Native American Psychology

By Timothy C. Thomason

The purpose of this book is to provide information that will help service providers understand the psychological concerns of Native Americans and provide effective counseling and psychotherapy for them. The book addresses a wide variety of topics, including assessment and diagnosis, culture-bound syndromes, best practices in counseling and psychotherapy, and related topics. Some chapters analyze how traditional healing methods work from a psychological perspective, and others consider the work of Carl Jung and Milton H. Erickson in relation to traditional Native American healing. Some of the chapters address conceptual and clinical issues, while others report the results of research by the author and others. The book contains many specific recommendations regarding how to provide culturally appropriate services for Native Americans.
Native Americans hold a special position among the ethnic groups in the United States, because they were living on the North American continent thousands of years before any other people arrived. The Native population is extremely diverse, with 574 federally recognized sovereign tribal nations, 334 reservations and trust lands, and over a hundred different languages. Although most Native Americans live in urban, suburban, or non-reservation rural areas, about 22% live on tribal lands, where many of them live in housing without running water or electricity. While a description of the problems and challenges Native Americans face can be discouraging, the population also has many protective factors. Resources common to most Native American communities include strong family bonds, identification with tribal history and the local culture, spiritual beliefs, and respect for the wisdom of tribal elders. Given the history of how Native Americans have been treated, and present-day neglect by the government, they exhibit remarkable adaptability and resilience. There is a strong drive to promote the well-being of the group and a willingness to participate in many different ways of healing. Although the number of traditional Native healers is declining, they are still able to provide valuable services and are utilized by many Native Americans who live on or near tribal lands.
This book reflects a personal and professional perspective on the topics discussed, based on many years of experience with Native people in Arizona and nationwide, but with no claim to speak for Native people. The recommendations made in this book draw on the professional literature on Native American psychology, the opinions of Native experts, and conceptual articles, literature reviews, and original research conducted by the author. It is hoped this book will make a modest contribution to the body of knowledge on this subject, with the ultimate goal of improving the psychological health of Native Americans.

• Language: English
• Publisher: BookBaby
• Release date: Jun 1, 2020
• ISBN: 9781098314088

Book preview

© 2020 Timothy C. Thomason

All rights reserved. No part of this book may be reproduced or utilized in any form by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the author.

Print ISBN: 978-1-09831-407-1

E-Book ISBN: 978-1-09831-408-8

First Edition

Contents

Introduction

Counseling and Psychotherapy with Native Americans

Clinical Psychology and Native Americans

Diagnosis of Native American Culture-Bound Syndromes

Carl Jung’s Encounter with Native Americans

Ritual Healing as a Form of Transpersonal Psychotherapy

Altered States of Consciousness in Native American Healing

The Medicine Wheel as a Symbol of Native American Psychology

Navajo Psychology and Herbology

Milton H. Erickson and Native American Healing

Best Practices in Counseling Native Americans

Psychological Assessment and Diagnosis with Native Americans

Counseling Native Americans: Theory and Process

Resources for Counseling Native Americans

An Introduction to Counseling Native Americans

Recommendations for Counseling Native Americans

Counseling Native American Adolescents

Counseling Native Americans With Alcohol Problems

Depression and Older Native Americans

Competencies for Counseling Native Americans

Recruiting Native American Students in Psychology

Books About Native American History and Culture

Author Publications on Native American Psychology

About the Author

Walking in Beauty

Closing Prayer from the Navajo Blessing Way Ceremony

In beauty I walk

With beauty before me I walk

With beauty behind me I walk

With beauty above me I walk

With beauty around me I walk

It has become beauty again

It has become beauty again

It has become beauty again

It has become beauty again

Hózhóogo naasháa doo

Shitsijí’ hózhóogo naasháa doo

Shikéédéé hózhóogo naasháa doo

Shideigi hózhóogo naasháa doo

T’áá altso shinaagóó hózhóogo naasháa doo

Hózhó náhásdlíí’

Hózhó náhásdlíí’

Hózhó náhásdlíí’

Hózhó náhásdlíí’

Introduction

The purpose of this book is to provide information that will help service providers understand the psychological concerns of Native Americans and provide effective counseling and psychotherapy for them. The book addresses a wide variety of topics, including assessment and diagnosis, culture-bound syndromes, best practices in counseling and psychotherapy, and related topics. Some chapters analyze how traditional healing methods work from a psychological perspective, and others consider the work of Carl Jung and Milton H. Erickson in relation to traditional Native American healing. Some of the chapters address conceptual and clinical issues, while others report the results of research by the author and others.

Native Americans hold a special position among the ethnic groups in the United States, because they were living on the North American continent thousands of years before any other people arrived. The European colonists and their descendants eventually spread all the way to the Pacific Ocean, killing or displacing almost all of the indigenous population, which was reduced from several million to about a quarter of a million people. Gradually the population increased, and now almost three million people identify themselves as Native American alone (about 1% of the total population of the U.S.). Another two million people say they are Native American in combination with one or more other races. These figures are based on U.S. Census statistics, which simply rely on self-report, and they include many people who claim Native ancestry but are not registered in any tribe or participate in any tribal activities.

The Native population is extremely diverse, with 574 federally recognized sovereign tribal nations, 334 reservations and trust lands, and over a hundred different languages. Although most Native Americans live in urban, suburban, or non-reservation rural areas, about 22% live on tribal lands, where many of them live in housing without running water or electricity. While a description of the problems and challenges Native Americans face can be discouraging, the population also has many protective factors. Resources common to most Native American communities include strong family bonds, identification with tribal history and the local culture, spiritual beliefs, and respect for the wisdom of tribal elders. Given the history of how Native Americans have been treated, and present-day neglect by the government, they exhibit remarkable adaptability and resilience. There is a strong drive to promote the well-being of the group and a willingness to participate in many different ways of healing. Although the number of traditional Native healers is declining, they are still able to provide valuable services and are utilized by many Native Americans who live on or near tribal lands.

The diversity of Native Americans makes studying mental health among this population challenging. There is no single Native American perspective on health, mental health, or healing practices. How could there be, since the term refers to several hundred distinct tribal communities spread over an entire continent? So any generalizations about what Native Americans think should be viewed with skepticism. Service providers should understand that individual Native Americans they encounter may not fit any of their preconceived ideas about what Native people are like. Although members of collectivist cultures tend to have stronger family and group bonds than members of individualistic cultures, they still exist and function as individuals, and research suggests they can benefit from individual counseling and psychotherapy, in addition to family, group, and network therapy.

To some extent applying European American theories about psychology and mental health to the indigenous inhabitants of the continent is inappropriate. As a field of study psychology is only about 140 years old, and most psychologists have been European or European American. The assumptions of Freud, Jung, Adler, Rogers, Beck, and the other psychological theorists who developed the profession of psychotherapy may simply not apply very well to people who live in other cultures. However, if psychology is defined broadly as the study of the psyche (mind), then philosophers since ancient times in many cultures have expressed their ideas about human psychology. Obviously Native Americans throughout their existence have had their own ideas about how the mind works, but because they had a rich oral tradition rather than a written history, it is difficult to know how Native people in past centuries thought about psychology. However, clues can be found in a study of traditional healing practices, and they suggest specific ways that psychotherapy can be adapted to the needs of Native American clients.

Today Native Americans span a range of acculturation, from very traditional to very modern. The most traditional Natives are more likely to benefit from seeing traditional healers when they are ill, but contemporary models of counseling and psychotherapy have great potential for helping Native people who are less traditional. Many Native Americans see both traditional healers and non-Native health service providers at hospitals, clinics, and counseling centers. It is essential that counselors and psychologists learn how to make their services culturally sensitive and appropriate for their clients, and thus more effective.

Although the people of the many different tribal nations have various ideas about mental health and healing, some generalizations are common in the literature. Many traditionally-minded Native Americans take a holistic view of the human being, and may not see mental health as separate from physical health or social health or spiritual health. They may not always distinguish between physical complaints and psychological concerns. They may also express emotional distress in ways that are not consistent with the standard diagnostic categories used in psychiatry and psychology. There may even be some mental disorders that are only found in Native American communities (all cultures are thought to have some culture-bound conditions). These factors can make it challenging for counselors and psychologists who are not Native American to provide effective services, but research shows that it is possible. Although the amount of empirical research on what works with Native American clients is very limited, there are plenty of clinical reports, expert opinions, case studies, and survey research reports. One of the goals of this book is to summarize the quantitative and qualitative research that describes culturally appropriate and effective approaches to counseling and psychotherapy.

Most Native Americans who have mental health problems seek services from non-Natives, simply because there are so few Native American psychologists, counselors, and related mental health professionals (and there are even fewer traditional Native healers). There are probably less than 500 Native American psychologists and mental health clinicians in the country, or roughly one per 6,000 people who identify as Native. This means that the great majority of Native people who need assistance will be served by non-Native people (mostly Whites). It is easy to recommend that mental health providers learn as much as they can about Native Americans, but with 574 tribes across the country, the reality is that most providers will only get to know those Native people who live nearby and seek services. This is why it is important for non-Native psychologists and counselors to understand how to provide effective cross-cultural counseling with Native people. Learning enough to provide culturally sensitive and appropriate psychological services is a challenge, but this book provides a foundation for that work, and includes many suggestions for further reading and other resources.

Much has been written about what the native inhabitants of the North America continent should be called. Regarding ethnic designations, in this book the terms Native, Native American, Indian, and American Indian are used interchangeably to refer to all indigenous peoples of the United States and their living descendants. There is no consensus about the best name for this population even among the indigenous people of the continent, with about half preferring the term Indian or American Indian and the other half preferring Native American. Any global term has the disadvantage of implying that all members of the group think or behave the same way, whereas we know that diversity is a hallmark of this population. When specific individuals or tribal groups are described the designation preferred by that person or group is used (e.g., Navajo, Hopi, Apache, etc.).

This book reflects a personal and professional perspective on the topics discussed, based on many years of experience with Native people in Arizona and nationwide, but with no claim to speak for Native people. The recommendations made in this book draw on the professional literature on Native American psychology, the opinions of Native experts, and conceptual articles, literature reviews, and original research conducted by the author. Readers who are interested in deepening their understanding of this topic are encouraged to explore the references to the literature contained in each chapter as well as the list of recommended readings. It is hoped this book will make a modest contribution to the body of knowledge on this subject, with the ultimate goal of improving the psychological health of Native Americans.

Counseling and Psychotherapy with Native Americans

Introduction

In 1492 the Italian explorer Christopher Columbus encountered the now-extinct Arawak people on one of the islands in what is today the Bahamas. He called them los indios , and the term Indians continues to be used to refer to the indigenous peoples of the Western Hemisphere (Trimble & Thurman, 2002). Many contemporary Indian people prefer that term to Native Americans, but both terms are in common use today (Greenberg, 2013). At the time of Columbus’s landing it has been estimated that there were four to ten million indigenous people on the North American continent, but by 1900, only about 250,000 remained (Grandbois, 2005).

The experience of Native Americans was different from that of all other ethnic groups who live in the country now. The indigenous peoples of North America had lived on their lands for thousands of years when Europeans colonized the continent, bringing wars and diseases that dramatically reduced the size of the Native population. Millions of the Natives died from smallpox, measles, typhus, cholera, scarlet fever, flu, and other diseases for which they had no immunity. It has been estimated that from 75% to 90% of the indigenous population were killed by diseases, far more than were killed by the gun (PBS, 2020). It may have been the greatest demographic disaster ever. Over time the colonists seized the land of the inhabitants and treated them as an obstacle to their westward expansion. Sometimes hundreds of Indian men, women, and children were killed, as in the massacre at Wounded Knee in 1890. Eventually most tribes lost their traditional lands and were forced to relocate. For example, during the 1930s over 125,000 Indian people from various tribes in the southeast were forced to leave their homes and move to a reservation in Oklahoma (Sue & Sue, 2003).

Government agencies implemented a policy to forcibly assimilate Indian people into the dominant society. Many Native children were removed from their families and placed in boarding schools, where they were forbidden to wear their traditional clothes, speak their language, or see their families. This policy of attempting to civilize the Indians by moving them to boarding schools continued well into the 1950s (Trimble & Thurman, 2002). The forced removal of Indian children from their homes and their placement with non-Indian families continued until the passage of the Indian Child Welfare Act of 1978. These experiences disrupted family and tribal cohesion and prevented the transmission of traditional cultural values from parents to children.

Were Native Americans the victims of genocide? Lewy (2004) made the case that the dramatic reduction of the Native population was not deliberate, since the Europeans did not come to the New World in order to infect the Natives with deadly diseases. Dunbar-Ortiz (2016), on the other hand, made the case that the military actions and forced removals of Native people (after the great losses due to disease) amounted to an effort to exterminate them, even though a significant number survived. Many Native authors assert that there is no doubt that the Native American population experienced genocide, and that any other opinion is simply an effort to deny responsibility (Churchill, 1997; Duran & Duran, 1995). Regardless of whether the term genocide is justified, no one disputes the fact that the European colonists, the settlers who moved west, and the U.S. government contributed to the devastation of the traditional indigenous population on the continent.

Over 300 treaties made with Native Americans by the U.S. government regarding housing, education, and health care were not honored (Richardson, 1993). The long history of broken treaties demonstrated to Indian people that the U.S. government could not be trusted, and the seizure or misuse of tribal land, and battles over fishing and hunting rights continue to the present day. While most Whites who are alive today probably feel little guilt about how Indian people were treated in past centuries, they should understand that Indian people who are suspicious of the intentions of Whites have good reason to be so. Non-Indian counselors and psychologists may be seen as representatives of governmental agencies or institutions, so they cannot assume that Indian people will just assume they are trustworthy.

Native Americans Today

Almost three million people identify themselves as Native American alone, and about 2.3 million more people say they are Native American in combination with one or more other races (U.S. Census, 2011). Because these figures are based on self-report, there is no way to know how accurate they are. It is difficult to know how many Native Americans there really are, because there is no one definition of what it means to be Native American. Is it a matter of genetic heritage (blood quantum), subjective identification with the culture, active participation in tribal activities, official registration with a specific tribe, or some combination of these factors? Various governments, organizations, and tribes use different criteria. Many tribes base membership on blood quantum in addition to having a documented connection to an ancestor who was registered by the tribe.

Although the number of people who self-identify as Native American has increased steadily over the past couple of decades, many of those people are not actually registered members of any tribe. Due to intermarriage with non-Natives, the number of people who identify strongly with traditional Native communities has decreased, and this trend is not expected to reverse. Well over half of Native Americans marry a person of another racial/ethnic group (Ahtone, 2011). Although the ethnic group will survive, eventually there will be very few people who are registered with a tribe, speak a tribal language, and actively participate in tribal ceremonies and traditions. Such ethnic dilution occurs in many groups, and may be an inevitable result of living in the modern world, where people are free to make their own decisions about how to live, and there are many strong influences from outside the traditional culture.

It is convenient to refer to Native Americans as if they are a homogenous population, but they are more like a mosaic of different Indian peoples. There are 574 sovereign tribal nations which have a formal nation-to-nation relationship with the U.S. government, and there are 334 Indian reservations. The total land mass under Native American control would make Indian Country the fourth largest state in the U.S. The Navajo Nation by itself would be the 40th largest state by land area (National Congress, 2019). Alaska is the state with the highest percentage of Native residents (14%). The Cherokee Nation has about 370,000 members and the Navajo Nation has an enrolled population of about 300,000 people (World Population Review, 2020). The next largest tribes are the Choctaw, Sioux, Chippewa, Apache, Blackfeet, Iroquois, and Pueblo. About one-third of all Native Americans live in three states: California, Arizona, and Oklahoma.

About 60% of Native Americans live in metropolitan areas; another 22% live on reservations or other trust lands, and 18% live in non-tribal rural areas (Whittle, 2017). So, contrary to a common stereotype, more Native Americans live in urban areas than in rural or reservation areas. Indian people are, of course, free to live wherever they wish, and many of them move from rural areas to urban areas seeking education or work. About 28% of Indian people speak their Native language rather than English at home. About 77% of Indian adults have at least a high school diploma; 13% have at least a bachelor’s degree, and 4.5% have an advanced graduate degree (Office of Minority Health, 2020).

A common misconception is that most Native Americans are rich because they receive profits from gaming at casinos on Indian lands. An example of a tribe that has done quite well is the Shakopee Mdewaknton tribe; each of the 480 adult members receives a million dollars per year from casino profits, making them the richest tribe in American history. But this tribe is an exception. The tribal casino business has stopped growing, and most tribes have no casinos at all (Williams, 2012), so the members of most tribes receive no income from tribal casino profits.

The average life expectancy of Native Americans trails that of other Americans by almost five years. Native Americans make up about 4.5% of the population of Arizona, but when the novel coronavirus struck in 2020, at least 20% of the people in the state who died from COVID-19 were Native American (Rettner, 2020). Native Americans have the highest poverty rate of any racial/ethnic group in the U.S., and unemployment among Indian people is a significant problem, especially in reservation and rural areas. In 2019 the overall unemployment rate of Native Americans was 6.6% (Bureau of Labor Statistics, 2020). Many young Indian people move from rural areas to urban areas where more jobs are available, but this often results in broken ties with tribal culture back home. Poverty is an issue for a significant minority of Native Americans; 28% of them live below the poverty level, compared to 10.6% of non-Hispanic Whites. The median family income for American Indians is $35,000, compared to $68,000 for non-Hispanic Whites and $50,500 for the nation as a whole (U.S. Census, 2012).

Native Americans are American citizens and can access education, health, welfare, and other social service programs available to all citizens. They pay taxes, are subject to U.S. laws, and serve in the Armed Forces. Native Americans serve in the U.S. Armed Forces at five times the national average and have served with distinction in every major conflict for over 200 years. In fact, Native people have the highest per-capita involvement of any ethnic group to serve in the U.S. military (NICOA, 2020). In World War II, about 25,000 American Indians served the U.S., and 41,500 served in Vietnam (and five received the Medal of Honor). About 3,000 served in the Persian Gulf, Iraq, and Afghanistan and currently there are more than 24,000 Native American active-duty service members (U.S. Census, 2012).

When many Indian veterans returned from World War II, they were upset that they were not allowed to vote. Suffrage rights were eventually granted, but Indians could still not vote in New Mexico and Arizona as recently as 1948 or in Utah until 1956 (Chavers, 2012). Native Americans belong to many different political groups and parties. Due to the relatively small size of the Native American population in the U.S., in the past most politicians have paid little attention to the concerns of their Indian constituents. Historically, Native Americans have some of the lowest voter turnout rates of any ethnic group in the country (Adams, 2019). Many are more interested in local than national issues, and obstacles to voting include polling locations that are not convenient for Indians living in remote areas and gerrymandering. In only three states are Indians more than ten percent of the total population, and in some states the majority of the Native people are not registered to vote (Chavers, 2012). Overall, only 40% of eligible American Indians were registered to vote in 2008 (Blades, 2012).

Although the Native American influence in American politics is weak, in 2012 there were 85 Native American elected officials in the U.S. (Pelosi, 2012). Since voting is a private matter, statistics on the actual voting record of Native Americans are not available, but many observers say they tend to vote for Democrats (Brown, 2008). Chavers (2012) stated that up to a million Indians voted for president in 2008, and although most Native Americans are socially conservative, a majority of those who stated their vote indicated that they voted Democratic (Ahtone, 2008). However, there are significant numbers of Republican voters among Indian people in some areas, such as Oklahoma, and the best known Indian senator, Ben Nighthorse Campbell, from Colorado, switched his party affiliation from Democrat to Republican. There are groups such as Conservative American Indian Republicans and the American Indian Tea Party. According to Ullmann (2008), neither Democrats nor Republicans have a great record on Native American affairs. Giago (2008), an Oglala Lakota and editor of Indian Country Today newspaper, suggested that Indian people should get together and form a Native American Party, since neither of the dominant parties appeal to all Native Americans. As in many other areas, Native Americans have various political opinions and values and cannot be characterized as adhering to one particular political agenda or party affiliation.

Historically, Native American religions exhibited a great deal of diversity, and have often been described as similar to animism or panentheism (the idea that the divine pervades every part of the universe). It has been estimated that only about 9,000 people still practice traditional Native American religions (Richardson, 2004). Most of the people from Europe who colonized North America were Christian, and missionaries imposed Christianity on the survivors of the invasion. Many Native Americans incorporated Christian beliefs into their Native religions, resulting in what has been called a bewildering range of idiosyncratic forms of Native Christianity (McNally, 2011). Although today they could go back to traditional beliefs and practices if they wished, the vast majority of Natives still identify as Christian. The type of Christianity practiced in many Indian communities has been characterized as fundamentalist in theology, conservative in practice, and often evangelical (Neusner, 2003). It has been said that Jesus himself is Native American, based on Pope John Paul II’s declaration that Jesus Christ in the members of his Body is himself Indian (Peelman, 2006, p. 13). The Native American Church, which uses peyote in religious ceremonies and incorporates many Christian beliefs, was incorporated in 1918 and has chapters in all of the Western states, with a membership of about 250,000 people (Fikes, 2012).

Based on the Pew Forum (2008) survey on religion it can be estimated that about 70% of Native Americans in the U.S. identify themselves as Christian, 9% belong to other religions, and 20% are unaffiliated, agnostic, or atheist. It is clear that the majority of people who identify themselves as Native American also identify themselves as Christian. Some Whites may think it strange that so many Indian people identify with the colonists’ religion rather than with their own traditional religions. A commenter in Indian Country Today (Jay, 2013) asked Why do the indigenous worship the same white man’s god whose name is invoked to legitimize the theft of the indigenous people’s resources and lands for colonization and exploitation? However, the phenomenon of identification with the oppressor has been well established (Freire & Ramos, 2000). Indian people may have adopted Christianity as a survival mechanism, and some Indian people probably retain it mostly due to tradition. Like everyone else, Indian people today are free to choose their religion and adapt it or practice it in any way they see fit, and about one-fifth of them are not religious at all.

Social Issues

As a group, Native Americans are generally described as conservative regarding social issues such as abortion, gun control, and same-sex marriage. Since the majority of Native Americans identify themselves as Christian, their opinions on abortion parallel those of conservative White Christians. However, there are exceptions; in some tribal cultures, such as the Lakota, each woman is expected to make her own decisions about family planning such as contraception and abortion (Ehrich, 2006).

Regarding gun control, Native Americans were of course victimized by the colonizers’ use of guns. Often the Indians were forced to give up their own weapons, rendering them defenseless, so it would be understandable if contemporary Indians were reluctant to forfeit the right to bear arms. They have only had that right since the federal government restriction on the sale of firearms to Indians was abolished in 1979 (Tahmassebi, 1991). On the other hand, the easy availability of guns probably contributes to the rate of violence and suicide on tribal lands.

Regarding sexual orientation, there is no reason to think there are any more or fewer gay and lesbian people among Native Americans than in the general population (estimated to be about 1.4%) (Chandra, Mosher, & Copen, 2011). An additional 2% of American adults identify themselves as bisexual or transsexual (Gallup, 2012), for a total of 3.4% of U.S. adults who self-identify as lesbian, gay, bisexual, or transgendered. While it has been speculated that multiple genders and flexible sexualities were sanctioned among some pre-contact American Indian communities, after the European colonization such diversity was generally condemned. Many Indian people who converted to Christianity adopted the idea that same sex relations were sinful. Discrimination against gay and lesbian people is not unusual in many Native communities, and although there are exceptions, disapproval of homosexuality is common among Native Americans (Gilley, 2010; 2006).

Regarding racism, the racial objectification of Native Americans continues today. An example is the use of Native images as mascots by many sports teams. Stereotypical depictions of Indian people with red skin wearing a full headdress have been seen in the mascots of the Cleveland Indians, the Washington Redskins, and the Atlanta Braves. American Indian activists have compared the use of stereotypical images of Native Americans to the use of black face for African