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Original

The Healing of Our People: Substance Abuse and Historical Trauma

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Pages 84-98 | Published online: 03 Jul 2009
 

Abstract

For the past two decades, one of the authors (Robert Morgan) has been involved in the development and implementation of culturally based outpatient, inpatient, and aftercare programs for Alaskan native and American-Indian populations in Alaska. After years of observation, it was concluded that the best efforts of our clinicians were inadequate to the task at hand, i.e., that of resolving the social and physical ills that have ravaged the Alaskan peoples since the occupation. Morgan and others sought to create a new model of diagnosis and treatment that combined the cultural strengths of the people with the technical and treatment skills of the conventional medical profession. The model was grounded in a clear understanding of the factors causing disease in the people, and that understanding came from the people themselves. Before the growth of the “healing plant” that Uncle Walter spoke of could be nurtured, it was necessary to first examine the question of cause and effect. Much of the cause is rooted in the “historical trauma” experienced by the Alaska Native People. The effects are numerous, but one of the most obvious symptoms is substance misuse.

Notes

2Freeman, L.W., Morgan, R., and Farquhar, T. (2002). Traditional peoples and the circle of healing. Complementary Health Practice Review, 7 (1):5–15.

3Treatment can be briefly and usefully defined as a planned, goal directed change process, of adequate quality and appropriateness, which is bounded (culture, place, time, etc.) and can be categorized into professional-based, tradition-based, mutual-help based (AA, NA, etc.) and self-help (“natural recovery”) models. There are no unique models or techniques used with substance users—of whatever types—that are not also used with nonsubstance users. In the West, with the relatively new treatment ideologies of “harm reduction” and Quality of Life (QoL) there are now a new set of goals in addition to those derived from/associated (with) the older tradition of abstinence-driven models. Editor's note.

4Freeman, L.W., Morgan, R., and Farquhar, T. (2002). Traditional peoples and the circle of healing. Complementary Health Practice Review, 7 (1):5–15.

5Brandt A.M. and Rozin P. (1997). Mortality and Health. New York: Routledge.

6A critical issue that is all-too-often overlooked in treatment is what are the environmental dimensions and “demands” of programs that can, will, and do promote engagement in treatment; compliance with goals and effective use of techniques, minimize and/or prevent the patient and the staff from not becoming therapeutically engaged as well as not maintaining stereotypic and stereotyped “drug user roles,” etc. Such dimensions include, among others: a relationship dimension, personal development dimension, maintenance and change dimensions, emotional catalyzer dimensions, information catalyzer/processing dimensions, environmental perceptions, attitudes and values dimensions, problem-solving/adaptational dimensions, dimension definer-boundary definer (Tuan, Yi-Fu. (1974). Topophilia. A study of environmental perception, attitudes and values. Englewood Cliffs, NJ: Prentice Hall).

1The journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.

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