Given this distant as well as recent history, it is not surprising many American Indians and Alaska Natives are distrustful of others. History has taught Indians and Natives that others may act in ways that threaten their physical safety or the survival of their culture. The impact of this historical backdrop on therapy is aptly described by Lockhart (1981):
For an Indian person to entrust himself to an Anglo counselor, or to someone . . . representative of the dominant society, may be extremely difficult given the results of past trust relationships. ... No longer is the issue of trust necessarily based in the present; it takes on a historical perspective that is even harder to deal with. It is essential that the conscientious counselor be aware of the existence of this distrust and its basis, and try to understand its magnitude in order that the counseling relationship be effective, (pp. 31-32)
In other words, some level of mistrust is normative and perhaps adaptive for the Indian or Native client beginning psychological treatment, especially when a clinician is White. Even an Indian or Native clinician, however, will likely experience distrust, probably being seen as having given up traditional ways or otherwise becoming part of the White establishment given his or her level of education. A clinician who minimizes, denies, or pathologizes this historical mistrust will likely weaken or perhaps preclude the establishment of a productive therapeutic alliance. For example, some clinicians might attempt to assuage the suspicion of their American Indian client by stating their intentions are to help Indians to improve their lives. To the client, these efforts might sound eerily familiar to words spoken by missionaries, politicians, and others expressing a desire to help while acting in destructive ways. These words might also sound like those of White liberals who can exhibit patronizing beliefs about
"poor" Indians or Natives needing considerable help from more capable Whites to "improve their situation."
The therapist who attributes mistrust to a personality flaw within the Indian or Native client is similarly counterproductive by ignoring the context that contributes to this mistrust. Instead, the clinician should aspire to gain an empathic understanding and acceptance of the distrust. This respectful and nonjudgmental approach will likely serve as an important building block in the foundation of trust necessary to other therapeutic work.
In a related point, clinicians should always be cognizant of the potential damage they can cause because of the inherent power differential between therapist and client. A clinician can dramatically effect how a client thinks, feels, and acts with respect to themselves, significant others, and their environment through various means (e.g., suggesting changes, confronting certain thoughts). For the Indian or Native client, the power differential takes on an added historical dimension. American Indians and Alaska Natives long have suffered at the hands of powerful others and been told that, as an individual and group, they are somehow "less-than." The clinician can unwittingly become another oppressor, an additional source of discrimination or devaluation. Devaluation can happen when a clinician applies Western ideas about proper behaviors, thoughts, and emotions unthinkingly to an Indian or Native client or views his or her client as powerless to help themselves or their people. Once again, Indians and Natives have been viewed historically as needing to adopt White ways, which were somehow better, and as needing a lot of help from more knowledgeable others in this effort to "improve their lot" and become "civilized."
An additional way that history can impact the assessment and treatment process relates to internalized racism or conflicts about ethnic identity. An Indian or Native client might (independent of the clinician) devalue themselves and their culture and/or be confused about their ethnicity. Three to four generations of Indians and Natives have existed in an environment that has necessitated difficult "choices" in a variety of contexts. One "choice" has involved adopting Western ways and/or "passing" as White with the benefits of survival and perhaps acceptance by those with more power. Some Indians and Natives have internalized the belief that the Western way is somehow superior after being bombarded with messages from source after source. Another "choice," maintaining "traditional" ways, has evoked sanctions ranging from social mar-ginalization to death. Understandably, the former has been the "choice" of some Indians and Natives in various contexts (e.g., the workplace, in school). Note that the word "choice" is enclosed in quotes, however, because racism and discrimination are barriers preventing Indian and Native success in the Western world regardless of desire.
To complicate matters, there has always been some level of rejection within Indians and Natives of members who have attempted to "assimilate," and, more recently, there has been a movement encouraging American Indians and Alaska Natives to be proud of their roots and traditions (Trimble & LaFromboise, 1985). For the 60% of Indians and Natives who are of mixed heritage (e.g., Alaska Native/Mexican), rejection by "full-bloods" or those with higher Indian blood quantum also occurs (Trimble, Fleming, Beauvais, & Jumper-Thurman, 1996). It is thus not surprising many Indians and Natives today struggle, whether attempting to negotiate two cultures, to accept the sanctions in choosing to live according to the ways of one, or not feeling a sense of true belonging in any social or cultural sphere. Addressing internalized racism and conflicts about cultural identity are important themes for clinicians to address in treatment with most Indian or Native individuals.
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