ABSTRACT
Indigenous Peoples of the Americas1 are a diverse population, with over 500 federally recognized tribes in the United States and over 400 in Latin America. Indigenous Peoples have experienced pervasive and cataclysmic collective, intergenerational massive group trauma and compounding discrimination, racism, and oppression. There is insufficient data on emotional responses to collective trauma and losses among Indigenous Peoples and how best to intervene in order to alleviate psychological suffering and unresolved grief. A long-term goal of historical trauma intervention practice is to reduce emotional suffering among Indigenous Peoples of the Americas by developing culturally responsive interventions driven by the community to improve behavioral health. American Indians and Alaska Natives2 are one segment of the Indigenous Peoples of the Americas. American Indians/Alaska Natives rank higher in health disparities than any other racial or ethnic group in the United States. American Indians face emotional challenges such as depression, substance abuse, collective trauma exposure, interpersonal losses and unresolved grief, and related problems within the lifespan and across generations (Beals et al. 2005; Manson et al. 2005, 1996; Whitbeck et al. 2004a, b; Brave Heart 2003, 1998). Although there is a paucity of research among Indigenous Peoples living within the United States, some studies indicate elevated levels of PTSD and depression among both American Indians and Alaska Natives (Manson et al. 2005) and Indigenous Peoples from Latin America (Sabin et al. 2003). In addition,
substance abuse is a significant problem (Walters 2004), with death from alcohol-related causes being five times more likely for American Indians than for White Americans. Additionally, suicide rates are 50 percent higher than the national average (U.S. DHHS 2001). Thus, there is an urgent need to reduce racial and ethnic health disparities, which have a significant public health impact, through designing effective interventions with American Indians/Alaska Natives (Wallerstein & Duran 2011). In order to develop culturally resonant interventions for Indigenous Peoples, more information is needed regarding collective as well as individual lifespan trauma, grief, and loss in this diverse population who have faced histories of genocide, colonization, forced assimilation, and exclusion that undermine intergenerational health and well-being. Despite the array of tribal cultural practices, many Indigenous Peoples share historical and contemporary experiences, intertribal organizations, and often congruent worldviews and values. With increasing migration to urban areas, approximately 60 percent of American Indians live in cities rather than on reservations (U.S. Census Bureau 2006). Trauma among American Indians/Alaska Natives is pervasive, often related to the mass genocide documented in the literature (Jaimes 1992; Stannard 1992; Hoxie 1989; Legters 1988; Thornton 1987; Prucha 1984; Tanner 1982; Brown 1970). The subsequent communal suffering, cumulative trauma, and prevalence of PTSD in some American Indian communities have been addressed by a few studies and clinical articles (Beals et al. 2005; Manson et al. 2005, 1996; Robin et al. 1997a, b; Robin, Chester, & Goldman 1996). For instance, Whitbeck and colleagues (2004a) found evidence of the impact of historical loss on risks for alcohol abuse among American Indians. The collective traumatic past of American Indians and Alaska Natives and subsequent responses merit consideration in the design and delivery of clinical interventions and research with these populations. Although alcohol remains the most prevalent substance abused by American Indians/Alaska Natives, there is increasing abuse of drugs such as methamphetamines, IV drug use, and risks of needle sharing resulting in devastating illnesses such as HIV/AIDS and hepatitis C. Thus, there is a need to target all substance abuse prevention and early intervention efforts for this population. 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.
