Clinical Paradigm Clashes: Ethnocentric and Political Barriers to Native American Efforts at Self‐Healing

Abstract

Euro‐American theories of psychotherapeutic intervention focus on therapist behavior or the therapeutic relationship, conceived in dyadic terms. The cultural prototype is individualistic and rationalistic: a one‐to‐one conversation in which the patient discloses and discusses innermost feelings in regular office visits. This may be appropriate for modern Euro‐Americans. However, anthropological research finds that in many traditional healing systems, intervention is communal, it utilizes dramatic ritual ordeals and altered states of consciousness rather than rational conversations, and the healer–patient relationship may be less central. This article argues that the latter approach is not ignorant of psychotherapeutic principles; it has its own (however opposed to Euro‐American assumptions they may be). Understanding this paradigm clash broadens our understanding of what psychotherapeutic intervention is. It also allows clinicians and policy makers to support traditional peoples in their own efforts at self‐healing. Examples will be drawn from the author's work on the healing ceremonies of the Native American Church among contemporary Navajos. [cultural psychiatry, psychotherapeutic intervention, clinical paradigm clash, healing, Native American Church]

Urban American Indian Youth Spirituality and Religion: A Latent Class Analysis

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Native Transformations in the Pacific Northwest: A strength-based model of protection against substance use disorder

“…These local initiatives are often only informally evaluated; as a result, they are rarely, if ever, reported in the SUD research literature. These grassroots efforts sometimes are portrayed as arising out of a clash between Western and Native clinical paradigms (Calabrese, 2008); however, their absence from the SUD research literature also reflects broader tensions between the cultural worldview of Native communities and the theories, worldviews, and cultural assumptions of Western social and biomedical health science research (Gone, 2012). …”

More Thoughts: On the Spirit of Community Psychology

“…For many Native North American communities, the rites and traditions of their populations are better resources to reduce self-defeating behavior than being a patient or client in an Indian Health Service Clinic. Local diversity becomes the topic of discovery rather than imposing a universalized template (Adelson 2008;Calabrese 2008;Gone 2007Gone , 2008Prussing 2008). These scholars point to the axiom that it is the nuance of each community that serves as the source of insights for helping.…”