Panel two talking about tribal perspectives on healing.
Our first speaker making her way up now, we'll not let her sit down will be chief Malerba,
the 18th chief of the Mohegan tribe on August 15, 2010, the first female chief in tribal's
modern history.
The position is a lifetime appointment.
And made by the tribes council of elders, prior to chief she served as chairwoman of
the tribal council and worked in tribal government as executive director of health and human
services and currently chairwoman of the tribal governance advisory committee for Indian health
service.
So esteemed leader for sure.
Join me welcoming chief Malerba.
[Applause]
>> Thank you.
So there we can bring up my slides.
So thank you for having me, I would say -- greetings from our Mohegan people.
And my early career was in nursing, I was a critical care nurse, I'm not that patient
and I'm not not necessarily a researcher but I was crazy enough to jump into tribal politics
so as tribal leader it's my job to give voice to policy, my job to advise, our federal partners
and my job to make sure that I speak for the people who perhaps have less of a voice.
So this picture for the generations, you will see the gentleman with the big turkey feather
head dress, that's my grandfather so I'm proud to follow in his footsteps.
One of the things that I know that I have five minutes and I have somebody here timing
me.
One of the things that I need -- we need to talk about, we need to name this problem.
We experience genocide.
I'm from New England.
We experience the immigration of the Europeans in the 1600s but by 1750s we have lost 90%
of our population and 90% of our land base.
So when we think habit what happens to us, we had land dispossession, widespread loss
of population due to warfare and disease and it is true that the blankets is true, I read
quote from Army general saying let's take those blankets out of smallpox hospitals and
hope hay do their job.
We lost our traditional foods, we were hunters and gathers, the colonists came and fenced
in our traditional land so we couldn't eat our foods.
Lots of traditional medicines, our medicine woman told us after time we couldn't pick
our traditional medicines because they were polluted.
Long standing oppression, discrimination, forced removal, forced sterilization, prohibition
on practice of culture traditional religion, toxins invading our environment injustice
and demeaning experiences and discrimination that still continue to experience still to
this day.
And so in 2015 bear net describes historical oppression as chronic insidious intergenerational
experience of subjugation, imposed and internalized in the daily lives of American Indians.
And Alaska native communities, families and individuals.
So it's a multi-facetted problem that requires a multi-facetted approach.
There is a disconnect between how tribes care for people and how federal bureaucracy works.
That's something we need to think about.
How can we impact this issue in a way that really has meaning and is impactful.
There are severely underfunded trust obligations to tribes and that continues.
Despite the fact that tribes are the only people in this United States that have treaty
obligations to help.
We're the only health program on the discretionary side of the budget.
Which means Congress can remove funding if they choose.
In ID addition, when when he think about grants and government is funded by grants, what happens
is we're competing against one another for funding that is necessary for our people and
sometimes what you will see is that the people who are in most need of the grants are ones
that have the least infrastructure to apply for the grants.
And so perhaps they're left out of that grant process.
You think about the multiple agencies that we all work with and advise and continue to
work with.
We need to think about how do we break down those barriers and how do we make it a less
siloed approach to funding.
So a that we're more impactful with the funding that we have.
And that we use.
As people heard me say in the past we need to stop funding disease du jour.
You heard that a little bit here today in that we need to start at a very lower level
which is let's stop thinking about the disease du jour, let's look at prevention and social
determinants of health.
Let's start impacting the community where they needs are.
Because if we create a healthy environment for our children to grow up in, even before
they're born, their lives are much healthier as we have seen from that study.
The other thing we want the think about is barriers we need to address.
There's lack of trust among native people in researchers because the research has not
always been used in our best interest.
We have to think about the fact that the social determinants of health have to be addressed.
When you have unemployment, when you have lack of education, lack of safety, you heard
about food security.
How do you have good food and how do you have good nutrition when perhaps the only place
you can buy your food is the gas station, that's the closest to you.
I have heard about communities, thank you.
Where there is one grocery store for 2 million-acres of land.
How do you buy your food?
How do you eat a healthy life?
So we need to think about those things, environmental safety.
But the one thing I know is tribes are very resilient.
Our world view emphasizes interrelatedness and harmony of our mind, body, spirit, and
spiritual access of all living things.
And that connection to our ancestors.
We connect to our ancestors when we engage in traditions and ceremonies.
Indigenous language has been demonstrated to improve sense of self-esteem so if we can
connect children in a way to ta culture that's meaningful, we need to do this but we need
to make sure people do not feel less than.
Our language has not been spoken in fluently in over a century.
And why is that?
Because we were told we couldn't.
We were told we were less than.
We were told our religion was the work of the devil.
And all those things are things we neEd to reconnect to.
I did not grow up dancing.
As a young girl because the women I grew up with didn't dance, but that doesn't mean generations
before them didn't.
So we need to embrace where people are at and if our young girls want to do a jingle
dance which probably isn't a northern woodlands tradition, we should embrace that because
they are engaging in a time honored tradition.
So I think I'll probably leave it at that but we need to make sure that we give our
kids that resilience and curl churl protection to live lives in a more traditional way.
We are reclaiming those traditional ways each and every day and that's a very important
thing for us to do.
So I think we have to embrace who we are, we need to be patient with the fact that we
have not been allowed in some instances, to really practice those traditional things.
We need to make sure we engage and give that next generation the strength to do the things
that will keep them healthy over long term an inform those next generations.
So I use this quote from medicine woman who spans three centuries which just so impressive
to me, she was born in 1899 and passed in 2005.
And she continues to be an inspiration to me, she was very much a traditional Mohegan
woman.
And I think her words still resonate with us because we need to start with our children.
So thank you very much.
[Applause]
>> Thank you, chief Malerba.
Next is Dr. Kori Novak, CEO for health and human services at the current tribe at California
and senior -- KARUK tribe in California and Stanford University, continuing of trauma
and manifestation trauma in the elderly.
She has a Ph.D. in human services and gerontology and post-doctoral fellowship in palliative
end of life care at Stanford.
Please join me in welcoming Dr. Novak.
[Applause]
>> Thank you.
Thank you for having me.
I appreciate it.
I'm -- I usually don't stand behind podiums, I'm so short you can't see me.
So and I can't see that far either so I'm just going to -- there I am.
So you're right I'm sitting over there.
I specialize in continuing of trauma and unlike the other esteemed colleagues that I had up
here, I'm not Native American but I care deeply about what these peoples have gone through,
trauma experiencend and how to heal from that trauma.
In particular, I care about the elderly.
Ads a gerontologist as much as I like kids, puppies plants and everything else, I love
old people.
When I talk healing from trauma, I look at not only generations that come before but
through a different lens.
So I once heard we learn traditions, and they come from our elders.
And from our elders to our children, those traditions reverberate in children's hearts.
And it's about what we share from our experience.
That guides what we have going forward.
If the experience is bad, traumatic, difficult, that's absolutely going to go on to our children.
It's like a glass of rocks with it.
No matter how many rocks you put in, whether you pour water in it, it's going to seep all
the way down.
So no matter how much we try to cover the trauma, ignore the trauma, fix the trauma,
until we get to the bottom of the trauma, which is the tree, like we saw earlier, we're
not going to fix it and it will seep out in one way or another whether a snide comment,
an offhanded remark, a look, a roll of the eyes, we're teaching children this.
And until we can fix the it's okay to feel what we feel, we'll continue to have these
problems.
So in elders, trauma manifests in a different way.
Often it is those remarks that don't -- that seem passive aggressive but they don't mean
to be but it's because they're coming from a deeply hurt place.
And when you deal with an elder, you can't just change it.
You have to do it in a different way.
A more patient way.
A kinder way.
Because this trauma has gone on as we say, inter-generationally, generations.
Ten years, 20 years, 30 years, a hundred years.
So when we're looking at some of the things that have been done with Native American people,
I can say from experience, those of us who haven't grown up in this culture, in the native
culture in the traumatic culture, come in not realizing that some of these things, these
often things not only continue to happen to these people but just happened a generation
ago.
Just happened to grandparents, not hubs offer years ago like when he we think in our school,
in the 1600s which seems so long ago, it happened in the 1900s.
It happened in the 2000s.
So when we're looking at this and how to fix it, it can't be a loop and saying research.
So one thing that I have done, and I have been supported with through the KARUK tribe
in far Northern California, five hours north of San Francisco.
So far in Northern California.
One of the things that we have been doing is trying to match both services and traditions.
So like Dr. Walter was say -- Walters was saying earlier, that's important.
Services help not but tradition will help in the future.
So we have a program which in KARUK means the medicine is good.
And that is about taking the social determinants of health, food security housing security,
job security and helping not only create that for now, so we have food security job security
education but also in the future and what's needed is bossY CEOs like myself who push
for that, who care and who don't quit because we're like little bull dogs and we're tenacious.
We just keep working at it.
That is what will ultimately help heal trauma, that's one thing that will help heal the trauma,
everybody coming together, not just Native Americans.
Anybody who experienced trauma, which as we learned is all of us.
Not a single one can sit here and say never had trauma.
That would be awesome, if it's you I want to talk to you afterwards.
Because you probably had some trauma we need to discuss that you don't know about.
Western medicine as a trigger, oftentimes the vernacular we use in western medicine,
it's a trigger to a native American or to a Japanese American or somebody that's experienced
this kind of trauma.
Even the word obese can be very offensive.
If you call me fat I can guarantee I won't be happy.
That's my culture of just -- not wanting to be called fat but it can be deeply, deeply
offensive to people who have had trauma in generation after generation upon generation.
So as we talk about these things and think about these things through the rest of our
time here and things said, please consider that there's two other lenses, the lens of
the elderly and how they're looking back on their traumatic life, and the lens of us who
did not experience some of this but are desperately trying to help because we see the wrongs and
we want to make them right.
So help us help you.
And let's help our elders help our new generations.
[Applause]
>> Thank you, Dr. Novak.
Last but not at least, you met Dr. Bigfoot who did the opening.
She's trained as a child psychologist and associate professor at the Native American
programs sentencer on child abuse and neglect University of Oklahoma health sciences center.
Funded since 1994 by children's bureau, she directed project making medicine and 2003
directed the Indian country child trauma center.
Currently Dr. Bigfoot is serving on the national child trauma stress network cultural consortium
work group, really a leader nationally in these issues around children and trauma.
, so welcome, Dr. Bigfoot.
[Applause]
>> This is what I'm going to do.
I'm going to chinning my setting because I can't take those lights.
So I'm going to come here and I apologize.
You change the bucket, right?
I'm changing my environment.
So I can see and not look at the person with the number zero on it.
I have some research -- I want the tell you a couple of stories.
One about a four-year-old with two-year-old and the four-year-old was attacked by a doc
when she was two -- dog when she was two.
And a couple of weeks ago this little four-year-old was with the two-year-old and the two-year-old
had been mauled by a bear -- I got bear in my head, by a dog about five months ago and
so they were in this setting and there was this dog that came charging up and all the
adults were going to very slow motion.
But this little four-year-old got there first, this is what she did.
She said stop, no, bad dog.
You're okay, you will be fine.
I'm here.
Stop, sit.
Quit.
You're okay.
I'm here.
I'll take care of you.
What is that?
This is children taking care of children.
This is the peer to peer stuff that we hear at one setting but it's being that good relative.
And then there's a little five-year-old.
Has you know, a very histo-- varied history, father alcoholic, aunts an uncles different
things, a lot of things that occurred.
There's a little five-year-old that answers the phone, for his father, that had been gone
for probably three or four weeks on some bing.
So this is the conversation that was heard.
So five-year-old, runs an answer it is phone and he goes hello.
No my daddy is not here.
No, I don't know where he is.
Oh, he's drinking.
Oh, you don't have to be sorry, it wasn't your decision.
No, I'm fine.
I know how to make good decisions.
Yes.
My daddy is good.
But I can make good decisions.
And I'm fine.
Bye-bye.
What's going on there?
Third story is about these kids who said that they only talk to select people.
Maybe one or two friends.
They rarely talked to anybody else.
And it's called -- we just say shy or not social or awkward and all that stuff.
It's really select mutism.
And they all got involved in a native language program.
And they became very engaging, they became -- even though they didn't have complete competency
with the language it gave enough competent -- enough confidence to have language conferences
with other people, to expand their abilities outwardly with friendship skills, it increased
their conversations with adults.
So now they're serving on panels talking about native language program and teasing one another
and laughing and creating programs.
What we have are kids that have histories of different kinds of trauma and everybody
does have trauma.
They mastered situations.
Even the little four-year-old they have confidence in managing what is present.
So see if I can work this one here.
I have cards and resources for you.
Another story was I was working with the suicide program in the school and they were saying
our kids are safe as long as they are here.
We can keep them safe as long as we are here.
I asked when kids are here and they learn reading, they only learn to read in the school.
Or when kids are here learning math they only learn math and they can only do it in the
school.
So you're not teaching them skills that they can take beyond these walls.
So being able to help children, youth, adults, parents, take those skills beyond just what
the experience is right here, right now.
Having that competency that mastery, being that good relative with one another.
We host lot of different kinds of themes including training clinicians, in culturally adapted
evidence based practice but we look at it from point of view that's specially with cognitive
behavioral models we have always thought that's not a new phenomena, we felt we wouldn't have
a lot of our ceremonies, walk of the tears is all about emotions and being aware.
And we in terms of understanding we always do the world is round rather than flat.
We pull from those understandings we had earlier to say these are not new -- these are not
new ways of -- or new concepts.
But in terms of ceremony.
I don't know if you can read it, it says the over arching belief.
We are reclaiming our old wisdom and traditional healing ways that have been lost or misplaced.
As indigenous people we have participated in ceremony to prepare for harsh time or following
a harsh time or offering ceremony to express gratitudes to process trying times to affirm
growth, support healing and build resiliency.
So when we think about -- resiliency.
When ceremony, it was to deal with traumatic events or times in process.
And that was why ceremony was so important.
The simple offering of water, when someone is in a distressing state, what do most people
do?
Can I get you a glass of water?
Why is water so important?
Because it cleanses.
It's not just offering something like water.
It's ceremonial in offering water.
That is really important.
There is a program in talk ache when individuals come out of prison, there are two, three,
four, five people that greet them at the plane.
And tell them welcome back.
What we're going to do now, we're taking you out on the boat.
And we are going to let the wind teach you who you are, we will let the water teach you
who you are.
We let the waves teach you who you are, let the fish teach you who you are.
Because it's important they recognize who they are as they come back to communities.
Because all that understanding of identity has been lost.
So we can take -- we can create the settings where people become empowered and less likely
to harm someone else because of who they are.
Because of being that relative that will take care of one another.
So we have a lot of different opportunities and different resources, I have clinical training
program, we can train clinics.
If we can train clinicians we have to think about the intervention, that is a good intervention,
we have to think about training those providers clinicians, in the best method possible.
Think about ongoing consultation, we don't just put something into a setting and think
that's sufficient.
We have to have ongoing consultation and training.
We need communities not just administrative support but community support colleague support,
let it be placed into the community because if it doesn't -- if isolated or separate from
and not integrated, it won't have as much impact.
We always need to see how things work.
And we think about it.
Has there been improvement on the shape of a canoe?
No.
We have found something that works for generations upon generations upon generations upon generations.
And so we know there have always been a research mind in our indigenous communities.
We wouldn't have ceremony if that wasn't the case.
We found out that certain ways of approaching people, certain ways of doing thing, certain
ways of embracing, those things work.
So we want to know this is work -- does this work also.
That feedback from that community is important and figuring how to make it sustainable.
Is it grant funded?
Billable?
Built into the communities?
So that it's sustainable in some way.
We have capacity to continue healing and rehealing and rehealing.
Do you think trauma was only something that evolved in the last 500 years?
We have had tornadoes in Oklahoma as far back as we could know, earthquake, fire, conflict
with one another.
My son recently got married.
Before we did I said once thing I want you to think about is you don't talk to your mother-in-law
because that decreases the conflict.
That has been hard.
Both my husbands, not at the same time, sequentially, let me work this out first.
We're both Cheyenne and they didn't talk to my mother.
So what is it we can help so we can decrease conflict and what we can do to increase healing.
We have different programs.
And ceremony, simple things or bigger events.
If we can think ant our programs if they are, not programs just funded but all the opportunities
if we can think about that ceremony.
So this 4-year-old that said stop quit don't, you're a bad dog.
We offered her something.
We gave her something because she was protective.
So we can build ceremony in to any good thing.
And as we think about it.
There are a lot of things very therapeutic.
Being on a boat is therapeutic.
Having greetings.
Recognizing naming, I have to apologize because I messed up the name, I think naming very
important that identity, that link, that connection to our history.
Is through those namings.
And name remembrances.
When I was growing up the theme I heard always was my elders praying for me and all of my
cousins and brothers and sisters and everyone.
And any time I hear anyone talk about grandparents, aunts and uncles, those are the words that
come back to my mind, that's the image back to my mind.
So yes we have many of those in back of us and we have many in front of us.
That we're doing the same thing for them.
That ancestors did for us.
Healing is possible.
We can teach very young children how the take care of themselves how to breathe.
I remember here on one hand we take care of individuals individually, we take care of
people individually in this one hand.
We do that one on one.
But on the other hand, we take care of everybody.
So as we look at things, yes.
One on one, but also collectively.
So I appreciate the opportunity to share this information and I have some resources if you're
interested.
Thank you.
>> Thank you, Dr. Bigfoot.
We're going to quickly go into our all panel discussion here but just thought give chief
a chance to responds to respond to comments.
>> I appreciate the comments about ceremony, one reclaiming but two working on a little
by because we need to embrace who we are, we need to show all of our community matters.
And so one of the things that we have been working on has been looking at life passages.
So now our high school graduates and college graduates we do a ceremony for them around
the fire and another one would be our naming ceremony which was something that had dropped
off a little bit.
And so I appreciate your talking about that because those are very significant to people.
And it is something I think is very healing.
And as we looked at some of our younger kids one of the things we have told them is, know
one knows those Mohegan words but say the ones who do.
One of the things that tickled me to no end was at summer camp we have this big summer
camp and as I walk down the line, they said chief and each one said a word.
The one word that popped into their minds and they were proud of themselves -- proud
of themselves so that honors ancestors to bring that back and honors those people who
couldn't say those words for many, many reasons.
But too, when we practice ceremony we connect our kids and our elders together.
And I think that's what's so very important.
Soy appreciate bringing that up.
>> Thank you.
Would you like to make comments?
In that case we'll have Dr. Brave heart come back on stage again and move to audience discussion.
So we have a couple of microphones for people here in the room with us and for those who
are with us via live stream, you probably notice in the email that you can submit questions
for the group to questions@HHS.TV not some other ending,
HHS.TV.
I think Theresa will be collecting those and le us know if any come in that way.
So I would like to open up to our audience here.
If they would like to ask a question or interact wees steamed panel in any way.
We have microphones over there.
I wanted to throw out a question, follow-up on the research one while we're getting that
microphone.
So if anyone like to talk how research we mentioned a few of us mentioned it.
Research is sometimes done well but mostly not.
In our native communities.
Would anyone like to make a comment on how research is unfortunately contributed to trauma
at times but also can be done in a good way and partnership with tribes.
Would anyone like to talk about that briefly?
>> I can mention that with, we have with our current study we have four IRBs or RRBs.
But it's for two communities because we have one -- we have the tribal research Indian
health service for that area, and then we have the University research review board
and I'm blocking on the other one.
All in tribal college.
But we have great relationships with all of them.
It's what's hard in terms of navigating is if you make one minor change you have to get
approval from all the other boards.
And that it really takes time to develop those relationships fortunately we are known in
one of our tribal research review boards, our own people.
So when we walked in the room we were the fourth on the agenda.
And it's kind of intimidating because the first three presenters, they got approved
but they put them really through the ringer.
One was from the tribe but the tribal chair man did not come.
So everybody was angry because he was listed as the principle investigator on the research
which was for secondary data analysis.
So the woman handled herself well but it was kind of like oh my gosh, we came out in force
because we had all of our grassroots community folks with us because that's part of who we
are.
I didn't as a researcher so I kind of just got into it because I wanted to make sure
that what we were doing was right.
So I think that that's something that we need to respect and have that conversation with
tribes.
I have had some native researchers not had good experience even with tribal research
review boards.
So it is good to develop those relationships because tribes want good research but they
want that research to be respectful, protected, whatever you're doing necessary, and we'll
come back to the tribe and history as people helicopter in, they leave and you never hear
from them again and there's no real benefit to the tribe.
So what we do, ours is a randomized control trial which means that the person doesn't
have a choice which intervention they get.
For us everybody got an intervention.
So we had enterpersonal psychotherapy, something NIMH has funded in the past and we had historical
trauma arm and we combined it with the group interpersonal psychotherapy.
That's something our tribal research review board liked because everybody was getting
something, nobody had to wait to get that help and then that's something true partnership
-- >> Absolutely.
>> So we're in the process of developing our IRB at Mohegan, one thing we worry about is
who owns the information, how does it get shared, where does it go and as part of NIH
tack some of the questions that arise around once the information is deidentified it can
be used for any research.
Which is a little scary.
For us.
But one -- we have expanded research to include cultural practices and our artifacts because
we believe our artifacts has soul and spirit so we're working with our elders on that.
. And working with our medicine woman on that
to develop something that is uniquely Mohegan so we're putting our toe in the water.
I'm really admiring the folks that have these formal IRBs, we hope to have one at some point
in time.
As our children become more educated and they're in graduate programs they ooher coming to
us with research projects.
We found we don't have a way to evaluate it and those are some of the things we want to
ground them in.
How are they going to do it culturally sensitive way.
That's what we're working on.
>> I think the protection of individual tribal members confidentiality is really important.
So tribal research review board is really good.
That we're working with, they understand that so they're not asking for raw data, storage,
they're asking for aggravated deidentified data and they do only that data.
Any time you do Powerpoint, any time we write a paper, we have to get tribal research review
board approval because they want to make sure that the tribe is protected, that the store
-- distorted harmful information is not out there.
And for me I'm very, very clear, I'm a LACONTA (phonetic) first, I'm not a researcher first
or any other identity first.
So that's really what I'm about.
So my research is -- I heard native researchers say, first identity is being a scientist.
That's not my first identity.
Though our people are scientific.
But I have a commitment and obligation to my people, my community, to make sure they're
protected, that the work I'm doing is going to be helpful.
And that's my prayer.
So that's what grounds me but research can help our people if it's done the right way
and creatively I know some of her work she mentioned talking about going back to the
places where original trauma occurred.
Do you have a question in the audience?
>> So first I have a quick question.
One is on aces, we talked about needing -- the need to create evidence based appropriate
like that cultural based but also think thinking about measurements, first aces is native population
score so high risk of (inaudible) talk about lack of appropriate measures of adverse child
hoot experiences, violence, repeated loss, poverty discrimination, these things that
occur over the life span, thinking about bays to measure adverse experiences in native communities,
(inaudible) and second is a practical level question.
This is chief Malerba about getting -- some tribal leaders know understand historical
trauma but a lot need to be educated.
They talk about you should get over there, we need to stop dwelling in the past.
Think about the future.
So how do you -- what are ways -- talking points to give to them or ways to get them
to look at historical trauma?
>> When I'm with other tribal leaders, we have to ground ourselves in history and what
is our -- what is our -- the focus of our discussion going forward?
So I think it's always important and if you have ever seen me talk you will see some old
photos and new ones because we have to think about what happened and I don't think we have
to get over its.
We have to acknowledge it and call it by name.
That's only way we're going to then really be sensitive to that.
Growing up as I said, growing up know one practiced our religion or spoke our language.
For 100 years.
The only reason we have our worth left is because one of our medicine women in 1800s
kept diaries in Mohegan and English.
I went to sitting bull college and sat in on some of the language classes and I'm jealous
of your people because they have 600 songs recorded in your language panned 40,000 words
in your dictionary.
It's just remarkable.
And I think the work that you do there is great.
So I think it's really acknowledging that and it's not something to get over.
We need to acknowledge it but also need to say how does our tradition change our world
view and how can we bring that back to our current day people.
When -- I will give an example.
So I trained peace keepers within our tribe an healing circles within our tribe.
I think the modern system of justice doesn't always work for native people.
So if there are intertribal dispute or interfamily dispute rather than going to court, and slapping
each other around, we think the better way is to go back to our earlier tradition after
healing circles.
When I started training the peace capers, one thing that the medicine come and I were
worried about was the fact that people feel like they don't know enough history to be
a peace keeper.
So with what we started with was teaching them history and making sure everyone had
that same knowledge base so no one felt less than.
I found a great quote from a tribal minister, in New England we became Christianize because
that was a way not to be relocated so we had ministers that taught in Mohegan and English.
And learned Latin and they were just unique individuals.
Someone from the English community said what do you do when somebody misbehaves?
This minister said we talked to them, we loved them and bring them back.
And isn't that a different way of restoring justice?
And it's something that's been lost in the translation.
So that's why we thought doing peace capitalling and having peace keepers within the tribe
traditional way of promoting healening the tribe so it's both.
Moving forward, but moving forward in a good way and in a thoughtful way.
So I never think that we should get over it.
I think we need to honor our past and we need to make sure we recognize it for what it was.
And that we reclaim our natural place in this world.
I hope that answers your question.
>> Can I add a little bit to that?
Some of that comes out of our real concern and worry about medical innovation of us and
of our historical trauma.
And the victim mind set people worry and I know I have heard this from my own elders
worry we will take on.
And so it comes out of a good place of concern for the people to not take a victim mind set,
that's internalized colonization so there is sometimes when I look at these challenging
questions from our community, we have to remind ourselves a place of not only hurt but really
deep love and concern for our people.
We reframe it.
If you go back to original teachings in this moment, we talked about this, this moment
I am my grandmother's ancestor and I'm my grandmother's granddaughter.
In this moment I'm my great grandmother's grand daughter.
I'm impacting not just me but the next seven generations, if I take care of health right
now, I not only impact the next seven generations I have the opportunity to take care of -- what
I'm carrying in my body from seven generations before.
What a powerful place to be.
Not a victim mind set at all to acknowledge anything we're carriening our bodies so when
we frame it that way our communities go a ha.
Okay I work with that.
It is a way to buffer against colonization and becoming medicalized pathologized people
in systems of care.
And so we have to honor and recognize that.
It makes me think of something, the that's the issue of resill generals, there's a -- resilience
and there's a lot of discussion in tribal communities focusing on resilience.
I agree with that but a word of caution is that we have people who are suffering and
they don't feel resilient.
When you overemphasize like you only get to talk about your resilience, you're shutting
down people and they feel more isolated, more shamed more depressed because then they can't
talk about having suicidal thoughts.
So we also have to work with our people around making talking about suicide okay.
They are protections put around that because we have certain spiritual practices and teachings
where words carry energy but if somebody needs to talk about something, you can smudge, put
up protection.
It's okay for them to do that and they can have help with it.
People get on the resiliency band wagon, it shuts down people in the community that really
need to have people listen and hear and not feel ashamed of how they feel.
Otherwise they're not going to get help and they may then kill themselves.
Suicide is very complicated.
>> I want to say something on resilience as well.
We have to remember resilience comes in bits.
It's not -- I wake up one day, everything is wonderful and perfect and I'm 100% okay,
sometimes I woke up today.
And that's resilience.
And too often when we look at groups of people, we say they're resilience because they have
overcome this and like you said, there's things that we overcome every day and we have to
remember when talking about resilience, it's in pieces and particularly with elders resilience
can be overcoming that one moment of loneliness and reaching out and going across the street
or getting the mail.
So when we talk about that, keeping in mind that it's not always some big beautiful fantastic
thing which sometimes it is, that's wonderful when it is.
But it's also opening my eyes, putting my feet on the ground and standing up one morning.
>> Thank you.
Another question out mere?
>> Hi, my name is Dustin, I'm from native American lifeline in Baltimore an Boston,
some of o our other staff is here.
First on behalf of myself thank you for research, how much you contributed to the community
and also coming out here today.
But my question is really so for both of our centers we operate with urban Indian populations
which are very difficult, very diverse, we're trying to update cultural programming and
again trying to foster resilience especially with our youth populations who have extremely
high rates of substance use.
Historical trauma and also really family history of very difficult intergenerational trauma.
But in terms of developing cultural programming, one area we're running into for Indian urban
population is having diverse tribal group.
I wanted to see if any of you have any thoughts or recommendations for how to have good cultural
programming when you have folks from a lot of different tribes.
>> I worked at Denver for a number of years so Denver is a very rich community in terms
of tribal diversity.
Certain groups are more predominantly represented in Denver.
There's urban programs in Albuquerque, there's vital programs in California.
Some of the things is getting as many people together to have input on any design so you
have multiple tribal groups recognized and included.
And then coming to terms how are you decide something naming a program, if you want to
use the traditional name that becomes a big issue.
Whether you use a medicine wheel or not, even within the same tribe, there are differences
in terms of colors an direction depending who you talk to, what healer you might follow
or naming your traditional laws.
Getting voices in and building consensus about what would be respectful to all tribes they
can agree on so part of the manual would have certain a product with certain colors or similar
bombs that represent that tribe, having different tribal language represented in different parts
of curriculum.
And really acknowledging that.
And looking at commonalities.
So I think of a good example, where some tribal communities they have a feast and have it
outside and like in the Southwest what they might do is actually share through both of
share food by distributing it or maybe tossing fruit or something like that.
And people scramble for it.
In the northern planes if you went to scramble for something being given, that's very rude.
What's behind that, we get caught up in surface differences but what's behind is the same,
you're feeding and giving to the people so trying to find out what are the common ways
even though we might express them differently and we often get caught in those differences.
As a person born and raised in Hollywood, California, I'm a real Hollywood Indian.
I think it's critical that we do some urban programming and I agree with Maria.
Finding the meta categories, that are shared and encouraging use to discover and try the
get connected with elders in the tribe and communities so they can do both and.
And the biggest thing for urban Indian natives that I have seen and experience even as urban
native youth growing up in Hollywood California, it's a sense of belonging.
As we talk about identity, how much internalize negative attitudes about native person or
Choctaw, whatever, your group is, and how much you buffer against that, what have parental
love and support do you have around you.
Not just parents, of birth but parents in the community aunts and uncles and others
who are there for you.
The biggest difference I had around being stronger in my identity wasn't my own family
but it was -- that I was hanging out with in LA.
LA is a very southern Oklahoma oriented culture down there.
Again meta categories how do you honor somebody, how do you ensure that elder an children are
fed.
How do you show respect.
How do you show respect for yourself and others.
Those things, Maria surfacing, we get hung up on the protocols.
Which cut across tribal groups.
Not pan Indian, take other people cultures and put them and mix them in a salad bowl
and say we got something going on here, we don't want to do that but to acknowledge the
differences but at the same time celebrate the commonalities that we have and encourage
you to discover what is their tribal way of being.
What do we know, is there an elder in the community who is -- can help this young woman
out.
Those things.
Then you got spirit youth, you got other elements there becoming who they're meant to be whatever
that is.
So there's lots of layers there.
We have a lot of who end up in Seattle because LGBT and they left home and they're on the
streets who are native.
So there's a -- you got other levels of stuff we had to deal with in urban areas.
>> I would agree, finding the commonality but I also think it's celebrating the differences.
And learning about those differences, even if not your tribe.
I learned something new all the time.
So I have a Mohegan frame of reference but we're not taught American Indian history.
Anywhere.
Except through our interactions.
That's really important, I would love to see a national curriculum, when I was taught the
gold brush I didn't realize 500,000 native people in California perished in the space
of 30 years.
So I know what happened to James town and I know what happened -- so I think it's celebrating
those differences too and you're right.
We shouldn't get too hung up because some tribes the children get fed first and other
tribes the elders get fed first.
So I think it's helping all native youth explore number one what's unique to them.
, what's unique to the other tribes and gain this awareness and celebrate that.
>> It's not like we haven't shared.
That's the other thing.
Part of colonization is creating silos, indigenous silos because we start to get protective.
For survival reasons but the reality is, we shared medicines, we share foods, trade, we
traded goods.
We shared.
But it was on our terms.
So that's the element.
>> I agree.
One of the nicest examples of that sharing is the fact that friends of mine mow hack
chief Dr. Beverly cook.
They have an alligator dance.
Not sure there are alligators in upstate New York, right?
So that's a great example of that, helpful sharing that happened so long ago.
>> That came from us.
>> Could have.
>> Wonderful.
Thank you.
We have couple of folks here, you had your hand up a little bit ago.
Go ahead.
>> Thank you so much, it's so relevant.
My name is Andrea (inaudible) from NIMH.
Chief of the mental health disparity this is of the office of research for global mental
health and we just had like a presentation of Dr. David Wilson, chief of the tribal office
in NIH and we were just talking about how important it is to address trauma.
He was talking to us about it.
I want the share with you, I cannot share much but we are just going to be -- it's still
a month or so, a new collaborative hub that NIMH is funding for supporting to reduce burden
of suicide in American Indians communities.
And it's -- one of the issues that we have been talking with about with respecting IRBs
and talking to them about data sharing, the importance for them and for us to as a scientific
community, as a community trying to understand and learn with them and learn from you what
are the needs are what are the concerns are and how important it is also when we have
the data that we can also understand so much more for their community.
So I think it is an ongoing communication, two ways respecting both sides and trying
to learn from each other.
It's a relevant very relevant and thank you so much.
>> Quick question.
I'm with women heart, the national coalition for women's heart disease, I'm very excited
about your findings and what we know about what causes heart disease, how far back it
goes.
Wondering if you can talk about your experiences with forgiveness.
And with all the trauma what works, what doesn't work.
With hear disease, it's a disease where there is a sense your decision created some of the
situations.
Im's paralyzing to people from moving forward.
>> I will start.
One of the important parts of aging and dying is forgiveness and for giving not only others
but yourself.
As you go through the dying process there's a point in time we internalize and close our
eyes as we're getting close to that next journey and we start almost like a film watching our
life.
And if we don't have the power to for give forgive ourselves or other, I have watched
people toss and turn and moan and grown because as they're going through this, and everybody
does, they suffer.
So part of looking at trauma, ahead of that moment in time in life is saving our elders
and ourselves from that traumatic journey to through death.
Part of that is what we're doing now and what we're doing for our children.
Is saving us at that vulnerable difficult moment and saving the people we love.
Because it's difficult to watch someone you love who is already passing, who you're also
emotionally really difficult place, and watch them suffer and cry and cry out because they
are looking for that forgiveness.
So I think that that's one of the things that forums like this are critical in the life
span looking at that, changing it and making it better.
>> I would like to go back to our understandings through our tribal creation stories.
And if you consider each tribe may have multiple creation stories.
And along with most tribes they also have tricksters.
Through those stories it talks about different human emotions and different challenges and
different ways of making decisions and different consequences, so there's things that can be
learned from these gracious stories from the tribal creation stories.
A sense of belonging too and within the creation stories it has about passing on or over I
should say, passing over those feelings.
It talks about that if trickster does something to you then you look beyond that.
You don't get caught up in it.
So there's different creation stories, forgiveness has been part of the many tribal creation
stories there's lessons to be learned by how -- we each treat each other or how the animals
treat each other.
How elements come together and how if we're disrespectful of the elements the consequences
that come, and then it's making amends.
When we look at ceremony, a lot is making amends.
So you make amends and you -- that's why again why we get naming ceremonies, why we have
acknowledgments.
Why we take relatives, it's making amends and making sure that you're in a good place.
I remember with my husband, he would -- he said the Cheyenne way is if you're fighting,
you never leave the person.
You stay until that was a teaching, it wasn't always in practice, we have values and then
we have practices.
Everyone knows we should exercise but who does.
We have the values and then we have the practices.
That you never left because if you left when there was some kind of conflict of disagreement
going on, that person would have a hard time for giving.
So in in all ways in many teachings and creation stories, is about for giveness, reconciliation,
making amends.
>> Quickly -- that's a rich topic.
I think at least one question before we are out of time here for virtual audience.
Relates to how trauma impacts the body, persons therapists trained in traditional talk therapy.
But realize the limitations of that and deeper healing work and wonders about some of y'all's
thoughts on healing trauma through the body.
Adventure kinds of things but other sorts of -- and I think ceremony gets at that.
Talk therapy is good but others to add from mental health toolbox but also from our cultural
toolbox.
Another rich topic to get to that briefly, it would be good.
>> I think for me personally because I started tradition and did psychoanalytic training
that I valued.
Part of that training means you go through your own therapy.
That is valuable and rich and What's ooh behind it is you don't -- you want to be as helpful
to the person you're working with as possible and stuff is going to get triggered.
So if you're not dealing with your own issues, then you could even possibly be harmful to
a person.
So I always recommend that.
But I also feel like it was very important was being going to ceremonies and being in
ceremonies approximate healing so it's not either or, it's both and.
And I think that in terms of how I practice, I'm still doing clinical work, I say a lot
of prayers.
In the session to myself, and I kind of see my ancestors around me, who are helping me,
that I want to help this person and actually prayed about that one time in a ceremony.
And was told that a certain spirit would be with me, which was something related to wounded
knee.
So I really believe we're working on multiple levels.
And that's -- when you do one thing you're working on multiple levels but I feel like
multiple types of intervention.
So some of the people that I see are really good about using other resources.
I'm not talking formal resources necessary will I but community resources having ceremonies,
thing like that, that'sling helpful.
One thing that I would think a caution as a clinician you have to know how the person
is feeling, what that I believe because I have seen somebody recommend a ceremony to
someone and it backfired because that person was conflicted between their specific denomination
in this instance was Catholic and raided in Catholic boarding school but from a traditional
community.
And I knew when I heard that recommendation, this person was not ready to hear that.
So you have to be careful that you're never imposing and just I'm wondering and you can
buffer a question by saying can I ask a question.
I never had anybody say no because they're curious but it buffers it so it makes it a
little more palatable to talk about something.
So those are just the thoughts that come to mind.
That's all important.
Work.
>> And I think to go on that topic too, sometimes it's a physical, it's a physical response
that sometimes is helpful so whether drumming, dancing, sweat lodges, connecting with your
community in a different way but also physically connects to your history.
So I don't think it needs to be either or.
It is both and that's a good thing.
We all live with a foot in both worlds.
Not one of us is strictly traditional versus not.
We all live in both worlds so it's important to make sure that we're doing more holistic
approach to things rather than just one or the other.
>> Ann dickerson's work around drumming and native use in southern California, that helps
with a sense of self-regulation as well as connection to culture.
Anything that works often works on multiple levels.
That's what y'all are saying, is so true.
>> I would say also I agree, I don't think it's either or situation.
I agree that you want to meet folks where they are.
But one thing I want to say about historical trauma, the impact is disconnection from your
own body.
And part is becoming embodied again and getting connected to how historical trauma.
So we do talk therapy sometimes people forget to connect back to actual physical body.
And I think we have underutilized opportunities for doing settings based interventions where
we're outdoors, we're in natural environments, we're in light.
We're in plant element.
This is where you can get also on another spiritual level connecting back with your
body.
And into that environment.
And we rewalk the trail of tears so tuck about getting back into the historical trauma environment,
but again it's reconnecting to that environment but not with staying in the drama but we get
women to this pipe of readiness for this, we don't just go oh let's walk the trail and
afterall, never be falling apart.
By the time we're ready we get there and they're going to for purpose to the environment which
is to vow to become healthier so they rewalk that to footsteps to reconnects to vision
of life they held for us.
And promised for us.
So now they're reconnecting to the vision of life in for the next generations so a way
of reframing.
But again, we had to get them to that point to that place.
You want to honor suffering or whatever things people had hoe but getting back to your body,
and into settings based interventions, whether parks schools green spaces especially for
kids, being in green space, all these things is I think really powerful because indigenous
people what we have in common mere is relationship to land, relationship to place that have deep
spiritual ties for us.
That's critical.
Even urban kids, looking -- I found this -- outside my door.
In Seattle.
I was like hey look at that.
You never know urban setting you can do cool things.
>> I just want to tie in to what she's saying, because when we think about what ceremony
was about or is about, it's about self-discipline.
It's about having an understanding of your mind your heart, your body, your place, your
connectedness.
It's about sacrifice and it's about service.
And it's about teaching and learning.
And that's about self-discipline.
So ceremony really taught self-regulation.
And one of the things that we see with trauma, is that people become disregulated.
So we have all of these understandings through our teachings that are old, old, old, that
tell us about self-regulation and managing how we think, how we feel, how we interact
with one another, what we value, what we honor.
And it is to help us be the person we need to be or be the individual spiritual being
that moves these understandings forward.
So really, it comes right back to self-regulation.
And it was -- it's an old knowledge.
So as we think what is helpful, all the things that we have had in the past were helpful
as we confront the disruptions that are impacting our children and our families.
>> Added to that, we have a strong capacity for delaying gratification, and impulse control.
>> Except around chocolate.
>> And humor.
But we traditionally very evolved, very high functioning people so we need to remember
that.
Because we are often getting messages that you guys are all screwed up and you can't
do anything right.
And our traditions we have ha lot of disciplines so I'm glad you made that point.
>> I want the make one very fast comment.
Nature heals.
And so being in nature is healing.
Dr. Walters said this a moment ago, it's about place and especially native people, it's about
place, and that's part of trauma, they were displaced.
So bringing people back to their place or explaining where their place is critical in
healing any kind of trauma.
Whether talking about it showing pictures or going into it.
>> So with that, I wish we could keep going all afternoon because the discussion is so
rich but we're also past the noon hour here on the East Coast.
Appreciate everyone who joined us.
Key take home points, trauma is a universal human experience, not unique to us as native
people.
We just had a lot of it but not unique.
Traumatized parents transmit trauma to children which is enter-generational trauma.
Some group experience trauma over long time and that in a sense is what's historical trauma
relates to.
And that has consequences for health mental health and these other outcomes.
Ongoing trauma is a poverty security food discrimination.
Reduce trauma and effects and those interventions and this is a key point that you have been
hearing in terms of grant programs or research.
It can have RCT western science evidence or thousands of years of native wisdom an tradition.
And as we're looking at ways of healing, we need to bring all of that wisdom to the table
as well as western science which is also important.
And that we as federal employees and agencies do support and partner and we need to with
our tribes they lead in heeling of communities.
And indeed we have much to learn from those communities so with that I want to ask you
to join me in thanking our amazing group of panelists.
[Applause] And acknowledge the white house council Native
American affairs SAMHSA, IHS and also the national health board for making this possible
and thank you particularly for joining us here in the room and virtually.
Thank you very much.
Have a great day.
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