The historical trauma response among natives and its relationship with substance abuse: a Lakota illustration.
TL;DR: Historical trauma (HT) is cumulative emotional and psychological wounding over the lifespan and across generations, emanating from massive group trauma experiences; the historical trauma response (HTR) is the constellation of features in reaction to this trauma as discussed by the authors.
Abstract: Historical trauma (HT) is cumulative emotional and psychological wounding over the lifespan and across generations, emanating from massive group trauma experiences; the historical trauma response (HTR) is the constellation of features in reaction to this trauma The HTR often includes depression, self-destructive behavior, suicidal thoughts and gestures, anxiety, low self-esteem, anger, and difficulty recognizing and expressing emotions It may include substance abuse, often an attempt to avoid painful feelings through self-medication Historical unresolved grief is the associated affect that accompanies HTR; this grief may be considered fixated, impaired, delayed, and/or disenfranchised This article will explain HT theory and the HTR, delineate the features of the HTR and its grounding in the literature, offer specific Native examples of HT and HTR, and will suggest ways to incorporate HT theory in treatment, research and evaluation The article will conclude with implications for all massively traumatized populations
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TL;DR: Advancing the understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health.
Abstract: This paper provides a review and critique of empirical research on perceived discrimination and health. The patterns of racial disparities in health suggest that there are multiple ways by which racism can affect health. Perceived discrimination is one such pathway and the paper reviews the published research on discrimination and health that appeared in PubMed between 2005 and 2007. This recent research continues to document an inverse association between discrimination and health. This pattern is now evident in a wider range of contexts and for a broader array of outcomes. Advancing our understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health.
2,688 citations
TL;DR: Assessment of historical trauma and implications for research and clinical as well as community interventions, andRecommendations are concluded on ways of alleviating psychological suffering and unresolved grief among Indigenous Peoples of the Americas.
Abstract: Indigenous Peoples of the Americas have experienced devastating collective, intergenerational massive group trauma and compounding discrimination, racism, and oppression. There is increasing evidence of emotional responses to collective trauma and losses among Indigenous Peoples, which may help to inform ways of alleviating psychological suffering and unresolved grief. Tribal cultural and regional differences exist which may impact how the wounding across generations and within an individual's lifespan are experienced and addressed. This article will review the conceptual framework of historical trauma, current efforts to measure the impact of historical trauma upon emotional distress, and research as well as clinical innovations aimed at addressing historical trauma among American Indians/Alaska Natives and other Indigenous Peoples of the Americas. We will discuss assessment of historical trauma and implications for research and clinical as well as community interventions, and conclude with recommendations.
503 citations
TL;DR: The comparison of the Holocaust and post-colonial Indigenous “survivance” suggests that the persistent suffering of Indigenous peoples in the Americas reflects not so much past trauma as ongoing structural violence.
Abstract: Recent years have seen the rise of historical trauma as a construct to describe the impact of colonization, cultural suppression, and historical oppression of Indigenous peoples in North America (e.g., Native Americans in the United States, Aboriginal peoples in Canada). The discourses of psychiatry and psychology contribute to the conflation of disparate forms of violence by emphasizing presumptively universal aspects of trauma response. Many proponents of this construct have made explicit analogies to the Holocaust as a way to understand the transgenerational effects of genocide. However, the social, cultural, and psychological contexts of the Holocaust and of post-colonial Indigenous “survivance” differ in many striking ways. Indeed, the comparison suggests that the persistent suffering of Indigenous peoples in the Americas reflects not so much past trauma as ongoing structural violence. The comparative study of genocide and other forms of massive, organized violence can do much to illuminate both common mechanisms and distinctive features, and trace the looping effects from political processes to individual experience and back again. The ethics and pragmatics of individual and collective healing, restitution, resilience, and recovery can be understood in terms of the self-vindicating loops between politics, structural violence, public discourse, and embodied experience.
404 citations
Posted Content•
TL;DR: An analysis of the theoretical framework of historical trauma theory is provided and a conceptual model illustrating how historical trauma might play a role in disease prevalence and health disparities is introduced.
Abstract: Historical trauma theory is a relatively new concept in public health. The premise of this theory is that populations historically sub- jected to long-term, mass trauma—colonialism, slavery, war, genocide— exhibit a higher prevalence of disease even several generations aer the original trauma occurred. Understanding how historical trauma might infl uence the current health status of racial/ethnic populations in the U.S. may provide new directions and insights for eliminating health disparities. This article off ers an analysis of the theoretical framework of historical trauma theory and provides a general review of the literature. A conceptual model is introduced illustrating how historical trauma might play a role in disease prevalence and health disparities. Finally, implications for public health practice and research are discussed.
384 citations
01 Jan 2008
TL;DR: The review suggests five areas for future research with an emphasis on youth: studies to improve understanding of what makes some Aboriginal youth respond positively to risk and adversity and others not, and more comparative studies on the role of culture as a resource for resilience.
Abstract: Resilience has been most frequently defined as positive adaptation despite adversity. Over the past 40 years, resilience research has gone through several stages. From an initial focus on the invulnerable or invincible child, psychologists began to recognize that much of what seems to promote resilience originates outside of the individual. This led to a search for resilience factors at the individual, family, community - and, most recently, cultural - levels. In addition to the effects that community and culture have on resilience in individuals, there is growing interest in resilience as a feature of entire communities and cultural groups. Contemporary researchers have found that resilience factors vary in different risk contexts and this has contributed to the notion that resilience is a process. In order to characterize the resilience process in a particular context, it is necessary to identify and measure the risk involved and, in this regard, perceived discrimination and historical trauma are part of the context in many Aboriginal communities. Researchers also seek to understand how particular protective factors interact with risk factors and with other protective factors to support relative resistance. For this purpose they have developed resilience models of three main types: "compensatory," "protective," and "challenge" models. Two additional concepts are resilient reintegration, in which a confrontation with adversity leads individuals to a new level of growth, and the notion endorsed by some Aboriginal educators that resilience is an innate quality that needs only to be properly awakened.The review suggests five areas for future research with an emphasis on youth: 1) studies to improve understanding of what makes some Aboriginal youth respond positively to risk and adversity and others not; 2) case studies providing empirical confirmation of the theory of resilient reintegration among Aboriginal youth; 3) more comparative studies on the role of culture as a resource for resilience; 4) studies to improve understanding of how Aboriginal youth, especially urban youth, who do not live in self-governed communities with strong cultural continuity can be helped to become, or remain, resilient; and 5) greater involvement of Aboriginal researchers who can bring a nonlinear world view to resilience research.
325 citations
References
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01 Jan 2001
TL;DR: This Supplement documents that the science base on racial and ethnic minority mental health is inadequate; the best available research indicates that these groups have less access to and avail-ability of care, and tend to receive poorer quality mental health services.
Abstract: Mental health is fundamental to health, according to Mental Health: A Report of the Surgeon General, the first Surgeon General’s report ever to focus exclusively on mental health. That report of two years ago urged Americans to view mental health as paramount to personal well-being, family relationships, and successful contributions to society. It documented the disabling nature of mental illnesses, showcased the strong science base behind effective treatments, and recommended that people seek help for mental health problems or disorders. The first mental health report also acknowledged that all Americans do not share equally in the hope for recovery from mental illnesses. This is especially true of members of racial and ethnic minority groups. That awareness galvanized me to ask for a supplemental report on the nature and extent of disparities in mental health care for racial and ethnic minorities and on promising directions for the elimination of these disparities. This Supplement documents that the science base on racial and ethnic minority mental health is inadequate; the best available research, however, indicates that these groups have less access to and avail-ability of care, and tend to receive poorer quality mental health services. These disparities leave minority communities with a greater disability burden from unmet mental health needs. A hallmark of this Supplement is its emphasis on the role that cultural factors play in mental health. The cultures from which people hail affect all aspects of mental health and illness, including the types of stresses they confront, whether they seek help, what types of help they seek, what symptoms and concerns they bring to clinical attention, and what types of coping styles and social supports they possess. Likewise, the cultures of clinicians and service systems influence the nature of mental health services.
2,329 citations
Book•
01 Jan 1996
TL;DR: McFarlane and van der Kolk as mentioned in this paper defined and diagnosed Posttraumatic Stress Disorder (PSD) and developed a general approach to treatment of posttraumatic stress disorder (PTSD).
Abstract: Part I: Background Issues and History. van der Kolk, McFarlane, The Black Hole of Trauma. McFarlane, van der Kolk, Trauma and its Challenge to Society. van der Kolk, Weisaeth, van der Hart, History of Trauma in Psychiatry. Part II: Acute Reactions. Shalev, Stress versus Traumatic Stress: From Acute Homeostatic Reactions to Chronic Psychopathology. Solomon, Laror, McFarlane, Acute Posttraumatic Reactions in Soldiers and Civilians. Part III: Defining and Diagnosing Posttraumatic Stress Disorder. Brett, The Classification of Posttraumatic Stress Disorder. McFarlane, Girolamo, The Nature of Traumatic Stressors and the Epidemiology of Posttraumatic Reaction. McFarlane, Resilience, Vulnerability and the Course of Posttraumatic Reactions. van der Kolk, The Complexity of Adaptation to Trauma: Self-regulation, Stimulus Discrimination, and Characterological Development. van der Kolk, The Body Keeps the Score: Approaches to the Psychobiology of Posttraumatic Stress Disorder. Newman, Kaloupek, Feane, Assessment of Posttraumatic Stress Disorder in Clinical and Research Settings. Part IV: Memory: Mechanisms and Processes. van der Kolk, Trauma and Memory. van der Kolk, van der Hart, Marmar, Dissociation and Information Processing in Posttraumatic Stress Disorder. Part V: Developmental, Social, and Cultural Issues. Pynoos, Steinberg, Goenjian, Traumatic Stress in Childhood and Adolescence, Recent Developments and Current Controversies. Prior Traumatization and the Process of Aging: Theory and Clinical Implications. Pitman, Sparr, Saunders, McFarlane, Legal Issues in Posttraumatic Stress Disorder. de Vries, Trauma in Cultural Perspective. Part VI: Treatment. van der Kolk, McFarlane, van der Hart, A General Approach to Treatment of Posttraumatic Stress Disorder. Ursano, Grieger, McCarroll, Prevention of Posttraumatic Stress: Consultation, Training, and Early Treatment. Raphael, Wilson, Meldrum, McFarlane, Acute Preventive Interventions. Turnbull, McFarlane, Acute Treatments. Rothbaum, Foa, Cognitive-Behavioral Therapy for Posttraumatic Stress Disorder. Davidson, van der Kolk, The Psychopharmacological Treatment of Posttraumatic Stress Disorder. Lindy, Psychoanalytic Psychotherapy of Posttraumatic Stress Disorder: The Nature of the Therapeutic Relationship. Turner, McFarlane, van der Kolk, The Therapeutic Environment and New Explorations in the Treatment of Posttraumatic Stress Disorder.
1,428 citations
Journal Article•
TL;DR: The abundant literature on Jewish Holocaust survivors and their children is used to delineate the intergenerational transmission of trauma, grief, and the survivor's child complex and interventions based on traditional Indian ceremonies and modern western treatment modalities for grieving and healing of those losses are described.
Abstract: American Indians experienced massive losses of lives, land, and culture from European contact and colonization resulting in a long legacy of chronic trauma and unresolved grief across generations. This phenomenon, labeled historical unresolved grief, contributes to the current social pathology of high rates of suicide, homicide, domestic violence, child abuse, alcoholism and other social problems among American Indians. The present paper describes the concept of historical unresolved grief and historical trauma among American Indians, outlining the historical as well as present social and political forces which exacerbate it. The abundant literature on Jewish Holocaust survivors and their children is used to delineate the intergenerational transmission of trauma, grief, and the survivor's child complex. Interventions based on traditional American Indian ceremonies and modern western treatment modalities for grieving and healing of those losses are described.
1,073 citations
"The historical trauma response amon..." refers background in this paper
...A Lakota/Dakota Woman (Brave Heart & DeBruyn 1998) Historical trauma (HT) is cumulative emotional and psychological wounding, over the lifespan and across gen erat ions , emanat ing from mass ive group trauma experiences....
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01 Jan 1998
TL;DR: The Emerging Biology of Intergenerational Trauma: Psychobiology of intergenerational effects of Trauma, Evidence from Animal Studies S.J. Suomi, S.B. Levine and S.M. Bernstein this paper.
Abstract: The Nazi Holocaust: Intergenerational Memory of the Holocaust N.C. Auerhahn, D. Laub. World War II: Conflicts in Adjustment: World War II Prisoners of War and Their Families M.M. Bernstein. Genocide: The Turkish Genocided of the Armenians: Continuing Effects on Survivors and Their Families Eight Decades after Massive Trauma D. Kupelian, et al. The Vietnam War: Warrior Fathers and Warrior Sons: Intergenerational Aspects of trauma R. Rosenheck, A. Fontana. Intergenerational Effects Revealed After the Fall of Communism: Intergenerational Aspects in the Conflict in Former Yugoslavia E. Klain. Indigenous People: Intergenerational Aspects of Trauma for Australian Aboriginal People B. Raphael, et al. Repressive Regimes: Stalin's Purge and Its Impact on Russian Families K.G. Baker, J.B. Gippenreitner. Domestic Violence and Crime: Intergenerational Child Maltreatment A. Buchanan. Infectious and Life-Threatening Diseases: AIDS and Its traumatic Effects on Families B. Draimin, et al. The Emerging Biology of Intergenerational Trauma: Psychobiology of Intergenerational effects of Trauma: Evidence from Animal Studies S.J. Suomi, S. Levine. Conclusion. 28 Additional Chapters. Index.
701 citations
"The historical trauma response amon..." refers background in this paper
...In addition to the Jewish Holocaust literature, the experiences of Japanese American descendants of World War II in tern ment camp survi vors also man ifest intergenerational trauma response features (Nagata 1998, 199 1 )....
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TL;DR: This article found that the Teton Sioux suffer from impaired grief of an enduring and pervasive quality due to massive cumulative trauma associated with such cataclysmic events as the assassination of Sitting Bull, the Wounded Knee Massacre, and the forced removal of Lakota children to boarding schools.
Abstract: This article, based on research conducted with Lakota human service providers, concludes that the Lakota (Teton Sioux) suffer from impaired grief of an enduring and pervasive quality. Impaired grief results from massive cumulative trauma associated with such cataclysmic events as the assassination of Sitting Bull, the Wounded Knee Massacre, and the forced removal of Lakota children to boarding schools. The research studied a culturally syntonic four‐day psychoeducational intervention designed to initiate a grief resolution process for a group of 45 Lakota human service providers. The methodology included assessment at three intervals: (a)apre‐ and post‐test, utilizing a Lakota Grief Experience Questionnaire andthe semantic differential, (b) a self report evaluation instrument at the end of the intervention, and (c) a six‐week follow‐up questionnaire. The results confirmed the hypotheses that: (a) education about historical trauma would lead to increased awareness of the impact and associated grie...
348 citations
"The historical trauma response amon..." refers background in this paper
...For example, Lakota (Teton Sioux) history includes massive traumatic group experi ences (Brave Heart & DeBruyn In press; Brave Heart 1998) incorporating (a) the 1 890 Wounded Knee Massacre ; (b) war trauma, prisoner of war experiences, starvation, and displacement; (c) the separation of Lakota…...
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...…of traditional grief resolution practices, may result in Native peoples becoming wakiksuyapi (memorial people), carrying internalized ancestral trauma and unin tentionally passing this on to their children (Brave Heart & DeBruyn In press; Brave Heart 2000, 1998 ; Wardi in Brave Heart 2000)....
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