positive group identity coupled with a commitment to continuingthis healing work. Confirmatory evidence corroborating this hypothesiswas found in the striking reduction in grief affects on the evaluationinstrument, with virtual elimination of helplessness and hopelessness, atenfold decline in guilt and shame, and a fourfold decline in sadness andanger. The increased acceptance of anger evident in the semanticdifferential implicitly suggests a noteworthy transformation of passivelyexperienced affective states into active ones, as well as increased capacityto externalize previously internalized experiences involving grief andtrauma.

All respondents professed more positive feelings about being Lakota.The increase of pride and joy, by approximately 30%, on the evaluation,in concert with the heightened evaluation and potency of the true self, andof potency of the Lakota on the semantic differential verify moreaffirmative identities. Traditional Lakota spirituality as a resource forfostering enhanced self-esteem, efficacy, and trauma mastery was alsoadvanced through the intervention. Further, the majority of participantsaffirmed their commitment to continued healing concretized in theformation of the Takini Network, a Lakota Holocaust Survivors Associa-tion.

The model intervention for Lakota grief and trauma resolution utilizeda culturally syntonic modality, the group in a circular formation, over atime-limited period. The modality (a) provided a container and holdingenvironment for powerful affects and testimonies, enabling the retrievalof dissociated traumatic memories (Danieli, 198 9; Koller et al., 1992), (b)maximized the probability of successful completion, thereby fostering a

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


sense of mastery, and (c) integrated affects and cognitions about thetrauma while endowing each member with an increased sense of selfcontrol (Koller et al., 1992; van der Kolk, 1987). Catharsis, abreaction,group sharing, testimony, opportunities for expression of traditionalculture and language, ritual, and communal mourning were all incorpo-rated in the Lakota intervention model.

Strengths and Limitations of StudyThe small size of the self-selected sample may have attracted recently

bereaved individuals, those already open to Lakota spirituality and theconcept of historical unresolved grief, and those with particularly nega-tive boarding school experiences. Nonetheless, it seems likely that thetraditional concept of the tiospaye (extended family kinship) wouldelevate bereavement responses in any Lakota sample. Further, thepervasiveness of trauma among the Lakota suggests that other Lakotasamples would equal the incidence of trauma in the study sample, andhence yield similar results. Generalizability to other tribes may be limitedto other Plains groups. However, my experience in presenting the studyto other audiences including Southwestern and Northwestern tribes andNative Pacific Islanders suggests this model is universally relevantamong native people. Finally, self-report measures are designed to reportboth on the intervention's strengths and weaknesses. Although censor-ship and misperception could skew results, the instruments includedprojective measures using the culturally sensitive semantic differentialwhich has solid reliability and validity.

Recommendations: Implications for Practice and Future ResearchClearly, the results of this investigation demonstrate that additional

research on trauma and grief responses is warranted among AmericanIndians and other populations that have survived cumulative trauma ofgenocidal proportions. Clinical case studies, as well as other qualitativeand quantitative investigations, would add to theory development.

The power of cathartic release during the intervention and the emo-tional impact of the testimonies cannot be adequately elucidated here.The impact of the model on self and group esteem among the participants,as well as the affective healing that took place suggests adaptation of thisintervention to work with a clinical population in a safe holding environ-ment. The intervention paradigm may facilitate treatment of psychoso-cial problems associated with trauma and grief such as suicide, substanceabuse, and depression. I have already replicated the intervention andincorporated it into a Lakota parenting curriculum designed to improve

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


parenting and arrest the generational transfer of the historical unresolvedgrief and trauma response (Brave Heart, in press; Cloud, Granfield, BraveHeart, Wolf, & Wolf, 1996). The intervention focused on parentalhealing from historical trauma, and fostering cathexis to traditionalvalues.

Attention to gender may illuminate the quality of responses totraumatic grief and associated gender role prescriptions. Research on riskfactors among American Indians such as phenotype and its correlationwith life span, as well as on generational trauma, may elucidate featuresof fixated grief. Further, additional research is vital for understanding theeffect not only of boarding school trauma but also of harsh day schoolexperiences, and of the generational influence of parental and grandparentalboarding school attendance on current experiences of child abuse andneglect, and psychosocial symptoms. Caution must be taken to modifythe intervention model to achieve cultural congruence with particularpopulations. Because of the intensity of the affect generated in theintervention, facilitators must safeguard against too much regression ordecompensation. Adequate ego strengths are required for successfulparticipation in this model, as currently formulated.

The importance of incorporating traditional Lakota spirituality andleadership in this intervention model cannot be overstated. It is doubtfulthat the intervention could be orchestrated by an outsider. Indigenouscore involvement would be critical in replicating this intervention in acommunity where the participants and prospective investigator are fromdifferent cultural backgrounds.

CONCLUSIONThis study empirically demonstrated the effects of an originally

designed, short-term, culturally congruent intervention for grief resolu-tion and trauma mastery among a coping segment of an underservedIndian population with elevated psychosocial problems. In addition to itsimmediate benefit to the Lakota community, this study has advancedknowledge about American Indian historical trauma and unresolvedgrief, and has promoted theory development regarding trauma and grief,as well as hypotheses about the intergenerational transmission of traumaamong oppressed populations and survivors of genocide. Research isneeded to identify the repercussions that gender and phenotype have uponthe degree of lifespan trauma, and the response to that trauma. Darkerskin color seemed to place Lakota men in the sample at greater risk forexperiencing trauma; phenotype and gender may impact not only theextent of trauma but also the effect of historical trauma interventions.

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


In conclusion, the findings from this study are promising for theLakota; healing from generations of trauma and unresolved grief appearsfeasible. Neither Wounded Knee nor the generational boarding schooltrauma can be forgotten. However, the Lakota must shift from identifyingwith the victimization and massacre of deceased ancestors and begin todevelop a constructive collective memory and a healthy collective egowhich includes traditional Lakota values and language, so the words ofthe Hunkpapa Elders Council will resound:

Let a hundred drums gather. It must be a time of celebration, ofliving, of rebuilding, and of moving on. Our warriors will singa new song, a song of a new beginning, a song of victory. Let ourwarriors sing clear and loud so the heartbeat of our people willbe heard by Sitting Bull and all our ancestors in the Spirit World,and our two worlds will become one again.

Let us send to our great chief a new song to sing when he ridesaround the people in the Spirit World:

Look at our children,They're going to live again,They're going to live again.Sitting Bull says this as he rides. (Blackcloud, 1990)

REFERENCES

Barrett, T. W., & Scott, T. B. (1989). Development of the grief experiencequestionnaire. Suicide and Life Threatening Behavior, 19(2), 201-215.

Berger, L. (1988). The long-term psychological consequences of the Holocaust onthe survivors and their offspring. In R. L. Braham (Ed.), The psychological perspectivesof the Holocaust and of its aftermath (pp. 175-221). New York: Columbia UniversityPress.

Black Elk, &Neihardt, J. G. (1972). Black Elk speaks. New York: Pocket Books.(Original work published 1932)

Blackcloud, R. C. (1990). (Warrior who comes home alone.) A gathering of Sioux... In honor of Chief Sitting Bull. Wakpala, SD: Blackcloud Productions.

Brave Heart, M. Y. H. (in press). Oyate Payela: Rebuilding the Lakota Nationalthrough addressing historical trauma among Lakota parents. Journal of Human Behaviorin the Social Environment.

Brave Heart-Jordan, M. Y. H. (1995). The return to the Sacred Path: Healing fromhistoricaltraumaand historical unresolved grief among the Lakota. Doctoral dissertation,Smith College School for Social Work, Northampton, MA. (Copyright by Author:Reprints available through the Takini Network, c/o the author, University of DenverGraduate School of Social Work, 2148 S. High St., Denver, Colorado 80208).

Bureau of Indian Affairs Labor Force Report. (1990). Aberdeen, SD: Bureau ofIndian Affairs-

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


Claymore, B. (1988). A public health approach to suicide attempts on a Siouxreservation. American Indian and Alaska Native mental health research, 7(3), 19-24.

Cloud, W., Granfield, R., Brave Heart, M. Y. H., Wolf, M., & Wolf, W. (1996).Taking care of our Wakanhenja (Sacred Children). (Curriculum development fundedthrough OSAP). University of Denver Graduate School of Social Work.

Crow Dog, M., & Erdoes,R.(1990). Lakota woman. New York: Grove Weldenfeld.Danieli, Y. (1989). Mourning in survivors and children of survivors of the Nazi

Holocaust: The role of group and community modalities. In D. R. Dietrich & P. C. Shabad(Eds.),The problem of loss and mourning: Psychoanalytic perspectives (pp. 427-457).Madison: International Universities Press.

Doka, K. J. (1989). Disenfranchised grief : Recognizing hidden sorrow. Lexington,MA: D. C. Heath and Company.

Erikson, E. (1959). Identity and the life cycle [Monograph]. Psychological Issues,7(1). New York: International Universities Press.

Erikson, E. (1963). Childhood and society (Rev. ed.). New York: W. W. Norton.Felsen, I., & Erlich, S. (1990). Identification patterns of offspring of Holocaust

survivors with their parents. American Journal of Orthopsychiatry, 60, 506-520.Fogelman, E. (1988). Therapeutic alternatives of survivors. In R. L. Braham (Ed.),

The psychological perspectives of the Holocaust and of its aftermath (pp. 79-108). NewYork: Columbia University Press.

Fogelman, E. (1991). Mourning without graves. In A. Medvene (Ed.), Storms andrainbows: The many faces of death (pp. 25-43). Washington, DC: Lewis Press.

Fogelman, E., & Savran, B. (1979). Therapeutic groups for children of Holocaustsurvivors. Internationaljournal of Group Psychotherapy, 29(2), 211-235.

Freud, S. (1957). Mourning and melancholia. In J. Strachey (Ed. and Trans.), Thestandard edition of the complete psychological works of Sigmund Freud (Vol. 14, pp.237-258). London: Hogarth Press. (Original work published 1917)

Heller, D. (1982). Themes of culture and ancestry. Psychiatry, 45, 247-261.Hoxie, F. E. (1989). A final promise: The campaign to assimilate the Indians, 1880-

1920. Cambridge, MA: University Press.Indian Health Service. (1995). Regional differences in Indian health. Washington,

DC: U.S. Department of Health and Human Services.Jacobs, S. (1993). Pathologic grief: Maladaptation to loss. Washington, DC/

London: American Psychiatric Press.Kestenberg, J. S. (1989). Transposition revisited: Clinical, therapeutic, and

developmental considerations. In P. Marcus & A. Rosenberg (Eds.), Healing theirwounds: Psychotherapy with Holocaust survivors and their families (pp. 67-82). NewYork: Praeger.

Kestenberg, J. S. (1990). A metapsychological assessment based on an analysis ofa survivor's child. In M. S. Bergmann & M. E. Jucovy (Eds.), Generations of theHolocaust (pp. 137-158). New York: Columbia University Press. (Original workpublished, 1982).

Koller, P., Marmar, C. R., & Kansas, N. (1992). Psychodynamic group treatment ofpost-traumatic stress disorder in Vietnam veterans. International Journal of GroupPsychotherapy, 42(2), 225-246.

Krystal, H. (1984). Integration & self-healing in post-traumatic states. In S. A. Luel& P. Marcus (Eds.), Psychoanalytic reflections on the Holocaust: Selected essays (pp.113-134). New York: Holocaust Awareness Institute, Center for Judaic Studies,University of Denver (Colorado) and Ktav Publishing House.

The Lakota Times (Special Edition). (1990, December). Wounded Knee remembered.Legters, L. H. (1988). The American genocide. Policy Studies Journal, 76(4), 768-

777.

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


Lifton, R. J. (1968). Death in life: Survivors of Hiroshima. New York: RandomHouse.

Lifton, R. J. (1988). Understanding the traumatized self: Imagery, symbolization,and transformation. In J. P. Wilson, Z. Harel & B. Kahana (Eds.), Human adaptation toextreme stress: From the Holocaust to Vietnam (pp. 7-31). New York: Plenum Press.

Macgregor, G. (1975). Warriors without weapons. Chicago: University of ChicagoPress. (Original work published 1946)

Macgregor, G. (1970). Changing society: The Teton Dakotas. In E. Nurge(Ed.),77iemodern Sioux: Social systems and reservation culture (pp. 92-106). Lincoln: Universityof Nebraska Press.

Nagata, D. (1991). Transgenerational impact of the Japanese-American internment:Clinical issues in working with children of former internees. Psychotherapy, 25(1), 121-128.

Niederland, W. G. (1989). Trauma, loss, restoration, and creativity. In D. R. Dietrich& P. C. Shabad (Eds.), The problem of loss and mourning: Psychoanalytic perspectives(pp. 61-82). Madison, CT: International Universities Press.

Osgood, C. E., Suci, G. J., & Tannenbaum, P. H. (1978). The measurement ofmeaning. Urbana & Chicago: University of Illinois Press. (Original work published1957)

Parkes, C. M. (1972). Bereavement: Studies of grief in adult life. Madison, CT:International Universities Press.

Pollock, G. H. (1989a). Mourning and adaptation. In G. H. Pollock (Ed.), Themourning-liberation process,Vol 1 (pp. 3-45). Madison, CT: International UniversitiesPress. (Original work published 1961)

Pollock, G. H. (1989b). On mourning and anniversaries: The relationship ofculturally constituted defensive systems to intrapsychic adaptive processes. In G. H.Pollock (Ed.), The mourning-liberation process, Vol I (pp. 251-287). Madison, CT:International Universities Press. (Original work published 1972)

Prince, R. M. (1985). The legacy of the Holocaust: Psycho-historical themes in thesecond generation. Ann Arbor, MI: University of Michigan Research Press. (Originalwork published 1975)

Rustin, S. L. (1988). A psychological examination of the survivors of the Holocaustand the generation after. In R. L. Braham (Ed.), The psychological perspectives of theHolocaust and its aftermath (pp. 161-173). New York: Columbia University Press.

Sack, W., Beiser, M., Clarke, G., & Rédshirt, R. (1987). The high achieving SiouxIndian child: Some preliminary findings from the Flower of Two Soils Project. AmericanIndian and Alaska Native Mental Health Research Journal, 1(1), 37-51.

Sanders, C.M. (1989). Grief: The mourning after: Dealing with adult bereavement.New York: John Wiley & Sons.

Shore, J.H.,Manson, S.M., Bloom,J.D.,Keepers,G., & Neligh,G. (1987). A pilotstudy of depression among American Indian patients with research diagnostic criteria.American Indian and Alaska Native Mental Health Research, 7(2), 4-15.

Sigal, J., & Weinfeld,M. (1989). Trauma and rebirth: Intergenerational effects ofthe Holocaust. New York: Praeger.

Stannard, D. (1992). American Holocaust: Columbus and the conquest of the newWorld. New York: Oxford University Press.

Tanner, H. (1982). A history of all the dealings of the United States Government withthe Sioux. Unpublished manuscript. Prepared for the Black Hills Land Claim by orderof the United States Supreme Court, on file at the D'Arcy McNickle Centerfor the Historyof the American Indian, Newberry Library, Chicago.

Thornton, R. (1987). American Indian Holocaust and survival: Apopulation historysince 1492. Norman, OK: University of Oklahoma Press.

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14


U.S. Senate, Miscellaneous Document No. 1, 40th Congress, 2nd Session, 1868,[1319].

van der Kolk, B. A. (1987) Psychological trauma. Washington, DC: AmericanPsychiatric Press.

Vestal, S. (1957). Sitting Bull: Champion of the Sioux. Boston: Houghton/Mifflin.(Original publication, 1932)

Wardi, D. (1992). Memorial candles: Children of the Holocaust. New York:Routledge. (Original publication, 1990)

Dow

nloa

ded

by [

Ston

y B

rook

Uni

vers

ity]

at 0

6:24

21

Dec

embe

r 20

14

the return to the sacred path: healing the historical trauma and historical unresolved grief...

Documents