2009

Vancouver: UBC Press

In a 2004 Throne Speech, the Canadian Governor General referred to “shameful conditions” in which so many indigenous peoples live. Particularly in the mainstream media, it is often taken for granted what constitutes, and what perpetuates, those shameful conditions. Finally, here is a book that describes, investigates, and problematizes aspects of those conditions, and through twenty individual essays based on empirical research and spanning 500 pages and many decades – that travel from Igloolik to Brantford to the notorious downtown East side of Vancouver – explores the ways in which those conditions shape the lives and life chances of indigenous peoples in Canada. Written in an accessible style, the chapters are neither lengthy nor over-full with terms of art and academic jargon. This is a book that can, and deserves to be, widely read by policy makers and students of indigenous issues generally.

The collection depicts the realities of indigenous peoples and communities through empirical studies that are respectful of indigenous viewpoints and community research priorities. The results give shape and nuance to what is often amorphously referenced as dysfunction or suffering, which although undefined inspires constantly changing policy directions that consume billions of dollars each year. The results of these studies are germane not only to those concerned with indigenous peoples’ mental health, but with social, political and economic spheres, which are major determinants indigenous health and wellness.

Divided into four theme areas, the papers provide a diversity of views, methods, and focus. Part one offers an overview of the broad outlines of suffering prevalent among indigenous peoples in Canada and other settler states. The first chapter in the collection, written by Laurence Kirmayer, Caroline Tait, and Cori Simpson, deserves to gain widespread inclusion on undergraduate course syllabi in Native Studies, Political Science, Anthropology, Social Work, Health Sciences, and Education. It provides an insightful and detailed overview of both the mental health status of indigenous peoples in Canada and the series of policies (and consequent political crises) resulting in what the authors term “social origins of distress”. Subsequent chapters in this section lay the groundwork for better understanding the book’s key contextual framework: James Waldram’s eloquent exploration of the concepts of culture and Aboriginality, and the intersecting frameworks of cultural and developmental psychology explored through the lens of indigenous youth wellness in the chapter by Grace Iarocci, Rhoda Root and Jacob Burack.

The second theme addresses origins and representations of social suffering. The social suffering paradigm is relatively new, having been developed during the 1990s most notably by anthropologists Veena Das, Arthur Kleinman and their collaborators. Their analysis of pain and suffering as a social phenomenon resulted from their frustration with social science theories’ inability to comprehend experiences of collectivities’ suffering impacts of war, genocide, terror and other, less dramatic forms of socio-political oppression. This collection represents the first major effort to analyze the situation of indigenous peoples through a social suffering lens, through a volume of multiple contributions drawing on research with a diversity of indigenous peoples. While the concluding chapter somewhat addresses the relevance of social suffering as a theoretical framework for explaining why diverse communities share similar forms of suffering, the editors would have done well to explore in-depth the notion of social suffering as a paradigm for better understanding the collective experiences wrought by assimilationist state policies as a way to link together the contributions in this section, as well as differentiate the social suffering paradigm from other, perhaps less useful explanatory paradigms such as historical trauma. Dara Culhane, in her ethnographically informed analysis of experiences of women struggling with addictions, explicitly situates her work within the paradigm of social suffering, drawing on the legitimacy it provides to researchers’ telling individual stories of suffering as a form of witnessing in a larger political project meant to undermine neo-liberal policy environments which blame the victim. Colin Samson’s chapter takes up from this theme, providing a cautionary tale of a medical doctor working among the Innu who does just that – blames Innu communities and parents for their own (and their children’s) suffering, in a vain attempt to absolve both the state and society from the abject poverty, hopelessness, selfishness and apparent self-destructiveness that seem to characterize the lives of the people she has failed to understand or to help. It is these two chapters that address what are perhaps Canada’s most infamous examples of indigenous suffering – Vancouver’s downtown Eastside, and the Innu of Northern Quebec – in ways which illuminate the explanatory power of the social suffering paradigm, a theory which provides an explicit linkage between indigenous suffering, and policies of assimilation and self-disconnection creating circumstances in which suffering – and primarily suffering – can thrive. Chapters in this section also touch on critical health issues for indigenous communities throughout Canada: residential schools, suicide, and fetal alcohol syndrome. What the chapters in this section highlight is the collective nature of pathologies as social phenomena issuing from the breakdown of culture and self-identity characteristic of collectives confronted with ongoing assimilative social and political pressures.

The burden of social suffering while great is not insurmountable: the third section of the book describes ways in which communities have begun to wrestle through the dark night of suffering toward healing. In the five chapters of this section, indigenous culture and identity play a key role in providing the foundations for understanding both the nature of suffering as a response to traumatic events and circumstances, and providing foundations for methods and practices for healing. Michael Chandler and Christopher Lalonde, whose pioneering work correlating key social and political factors with suicide rates has been among the most influential research on Aboriginal policy in Canada in recent years, provide an overview of their research into the socio-political factors around indigenous youth suicide rates among First Nations in British Columbia. Their work shows evidence that where communities have strength of conviction in their culture and relationship with (and consequent responsibilities to) their lands – as evidenced by community establishment and control of various social and political institutions – youth either do not, or less frequently, commit suicide. Theirs are important findings, demonstrating that what is often understood to be a much higher rate of suicide among indigenous populations generally is actually a much worse problem among a minority of First Nation communities. In their work are clear indications to policy makers how and to what extent policy in social, political and economic areas can affect the health and wellness of First Nations youth, and by extension, their communities.

Policy for wellness, and the concrete measures taken to implement such policy is neither homogeneous nor simple: the last theme in the book “Healing and mental health services” looks at how implementing health services for indigenous communities is either facilitated or undermined by the myriad legal, jurisdictional, geographic, policy, and pedagogical factors that impact the development of both capacity and infrastructure devoted to the care of indigenous people. This section will be of greatest interest to those working in health care policy and administration, as the articles provide a series of ethnographic “core samples”: deep and complex explorations taken at different moments in time, of how indigenous-focused services meet or fail to meet the needs of their target populations. Issues raised in papers in this section, such as that by Gregory Brass about addressing the needs of indigenous men in a post-release therapeutic program, and the chapter by Joseph Gone about becoming a Native psychologist, resonate with the issues elucidated by James Waldram in his chapter in the introductory section on the nature of Aboriginality and the tendency of policies, programs and even research categories to generalize indigenous culture and identity to the point of meaninglessness. In this section we learn how much easier it may be to serve geographically and culturally bounded populations such as the Six Nations in Brantford in comparison to the diversity of indigenous peoples inhabiting the city of Montreal. What we are left with here is the sense that the same policy milieu that causes suffering persists anon: indigenous peoples in Montreal will most likely get the most culturally relevant care from health centers catering to newly arrived refugees; the corrections system basing its healing programs on pan-indigenous spirituality may not be meaningful for culturally connected Indigenous inmates; that the theory and pedagogy of psychology requires a fundamental cultural disconnection of those indigenous peoples who must acquire the credentials essential to participating in community control of mental health services. Looking at it another way though, one gets the sense that these are problems wrought through an ascent to control: these questions are empowered. These are the questions of critically and experientially informed thinkers steeped as much in knowledge and practice of indigenous culture and its importance to mental health, as in the knowledge and practice of what Joseph Gone terms the “psy-fields” that have played such an important role in surveillance and definition of the mental and cultural health of indigenous communities. The questions are in that sense, hopeful.

Overall, Healing Traditionsis the one many of us have been waiting for. It challenges neo-liberal stereotypes about Indigenous suffering with evidence compelling and eloquent. It confronts simplistic assumptions with deep and layered understanding.

Knowing that it is out there, lifts my heart.

Reviewed by Stephanie Irlbacher-Fox, PhD: She is the author of Finding Dahshaa: Self Government, Social Suffering and Aboriginal Policy in Canada (2009), and works as an advisor to Indigenous peoples organizations in the Northwest Territories, Canada.

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Tags: Canada  First Nations  mental health