Dr. Maria Yellow Horse Brave Heart Speaks on Historical Trauma

Delegation from Maine-Wabanaki REACH travels to Northampton to meet esteemed researcher

On July 27, the Smith College School for Social Work welcomed back to campus Maria Yellow Horse Brave Heart, Ph.D. '95, to give the Lydia Rapoport Lecture. Brave Heart's visit not only was an opportunity for the campus community to learn from her work, but also provided an occasion for Smith to bring together an eminent researcher with social work professionals who have significantly benefitted from her work. Among those who attended the lecture and met with Brave Heart was a delegation of Maine-based child welfare social workers, educators, and activists who have embraced Brave Heart's theories and interventions and have implemented them in their work with Native communities.

Brave Heart is currently associate professor of psychiatry and behavioral sciences and director of Native American and disparities research in the University of New Mexico's Division of Community Behavioral Health. Previously, Brave Heart was on the faculty at Columbia University School of Social Work and was a research team member with the Hispanic Treatment Program of New York State Psychiatric Institute/Columbia University College of Physicians and Surgeons. She was also on the faculty at the University of Denver Graduate School of Social Work.

In her lecture, "Historical Trauma and Unresolved Grief: Implications for Clinical Research and Practice with American Indians and Alaska Natives," Brave Heart provided an overview of her research, traced its development, and addressed her current projects. She spoke of the early spark for her research, recalling her work in clinical practice among Native communities.

"I had a sense of carrying grief that was larger than myself and my own community," said Brave Heart. "I made a conscious connection that American Indians are survivors and that we share some things in common with Jewish Holocaust communities."

Brave Heart introduced the term "historical trauma" to describe this specific trauma that Native people experienced in the United States. She defined it as "cumulative emotional and psychological wounding across generations including one's own lifespan." While historical trauma is the result of centuries of colonization and abuses, Brave Heart highlighted the effects of the separation of families and forced assimilation of the boarding school experience. The reaction to this wounding, which she calls the historical trauma response, often includes survivor guilt, depression, PTSD symptoms, physical symptoms, psychic numbing, anger, suicidal ideation, and fixation to trauma, among other features and behaviors.

In 1992, Brave Heart founded the Takini Network (now the Takini Institute) in South Dakota. The Network was devoted to reducing the suffering of Indigenous Peoples through community healing from intergenerational trauma. She developed an intervention to treat historical trauma response, calling it Historical Trauma and Unresolved Grief Intervention (HTUG). Her approach was to put modern psychosocial issues of Native communities in a historical context, to identify and understand historical trauma, to help people work through their grief and loss, and to ground the treatment in Native traditions and culturally-specific coping and self-soothing strategies.

Brave Heart's subsequent research has provided evidence that, with the HTUG intervention, there is a reduction in anger, sadness, guilt, and shame¬—and an increase in joy—among participants. It has the effect of reducing the stigma and behaviors around trauma that plague Native communities. In 2009, HTUG was selected as a Tribal Best Practice by the First Nations Behavioral Health Association and the Pacific Substance Abuse and Mental Health Collaborating Council, in conjunction with the Substance Abuse and Mental Health Services Administration (SAMHSA). In 2001, it also was recognized as an exemplary model by the Center for Mental Health Services, SAMHSA, for a Lakota Regional Community Action Grant on Historical Trauma.

Another graduate of Smith, Josephine Chase, Ph.D. '11, collaborated with Brave Heart on this and ongoing projects. Such projects included the Models for Healing Indigenous Survivors of Historical Trauma: A Multicultural Dialogue among Allies conferences, also supported in part by SAMHSA, in 2001, 2003, and 2004.

Brave Heart's current research is a National Institute of Mental Health-funded pilot study, Iwankapiya-Healing: Historical Trauma Practice and Group IPT for American Indians. The study compares the effectiveness of the HTUG intervention combined with group Interpersonal Psychotherapy (IPT), versus the effect of IPT alone, for Native adults with depression and related disorders. At the time of the lecture, the study was still ongoing, so Brave Heart could not share final results; she reported that those participating in the study thus far report positive changes and improvement in mood.

The social workers of Maine-Wabanaki REACH who attended Dr. Brave Heart's lecture have little doubt about the effectiveness of HTUG. Co-directors Esther Attean and Penthea Burns, and Health and Wellness Director Maria Girouard, traveled to Northampton with ten other colleagues to meet and speak with Dr. Brave Heart, whose research and approaches have deeply informed their work.

Maine-Wabanaki REACH is a cross-cultural collaborative that works to develop better welfare practices with Native families. It developed in 1999, when Native and non-Native social workers came together to address issues of compliance with the Indian Child Welfare Act. As they worked, they began to look at the child welfare system in a broader social context, and saw that, in order to be effective, the system needed to change.

To address these issues, REACH established the Maine Wabanaki-State Child Welfare Truth & Reconciliation Commission (TRC), whose mission was to investigate and report on the Wabanaki experiences with Maine's child welfare system. Their goals, according to their directive, were to, "Uncover and acknowledge the truth about what happened to Wabanaki children and families involved with the Maine child welfare system, to create opportunities to heal and learn from the truth, and to collaborate to operate the best child welfare system possible for Wabanaki children and families."

Smith alumna Carol Heifetz Wishcamper was co-chair of the TRC—and among the visitors who came to Smith to hear Brave Heart's lecture. She explained that, from the early stage of the TRC, Brave Heart's research shaped their work, and was, in fact, quoted in the TRC mission statement.

"Dr. Brave Heart's work became influential because it helped to give language to why is it that we do all these technical kinds of fixes in terms of child welfare but the problems don't change," said Wishcamper.

"We had language and structure and scientific research to back up all of these things that we knew," said Esther Attean, in agreement.

According to Penthea Burns, the commission sought to "understand the harm that's been done." They spoke with individuals who had touched the system in some way and gave them opportunities to tell their stories, either privately or in a communal setting. They incorporated traditional practices, such as circle ceremonies, to facilitate the process of opening up and telling the truth.

"We knew the investigation would be disruptive to our communities, so we used our own circle process to make sure that people felt supported, that people could practice being heard, that we had the communal and collective spirit of healing together as a community," said Maria Girouard.

The experience was extremely powerful for all involved, particularly in the way it gave the Native community a chance to speak of experiences they had buried.

"How many times have we heard people say 'I've never told anyone this before,''' Attean said.

Girouard also spoke of the impact of addressing the history of trauma and its continued impact.

"Educating around that has been really freeing for our communities to realize the socio-economic distress we have experienced is not all of our making," she said, echoing Brave Heart. "There is a long history that precedes it, and there is a reason we are the way we are. We're really tapping into our own traditional knowledge and ways of being together."

This year, the Commission published a report, indicating their findings and providing a list of recommendations to promote best child welfare practices.

"One of the major findings of the commission was we're sitting in a system of structural racism that is part of the bureaucracy, and until that shifts, these other thing really can't happen with any kind of vitality," said Wishcamper.

REACH is now monitoring the implementation of the recommendations, continuing the healing work of the community, and building a network of allies to change the system. They aim to better educate child welfare workers and policymakers in Wabanaki history, to increase the state's compliance with the Indian Child Welfare Act, and to nurture respectful working relationships with Native communities.

A few days before the meeting Wishcamper had told Smith's Grécourt Gate, "To this community, Brave Heart is a rock star. People are really excited about getting to meet her and maybe getting some feedback on the work they are doing."

When Brave Heart and the Maine contingent met for several hours before the Lydia Rapoport Lecture, they shared stories, and compared approaches, challenges, and experiences. Even with the limited time they had, the meeting left the Maine visitors wanting more.

"I wish we could talk to her longer," said Attean. "We were just starting to tease and unravel things. I would have loved to talk to her about spirituality: how she integrates that, how you use that to change the clinical mental health system."

When she speaks about her work, Brave Heart explains that ultimately, she finds that the HTUG intervention is restoring hope among Native communities.

"Participants are sort of lighted up and vital," said Brave Heart. "There's just so much hopefulness and also gratitude that someone is listening to what they've had to go through."

It was clear, from their conversations, and their exhilaration at meeting with Brave Heart, that the practitioners from Maine see the same possibilities for hope and healing in their communities.