American Indian and Alaska Native Mental Health Research
The Journal of the National Center
Volume 2, Number 2
bl h d b th t n l C nt r
Un v r t f C l r d lth S n C nt r p rt nt f h tr 4200 E t nth Av n nv r, C l r d 80262
ISS 08 4
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
E I O I C IE S E O M. MA SO , h OU A MA AGE E O A . A MUO
ESEA C ASSOCIA ES
MO O EISE , M E O E. E Y, h p rt nt f h tr p rt nt f Anthr p l Un v r t f r t h C l b Un v r t f Ar z n I I A. MAY, h OSE E. IM E, h p rt nt f S l p rt nt f h l Un v r t f M x W t rn W h n t n Un v r t . A E WA KE , M A SI K WA KE , MS Al h l & r p nd n r t nt Un t p rt nt f h l r n S ttl t r n M d l C nt r & p t l Un v r t f W h n t n E ESA A OM OISE, h EA ICE ME ICI E, h S h l f Ed t n p rt nt f Anthr p l St nf rd Un v r t C l f rn St t Un v r t , rthr d GEO GE GUI ME , h OSE WES E MEYE , M p rt nt f C p r t v S l p rt nt f h tr Un v r t f t S nd Un v r t f M nn t O E O SE, h IC A SC U , h A r n Ind n St d C nt r C th dr l f rn n Un v r t f C l f rn , An l Un v r t f tt b r h GE A . MO A , Ed O MA G. GES, h C ll f n & r l v l p nt p rt nt f h tr Un v r t f Al , rb n Or n lth S n Un v r t OSE . OOM, M . A I KI IE, M p rt nt f h tr p rt nt f h tr Or n lth S n Un v r t Or n lth S n Un v r t WI IAM . SACK, M KE E IO p rt nt f h tr t v A r n St d r r Or n lth S n Un v r t Un v r t f M nt n E UCE, h O Y W IG , h p rt nt f h l Ind n St d r r W h n t n St t Un v r t M nt n St t Un v r t GO O E IG , M AMES . S O E, M p rt nt f h tr p rt nt f h tr Un v r t f C l r d lth S n C nt r Un v r t f C l r d lth S n C nt r O A W. EC O , M A A E. A O , h p rt nt f h tr p rt nt f h tr Un v r t f C l r d lth S n C nt r Un v r t f C l r d lth S n C nt r C. OSE I E, h O E E S, A h l S rv Gr t r n v r C n t S p lv d t r n Ad n tr t n M d l C nt r M nt l lth S rv IA E . WI IS, h CA ACE M. EMI G, h Ch ld St d C nt r p rt nt f h tr O l h lth S n C nt r Un v r t f C l r d lth S n C nt r O E AC 0E E G, h SA A K. OOS, h p rt nt f Anthr p l t r n Ad n tr t n p t l Un v r t f C l r d rtl nd, Or n G ACE OW ESS SAGE, h AMES OE EI , M M lt lt r l C nt r f r C n l n p rt nt f h tr & C n t v l p nt Or n lth S n Un v r t Un v r t f C l r d
S b r pt n r t r $ (US rr n p r v l — n l d n p r r pl n nn l n r ph. M h p bl t : UC SC t n l C nt r rn l. M ll t t n l C nt r f r A r n Ind n nd Al t v M nt l lth r h, C p M l x C24 , 4200 E t nth Av n , nv r, C l r d 80262, Attn: rn l M n r.
ISS 08 4 4 88 h t n l C nt r f r A r n Ind n nd Al t v M nt l lth r h nv r, C l r d All ht rv d
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
American Indian and Alaska Native Mental Health Research
h rn l f th t n l C nt r l 2, b r 2
Editorial 2 Biosketch 4
Ghost Illness: A Cross-Cultural Experience with the Expression of a Non-Western Tradition in Clinical Practice 6 Robert W. Putsch, III, MD
The Fears of Navajo Children: Adaptation or Pathology? 27 Frank D. Tikalsky, EdD
Unresolved Grief and Mourning In Navajo Women 32 John K. Nagel, MD
A Consideration of Constitutional Factors in Aggressivity 41 Sydney G. Margolin, MD
Special Commentary 58
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
SYDNEY G. MARGOLIN, MD Apr l 2 , 0 b r , 8
In Appr t n f S dn G. M r l n, M
h f ll d t n f American Indian and Alaska Native Mental Health Research d d t d t th r f S dn G. M r l n, M . h rt l nt n d h r n l br t r. M r l n nt r t n A r n Ind n p pl nd th r lt r , h p n f r th S th t, nd h n ppr t n f lt r l d t r n nt f b h v r.
h nt nt f th p p r t h ll n thn ntr b nd p nt r t n t n . h p rt n f r n f l nd lt r l d ff r n n v l t n nd tr t nt f A r n Ind n n d r d ntr l t th r p t r n r l t n h p nd tr t nt t . At t th th r p t tr t ll f l t t th r ppr pr t n nd h n r n f p rt nt p t f n nd v d l n r l nd h l n tr d t n . h n b f l f r Ind n nd n n Ind n p t nt l .
I h p th rt l rv t t l t nd pr v n v n f th n n nd t n n . C rt nl r. M r l n ht b b t r b r d n t r f h l t f r th d v r f th p r v d nd nd r t d.
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
E I O IA
r. S dn M r l n n nt r t n nd pl x p r n. r ll nt nd r v , h xp t d r t d l f h lf— nd th r nd h . A r lt, h r pr nt d n d ff r nt th n t d ff r nt p pl . n f ntr t n d , d v r nt r t , nd p r d x l p r p t v . ph l pr n nd n , h v h pn t ll r n nt, nd h b r n r , nt n , nd pr f n l. S dn pr f n l r r r nd pl h nt p f r th lv . rl r d pl r t d n tr d t n l p h n l th n nd v d l ntr p h f . h n, thr h th n f p h n l t th d nd h pn t t hn , h d lv d d p nt p h t d n r r h, h r h n b t d th n pt f ph l r r n n l d pt v r p n t tr nd n l t th r p . n ll , thr h h r th A r n Ind n nd p n , h p n d th r n f h nt r t nd t d t n l d lt r l d t r n nt f b h v r, nd h p l t d n th d f nt rv nt n . In h l n l r th nd v d l p t nt , S dn h d th n nn b l t t b rv nd nd r t nd th n th t th r j t n t d. d nt v l d th "p rl " nd ht h d n n th r rd. At th t , h h d th nn n h b t, b th th t d nt nd ll , f nd dl n x tl h t h th ht. h h b t, b n d th h r l t n t n n f th th r l nd fr t rn l d n f d , t l d t h b n p r v d th n f v r . r. M r l n t f p n t th b nd r f nv nt n nd th pt d d r r fl t d n h r n th r . n t d th t h t d nt d f n th r t r nd r f d t ll th r tr t nt th nv n n f p h n l t j r n. n r d th t r d r n l r t r l nd h t r p p r , b l v n th t th ph n n l d r pt n f p n r n th f ld— r d, l l r, Kr p l n, t .— r f ll r, r h r, nd r r t th n nt p r r r t r h h p t d f tr n t f t l n l d t nt pr n v d d n t t r . On f th nt l th n S dn l f nd r th n t n th t th r l t nd l f f p t nt nd th r pr bl r r h r, r nt r t n , nd r pl x th n ld b n p d r d f n d b n th r t l fr r . h n l pr v d d r l th th d nd t l f r xpl r n th n h rt d r n f h n p h l l xp r n nd b h v r. S dn f lt tr n l b t p n p h tr nd p h n l f r l n h r d n d l ph l h n , h n h v r b r t r . l b r t r f ll d th p l r ph , v d t p nd nd p nt, nd th r ph t t d l tr n d tr .
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
S dn h d n nt n r t b t n l p pl nd n h n pr bl . Ind v d l ff r n t t , v r ph b , d t rb n d t v ph n n , nd lt pl p r n l t r n th t d th t h h d v d t p d. nt r t d n th r t f h l n pr nd xp r n n th h n p h . n l d d h t r l n h p th pr t nd h n f th r lt r . ht t ppr t th h n t b n th pr t v t nt nd h n . In th , h h n r d th h l n tr d t n f A r n Ind n . In h r th A r n Ind n , S dn ppr t d " n th d h rt." d t pr nt h b t lf— r , n r , nd nd— n th h n t, npr t nt nv r n f th r rv t n, fr th p t t v pl x t f th " v l z d" d n t . In nd r nd th d n t , S dn r h pr f n l d n r t f th t , ld l tt n th r p r n l d f h n t r . At h th h d v t d f , h ld p h tr t p h n l t, Gr t l t h n, M , h h d r r l x d, p r n l d . Al , l l nd tr v l d t ll f r th r n f h r p r n l lf. S dl , S dn n v r pl t d th b h h d xpr d b t n t r t . pr p d b n h pn , p h t d n , nd thn p h tr n v r t r l z d. S dn h lth f l d h n th l t r f h l f . h r t r f th rt l nt n d h r n— r n l l , h , b rt t h, M , nd hn K. l, M — r ll r tl nfl n d p r n ll nd pr f n ll b r. M r l n. Oth r , n l d n h ld p h tr t, ll St nn , M , f S nt , M x , nd El z b th K bl r , M , r n th n r d nd n p r d b S dn M r l n nfl n . h d t n f th rn l f th t n l C nt r d d t d n r t t d t S dn r nd n p r t n.
hn K. l, M G t Ed t r
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
IOSKE C
S dn G. M r l n, M , r f r E r t f h tr , Un v r t f C l r d S h l f M d n , p rt nt f h tr , d d b r , 8 t h h ft r pr l n d th h p t t nd l v r n r. 6, h v n nt n d h t v p h n l t pr t nt l j t f nth b f r h d th. d r t r f th d l h l n h v r b r t r fr t . r r t th t h A t h tr t n h r f Inp t nt S rv nd h tr n S rv b t n 46 nd . t d Un t d St t Ar d S rv C n lt nt r p h tr t t th S r n G n r l n W rld W r II nd ft r rd fr 44 t . pl t d h nd r r d t t d t C l b Un v r t n 2 nd tt nd d Y r St t Un v r t M d l S h l r d t n M n 6. Aft r d l h l h d d h nt rn h p nd n r l r d n t M nt S n p t l n Y r C t fr 6 t 40. h n r d Abr h n r h ll nd h M nd t n r h ll n 4 nd 42. r. M r l n ll n n f r h ntr b t n n th r f p h t d n . nt r t nd r r h n th p h ph l f p h t lln r n d n f th ntr l th f h l f r . In C l r d h b f n t d th thn p h tr thr h h r th p n nd A r n Ind n p p l t n . p n f r th S th t v d nt n h t v pp rt f th d v l p nt f S th t St d C nt r t rt C ll n r n , C l r d . h d l n t nd n nt r t n n t r l h t r f p h n l nd t nfl n f h t r l, l l, nd lt r l nd t n th r d d t n . r. M r l n nd h f , h ld p h n l t, Gr t l t h n, M , nj d n fr nd nd nt n n b th A r n nd nt rn t n l p h n l t n t . r. M r l n pr f n l ntr b t n n l d 0 r f t h n d l t d nt ll n p p r nd pr nt t n h h r d fr h v t l n l xp r n nd r r h. Wh t h t l t d nd pr v d n h t d nt , r d nt , nd f ll t nd h t ppr t d pl h nt.
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
I l d t h v b n d t dd f rd t th M r l rn l. I r t f l t r. Sp r M n n f r n r t n th d f p bl h n rt l r tt n b fr nd nd ll f S dn . r . l, t h, nd l r ll l r r nd th h v ntr b t d t r l th t ld h v b n f r t nt r t t S dn . I nt t th n th d pl f r th r ff rt nd t p nt. h r ntr b t n ll nh n r r f S dn —r r h r, t h r, nd fr nd.
Gr t l t h n M r l n, M
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
GHOST ILLNESS: A CROSS-CULTURAL EXPERIENCE WITH THE EXPRESSION OF A NON-WESTERN TRADITION IN CLINICAL PRACTICE
O E W. U SC , III, M
A S AC . Ethn ntr b l f nd ttr b t f lln , t l , nd d th r d d n p t nt fr thr d ff r nt lt r v j , S l h, nd rn n . h ll tr t th r l f th d d n n rn nd f r r l t d t lln , d pr n nd d l b h v r. h r pr nt d n th br d r nt xt f h n xp r n th d th nd d n r pr nt d n th d l nd nthr p l l t r t r . n t nd th r p t ppr h t p l b l f r ll tr t d.
It t lv d n b r d . W f d n, nd v n l th . h ll ll f d nd l th . t th th r d . W ll t n r d . n t nd n t . n t rn f r r r l t v . d n t ll f r ... A h f n r pr r ( nd , 84, p. 2
G . G tr ht h d n t t n n th . n t l b . Wh n r h r d t n t n, t l f r . ll th n t t tr bl . Or n t t h r nd t n n l . A Cr f n r pr r ( nb rr , 62, p. 6
AME ICA I IA A A ASKA A I E ME A EA ESEA C 2(2 , pp. 6 26
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
G OS I ESS
Wr t n n d th nd d n f h v l n th pr bl xp r n d b d n nd v d l nd th h r f r th th rv v r f d th n f l h v r v d f r l tt nt n. th nd d n p r pr bl f r rv v n f l b r . l f nd pr t r rd n d th nd th d d h v h d pr f nd ff t n th b h v r rr nd n lln , nd n n r p h v l d t tr d t n n h h p t nt nd r f l b r p r v n b n nn t d n v r t n h h d d ( ft n f l b r . h tr d t n l t n r rd n nn t n b t n th d d nd th t l f lln ll b r f rr d t " h t lln " n th p p r. Gh t lln pp r t b lt r b nd ndr . Sp r t r " h t " b v d b n d r tl r nd r tl l n d t th t l f n v nt, d nt, r lln , nd th r rr p t v f b d l t l v . W t rn l n l f r l t r n l f r h t lln , nd th p r ll l b l f nd b h v r r d b nd h dd n th n W t rn l f br ll th p r d f W t rn p h tr nd d n . In ntr t, p f t r n l f r h t lln n t nl x t n n n n W t rn lt r , b t th t r x t th xt n v nd l b r t n f d l n th th pr bl . h r rr n th th t th d d t n th th ll tr t d b th f n r pr r t th b nn n f th p p r. h t tr b l r p xpr d l r f r n pr r ddr d t th d d.
n t nd n t . n t rn f r r r l t v . d n t ll f r ... A h f n r pr r ( nd , 84, p. 2
ll th n t t tr bl . Or n t t h r nd t n n l . A Cr f n r pr r ( nb rr , 62, p. 6
S n p d l nf r f h h r t f rt l t d r n b r v nt, th pr r nd th h v b n f t. Add t n ll , th r r l nd b l v d n f n t d lf d tr t v p l n th b r v nt p r d. h t th t th p h l n t r p n f nx t , dr d, nd f r f d th n n th r b d n r l t . W ll b rv th l n l n f n f th th n th thr f " h t lln " h h f ll . E h f th nd v d l t b pr nt d h d nt r t n t ll p h t p n nt t th r xp r n f lln , d pr n, nd nx t . In h n t n , h v r, th r v r d r tl t d t p l, lt r b nd b l f nd t th r n f h ll n t n nd r dr f d d r l t v .
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
O E W. U SC 8
This paper reviews three patients who come from cultures which have well- documented views regarding illness caused by the dead. The patients are Navajo, Salish (a Northwest coastal group), and Hmong (a hill tribe in Laos, Thailand and China). Concern over burial, ghosts, and ghost sickness is well known in the Navajo (Haile, 1938; Levy, 1981). The religious/therapeutic expression of this concern is seen in multiple Navajo healing ceremonials that belong to the evil chasing or ghost way chant groups. Both the Salish (Ahern, 1973; Collins, 1980) and Hmong (Chindarsi, 1978) people have ancestral religious process, and both groups have ceremonial means to deal with ancestral interference and ambivalence. All three of the individuals to be discussed sought help from Western trained physicians for physical complaints. Following the cases, there is a discussion of the ghost illness tradition in the broad context of experience and beliefs relating to death and dying.
Case 1- A Navajo Woman with Ghost Illness t f On t r bl t May, 1977 1) Bilateral accessory breasts 1972 2) Infertility, 5 years duration, resolved 1977 July, 1977 3) Post-partum depression, family problems
This 27-year old Navajo woman was seen in an emergency room two months after the birth of her first child, a daughter. She complained of painless swelling in both axillae which had begun during the eighth month of her pregnancy. Earlier, her family physician had advised her that the swellings were caused by the enlargement of accessory breast tissue, and he had counseled her to avoid breast feeding in an attempt to prevent further enlargement. She had complied, but in spite of this precaution, the tissue failed to recede during the post-partum period. Her pregnancy had ended a five-year problem with infertility. She was perplexed by the developments that followed delivery. "We waited so long...I should be happy, but I'm not...I've been having crying spells, and I get mad over anything." In addition, she had developed difficulty sleeping, had lost interest in her usual activities, and noted a markedly diminished libido. She had argued with her husband over minor issues, and on two separate occasions, she became angry and "took off in the car." "I found myself driving 80 to 90 mph, headed for the Navajo reservation...it really scared me, I was going 80 right through last night." Fright generated by this driving episode had precipitated a Sunday morning emergency room visit. The patient presented two major concerns. One involved the lumps under her arms; although she acknowledged that these were accessory breast tissue and not cancer, the patient found herself worrying about "looking ugly" and about dying. Her second concern was of "losing her mind;" she explained this fear by referring to "not caring about anything" and to her "crazy driving." Additionally, she mentioned a brother who was a binge drinker, often threatened people (especially her mother), and was judged by the family to be uncontrollable and "out of his mind." "I'm afraid I'll get like that."
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
9 GHOST ILLNESS
r n th nth f ll n th b rth f h r f r t h ld, th p t nt h d xp r n d r p t t v d t rb n dr . Sh b n dr n b t h v n n p r t n nd h d n t d th dd n r r n f n ld, r rr n dr f h r d d f th r. h dr f h r f th r h d p l n n f r h r: "Wh n v r I dr h , t f l l I n t d th n r z ." Sh d t l v "dr v n f t n" n x pl f h t h nt. Wh l h r r n l dr b t h r f th r rr d pr r t h r rr , th dr h d dd nl r r d, n r n n fr n d r n th p t p rt p r d. r f th r h d d d dd nl x r rl r nd r r t n n h h h " th h th h l t ." Sh h d r d th f d t l rr nd n h r f th r d th ft r th nt rv r d nt b t p bl v j nt rpr t t n f h r dr : " t th nd f dr n th t th dr r th n th t th n b d n t h pp n, n ll v j r f r t dr l th t Ch'iidi dreams. (Ch'iidi is a term th t r l t t h t r l t d t r l , pl , dr , r v t t n . It h b th l n t r f r " r z ." h p t nt f lt t n r t xpl n h r n rn n d t l. S x nd n h lf r pr v l , h h d t d n th d l v r f h r n t br th r t h t h r th r l t pr n n . h pl nt h d b t , nd h h d t t h r th r t th n r t h lth l n . Sh r t rn d h l n n th tr t f nd th t h r f th r h d dd nl b ll. "It t rn d t th t h h d r pt r d pp nd x. I nt tr ht b t th l n ...th t ll h d th r, nd th nt t th h p t l ( l tr p b b l n . t r th d t r d t h d n t f r. d d h n th tr d t p r t n h ." Wh n th p t nt b ntl d v l p d n ht r b t h r f th r, h r th r n t d th t th p t nt n d d r n l t r d h r f th l n nt nfl n f th f th r p r t. h p t nt th r f lt th t th p t nt h t d t th f th r d th. h p t nt h d d d th n d f r th r n l th h r h b nd. " t," h t t d, "h d n t b l v n t." h r r th r pr bl . h p t nt h d xp r n d rr t b l t , d r d nt r t n d l t v t , nd n b l t t r l t ll t h r h b nd n th b rth f th r h ld. Add t n ll , h n t d th t r f r n t h r " Ind " b h r h b nd Sp n h p n f l r n v r p tt n . "Wh d th ll h Ind n? h n n , h d n t th t?" In th p t, th p t nt nd h r h b nd h d xp r n d d ff lt h n th nt r d th nv r n nt f h th r h . r th r n, th r p rp l l v n fr b th f l , nd h d b n pp rt v f each th r h n t th r n l h . Unt l h r h b nd br f l ff t r , th h d b n d n ll. h p t nt nd h r h b nd h d p rt p t d n v j r n l n n r n . r f l nd fr nd h d n ll t t d th t t " n t r ht" f r th h b nd t h lp v j r n l . Sh nv n d th t h r f l pr n n th d r t r lt f tr t nt b f l r n l t n th r rv t n f nth b f r b n pr n nt. On h r h b nd d , h h d r d t th hr t n n f h r d ht r v th C th l h r h. r h b nd
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
O E W. U SC 0
f l h d d tr d t n l h l r nd h d n r n f th p l f l n l d f C r nd r . h h b nd nt, f r n t n , r rd d bruja ( t h b th r t f th f l , nd n b r f f l pr bl h d b n r b d t h r l v l n .
An Approach to Treatment h th r p , tl n d b l , d n d t lt n l nt f r b th th tr d t n l v f th lln nd th b d l pr bl th p t nt xp r n n . Arr n nt r d f r t r r v l t n, nd th p t nt dv d t t ff nt p r d t b rt n th t th ff t f h r pr n n n h r br t x ll r lv d. 2 n t r r nd rt n t n r th t th r n th r nd r n l pr bl ntr b t n t th pr l n d p t p rt d pr n. ( h n l d d n v l t n f r p t p rt h p th r d . n th d n r nd rt n r rd n th pl d p r t b l f nd b r nd . E h p h d d pr r n n t th th r b r nd h v r, th r b l f nd thn d ff r n h d b n d r n th p r d f tr . h p t nt v d h r pr bl fr d t n tl v j p nt f v . At n p nt, h xpl n d h r b h v r b d r tl t t n th t h r f th r " n d th th n , h th n h d t." In f t, th v h r d b h r th r, h h d d d th n d f r r n l r p t dl , b l nd v r th ph n . h p t nt n t Chr t n, nd ft r th b rth f th r d ht r h d p rt p t d n C th l hr t n n th t "r ll b l v n t." r h b nd nd h f l h d b n nh pp v r h r f l r t p rt p t f ll n C th l , b t th r pl d b h r p rt p t n n th hr t n n . h d ff r n b t n b l v n n th n nd r p t n th r v d. h p t nt h b nd v nt ll r d th t t n r t r p t h f v nd t d l th th dr " n v j ." 4 h pl d d d t tt th pr bl f th dr f r t. h r f r t d n t h v r n l d n d v t l d th th n d f r th p t nt t t n p nt n r r n f th v l d v l p d r br t t nd h r h b nd l ff. ( ff r t th t , nd th r n ld r r l n tr p t th r rv t n.
Discussion h l x pl f th h t lln pr . h nd v d l v th xp r n b th n lt nd n f xpl n n th d th h nd t d b h v r. th p t nt, th dr r n r t v d n th t h n t d ( t ll , b ll d . h th r n f r h r t n b t n r l dr v n nd th dr (l t r ll , "h n d t" . Sh
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G OS I ESS
n t n r p n b l t f r th t n t n l v l th pr bl n f ntr n f n xt rn l f r . h p t nt v n n rt th th t d r b d b K pl n nd hn n ( 4 .
In h t n , th p t nt a v t f th l v l n f th r ... h v p l t d th t, n n f t th r n h t, th pt d r v fr th p t nt n b l f nd tt t d . h l d f n t n f th lln th t f n v l n th d. In th r n pr , th n t r n t lf n th d f th v t nd t r t tr n th f r h pp rt. (p. 2
A rd n t W t rn th r , th h t f th f th r pr j t n f d th h r n t f th p t nt fr tr t n th h r r br t , f r f r r , p t p rt d pr n, nd n r t h r h b nd. Wh l th W t rn xpl n t n p h l z b t th h t xp r n , th v j xpl n t n n r t z t. h h t r l, n nt l p rt f th t l f th pr bl . h p t nt h d xpl n d h r f r b t " n r z " v d n f h r br th r b h v r. rt f h r p r pt n f r z n h d t d th b n " t f ntr l" nd p rt h d t d th "th n n b t d n ." th r ttr b t th t th f l h d r b d t h r br th r t n t r n th r. At n p nt, h r f l bl d h dr n n n r t l d rd nd t h r ft. Alth h th h d ht th r p t h lp f r h thr h tr d t n l n (th tr d t n l v j p ll n nd thr h th t v A r n Ch r h, th br th r dr n n h d p r t d. h f l f lt th t h r br th r h d n ntr l v r h b h v r, nd h b h v r, l h r n, h d b d tr t v . t r ll , th r l ttl r f r "n t r l d th" n th v j . Ev r n th ht t d th r lt f l v l n , nd th r f r n ( x pt f r d th n ld h h ht f r t b n " ll d." h l n t ll , th lt r h v n v r l ttl tt nt n t th x t n f d th n t r l nd n v t bl v nt n t " ll d," nd th v d n f r th r r th h r l r t n th v j th t t h lp t nd r r th p t nt v f th v nt d r b d b v . A r lt, lf d tr t v b h v r n t l ll n lf d tr t v . h v j ft n v lf d tr t v b h v r th f lt f n l , r th r lt f "b n dr v n t t." h p t nt v n t d n r t . h r v d n f f l r nt n th p nt " (th f th r dr v n t t." r th r r p n n l d d th t n th t h ld t th p t nt b rr n n f r r n l, nd r t th t th p t nt r t rn h t l v nd t h lp t. h p t nt r t d t th t n th b t . Sh d d n t l th r th pr r t r t rn h r th n n t d th n t pl n . K p n nd th t th th r t d th t th p t nt h d nn t n th th f th r d th. h t n h v nd d n l t th r d r. v r, t bl h n bl f r d th n t n n n r t n n th v j . h th r t r t n th t nn t n x t d b t n th d ht r t n nd th f th r d th nt r t n fr th p nt
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of view of family dynamics. The author has observed the same accusation after the death of a parent in other clinical situations. The effect on the child is profound and frequently ties the child in a highly ambivalent fashion to the surviving parent. The ceremonial provided a solution to the dream and established a compromise with the mother. Having made the decision to undertake the ceremonial, the couple verbalized a series of plans to handle their remaining difficulties. By Western psychologizing standards, the dreams and the patient's interpretation of them were clearly projections of her anxiety and depression. Her own view differed, the threat seemed all to real. Toward the end of an interview, the question was asked again with a slightly different approach: "What does your mother say is causing these troubles?" There was no hesitation; "She says my father is making me do it." Her mother had not focused on the patient's marital problems, financial troubles, being isolated in a mountain town, or the new baby. The patient's decision to focus on the ceremonial becomes all the more clear and reasonable when seen in this context. This initial step appeared to be necessary in order to remove the threat and to re- establish her role as an active mother and wife.
Case 2 - A Salish Woman with Ghost Illness Date of Onset Problem List Summer/Fall 1976 1) Rheumatoid arthritis Longstanding 2) Diabetes mellitus, insulin dependent Longstanding 3) Obesity 1976 4) Positive tuberculin, treated with isoniazid (INH) a) Hepatitis related to INH therapy Summer, 1976 5) Depression Longstanding 6) Asymptomatic diverticulosis
This middle-aged woman was referred for the evaluation of diffuse arthritic complaints. Two and one-half months prior to her hospitalization, she had developed recurrent problems with early morning stiffness and aching of the proximal interphalangeal joints of her hands. She became progressively unable to care for herself during the six-week period immediately preceding hospitalization. She required assistance dressing, eating, and bathing. Two weeks prior to her admission, she became almost entirely dependent upon the help of others. Physical examination in a referring clinic did not explain the severity of her illness. Her laboratory evaluation had been negative. At the time of her admission to the hospital, she was a remarkably disabled woman; walked with a shuffle, shoulders forward, stooped over, and with her arms folded across her chest. Her evaluation in the hospital supported the referring clinic's view; there was a disparity between her laboratory evaluation and physical examination on the one hand, and her severely incapacitated state on the other.
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h p t nt h t r n l. Sh d t d th n t f h r lln t p f d t n th pr d n f ll, th rn n ft r h xp r n d v t b h r d d f th r. "I f lt b p n t th b d nd I th ht, I nd r h t h b nd d n n th t d f th b d. I f lt th b p n, I p n d nd f th r t nd n th r . h d n h t , nd l d th h n b r d h ..." h p t nt n t d th t h t th t , nd t t d th t h r f th r p nd d h r th p l ft f S l h p r t n . A l t r p rt f th nt rv n l d d n nt f n t d p d h h h f lt h v ntr b t d t h r lln . Sh t t d th t h r rthr t h v b n d b h r f l r t b pr p rl "br h d ff ft r p rt p t n n h l n r n . h n d nt h d rr d b t thr nth pr r t h r d n, nd th r n b n d n f r n nd v d l h h d lt pl rthr t pl nt . h p t nt h p th z d th t th p r t th t n th rthr t nd v d l lln h d " ff nd h h d b n tr n f rr d t h r lf. ( r h n ff h l r nd p rt p nt n h l n pr t n pr t d b S l h r p . It d t pr v nt n d n r p r t fr t n t th r d r n nd ft r th h l n pr . h p t nt h d t d n th b f h r S l h b l f nd d p r t S l h nt rpr t t n f h r n . Sh h d ht th t n f d ff r nt h l r fr n b r f d ff r nt S l h r p . M lt pl tt pt t d l n th h r pr bl h d b n n f l. At n p nt, h tr t d d r n rv n th Ind n Sh r Ch r h. " h th p r t, nd t t ff ." v r, th h l r n h r f th rv n t d th t th " h l h r h d t b r n nd p t," nd b "h f lt th p r t t p rf l, h p t t b n th n xt rn n —I t ll n th t I n v r f lt b d I d d h n th t n p t th t th n b n ." At l t t th r d n n h d tt pt d t d l th h r, nd th th r p h d f l d. S b ntl , n f th d n n t d th t h n d d t W t rn ph n b th lln n t r p nd n . In n tt pt t p t th p r t l p t f h r lln nt p r p t v , th p t nt d r b d rl r lln f l r n t r . "I v l t l n b r f t ." A n x pl , h r p rt d b n ll ft r th d th f h r f th r 8 nth rl r. r n h f n r l h h d n p l t "j p n h r v ," nd t l t r " t ll f l n r l b d." Sh tr t d b d n n h "t ld th t I h d l t l n th r v rd...th t t h d b n t nd n t th r n th r n nd ld ll th t t ." th r p nv lv d r tr v n h r l. Sh th n d r b d nd p d f " p r t n " nd n d n r v l d l n r h t r f rthr t pl nt . S x r rl r h h d d v l p d p n n h r r , h ld r , nd n f r p r d f thr r f r f ll n n p d n h h h h d n dv rt ntl n rth d n h l l r n n r f r n h . " h p r t fr th n r pp d r nd r nd h ld r, nd th d n n h d t t th ff b f r I t b tt r."
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An Appr h t r t nt A rd n t S l h tr d t n, dr f th d d p rt nd lln r v n d th, r ht nd t th t th p r t h l d l n th dr r. h f ll n t n d t th p t nt: "Y r t r v th d th t h v b n th n n f n d th." Sh d t l r pl d, "I t ld th r th t f th pt d n t l r b pr n , I d th f th r p r t." h S l h n tr l r l n d nd r p t nd r n t n f th d d b ft nd pr r (A , 8 C ll n , 80 l , 4 . In r t n n h h n b l v th t th r b n d ll b p r t, th r p r v d thr t f l l , r v n d th.
In th 0 , th n n ...(S l h ... ld t ll ttr b t hr n lln d r n W nt r t t p n b p r t d nd n th p t nt t n t n n d n r, ll n r f p r t n r d t b p d n W nt r nd t ff r n lln tr t bl nl b n n nd d n n . ( l , 4, p. 4
Alth h th p t nt h d lr d b n d n r, h nv n d f th n d t "br n t" h r f th r n . Add t n ll , rd n t th S l h tr d t n, p r t ht b th r n f th l v n b th p r t l th n . A fr nt nt rpr t t n th t th l v n h v th n th t b l n t th d d, r th t d r n d d b th d d. h n b bj t f d nd r t rn d t th d d b f r n l b rn n . h p t nt d n d th t h ht h v th n th t b l n d t h r f th r. v r, ft r n t t n f d n b t h r b l f nd n rn , h pr v d r r bl , b r b l nd t v , nd b n t r f r h r lf. In dd t n, th p t nt nd h r th r h d b n d n th n d t h v r l rv f r th f th r. h rv t b h ld n r th nd nn v r r f h d th, th p r d h n th d d f th r p r t ld nd r n nd b l f thr t t th l v n . h p t nt f r d d n n th p r d b f r th nn v r r f th d th. r nt rv nv lv d d n f th r l, f l b r p n n b t t, d r nt b t n h r lf nd h r bl n , nd th r l t n h p b t n th rv v n f l b r . Ev nt ll , h v n d r t n r nt t pl t th r n l. Sh th n nn n d h r pl n t nd rt th n n f h r f th r n , nd t pl t h r l rv . r r t h r d h r h d f I ld h r th r h , h d, h d th tr bl . r th r h ll n t n h r f th r " ll th t ," nd r f d t b l v th t h r ll n . r n th nth f ll n d h r fr th h p t l, th p t nt rh t d rthr t r n d, nd th v l t n f th rthr t h n r v l d t p l ph l f nd n th th dd t n l pp rt v l b r t r v d n . S x l t r, t f ll p pp nt nt, h h d r d pr r n, th ll n f th n v v r th t rp ph l n l j nt b n t n t bl , n r d n f h r r p, t . In ntr t, h r nt l t t h d pr v d r r bl .
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G OS I ESS
Sh h d d t nt t r t rn t r . Sh t n r f h r lf nd h r th r. r pp r n nd t v t t d r r bl r v r l n h r nx t nd rb d d t n.
n A n b r f d l r: ( Ch n b t n p t n , tr d t n l xpl n t n f h r lln , th p t nt h d nt rpr t d th n t f h r pt n th t h h d b n n l d t b h r f th r p r t nd th t h , r n l thr t n d th n nt d th. (b h p t nt pr bl th nr lv d r f r h r d th h r th r, nd b th n t th n l n th t n n t d . h d ht r n t ll h d f r d h r n d th, nd l t r b th n t th n l n th t t n ll r nd h ld h thr t n d. ( th r f ll d th nx t , nd h d v r b r v nt pr bl . (d h d ht r r f r t n l l x rb t d b th r n f h r rh t d rthr t . h th r d n l f h r h b nd d th d h r r l t nt t p rt p t n th r l rv . h rv ld b n rr v bl n nd r n t n th t n d d f rr h d t n nd, nd th t h r h b nd nd d n . h th r p t t n r p f ll d n d t t th r t n . h p t nt n r d t n h r f th r p r t n , t v th n p, nd t h lp th th r n l pr . h th r n r d t p rt p t n th r l rv . h rv f ll h ld t nth l t r, nd th p t nt p rt p t d th v r n p t f v r pr bl th t v rh t d rthr t .
C A Hmong Refugee with Ghost Illness t f On t r bl t S pt b r 6 d h , l p d rd r n t nd n 2 A b , h r 0 M rr 4 f , n l n l
h p t nt r ld, n l n l n n. Sh b rn n th n rth ntr l h hl nd f , h l d f r h rt p r d f t n C th l h l, nd fl d ft r h r p r nt r ll d. Sh r t d t th Un t d St t fr h r f p h n h r ld nd rr d n n r f h rtl ft r rr v n n th Un t d St t . h t h d t n h l nd. h nth f ll n h r r t n t th Un t d St t , h d v l p d v r h d h h h rr d n t thr t p r , nd n ll l t d 24 t 48 h r . h h d h r pr d n ntl l ft d d, nd r t d th n nd n l v t n . Sh h d ft n n d th h d h , b t
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h h d n t xp r n d n r , r v l pt . th r p r n n r pr r b d d t n h d pr v d d n r l f. r h d h d t r p nd nl t l p. Sh d n d p t d l h t r f tr , z r , r th r n r l pt . Sh d d r ll p tt rn f nfr nt h d h d t n fr h r rl t n , h d h th t rr d d r n t f tr . r r nt ff rt t l p ff th h d h h d ft n d h r t t h nd h r En l h l . Sh h d b n n t l t l t ht t n r n r nd l n v r nth p r d. h ph n nv lv d h d r rd d v r t f pr n f h r pr bl : r n , l t r h d h , nd n "t n n, l t z t n, nd dj t nt pr bl ." Ext n v n r l v l t n h d b n nr v l n , nd p r l th r p f r t n n h d h , r n , nd (l t r l t r h d h h d b n n f l. In O t b r, , th p t nt h d rr . r h d h p tt rn h d p r t d thr h t h r t nth f pr n n , nd th r ft r. Sh r v l t d f r h d h n n r f 8 nd p rt f th n r f d n h r l p p tt rn nd dr . Sh r p rt d v r l d t rb d l p nd r rr nt n ht r n h h h h r d d p r nt : "Sh h r th r nd f th r... t h r f th r f t rd h r... t r ht t h r." Sh ld n r n nd h r h b nd r p rt d th t h ft n d r f r n t d th t th t : "S t , h p n h n t d ." f rr n t th dr nd th f th r , th h b nd d, "Sh th n h n t t h r th h ...." Sh h d b n xp r n n l r dr p tt rn n th n t f th pt t l . S v r h d h p d r l pr d d b th dr .
An Approach to Treatment h n t r f th dr d d n d t l. h p t nt r t n t th dr — p f ll , th t h r f th r " n ft r h r... n t t h r th h "—r pr nt n v r l nt rpr t v pt n r rd n h dr . It p rt nt t r n z th t th p t nt pr bl th h r dr n r n t d n r t . A n ht l n n f n r pr r n n S r d r t r f r n t b th lln d b h t nd th r l t n h p b t n d th nd dr . A tr n l t n f p rt f th pr r d f r f l th t h d l t th r f th r f ll : "If d n t nt t r n h lth nd pr p r t d n t tt r, b t f nt t t v h r t t r f th r b v n h thr j t , nd thr nt f p p r n ... r r nd r th r h b n n n . h r th n th nd th n t th h ... h r n t th r f nd t th b dr . h f r t t t t th r f nd l t r t t r b d . d d n t nt t d b t SI YONG th h t d CHIJIER t t h h h rt. If h t h n b d th CHIJIER, th t p r n t d ..." (CHIJIER is nd f lln h h th n b l v b l n t SI YONG, th h t.
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G OS I ESS
h ld n h d n ht r l t n ht. dr d th t h tr d n th h t fl r. dr d th t h r d th h t h r . dr d th t h t pp d n th r v ... h ld n d d n t nt t d b t th h t p n th rld bl th p p . h bl t n th rld nd bl t l n th , nd th n bl t t th h f th ld nd th n th l f th ld n nt th th h t nd h d d... (Ch nd r , 8, p. 0
Once again we find the theme of the dead calling for, or returning for the living. It had significant meaning for this patient. Interviews with the patient and her husband evolved as follows: 1. To begin with, the couple was encouraged to discuss the religious practices and beliefs of their parents and grandparents. This was a natural extension of an earlier discussion of details regarding the patient's origins, early experience, family members, etc. The parents on both sides had practiced ancestral worship and the discussion focused on what they "would have thought" about the dreams. The couple's response was clear: the dream meant that the wife was threatened. The couple insisted that they were not aware of a solution. 2. To the patient, the dreams represented a direct threat that within the context of Hmong beliefs, the spirit(s) needed to be neutralized (via gifts, prayers, by showing respect, and the like). For these reasons, a separate discussion was then undertaken; it focused on generalities regarding the ancestral aspects of celebrations and ceremonial meals, or gifts. The couple was given an example of a family who had prepared meals and gifts, and offered prayers to their ancestors during a time of trouble. It was not pointed out that these practices were often viewed as helpful to the participants, and that in the face of need, similar offerings and prayers could be undertaken any time of the year. 3. The couple protested, "We've heard about those things, but we don't believe them." "We're Catholic, we both went to Catholic school, and we don't know about those things..." (Their combined exposure to Catholicism had been less than 20 months.) In a concrete sense, being Catholic implied immunity to the patient's interpretations of the dreams and was viewed as an effort to avoid unpleasant, threatening explanations of the dreams. Additionally, their statements about their Catholic backgrounds were viewed as attempts to avoid being labeled as different. The discussion then focused on the difference between knowing about things and believing them. They both knew about the beliefs and the point was made that the wife's interpretations of the dreams were very similar to those she attributed to her parents and her grandmother. 4. The patient and her husband were encouraged to discuss the matter further with the family members and with some older Hmong people that they respected and trusted.
Diagnosis and Treatment in the Community Initially, the couple approached an older brother of the patient. His initial reaction was similar to their own: he stated that "as a Catholic," he did not know enough to make a decision. All three decided to discuss the matter with an uncle, and thus
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began to involve the entire family. Within 48 hours, a number of relatives and other Hmong refugees gathered, a meal was prepared along with gifts and prayers for the deceased relatives. A diagnosis had emerged the family had decided that the patient's problems were due to failure to seek parental permission for her marriage. Since the husband's parents were also deceased and he had no relatives in the United States, the wife's family and other members of the Hmong community assumed primary responsibility for preparing the meal. The patient and her husband were seen in a follow-up visit. They were delighted with the outcome; she had become cheerful, animated, and involved. She remained headache-free for a six-month period after the meal. After six moths had passed, she developed a problem with anxiety associated with a second pregnancy. However, neither the dreams nor the headaches recurred. The patient did report a dream two weeks after the meal. She dreamed that she was visited by the deceased mother of her husband. The older woman made a sign of respect to the patient and voiced approval of both the patient and her marriage.
Discussion A number of questions have been raised about this case. Does this illness have a unified etiology? Was there more to it than the dreams and associated meanings? Why insist on the term ghost illness? The patient had experienced multiple traumatic events and complicated changes, which included the experience of war, the killing of her parents, flight from Laos, refugee camps, immigration, marriage in the absence of family support, and an early miscarriage. The patient was isolated from the community at large by language, lack of knowledge of the society, and the like. Certainly these were all valid features of her problem, and they existed in the face of what appeared to be prior underlying problems with tension and occasional headaches whenever she was under pressure (evidenced by the problems she experienced in younger years). According to Western psychology, the sum of her difficulties could be viewed as creating high levels of anxiety and depression. A Western solution would focus on helping her explore and work out those difficulties. However, Hmong tradition lacks a similar formulation of this sort of problem; there is no Hmong term for anxiety or depression. Therapeutically, the decision was made to separate out the concrete fears associated with the dream intelpretation—literally, the perceived threat of death. The ceremonial therapy was aimed at the dreams. The more complex issues of the young woman's character and personality structure, and of her status as a monolingual parentless refugee and a newlywed with a recent miscarriage would remain. The patient's dream-related fears and associated ideation about dying may return, but they are likely to do so only in response to a new set of circumstances. Should ghost dreams recur, the meaning of her reaction to them will be partially dependent upon her circumstance at the time. In this case, the term "ghost illness" describes the traditional view of the cause and potential effect of the dreams. Discussion of
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19 GHOST ILLNESS
S th t A n tr d t n b t th d d pr v d d p f n f n t n b t th lln nd t d f r . It l t bl h d b f r p rt l l t n th n th nt xt f th b l f nv lv d. h l pr v d d b r l t v nd th n n t n tr l z d th p t nt dr nd dr d. p rt p t n , h d lt th h r n nd h r h b nd d nt t n n , thr t n n , nd d ff lt pl . h th r p t t v t nd rt n th th f ll n l d nd pp rt f r p nd n b v d d pl n r f f r nd n rn nt pr th t h d p rf l n n t th p t nt. In dd t n, th th r p t pr d r tl d n h d h r n f l t n. h pr b l z d th n rn nd pt n f ll n n t . A n n th r th r p t t n , th p t nt f r d t d n r rd n h r b l f —b t th t n t n l. h th r p t r l f th ph n nd rt n th t d t l l n l d f n b l f th t , th t d t l d n l d f t r n l , pr t , nd th l . A v d nt fr th h t r , th p t nt nd xt nd d f l n d t f ll n n f th p r rd n l t n t th pr bl . Gh t Illn nd n Exp r n nd l f In rd r t pl th pr v thr nd th th l f th h t lln tr d t n n br d r p r p t v f h n xp r n , th p p r ll n xt d th pr v l n f th h t lln ph n n . It ll b l n d t : ( th p d l f h n xp r n th d th n f l b r , (b th p l t d d r n b r v nt, nd ( b l f r rd n h ll n t n , dr , nd r rr nt th ht f th d d. Gh t lln ll n n n n rth A r n Ind n r p . r n t n , th M h v h v h d r h t r n l f r th pr bl th t n l d r l h t lln , h t nt n t n, h t l n d , nd f r rd n d h t d ( v r , 6 . M h v d f n t n, lln r pt fr dr n f d d f l b r , b d r t nt n t n th th d d, b v l t n f f n r l pr t , b t h r ft ll n , b nt t th t n , nd n. h M h v h v tt h d h t r l t d t d v r t f t lln . (On t r ll th t th nd b d p r t n th t x t n W t rn b d l p r d d n t x t f r n b r f r p l th M h v . h ppl t l r n b r f h n r p , p rh p th j r t . S l r b l f r d pr d n A r n Ind n r p , lth h th r b d v r t n n p f r l nd th l . r x pl , th r nthr p l l t r t r d r b n n rn v r nt rf r n b th d d n d v r r p h th S x ( r , 86 , C n h ( n , 2 , (Ort z, 6 , E (Sp n r, 6 , nd S l h p n p pl (A , 8 l , 4 . An t v n tr l r l n x t f r th S l h tr b n th rth t, f r th b f r rr nt pr t n th r "S " tr d t n, nd h b n n rp r t d n n r t f h n nt th r n r Ind n Sh r r l n. h d d r pp d b ft nd pr r , h lp b ht fr th d d, nd l t r
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t l n l n b l t d. h pr t h v th p t t h lp th l v n r v tr n th, p r, nd d fr th d d. h r l d n d t pr t t b l v r fr p t nt l l v l n n th p rt f th d d. Exp r n th th d d br dl r pr nt d n th nthr p l l t r t r . h d d pl r l n th r l n, h l n pr t , nd b l f f Ch n (Ah rn, , f Ind n r p ( hn n, 8 Sh rp, 82, z r, 8 , th h ( b h, 80 , Afr n p pl ( h nn n, 60 nd n Ind (K r, 82 . On n f nd r n l n f d l n th l n p r t , n t r , nd n t r pr nt t v f h n p r t . h p rp f th r n l pr r n fr bt n n d r t t n , bl n , r pr t t n fr th d d, t bt n n dv n h t d l th r dr v ff l n nt p r t. Int r t n l , h t h v th r rv d th n d f th l v n r h r d th n n l h n f h n. Illn , r v n nfl t b t n nd v d l , b ttr b t d t l v l nt p r t (Sh r , 8 . h v "th t d th n nd f n n nd f th p r n nv lv nt th th rld f th l v n " h b n d r b d W t rn " thn ntr pt n," h h ntr t d th th v f " M l n n p pl ...( h ... th t h t h n n , th t t r f th ff t f t d th n t rv v r nd n nd n v nt , nd th t t p bl f nt t n th h r t ll l v n " (C nt , 84, p. 0 02 . n Exp r n th th n l M b r h p d l b f r r t n t d th nd d n r br ht nt h rp f b n b r f tr n t d f rt l t n th d t rv v r f d th n th f l . In 6 , ( 6 r p rt d n th rt l t f b r v nt n 0 l r l t v ( d nd f l b r n W l . Ov r 2% f d d nd v d l d d th n n r f l n p . W d r d d t th r t f % nd d t th r t f 8. %. Ov r ll, th r t r pr nt d v n f ld increase n d th h n th b r v d r p r p r d th t h d ntr l r p fr th n t . h r dd t n l v d n th t th r nd r f th f l l t n r d r (pr r l bl n nd h ldr n . In n th r t d f 4,486 d r n En l nd (Y n W ll , 6 , rt l t f nd t x d th t f ntr l r p b 40% n th f r t x nth f b r v nt. lz n nd Sz l ( 82 , t d th t nl l d r t n r d r , nd f nd th t br d t t t l n l f d d r p f 4, 02 p r n f l d t pp rt n r d r d r n th p r d f b r v nt. In ntr t t th f nd n , K rr , K nv , nd t ( 8 , d d pr p t v t d f ,64 d d p r n n nl nd, nd f nd tr n n r n r d r n th f r t r f d h d. Add t n ll , h h rt l t r t n th d d r l rl d n tr t d n t t t b d n ll d th n th Un t d St t b t n 4 nd . Kr nd l nf ld ( , d n tr t d th t d th r t f r d d nd v d l r n d fr 4 t r t r t r th n 0 t th r t n rr d nd v d l f th . r bl , th t d h d th t d d nd v d l r t n r d r fr d v r t f d . h
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21 GHOST ILLNESS
n l d d t b r l , v l r l n f th ntr l n rv t , h rt d , rt r l r t d , h p rt n n th h rt d , ll d nt nd d . An x rt l t r t xt nd b nd th f r t r f l , nd th f r b n t pr v d r l b f r th d pr d h n dr d f th d th f n th r h n. M th l , r l n, nd p p l r d r rd n d th f n th n t n th t n d th f ll n th r. h th nd b l f d f t l h n xp r n . A n th t l r p tt rn h v h ld v r th nt r , t l rv v r xp r n f n r d r h pr v d d d r t b f r th dr d f d th f n th r. h rv v r n th thr t, h h t t pl d th th r n p l t d . h I p l t r n r v nt h p l t d t th t f n th r d th b l ll nd n r t l r pr nt d b th nd pr t f S tt , n h h d ld thr h r lf n th f n r l p r f h r h b nd. Wh th r n v S tt n nd v d l p l r lt r l xp t t n nd r t th pr r f th r , th t th . If th t f S tt l l nd r t r p pr r , t , nd nf r bl xp t t n , th n th d b p t f r th r p. h d p l f b r v nt pr v d n dd t n l t b t n th d d nd rv v r f th xp r n . f rr n n t th t d b Kr nd l nf ld ( , th pr p d thr h p th t xpl n th h h fr n f d th n th rv v n d d nd v d l . h f r t t h p th d l th th n t n th t rr t l t nd v d l th p r bl h h r lln nd n b l t , r b t ll xp d t nv r n nt l r nf t f t r h h l d t rl d th. h th rd h p th d l th th f " r f, th n rr nd r p n b l t , lt r t n n th d t, r r ...fr ntl r d d n nd t n," nd th l . n t n r tr n l t d t xp r n th n th f l nd n t . In r lt r l l n l tt n , n f nd p t nt h h v h d d r t xp r n th pr p r t n f r b r l, n l th n fr th d d, h n b r l d , d n th r v , b r l f th d d, nd v n th h n f n tr l b n f r r b r l (Ah rn, C ll n , 80 . In th r rd, d th n n t nd f l pr v l v l f d r t p r n l nv lv nt th t n t b tr f r W t rn z d p pl . h r n th n t t th t th pr t f b r n n n d d n r l d r b d f r th rv v r . h p nt th t d ff r nt pr t nd b l f d t t d ff r nt p r pt n f d th r l t . In dd t n, nd v d l nd r p h v h h r fr n f xp r n th d th n d t f l b r . O r xp r n th A r n Ind n p t nt , f r n t n , h r r bl n d n f d r t nd fr ntl r nt xp r n th d th. h xp r n n r l ld th nd v d l r t n nd th ht h n thr t n d b lln r dv r l f v nt .
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ll n t n nd r f th d t nt r p rt r xp r n dr r h ll n t n f th d d d r n t t f ph l nd r p h l d r pt n. h r n f tr bl fr v r t f r pr v n rn over d th. h p ll tr n p t nt th d r pt d f l pr , nx t t t , r d pr n. h pr l r th n r t n th t v r t r v nd r d tr t v p l , v n p l t rd lf d tr t n. r f th dead may be t d th v r t f r t n n th p rt f th dr r, lth h th p t nt n t xpl n th v nt b th nd f f r l d b d rn p h l . It p rt nt t r ll th t th dr r ft n v d r l v nt , r l n th n th t th h t r th p r t r l. h nl h r d b l f th t dr p rt nd tr bl l d t n f dr d n th p rt f th dr r r th dr r f l . r f th d d r t d th h h fr n f l p d r pt n nd pr v d d r t v d n f nx t nd r d pr v p tt rn . r th r n , t nt l t bt n l p h t r nd dr p tt rn fr p t nt h lt r h v h t r nv lv nt th n tr l b l f . h l n n h ld r n z th t h dr f d th r th d d b v l nt t n th d d n n t t . r p nt t b d n th r rd. r t, th p t nt d r b n xp r n dr nd ttr b t t t n n n t t . h ft n d n t v d th l f pp r n t b nb l n d, n n , r v n d n r . (An n h r p rt n th d d n waking state l l t b v d d b th r nd b r rd d n l, d n r , r v n p h t . h n v r l ph n n x pt n th r p th t h v f r ll n t n d th t v t b n t n xp t t n . S nd, th p t nt ft n pr j t th r n dr d f h ll n t n ( r dr t th l t n r nd thh ld r lt r th d r pt n f th xp r n . h ft n xpl n d n t r f "n t nt n t p t b rd n n n l ." h rd, n t , p ll th th t h v n t d v l p d r d p nd d p n r tt n l n , h v p d xt n v tt nt n t dr n , nd t th p rt nt pl t n dr h ld f r th l v n . Ind v d l fr th t t b d lt th n f h n th t t th r dr n p tt rn nt nt , p ll th r dr h lp t xpl n th r n xpl n t n f d r pt d h lth r l f p tt rn . rth, p t nt fr b r nd th t n l d xt n v l r l b l f nd r l r tt n l n , n th t dr r t v . h t , th b l v th t p n b t dr l t r ll tr bl . In , r p rt d n th "h ll n t n f d h d." nt rv d 2 d d nd v d l n W l h n t nd n r d b t v l, t t l , r d t r h ll n t n f th d d. n l d d th xp r n h t r d " ll n ( n f pr n " f th d d p . Of th 2 p pl nt rv d, h r p rt d th t (4 . % h d p t b r v nt h ll n t n . M n f th h ll n t n l t d f r r t th t f nt rv , 06 p pl ( 6. % t ll h d h ll n t n . It p rt nt t r n z th t d d n t n l d xp r n
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2 G OS I ESS
r p rt d t h v rr d t n ht, r n r t r n n th v n n f r th p rp f h t d , r rd d ll th n t n dr , n t h ll n t n. In dd t n, h d d n t nt n t n n h h nd v d l r p rt d n xp r n nd th n r t n l z d b t t, f r x pl , n th h d n th d d n "th r nd ." In t d , th n d n f p t b r v nt h ll n t n n r d th th d r t n f rr , t nd d t d pp r th t , r r l t v l n rr n , nd n r ll r n d r t h h th rv v r h d n t pr v l r v l d t pr f n l. h nf r t n r n d "f l " . Alth h % f th n, nd 2% f th n h d d l d th r xp r n t th r , n n h d r p rt d th t ph n, nd nl n p r n t f h d p n th b r f th l r r rd n th xp r n . f lt th t t f h p t nt r h lp d b th xp r n nd th t th h ll n t n rv d f l p rp . f lt h l d v d n th t r l b l f pl d r l n th fr n f th xp r n . h j r t f h bj t r Chr t n f th r An l n r W l h M th d t d n n t n , nd 4 % d n d r l ff l t n. f nd n r n t n t nd v d l f C lt d nt. In 8, M th r p rt d nt rv th 2 d n S th t rn nd n nd f nd th t 0% h d xp r n d h ll n t n r ll n f th d d p . Add t n ll , n 6 , Y t nd ll r p rt d nt rv th 20 d n nd f nd th t 0% f th r p rt d f l n th pr n f th d d p . t th t n n f th t d r p rt nv lv d nv t t n f t t n n h h th h ll n t n r dr pp r d t b pl n r l n th nd v d l t t f h lth. h d , h v r, t bl h th x t n f h n xp r n th h ll n t r ph n n ft r b r v nt. h f r t n th p p r ll tr t d r l t n h p b t n h t dr nd d l d t n. S l r dr , r n t n nd h ll n t n f th d d h v b n r p rt d t th th r n d l A r n Ind n p t nt , rv v r f d n Al t v f l , nd b n f l d . r ll f th r n , nt f nt l t t n A r n Ind n p t nt h ld t nt r t n th th d d (dr , r n t n , nd h ll n t n nt r f l nt. th W t rn nd, n h ll n t n f th d d, n , h r n , t l n t , b n t h d b , r n n th pr n f th d d, r n d r d pr j t n f th l v n nd v d l h r p rt th xp r n . It p rt nt t r n z th t th W t rn tr d t n n t h r d n n v r l b . t nt v nd r t n t xp r n th th d d t b d th r t r , n th r th nd v d l xpl n t n r xpl n t n pr v d d b h lt r b n d rd th v b d n W t rn p h l . In l n l tt n , th xp r n t ft n nv lv d d r l t v r fr nd , nd l fr ntl n h d nt t n t l r.
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S r h r n r lt r l n r l r bn r l t t h h n n r f r h n dr nd h ll n t n f th d d r. On t j d h ll n t n nd dr f th d d n th nt xt f n nd v d l l f h t r nd r t n . t nt pr nt th xp r n b n pr t t v , f rt n , r thr t n n . Cl n l f nd n p r ll l Sp r ( d r pt n f th lt pl h n ttr b t f h t . r nt t n h h nd t p th l r d ff lt f r th p t nt r h hl v r d. It n t n r f r dr r h ll n t n t f ll th p t nt th dr d. r x pl , pr f d n f f rt nd r rd n d t r h ll n t r xp r n th d d n r pr nt d b n Ir h n. Sh r f d t h n h r r d n b h f r d h ld l nt t th h . Sh t t d th t f h v d, h r n ld n l n r b bl t f d nd n t th h r. r f l f lt th t th xp r n r pr nt d h r x f r r f n t d l th th n d t h n r d n . An E p t nt r p rt d th t h nt n dr involving h d d br th r nd t d th t d h nt n n l b f r h . lt n l x t d nd nx t r p rt th n l d . In v , th dr r pr nt d v d n f th p t nt r t rn t p t v tl ft r l n lln nd f l r r . r r t r r h h d xp r n d dr f th d d h h h d f ll d h th dr d ( t h, n pr . r n ll ll p t nt r p rt f rt n dr f th d d n pr p r t n f r th r n d . h tr d t n f h t lln r nd th t th nt rpr t t n f lln d p nd nt p n b l f t . An lln n pr v n rn v r l nd d th, nd r lt n th p t nt h v n n nt r t n th th d d. Wh n p t nt th p l b l f nt rf th W t rn d n , f l r t t th r b l f nd n rn nt nt l d t n n b l t t th r nd r t nd r r lv n f nt l n l pr bl . A d t n t d p r t b l f ft n r r th t l t n f t th nt xt f th p t nt b l f t nd lt n l d l th b th th W t rn nd n n W t rn tr d t n .
p rt nt f M d n nd r r C r f M d l C nt r 200 2th Av n S th S ttl , W h n t n 8 44
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2 G OS I ESS
f r n
Ah , E. ( . h lt f th d d n Ch n v ll . St nf rd, CA: St nf rd Un v r t r . A , . ( 8 . C t S l h Sp r t n n : h rv v l f n n tr l r l n. S ttl , WA: Un v r t f W h n t n r . h nn n, . (Ed. ( 60 . Afr n h d nd d . r n t n, r n t n Un v r t r . Ch nd r , . ( 8 . h r l n f th n j . n , h l nd: S S t . C ll n , . M. ( 80 . ll f th p r t : h Upp r S t Ind n f t rn W h n t n. S ttl , WA: Un v r t f W h n t n r . C nt , . ., & C nt , . A. ( 84 . A p t f d n n n rth t r t n. O , 4, 0 . v r x, G. ( 6 . M h v thn p h tr : h p h d t rb n f n Ind n tr b . W h n t n, C: S th n n In t t t n r . nb rr , . ( 62 . h M nt n Cr : A t d n r l p r t n . Upp l , S d n: Al v t nd W ll. l , . ( 8 . Or n l nd f th v j n . v n, C : Y l Un v r t bl t n n Anthr p l , b r , Y l Un v r t r . l n , K. ., & Sz l , M. ( 8 . M rt l t ft r b r v nt. A r n rn l f Ep d l , 4, 4 2. l , W. ( 4 . S l h nt l h lth nd lt r h n . r nt , Ont r : nh rdt nd W n t n f C n d . pr nt d Ind n h l n : Sh n r n l n th f rth t t d . S rr , C: n , 82. hn n, . ( 8 . Wh n d n b tt r th n l v n : l d n th G nj f p G n . Ethn l , 20, 2 4. n , . E. ( 2 . S n p . C n h d n n. Y r , Y: lt, n h rt & W n t n. K r, S. ( 82 . Sh n , t nd d t r . A p h l l n r nt Ind n nd t h l n tr d t n . t n, MA: n r . K pl n, ., & hn n, . ( 4 . h l n n f v j p h p th l nd p h th r p . In A. K v (Ed. , M , f th, nd h l n (pp. 20 20 . Y r , Y: r r . K rr , ., K nv , M., & t , . ( 8 . M rt l t ft r b r v nt: A pr p t v t d f ,64 d d p r n . A r n rn l f bl lth, , 28 28 . Kr , A. S., & l nf ld, A. M. ( . S p d l p t f th h h rt l t r t n th n d d r p. rn l f Chr n , 0, 20 2 . z r, ( 8 . M A t : C lt r b nd lln n S n r nt n t . O n , , 8 . v , . ( 8 . v j . In A. r d (Ed. , Ethn t & d l r (pp. 6 . C br d , MA: rv rd Un v r t r . , ., & , ( 84 . pl f th G ld n r n l . Y r , Y: h nd d n. M rr , . ( 8 . W d nd th r f l . In t t t fC n t St d , l. . nd n, En l nd: tl d nd K n l. Opl r, M. E. ( 6 . Ap h d : A j rn b t n t rld . Y r , Y: lt, n h rt, nd W n t n. Ort z, A. ( 6 . h rld. Ch , I & nd n, En l nd: h Un v r t f Ch r . r , M. . ( 86 . O l l n. Ch , I & nd n, En l nd: h Un v r t f Ch r .
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t h, . W. (In pr . n n r lt r l r . In W l r, . K., r t, . W., nd ll, W. . (Ed , Clinical methods, ( rd d. . t n, MA & nd n, En l nd: tt r rth . , W. . ( 6 . M rt l t f b r v nt. British Medical Journal, 4, 6. , W. . ( . h h ll n t n f d h d. British Medical Journal, 4, 4 . Sh rp, . . ( 82 . Gh t , t h , n nd d th: h tr d t n l nt rpr t t n f nj r nd d n r r l r f p G n . Papua New Guinea Medical Journal, 25, 08 . Sh r , . ( 8 . Gh t nd G v rn nt: A t t r l n l f lt rn t v n t t t n f r nfl t n nt n S . Man (NS), 13, . Sp n r, . . ( 6 . The North Alaskan Eskimo. W h n t n, C: S th n n In t t t n r . Sp r , M. E. ( . Gh t : An nthr p l l n r nt l rn n nd p r pt n. Journal of Abnormal and Social Psychology, 48, 6 82. b h, S. . ( 80 . Buddhism and the spirit cults in Northeast Thailand. C br d , MA: C br d Un v r t r . Y t , ., O n , K., I , ., & Y h r , S. ( 6 . M rn n n p n. American Journal of Psychiatry, 125, 660 66 . Y n , M., nj n, ., & W ll , C. ( 6 . h rt l t f d r . Lancet, 2, 4 4 4 6.
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THE FEARS OF NAVAJO CHILDREN: ADAPTATION OR PATHOLOGY?
A K . IKA SKY, Ed
A S AC . t nd rr nt l t r t r n rn n th f r f h ldr n n r ll nd v j h ldr n p f ll x n d n th p r p t v f rr nt r r h nd n d pth nt rv . h p t n t n th t h h f r fr n n v j h ldr n n t b pr f v d n f p th l , b t r th r v d n f lt r l p tt rn th t h p rt nt d pt v v l .
The Anglo-Saxon heritage, which venerates fearlessness, supports the traditional clinical view that predisposes us to regard fears as generally undesirable behavior and potentially pathological. This view stands in sharp contrast to the view of fear held by the Navajo. The Navajo view was described by Kluckhohn and Leighton (1956): "When one first studies Navajo belief and practice, he thinks more than once that the Eskimo's description of their religion—'we do not believe, we fear'— would be appropriate for the Navajo as well." At times the clinical view is no doubt correct. However, if certain behaviors such as fear are often concomitants of serious personality disturbance, this correlational fact does not establish the criteria for determining when fears should be regarded as pathological symptoms, neurotic traits, or prima facie evidence that something has gone awry psychologically. Furthermore, it is possible that what appears to be psychologically maladaptive may in fact have important adjustment advantages within the context of a given culture. What role does culture play in establishing the milieu that gives existential meaning to such fears?
The Western Clinical Approach A review of the Western psychological literature dealing with fears and phobias reveals that they have ordinarily either been examined in light of a variety of learning models, such as operant and classical conditioning, or viewed psychoanalytically, as representing ego processes such as anxiety and defense. But—and this is the important point—in all these studies, high fear frequencies are considered, a priori, as a sign of pathology, and what is determined to be a rational or an irrational fear is established on the basis of clinical criteria and without consideration of cultural variables. An implicit assumption in the clinical approach has been that if we somehow determine the statistical mean of the fears extant, then significant statistical deviation from that mean represents pathology. A corollary assumption holds that the fewer the fears, the healthier the personality. The bias is clearly in favor of fearlessness.
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Anthropological Views of Fear The anthropological literature, on the other hand, has predicated its research on a relativistic position which emphasizes the vital role played by culture in determining the fear frequencies of given groups of people. In this research, culture is also regarded as determining the various meanings of fears. This literature, in effect, argues that fears and taboos may represent "a sociology of danger" (Steiner, 1956). That is, they prescribe behaviors which are appropriate in potentially dangerous contexts. Thus, fear derives its meaning from the perceptual view of members of a given culture. One of the most provocative, early anthropological studies challenging ethnocentric Anglo-Saxon views of fear was R .L. Fortune's (1932) studies of the Dobuan people. Fortune's work portrays a culture in which fear is the all-pervasive theme. Darkness, food grown by others, the possession of property: almost everything is the occasion for fear. Every woman believes her husband a sorcerer and every husband believes his wife a witch. For a Dobuan not to be riddled with fear is culturally atypical, or if you will, abnormal. A later study by Evans-Pritchard (1937) described similar patterns of apprehension in the Azande, and Kluckhohn and Leighton (1956) examined the pervasive belief in witchcraft among the Navajo. Such anthropological studies of cultures with particularly high fear levels should perhaps have given clinicians reason to question their use of exclusively psychological models in interpreting fears. Furthermore, there was early empirical evidence indicating cultural patterns in the fears of children which apparently has not been incorporated into our clinical thinking. In a cross-cultural psychological study using the Emotional Response Test, Havighurst and Neugarten (1955) noted that Midwestern children cited "objective danger" more frequently than children from the American Southwest. The study also found that Southwestern children were inclined to attribute two sources of their fears: the supernatural and objective reality. Certainly here was empirical evidence, slight though it was, of cultural patterning; however, for better than 25 years there are no indications in the literature of further attempts to empirically and cross- culturally examine the issue. In fact, those familiar with Navajo ethnography wondered why Havighurst and Neugarten did not find more dramatic differences.
A Study of Fear in Navajo Children In a recent study comparing third grade Navajo children with third grade Anglo children, Tikalsky and Wallace (in press) used the Louisville Fear Survey for Children (LFSC) and employed factor analytic and chi-square techniques. They determined that Navajo children had higher fear frequencies on 49 out of 60 items on the LFSC. There were also factor analytic suggestions that the structure of Navajo fears differed from Anglo fears. In reviewing the pronounced differences in fear frequencies found in this as opposed to the Havighurst and Neugarten (1955) study, one must speculate on the reasons for such discrepancies. A unique feature of the Tikalsky-Wallace study is that it utilized a Navajo interviewer (as opposed
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29 THE FEARS OF NAVAJO CHILDREN
to an Anglo interviewer) and focused on children with relatively traditional backgrounds. Perhaps certain fears are acknowledged only when one is being interviewed by a person who shares your culture. In wake of the factor analytic study of Navajo fear responses on the Louisville Fear Survey for Children, a series of in-depth interviews were conducted with the Navajo parents of one of the subjects. The parents reported relatively high fear responses for their third-grade daughter (31 out of 60 items). The purposes of these interviews, which involved the assistance of a Navajo interpreter, were to determine parental attitudes toward their daughter's fear responses, and to gain insight into the parent's views of fear as well. It should be emphasized that the parents interviewed represent traditional Navajo backgrounds. Both parents speak Navajo, and preferred to speak Navajo at home. While relatively fluent in English, they were by no means facile. The parents live with their daughter in a hogan located in a relatively isolated part of the reservation near hogans of six other families who comprise their extended family. Neither parent graduated from high school. Neither parent demonstrated concern about the fears which they attributed to their daughter. When asked to account for the multiple fears they checked on the LFSC, they observed proudly, "She is a good child and wants to do things right." Questioned about how they would feel if the number of fears were diminished, they specifically indicated that this was a matter of little importance unless "something of importance was forgotten." They then went on to affirm that nothing was wrong with their daughter and proudly produced her report card which, in fact, indicated excellent school progress. They also noted that not to know what to fear is to be vulnerable to great difficulty at the worst and—at a minimum—to disturb the harmony that is so important to the Navajo. Several questions were raised with the parents to gain a clinical impression of the child's emotional status. No signs of gloss pathology were found; however, many indications of a variety of fears were noted. Were the Navajo parents engaging in denial? Or should we consider cultural variables when attempting to understand the fears of children of Navajo and other cultures? Should an attempt be made to discover what pragmatic, cultural function a child's fear may serve?
Implications for Clinicians Kluckhohn (1944) argues that Navajo witchcraft (which encompasses many fear patterr s) has an important adaptive function for the Navajo. He also understood that the Navajo believe that witchcraft is a means of achieving power as well as maintaining harmony. Any student of Navajo culture understands the importance of power and harmony for traditional Navajo people.
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Bulow (1953) in a study of Navajo taboos argues that "taboos are prescriptions of proper behavior in dangerous or potentially dangerous situations." In a position very similar to Kluckhohn's, Bulow argues for the important adaptive value of fear for the Navajo. Thus, there is an obvious need for the clinician to comprehend the whole of Navajo culture if fear behavior patterns are to be understood. How deeply rooted are these patterns? Chisholm (1983) suggests that adaptations made by the Navajo several hundred years ago could have etiologicaVgenetic effects today! In my work as a psychologist on the Navajo reservation, I have learned that clinicaldecisions are often reached without consideration of ethnographic perspective. Such decisions can be seriously awry due to the ethnocentric biases of the clinician. Both current and past anthropological and psychological studies offer support to Linton's (1945) admonition:
Unt l th p h l t n h t th n r f b h v r p d b p rt l r t r nd n d nt th nd t r f p r n l t , h ll b n bl t p n tr t b h nd th f d f l nf r t nd lt r l n f r t t r h th th nt nd v d l.
It very well may be that attempts to eliminate some fears of Navajo children is an attempt to deprive them of a mechanism that has adaptive value. Further study is obviously necessary.
Summary Traditional views of fear may not be appropriate when attempting to understand the fears of Navajo children. A review of the literature, a recent cross-culture study and in-depth interviews with Navajo informants reveals ethnocentric bias both in traditional psychological approaches to the study of fear, and in clinical decisions determining when fear responses are to be considered abnormal.
1500 Cattle Drive Dillon, Montana 59725
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l , E. ( 82 . Navajo taboos. G ll p, M: h S th t rn r . Ch h l , . S. ( 8 . Navajo infancy: An ethological study of child development. Y r , Y: Alp n bl h n C p n . Ev n r t h rd, E. E. ( . Witchcraft, oracles and magic among the Azande. nd n, En l nd: Oxf rd Un v r t r . rt n , . ( 2 . Sorcerers of Dobu. nd n, En l nd: G r tl d & S n . v h r t, . ., & rt n, . ( . American Indian and White children: A socio- psychological investigation. Ch , I : Un v r t f Ch r .
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E EA S O A A O C I E
Kl h hn, C. ( 44 . v j t h r ft. p r f th b d M f A r n Ar h l nd Ethn l , rv rd Un v r t : 22, . 2. C br d , MA: h M . Kl h hn, C., & ht n, . ( 6 . h v j . C br d , MA: rv rd Un v r t r . nt n, . ( 4 . h lt r l b r nd f p r n l t . Y r , Y: Appl t n C nt r Cr ft . St n r, . ( 6 . b . nd n, En l nd: C h n nd W t. l , . ., & W ll , S. ( n pr . C lt r nd th tr t r f h ldr n f r . rn l f Cr C lt r l h l .
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UNRESOLVED GRIEF AND MOURNING IN NAVAJO WOMEN
O K. AGE , M
A S AC . Gr f nd rn n r n r l p h l l pr n r p n t l . h r th n h r b nd v d l p h l ll l t nd fr th lv fr th b nd f tt h nt t th r . Alth h h r t r t t nd ph f th pr n b d rn d, th r n d r bl lt r l p tt rn n nd h p n f th xp r n . C x pl r v n f v j n h xp r n p nt n dr nd h ll n t n f l t l v d n n xpr n f th r nr lv d r f nd rn n .
Intr d t n In th h t r nd tr d t n f W t rn d n nd p h tr , r f nd rn n h v b n d t d r b th p h l l pr n r ll xp r n d b nd v d l h ff r n t n ll n f nt l . It nd r t d th t t p ll th pr r t pl t l n f t d nd r r t n h r n nd v d l h xp r n d th l b d th f n t n ll p rt nt p r n h l fr nd r r l t v . r d ( n h p p r nt tl d "M rn n nd M l n h l " r t :
M rn n r l rl th r t n t th l f l v d p r n, r t th l f b tr t n h h h t n th pl f n h n ntr , l b rt , n d l, nd n. In p pl th nfl n pr d l n h l n t d f rn n nd n ntl p t th f p th l l d p t n. It l ll rth n t th t lth h rn n nv lv r v d p rt r fr th n r l tt t d t l f , t n v r r t t r rd t p th l l nd t n nd t r f r t t d l tr t nt. W r l n t b n v r ft r rt n l p f t , nd l p n n nt rf r n th t l r v n h r f l. (pp. 24 244 t r n th t p p r r d d r b th r f r f nd rn n n t n f th t n ll p rf l nd p nf l pr f thdr n tt h nt fr "l v d bj t" h h "r l t t t n h h n ... n l n r x t ." At th t l , r f, nd rn n r n nt l nd n v r l h n xp r n . Ev r lt r r l nd h l n tr d t n t d l n th th pr . xt nt h lt r ll d t n t r p f p pl d nt f t lf thr h h t p th th f t f d th n t h t l l pr t nd h t pr v d p th f pp rt f r th l v n rv v r . C lt r l p tt rn n nd h p n f th r f nd rn n xp r n pp r t h v th r
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bj t v th n r l, h lth d pt t n nd l b r t n f th rn r. Y t n n lt r th pr n r nd n ht xp t th r t b lt r l pr r pt n f r d n n nd tr t n p th l l t . S t n t rpr n t d v r n th r h h t r nd tr d t n f v j lt r nd d n pl x t f r t , r t l , nd r n l pr t d l n th th xp r n f l , r f nd rn n . t W , nd r bl n W nd l n W h nt n r nd f l t t n r l r f nd pr t t n t p th l l t (S ndn r , , pp. 4 8 . ( 88 d r b h d h r En W (S n h nt nd Ev l W (Gh t W tr t d t rb d nd r nr lv d rn n .
Gr f nd M rn n r In v r lt r th p h l l pr f r f nd rn n pr v d th n h r b th l v n rv v r r thr h th l f "l v d bj t." A r lt r th pr pp r t f ll r l r n . M n r t r h v d r b d th pr f r f nd rn n . h tr t, G r En l ( 6 , n p p r nt tl d "I Gr f ?", d f n d r f :
th h r t r t r p n t th l f v l d bj t, b t l v d p r n, h r h d p n, j b, t t , h , ntr , n d l, p n f th b d , t . Un pl t d r f r n n t nt r , d f d nl b th br ptn f th l , th n t r f th pr p r t n f r th v nt, nd th n f n f r th rv v r f th l t bj t. G n r ll , t n l d n n t l ph f h nd d b l f, n h h th ff r r tt pt t d n th l nd n l t h lf n t th h f th r l t . h f ll d b t f d v l p n r n f th l , r d b th p nf l ff t f dn , lt, h , h lpl n , rh p l n b r n , b n f l nd pt n b n r x , l p d t rb n , t t pt f p n r th r d f rt, l f nt r t n n l t v t nd t , p r nt f r p rf r n , t . n ll , th r pr l n d ph f r t t t n nd r v r d r n h h th r f rn n rr d n, th tr f th l v r nd t t f h lth nd ll b n r t bl h d. (pp. 8
M n p h tr t h v d ff rt t d f n th n nd p tt rn n f r f n rd r t b tt r nd r t nd t. lb ( 6 d f n r f "th n f bj t v t t d t l f ll n n rr tr v bl l ," nd h d t n h rn n "th p h l l pr t n t n b n rr tr v bl l l d n t th r l n h nt f th bj t." n , " h nd d b l f" ll "d r n z t n nd p nf l ff t " r r th pr pr t f r f h l th h l pr n l d n r t t t n nd r r n z t n nt l t t f t r rn n . ll ( 6 v ph t th " d pt v " nd "l b r t n " p t f th r f nd rn n xp r n . r th t th pr r l rl r n v ph nd t . h n t l t f h , th r f r t n nd th r f rn n l d t n r l b r t n f th " n r f th x " f r n
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JOHN K. NAGEL 34
attachments. Pollock gives emphasis to the notion of growth through loss and adversity. Bereavement comes to an end when the loss is assimilated and the meaningful aspects of that attachment are entrusted to memory. Dreams and hallucinations of the dead in association with grief and mourning experience have been reported by other writers. Matchett (1972) noted repeated hallucinatory experiences as a part of the mourning process in Hopi women. He described Hopi women as inviting images of their lost loved ones on themselves through a kind of spontaneous self induced trance state in the twilight of the evening. Shen (1986) reported similar phenomena and suggested that perhaps this was a normal characteristic for Hopi grief and mourning. Apparently, Hopi hallucinations do not seem to have the same ominous pathological connotations that they have for Navajos. Finally, Rees (1971) drawing from a large sample of widows, reports hallucinations of images of their dead husbands as part of their normal mourning experience. Disturbed grief and unresolved mourning occur when the bereaved person is unable to complete this process. Many ways of failing the completion of this process and getting stuck are imaginable. A full account of the aberrations and pathologies associated with these processes is beyond the scope of this paper; however, the case examples presented should be illustrative.
Navajo Cultural Context h n h, as Navajo people call themselves, inhabit the arid lands of northeastern Ar z n , southeastern Utah, and northwestern New Mexico living on a reservation of about 25,000 square miles. They number about 135,000 people making them the largest tribal group of American Indians. The traditional economy of the culture was based on raising sheep and this continues to be the main stay of wealth. Although known for their silversmithing and rug weaving these traditions do not apply in every family so remain a supplemental source of income for some. Families live in close-knit matrilineal, matrilocal group encampments referred to as "camps" usually at some distance from one another and often at considerable distance from any town. Contemporary Navajo families do not live the "leisurely and relaxed" life described by Vogt and Kluckhohn (1951) for the 1940s. Evidence of poor housing with lack of running water and electricity persist; yet, it is not uncommon to see hogan, housetrailer and television satellite antenna juxtaposed. Family life styles follow suit blending past and present in uncertain harmony. Even Navajo language in common use is pidgined and punctuated with English words and references. Formally leadership is centralized in the Navajo tribal offices at Window Rock, Arizona but rurally in remote camps leadership remains situational. Tribal elders and traditional medicine men continue to receive the respect and esteem of the people as they are sought out for counsel and healing. Traditional Navajo religious and medical practices are complex and seem to resist Anglo efforts to understand them. Even so, the extensive work by Kluckhohn and Leighton (1946), Haile (1943), Reichard (1950), and Sandner (1979) give us a basis
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for understanding the "Beauty Way" principle of the individual living in harmony and balance with nature. Illnesses arise out of disruption of these patterns of harmonic balance. Natural and supernatural forces can cause disharmony and thereby cause illness. Natural phenomena like lightning and ill winds; as well as skinwalkers, witch people and ghosts are believed pathogenic. Traditionally, the loss by death of a close relative was perceived as a dangerous time. As Kluckhohn and Leighton (1946, p. 185) pointed out "the intense and morbid avoidance of the dead and everything connected with them rest upon fears of ghosts". Traditionally, it was believed that most of the dead may return as ghosts, to the burial place or former dwelling especially if the deceased was not buried properly. Leighton and Kluckhohn (1948, p. 91) add the fact that ghosts were believed to be "especially malevolent toward their own relatives." Miller and Schoenfeld (1973) in their paper "Grief in theNavajo: Psychodynam ics and Culture" describe the Navajo patterning of grief and mourning as follows:
h pt d p tt rn f rn n l t r v n t p r d f f r d . r n th t f d n f th l t b r ll d nd xpr n f f l n nd n d. v r, v n d r n th t x v h f t n n t l d p n f v r bl b th n t . ll n th f r d p r d th rn r xp t d t r h l r t n th n f rth r xpr n f t n n rn n th l . Inv lv d n th r tr t n th f r f th p r f th d d p r n. (p. 88
Case Examples Case No. 1 Mrs. RC was a 28-year-old married Navajo mother of two children who was brought to the hospital emergency room by her family because of acutely agitated, wildly out of control behavior, threatening suicide. The family gave the history that she and the family had been on vacation n th nt n n r O r , C l r d nd h d t pp d t n f th n v rl . C 0 r ld d ht r h d b n pl n nd l b n t n th r v rh n th r h n h d nt ll l pp d nd f ll 200 f t t h r d th. C r t d d t l th t r f pr t t t n nd ll n t t h r d ht r. l h d t r tr n h r h d ff rt t thr h r lf v r th pr p tr l n t j n th h r d ht r n d th. In t ll n th h p t l h r p nd d t ld d t n nd l pt f r n xt nd d p r d n l xh t d. r th f r t v r l d n th h p t l h r n d thdr n, n n t nt rv l nl t t r ff f n tr n . A h nv t d t t l b t h r b r nd h d r b d h v n p nt th r th h r f l n th nt n n h r th r " h p p." h t n h d b n h r f r t t ff th r rv t n n v r l nth . A h b r f rt bl t l n , h bl t t l b t th d nt nd h r d ht r d th. Sh xpr d h r r f n nv l n f t r nd xpr n f l n n nd dn .
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JOHN K. NAGEL 36
In several interviews she talked about vivid dreams in which her daughter would appear lonely and in need of comfort. Less disturbing to her were apparitional visitations, i.e., visual hallucinations, in which her daughter would appear at her bedside reaching out for her hand. RC felt ambivalent about her dreams and hallucinations both wishing for them but fearing them at the same time. Family showed less ambivalence about RC's reports of these experiences and when the idea of traditional Navajo treatment was explored, her husband offered that he had already consulted a "hand-trembler" known to his family and an Enemy Way sing of Squaw Dance had been recommended. As he said that this would be expensive and take some time to arrange he was told to take her to another "singer" for a Blessing Way to protect her until the other could be done. She was sent out of the hospital on pass for the Blessing Way which left her feeling quite relieved. , She was discharged from the hospital and seen on an outpatient basis for four follow-up psychotherapy visits past the time of her Enemy Way "Nidah" ceremony which she talked about as having brought her great relief and comfort.
Case No. 2 Mrs. BB was a 50-year-old widowed Navajo woman who came to the office because of disturbing dreams about her deceased husband who had been drinking in Gallup, New Mexico when he was hit and killed "run over" by a train. Although she had a high school education and a good job with the Bureau of Indian Affairs (BIA), she was disturbed by what she claimed were her mother's and grandmother's ideas that she was being bothered by her husband's ghost. She acknowledged that she had trouble sleeping and sometimes felt a vague sense of his presence. Initially she decided to see a psychiatrist as she had felt reluctant and a little frightened to go "Navajo Way" as her rural traditional family was insisting. By her second and third sessions of psychotherapy she had started antidepressant medication and she was opening up to further invitation to think about what she was experiencing the way her mother and grandmother would. BB talked about how she had begun to experience ghostly apparitional visits sitting in her home in the v n n but that the medicine had helped her sleep so that hallucinations went away during the night. In psychotherapy she reviewed in detail her understanding of the gruesome accident and the care that the family had taken to make sure that his body was prepared "Navajo Way" including clothes rented, rings placed on index finger, turquoise and four sacred plants in the casket. In spite of all of this precaution she was still troubled. After the third session she consulted a "star-gazer" who diagnosed the problem saying that a piece of her husband's skull bone with hair and blood would be found at the scene of the accident and needed to be buried properly with him. Also she needed an Enemy Way ceremony which was provided for her by her family. She was continued in psychotherapy supportively and on medication until four sessions after her Squaw Dance.
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37 UNRESOLVED GRIEF AND MOURNING
Case No. 3 M 24 r ld n l v j n h nt n l h l nd dr tr t nt nt r t t n th t h th n n f ll n h r lf n h h d b n dr n n t n d r bl x n th d th f h r th r f v nth b f r . Sh h d n r f t l d nt h l dr v n nd r th nfl n j t th b f r h r f r t l n v t. nv t d t t l b t h r b r nd h h h d r b d r r l nd tr d t n l. Sh h d b n r d th n xt t th n t rl f ht h ldr n. A h h d b n b rn th n n t l h p d rd r, h nd h r th r h d b n p ll l thr h t h r r n p r . In th IA b rd n h l h h d d n p ll ll p n t n f r h r bv ph l d ff lt . Sh h d tt n d r t r l j b n th IA ff nd h r f l h d b n pr d f h r . Sh ld dr v n l t v t th n rl v r nd. Sh h d n t b d l h l t n xt nt b f r th r d th. In b t M f v nth pr v l h d r b d h v n dr v n p t h r th r h p p n th nt n . A h t h rd n h p th h r th r nd t r , l htn n h d tr nd ll d h r th r n t ntl . d r b d h r lf h v n b n l ft t nn d nd h rr bl fr ht n d. Sh r n d th h r f l f r th l nd p r d nl nd th n r t rn d t h r j b l l v n th f n r l rr n nt nd th tr d t n l rr n nt f r tr t nt f th h p h rd nd f l b r n "M l Sh t n W Ch nt" r n . Alth h h tt nd d th f n r l h r p rt d h v n xp r n d dn b t n t r . Sh t bb rnl r f d t tt nd n tr d t n l " v j W " r n nd r t rn d t h r j b. At h l n h b n xp r n n n n th d t rb n dr v v dl n th r. Sh t rt d dr n n n n ff rt t l p b tt r th n h r l f l t n n f l p tt rn. Sh t rt d n p n th j b, t t n nd r d l b t h r pp r n . Sh h d b n d l t th t f h r r ll v r d nt. nx t t l nd v r r p n v t p h th r p . Sh t dr n n nd pt d ppr pr t v t n nd nt d pr nt d t n. Sh t b n tr th h r j b nd h n r d t r ppr h h r f l . h f l n t d th t h h v th ppr pr t r n n rd r M l Sh t n W , l n W nd f n ll Ev l W (Gh t W . Sh nt n d n p h th r p thr h t nd h nt n d n d t n . Int r t n l , t rd th nd f th r p ft r h r r n h r p rt d h lth pl r bl dr n n l d n n nv lv n h r th r n th ft rl f t n r f nd r n h ld h h h d n d t b th f l f t h h d b rt d r b f r . n E h f th thr n n th x pl xp r n d pr f nd l n th d th f n t h th r d pl , n n f ll tt h d. E h f th l t l v d n dd nl n fr d nt v r h h th h d n ntr l.
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JOHN K. NAGEL 38
In retrospect, RC's reaction was the most natural, normal and unconflicted. She had no hesitation or embarrassment about availing herself of both medical systems— White Anglo doctor/hospital and traditional Navajo medicine man/chantway. BB struggled in conflict over who to see and what to do seemingly caught between the two cultures. With some respectful nudging and coaxing, she too made use of both systems. Finally, NB was most conflicted about allowing herself any expression of her grief at all, not wanting to deal with the fact of her mother's death. Not until her own near death experience in a roll over accident in a car did she become willing to get any help from either system. In the end, NB was able to bridge successfully back and forth between the two cultures and the two healing traditions getting something of what she needed from each one. Although the kind of "bridging" or "coupling" across cultural context and medical traditions can be very useful, it also can be touchy and temperamental. Respect for the patient's ego defenses, as well as the therapist's empathy, interest, patience, and concern for the well being of the patient in his/her family context are essential threads in the weave of any transcultural theory effect. Conscious, deliberate listening and pacing with the patient's process, and attention to his/her interdependent, interpersonal world are equally important. Finally, in discussion of these cases, taking them in reverse order, one is reminded of what Pollock (1961) has suggested. That is, NB in losing her mother lost her past; BB in losing her husband lost her present; and RC in losing her daughter lost a part of her future. All three women were traumatized and all had manifestations of pathological mourning.
Summary Few experiences in the human life cycle approach the richness, intensity, depth and complexity of grief and mourning. Mind, body (heart), and spirit (soul) react and respond voluntarily and involuntarily in simultaneous interplay. Culture shapes and patterns this weave of the fabric of grief and mourning. Navajo culture allows for the bereaved's experience of significant dreams and hallucinations of the deceased person. Even though these experiences in cultural context may harbinger "ghost attacks" or "ghost illness" they may announce to hallucinophobic culture's such as our own another dimension of the full range of grief and mourning experience. Perhaps all clinicians would serve their bereaved patients better in asking them about such experience. Dreams of the dead and all varieties of hallucinatory experience may be more in the realm of variation than deviation when it comes to grief and mourning experience.
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U ESO E G IE A MOU I G
In the cultural wisdom of traditional Navajo medicine, a Navajo medicine men has been quoted as saying:
In the old days Everything spoke to the Dineh (the people) The rocks, the grass, the trees— They all taught us But nowadays The Dineh have gotten so busy That the rocks, the grass and the trees don't speak anymore Or maybe the people have just forgotten how to listen
When it comes to grief and mourning, therapists need to learn how to listen with open minds and open hearts to the full range of human experience which constitute the grief and mourning processes. Clinical experience teaches that significant dreams and all kinds of hallucinations are ubiquitous in the normal grief/mourning spectrum. Culture shapes and patterns these processes and interprets and judges significant aspects of the individual's experience. The intensity, frequency and affective response to dreams and hallucinations seems to lead to a determination as to whether these experiences are deemed "normal" or "pathological" in a given cultural context~
2216 Hoffman Drive Loveland, Colorado 80538
f r n
, ( 88 . d h. t v pl : h rn l f th rd M 2( , 2 . lb , . ( 6 . r f rn n . Int rn t n l rn l f h n l 42, 40. En l, G. ( 6 . I r f d ? h t M d n 2 , 8 22. r d, S. ( . M rn n nd l n h l . S.E. 4, 2 2 8. nd n: rth r . (Or n l r p bl h d n l , . ( . S rt r t f th v j . r n n n f th S th t , 2 2. n n, . . ( 4 . rth rn nd S th t rn Ath p n h t l . A r n Anthr p l t 4 , 46 46 . Kl h hn, C., & ht n, . ( 46 . h v j (pp. 84 8 . C br d , MA:. rv rd Un v r t r . ht n, ., & Kl h hn, C. ( 48 . Ch ldr n f th p pl (p. . C br d , MA: rv rd Un v r t r .
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O K. AGE 40
nd nn, E. ( 44 . S pt t l nd n nt f t r f. A r n rn l f h tr , 0 , 4 48. M t h tt, W. . ( 2 . p t d h ll n t r xp r n p rt f th rn n pr n p n. h tr , (2 , 8 4. M ll r, S., & S h nf ld, ( . Gr f n v j : p h d n nd lt r . Int rn t n l rn l f S l h tr , ( , 8 . ll , G. ( 6 . M rn n nd Ad pt t n. h Int rn t n l rn l f h n l 42, 4 6 . , W. . ( . h h ll n t n f d h d. r t h M d l rn l, 4, 4 . h rd, G. A. ( 0 . v j r l n: A t d f b l . Y r : ll n r S r I, nth n . S ndn r, . ( . v j b l f h l n (pp. 4 8 . Y r : r rt r v n v h. Sh n, W. W. ( 86 . h p Ind n rn n h ll n t n . rn l f rv nd M nt l rd r 4(6 , 6 6 . S h f h, It W. ( 8 . M rt r t f th v j Ind n . A r n t r l t, 2 , 0 06. t, ., & Kl h hn, C. ( . v j n p pl (pp. , 6 42 . C br d , MA: rv rd Un v r t r . W n, . C., ll, W. W., & O n , I. ( 42 . v j h t l . Un v r t f M x ll t n, Anthr p l S r 4( , 4 .
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A CO SI E A IO O CO S I U IO A AC O S I AGG ESSI I Y
SYDNEY G. MARGOLIN, MD
t l r f th r l t n h p f pr f n l b r nd t r th th Ind n r b d d n th p p r nd th t b r . I ph n, th p l z d tr n n n h n b l , nd tt d t th th r nd pr t f p h n l . r th p t x r I h v b n f ll t n th p rt nt f h tr , t th Un v r t f C l r d S h l f M d n . In dd t n t t h n r p n b l t , I h v b n d n r r h n n p t f h n b h v r, r n th n d pl n nd th d th n r r d. W th r p t t th bj t tt r f th p p r nd th f ld fr h h t , I b l v th t I t th t I n t n nthr p l t. h d p t th f t th t th d pl n f nthr p l ht l th t r l l t t th n rn f th t d pl n . h t r f nv lv nt th th Ind n r b h h th bj t f th p p r f ll . Wh n th r b l C n l ht h lp fr th Un v r t f C l r d S h l f M d n th r r , r. hn n , ppl d t th p rt nt f r v nt v M d n ? r. n , h h d th nf d n f th r b l C n l, pr nt d th r h f pl nt, "th r n n th p pl nd th r d n t." r. n n th Ind n v r ll, f r h h d b n bl lth Off r f th r th t nt n d th r rv t n. M r v r, h h d nd t d h lth rv f th r b nd v r ll nf r d b t th n d n f l t d d n t. It h ld b p nt d t th t th h f pl nt r p rt d b r. n n r l t ntr r t h n l d f th . v r, b h pp r d n th r b h lf, h xpr d th Ind n d f r t nd th n l t r v h n nv l bl nt. h A t n Ch r n f th p rt nt f r v nt v M d n , ft r h v n t bl h d th t th h f pl nt d d n t nd t n p d nd th t, n f t, th p p l t n f th r b n r n , t d t r. n th t h n lt th v n f h t M d n f h h I th n n h r . Aft r pr l n r xpl r t n f th t t n I pt d n nv t t n fr th r b l C n l t d h t I ld. It h ld b ph z d th t n p r n l r l t n h p t th r b nfl n d b t j r f t r . r t, I nv t d f r p rt l r p rp . It pp r nt th t th r t n tr t ll d ff r nt fr th nv t t v t t n f th nthr p l t. h l tt r, r l , bl d t p h pr n n th p pl t b t d d. S ndl , I " d n n" h nfl n n t n bl d n nd pr d r . h n v n t th Wh t ph n l rl d t n h d h fr th Ind n d n n.
AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2(2), pp.41-57
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O K. AGE 40
nd nn, E. ( 44 . S pt t l nd n nt f t r f. A r n rn l f h tr , 0 , 4 48. M t h , W. . ( 2 . p t d h ll n t r xp r n p rt f th rn n pr n p n. h tr , (2 , 8 4. M ll r, S., & S h nf ld, ( . Gr f n v j : p h d n nd lt r . Int rn t n l rn l f S l h tr , ( , 8 . ll , G. ( 6 . M rn n nd Ad pt t n. h Int rn t n l rn l f h n l 42, 4 6 . , W. . ( . h h ll n t n f d h d. r t h M d l rn l, 4, 4 . h rd, G. A. ( 0 . v j r l n: A t d f b l . Y r : ll n r S r III, nth n . S ndn r, . ( . v j b l f h l n (pp. 4 8 . Y r : r rt r v n v h. Sh n, W. W. ( 86 . h p Ind n rn n h ll n t n . rn l f rv nd M nt l rd r 4(6 , 6 6 . S h f lt, . W. ( 8 . M rt r t f th v j Ind n . A r n t r l t, 2 , 0 06. t, ., & Kl h hn, C. ( . v j n p pl (pp. , 6 42 . C br d , MA: rv rd Un v r t r . W n, . C., ll, W. W., & O n , I. ( 42 . v j h t l . Un v r t f M x ll t n, Anthr p l S r 4( , 4 .
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SYDNEY G. MARGOLIN 42
It t v r t r t nd r t nd h t th r f th t r " n " nt nd t nt rpr t th h dd n n n f th r n t n th t th r d n t. In n , I ld th t th nd r t nd n f n nd nt rpr t t n f d n t r th th f th p p r. M n t l ff rt t t bl h t r f r n f r th " n " n f l. h Ind n d t t l n t r f p h l l nd b h v r l ll n r th r th n n t r f d l r ph l l pl nt . h r r r f r n t l h l , "b d f l n n d ," p th , n l n f f l , pp r nt l f lf nt r t, nd rr pl bl l f pr p rt , h n r , nd th r p r n l p n . I h ll n t nt d t l b t rr n nt th th r b l C n l r f th v l t n f th d f r n th th r b , n r ll I h v t t d th t hn th t r d v l p d t lv n f th pr bl f n t n, nt rpr t t n, n l , nd d t r d t n. I l r n z d n th b h v r f v r b r f th r b l C n l th t d r pt n f h t r t n nd f d n t t d r d r t d l f nx t . h r t d th fr n n n nd d pl d d r t l d t h r. h r j n nd t n f h th r d t b b d n th n t n th t h p r n ld b ntr d d p n, h nn r t r t xp d, nd th t h h ld b h lpl nd n l n r bl t pr t t h lf. t d th t th rr d b t h nd xp r , I d l r d th t r l t n h p t th Ind n ld b th t f ph n t h p t nt nd th t h t tr n p r d b t n th p t nt nd h ph n r t nd v l bl t n n th t th p r n f th p t nt. M r v r, b I l ld r rd th r b h l p t nt, I ld p ll tr b l n l d r t nt l th r b l C n l h d th r z d t r p rt f nd n . In d nt ll , th th r z t n v n t b t r ft r f r r f r . h ppr h ff t v , f r I l rn d l t r xp r nd h r t f th t npl nt ff t th r b ld xp r n nd, ndl , th r b h d x d f l n b t b n th bj t f n th r d t d . An nt r t n x pl f th r t n t h nd xp r rr d h n th Ind n , nd r th d n f nt r t d Wh t p pl , t p "W r h p n Al h l " t h h nv t d p n l f xp rt . An p r h d h n t b pp r nt th Ind n ld n t pr nt n h t r t th p n l, f r th Ind n n t n ld b d t l r n z d nd th r b h d nd xp d. h rr d d p t th f t th t ll th tr b l p pl n h th l h l Ind n r n . h nd th pp r nt n n t n th Ind n h p r n t v n rn th ntr p f h t l t nd p. h f rth r n f n f th ll b d d l t r n n th r nt xt. 4 A pr l n r v l t n f th r d l nd p h tr pr bl , th th t n f r. n , d l d th f ll n . . A lt ph h lth rv h d n xp t dl r v l d n x pt n ll h h n d n f h p rt n n, d b t ll t , b t , nd ln tr t n.
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4 CO S I U IO A AC O S I AGG ESSI I Y
2. A h h nf nt rt l t x t d, pp r ntl t f pr p rt n t th t l z t n f th v r d v l bl d l r . h Ind n h v , thr h l Cr nd l Sh ld, t th ph n nd h p t l d b th n n Ind n p pl . In dd t n, th Un t d St t bl lth S rv nd th r f l t r v l bl t th . . A h h n d n f v l nt d th nd nj r d t d nt n t d n th Ind n nd r th f 0. Al h l, t b l , nd th f h n z d, b t bl , r xpl v p nt r pr n nt ntr b t n f t r . It h ld b p nt d t th t h l t tr th t l h l nt rf r th j d nt nd th nd f ph l rd n t n n r f r th h ndl n f v h l nd th r h n , th nd t n r n t n r l th xpl n t n f r v l nt d nt . 4. h r t n n nd ft n nfl t th nt f th rr nd n n n Ind n n t h b r t nd d t r rd th r b d l n nt, h ftl , nd l h l . . h r l h l f v r n d r . h l d r f th r b l C n l r n rn d pr r l th th t t p f dr n nn h h nt rf r d th th nd v d l b l t t r , r f r h f l nd h lf, nd h h nt n z d th n n Ind n n t . It f n d r bl nt r t, h v r, th t th Ind n th n th r n v l t r n t r t l f h th r dr n n f r th r n . It h ld b ph z d th t th r b l C n l n t nd rd t h h th , nd v d l , d d n t b r b . M n f th , h l n t l h l n th l n l n , r n n nv lv d n p d h l dr n . 6. h r n ll d n b l t r d n l n t n f th r b h l t d v l p nt f r r , r n h r , h n , t hn n , nd pr f n l n pr p rt n t th r r nd f l t v l bl t th . h r b n h r t d l f n h h h d t th thr h f l l nd l t, nd r lt fr l nd th r n r l n th r rv t n. h r b h d d v l p d n t t nd n r h b l t t n pr r h h nt nd d t th r tr b l r r t h lp th r n p pl t d pt t th n nd t n . h pr r , h v r, h h hl ht d th f t th t th n th r lt r th r x t rt n l f r n nt v r r th . r th p nt f v f n th p rt n f r n, n th d n f th pr nt l f t t n f th r b , t nt l t r n tr t t n f t t n d r n pr r rv t n d . h n t t d f r n r n . r n nt n th r n th h hl l nt d n t r f l t r t r b t th r b . h rl t r f r n b t th 6th C nt r h n Sp n h pr t fr M x ht t tr v r th M nt n . h nt ph z th r b l tt n , r d, bl n , n l l bh n tr t l n th th r l f r p n t ff rt t nv rt th . I h v rr p nd d th n C th l h l r h nt n th f l , t l , nd nd x f ll v l bl r t n nd r p rt b th xpl r n pr t . h n l d th t n ll t n ll. Alth h n r r pr r l n rn d th th r b l n , th nt f v r f d nf r t n n t bl ll. h Ind n v r l nt b tt r nfl t th tr n nt n nt l tr v l r , tr pp r , n r , r n h r nd
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SYDNEY G. MARGOLIN 44
fanners. The accounts of these struggles stress the Tribes' savagery, cruelty, and indifference to agreements. These reports on the Tribe were greatly influenced by the interests of the reporters. The Tribe, collectively and individually, do not know their own history. As a matter of f t, their language does not contain a term for the abstraction of history or background. 6 They are not remarkable for any indigenous arts and crafts. Such work as they turned out was obviously derivative and not elaborated along any lines that could be designated as this particular Tribe.' Collections of their folk tales, myths and legends are meager but revealing (Kroeber, 1901; Lowie, 1924). They are obviously influenced by other Ind n tr b nd b n n Ind n . h d nt f bl xtr n l nt r v r d t r n d n th r l t n, th r v l n th tt t d f th r b t rt n th r Ind n tr b nd b v ll t th r Wh t n r r . h t r l x d n l r h n th v r t nd x pl f r n nd n th xp t t n f p n nd pl r , th t , th v l pl d n th n t n t l nd bj t . h r n tr t n f th p t, th r f r , pl x b d n ( d tt dl l t d nd ft n b d h t r l t r l, (b n n l f th r r p rt d f l t l nd th rd n t th d p r bl t th f Kl h ln, h , v r x, M Gr r, n , nd th r , nd ( n n l f th d t f th rr nt n f t b h v r f th r b nd t h ldr n, d l nt , nd d lt . h nf r t n n th r b nd nd v d l b r bt n d n th f ll n . . Int rv th r f Ind n Aff r ( IA p r nn l, bl lth S rv ff l , nd th n n l t d r p f ld r Wh t p pl h h d l v d l l th th r b ll th r l v nd th h l nd l p r nn l. 2. v f A n nd bl lth S rv f l , nd S p r nt nd nt r p rt , t . . Int rv f th ld t b r f th r b n th rv t n n b l n l Ind n nt rpr t r . 0 h t l ht t v r rl r ll t n nd xp r n . 4. Int rv th tr b l l d r n rn n th pr bl f th tr b n b th , f l tr f tr b l b r , nd v d l Ind n r f l h n d d d l r r h r n d ff lt th th l , h l nd th r l n . . St d f r rv t n l f n fr fl t n nn r b l v n n th rv t n d r n th r nd t v r t d r n th r. 6. rv n ph n n th tr b l l n h r I x n d n Ind n , t d l nd d v l p nt l h t r , l rn d h f th r Ind n l n l rn d b t th th r nd pr t f th d n n nd th Ind n ph r p l rn d b t th r f nt f th b d n t nd f n t n ( . ., pr n n nd b rth h rd th r dr , d r pt n f ff t , tr b l nd p r n l r t , th r tt t d t rd pr p rt , n , nd Wh t n v l , th r nt rp r n l r l t n h p nd f l l f ." . rv n r n n nd r f rr n ph n f r th Ind n . I rr n d f r th r d n t th C l r d G n r l nd h tr p t l h r th
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45 CONSTITUTIONAL FACTORS IN AGGRESSIVITY
would stay for several weeks to several months. This made it possible to conduct a variety of physiological studies as well as psychological tests. These hospitalized Indians would be seen by residents and by me. The hospitalized Indians provided a unique opportunity for information. I was the only person known to them and I was a link to the Reservation, the means to their well-being and to the gratification of their needs. 8. Examination of the children of this Tribe by an experienced child psychologist along with direct observation of their behavior on the Reservation. This information made it possible to construct many hypotheses about the continuation in the present of the apparently forgotten ways of the past. It will become apparent later in this paper that the basic concepts of the past can be identified in disguised and distorted forms in the new context of the present. This feature accounts for much of the so-called maladaptive, pathological, and inflexible behavior of many of this Tribe of Indians. Before the advent of the horse in the Tribe's life early during the 18th Century, it is probable that the smallest possible groups of the Tribe moved about on foot in an incessant search for food. They were subject to the economic truism of nomadic food-gatherers that the smaller the groups the less territory to be covered in order to obtain food, and the less depletion of foodresources there would be in the territory as a whole. At the same time, however, they had to be large enough to defend themselves and their source of supplies. This made for highly ambivalent relationships with neighboring family groups and with members within a given family group. The rivalry and envy inherent in a struggle for survival under these circumstances was tempered by the constant awareness of recurrent needs for mutual defense against invading Indian groups. The development of a kinship system (matrilocal and matrilineal) helped to provide the necessary equilibrium between these almost mutually exclusive attitudes towards individual and group needs. The fusion of a kinship system, (i.e., of a different order of libidinal components with the economic, aggressive, and more archaic pregenital l b d n l t r an interesting question. The culturalists, of necessity, would seek to emphasize the economic and environmental issues in this question and possibly concede the libidinal factors were secondary in time and importance. It is justified, however, to point out that the so-called economic and environmentally determined b h v r f the nomadic family is mobilized around pregenital drives. Hunting, raiding, and defensive fighting characterized the direct expression of this Tribe's aggressivity. Most, if not all, of this seemed related to the control of their land and the securing of game. It appeared to be of no matter whether food was obtained in the hunt, or by raiding other Indian tribes, or as a share in the successful kill and food gatherings of the same tribe. The folk tales reveal manifest aggression between men and women, not on genital levels but because of failures to provide food, shelter, and protection for each other. Women are frequently represented as depriving, inconstant, traitorous, and at times physically destructive. The reservation life created many problems, none of which were predicted or recognized. To begin with, the reservations and the groupings of the Indians on them did not correspond to the reservation tribal kinship and band groupings. Over
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SY EY G. MA GO I 46
p r d f t , th n h p l n b h z nd n t n t n b nd r ll. h b n t pl t n f th nd t n f r " nbr d n " ll b d d l t r. S ndl , th t f tr b l l d r h p h h pr t ll b d n h nt n , r d n , nd f ht n pr f l d b d f lt n th r rv t n. h v l f r h tr d t n l l d r h p pl d d n t x t n r rv t n l f . h r r p r d r b ll n , f h h r ll d r . d r pr n p nd Ind n p nt n l r p d r nd th . d r h p, n t r f th v l f th n r r , pp r ntl n v r d v l p d d p t n r nt nd v n br b t t d. Wh n th Ind n d d n t t nd pl t tr t th th Wh t , tr b l b n r l t d t th pr f t f th d l nd n t t n pt f l lt t th r r pr nt t v r f n th l d . 2 It pp r ntl b l v d th t th Ind n ld f ll th h t r l d t n f n r d p pl , n l , d nt f t n th th v t r . t r , h v r, nt n n x pl f h t h h pp n d h n h d nt f t n d d n t r. h n r d p pl nd th r n t n r xt r n t d. It bv th t th "j n th f n t b t th " tl t nd t p r t v h n z r f p pl nd th r . h r nd f ll f p r , f r x pl , t nd t pr v d n f th l l tt n n h h th b l l nd p h l l n t f n n d v l p. In v r l nt r f th W t rn ph r , n t bl , C ntr l nd S th A r , th pr h b n pr d n nd p nd ntl f th r n th E t rn ph r . It h ld b ph z d, h v r, th t h t v r b l l nd p h l l h n t t b t bl h d n th t h ph r , th n d n t n r l b th . Wh n t n d r d th t th t r ph l r p h v h d r r l nd p nd nt d v l p nt v r th nd f r , h h p th n pp rt. h l t n, n d nt ll , r l t v f r th r n r n t pp th t nl n r t n f Ind n h d rr d, r th t pr h t r nt t th th E t rn ph r h d n t t n pl fr t t t . A r n Ind n h v n t d nt f d th th r n r r . h A r n p pl , d p nd n n r n l nd n t n l nd t n , h v h d r dl b v l nt nd n n t nt tt t d t rd th A r n b r n . h h v n t d f tt pt t r thl xt r n t n, r t v nd v rd t r n d b n v l n nd d l z t n th pl f l t t n f Ind n n n t r , n rt d ff rt t tr n f r th Ind n nt ddl l A r n Chr t n h l r n th t r t n th r Ind n lt r . It ld b n v r pl f t n t ttr b t th f l r t d nt f t th t bb rn r t n f d f t d nd ppr d n r t . hr r nt h ld b n d r d n th nn t n. On th t n t ll Ind n r p n th W t rn ph r h v th h t r l nd b nt p l t l r l t n th th Wh t n th Ind n f th Un t d St t . r t ll ll f th l tt r h v tr t th th Un t d St t h h r pr nt l t n t nfl t v r l nd, r ht f v r nd , nd th r n . In l v , E d r, nd r th Ind n f th And r n t n th n r t nd n th r lt r t n nd rt nl n t l t n h v rr d." In r t h C l b , l n th f C t nd th nl nd r v r , th Ind n r n t n th p tt rn f n
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47 CONSTITUTIONAL FACTORS IN AGGRFSSIVITY
nfl t th th Wh t th Ind n f th Un t d St t . W rf r d d n t r nd I h v b n t ld b th C n r f Ind n Aff r f r th St t f r t h C l b th t tr t th th Ind n d n t x t. r t , th Ind n ll t v l nd nd v d ll r h rpl d ff r nt t d fr th Wh t p pl . h nd r nt b d n th b rv t n th t Ind n pp r t d nt f th h th r nd t l t h th r lt r h n br ht t th r b pr x t , n t, r f r d r t n, h b th Un t d St t . h rd, th Afr n r , f ll n h f r d tr n pl nt t n t th Un t d St t l v nd, d p t h t t n ppr d n r t , d d d nt f th th A r n Wh t lt r . In th nn t n, t f nt r t t h t n r t bt n l v fr Afr h n th r h b r n l r rv r n th nt n nt. h h t r f l v r n th Ind n pl t d b th f t th Ind n r d l n l v d h th r rd n t th f r l f v t r nd l r . h l nd n r l f th l v d p nd d p n th l nd n r n z t n f th n l v n tr b , ll p n th d t n t n b t n l v , pr n r, nd n d pt . On th n l r, h v r, d p t tt pt b th Wh t p pl t n l v Ind n , th pr t n v r r l t bl h d. On th rv t n, th d r t xpr n f r n b th r b nt r l t fl d b r thl p rv n nd th tt t d f ttl r r nd th rv t n. h r n n d r t n f th n n f ppr d r n, lth h th d r pt n f Ind n r v nd d t b h v r r ll d nt d. h r r rd d th l pr bl nd r d lt th rd n l b p l t l nd r l t r . h b h v r n t ph n n l ll v l t d p bl h v n d t r n nt t d f ll d fr ll. A h nt n n , r v r, v r r p dl b p bl , p rtl b th Ind n r r r l r tr t d t th r rv t n h h d d n t nt n n h t rr t r t pp rt th r p p l t n b nd b nd th r f d ppl r r dl d r d b th t v t f n r , r n h r , f r r , nd th n r l p n n f th t b l nd ll t nt . rth r r , h nt n nd r d n b th r b r r r l nd n th lv b t r r rd d pr r l n f n n f d nd th r n r ppl . h r b ld pt th t nfl t th r th d f bt n n th . W th n th fr r f th r f d th r n n , th ld th t n t th r nd . th r b n v r b lf ff nt n th xt rn ll tr n f r d l f nd nv r n nt, t n r f r th G v rn nt t pr v d r t n n rd n th tr t r nt . h , pl h t th r b ld pr v d f r t lf, b th b f th r r n l x t n nt l r ntl h n r n ll n h, th r r t f th rr d l rv t n t rn d t t v r v t n r l lth. h r t r l nd ph l n d r n r th n pl t, lth h th r tt t d t rd h f n tr t n, h nd n t t n r n rn n bl lth S rv nd th r pr f n l n th tt r . h h v ll, l r ddl l h th l tr t , n t b l , p p tr , r d , t l v n, d l th , nd n l b r t r tr . 5 h rv t n l pr p r lth h th r r n n f l v l h d t v t . h d n t pp r t tr r th t r l d th n n p r h , f r th r b l n r t
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SYDNEY G. MARGOLIN 48
exceeds even that which was built into these goods. They do not invest their income nor do they accumulate it in the form of capital or savings. The Indian is typically "penniless" although there are some striking individual exceptions. Despite all these various changes in their circumstances, there still persists inflexible personal and social pathology that are the instinctual derivatives of aggression. In short, the problem of their aggression still remains to be accounted for. What are the origins and determinants of this aggression? What are its characteristics and intensities? What are the defenses and transformations in the present tribal life situation? And, finally, what is there about the Tribe's aggression that causes it to override the external controls that appear effectively to regulate non- Indian aggressivity? Freud (1930/1961; 1950) proposes that repression is the precondition both for civilization and for its cost, namely, mental disease. To explore the question of origin, we have to consider the factors that would tend to predispose to an intensification of innate characteristics. Further, we must look for those environmental conditions which the innate factors would seek out selectively and, in the interaction, become reinforced. With regard to the innate factors, the highly competitive hunting, nomadic food-gathering economy undoubtedly came to place a very high premium upon manifest aggressiveness both in the man and in the woman. 6 The traits derived from this instinctual aggression would make for successful hunting and the defense of resources. Under these circumstances, such characterological features (i.e., properties of the ego) would function as an essential intrapsychic guarantee of survival by facilitating the discharge of this aggression. In this case, does the pleasure principle prevail and as a consequence, the overriding effect of complementary innate instinctual and ego factors become decisive for a nomadic, hunting and food-gathering economy? Can ethological concepts be applied in the sense that the gestalt of instinctual intensity and facilitating defense mechanisms will seek that environment and way of life that will provide maximum optimal releasor and discharge stimulir The extent to which such generic aggressive drive fused with specific ego mechanisms can be inherited is, of course, unknown as far as humans are concerned. The study of the inheritance of behavior in man is much too new for the availability of laws and principles that can be applied to the questions raised in this paper. The behavioral traits associated with certain congenital diseases are not necessarily pertinent, for the bodily disease exerts both psychic and organic influences. The detailed study of twins has great promise despite the immense number of factors to be controlled by what amounts to a community of investigators. The epidemiological studies are inconclusive, primarily because of inadequate phenomenologic, taxonomic and etiological formulations of mental disease. Moreover, most populations are not genetically stable enough to be used as a controlled variable. Freud, in his psychoanalytic methodology, offers a strategic advance over the uncertainties of the epidemiological approach. To begin with, he provides theories and operational hypotheses about the forms and functions of the mental apparatus that are constitutional and inherited, as well as their lines of development in the sense of Anna Freud. We are given a framework, partly metapsychological and partly biological, built out of instinct and libido theories and the structural design
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4 CO S I U IO A AC O S I AGG ESSI I Y
f th n p h n t , p nd nt n t t r . h t th pr n pl ppl d t t nd t b n r d nl b n l n t v l d r t , f r t b p h n l d n t l th pr p t n v l d t d h l nd n t . It d r v th pr n pl fr th t d f nd v d l nd l v t t th r r h f th r d pl n t d l th th . M r v r, t r n z th t th r l t n h p f p h n l t th pr h t r f n nd t nthr p l nl p rtl d t th l r r t r f " n f n." h pr nt t t f th r l t n h p tl d t r d p rt l r p r n l nt r t n th r n f n nd f h . r d tr d th r l f n t t t n l l nt n h d l f th nt l pp r t nd n th n pt f " pl nt r r " n th t l f nt l d . h n t t t n l f t r f v n nt n t ld nt r t th n t nd nv r n nt l f t r . h r lt nt ld b th f r nd nt nt f h lth r d nd th r t b l t . h n l t t hn ld d v r th t h h d f bl nd th r f r r l l l n t t t n l, nd th t h h n t d f bl nd th r f r r l l t b r n t t t n l. It h ld b p nt d t th t n th ll d "th r p t t t" r d n rn d h lf th p h n l n f n nd n t th p h n l t r r l n l d bl pr t t n r . r d f rth r h p th z d th t n h n t n t r n t d n h p th t l t t t , t ld b p bl t nfl n n t n t l b h v r b p f n p l t n f th t t t . h n l nn t n t t th b n t r t b l t t t nd nn t p nt th t. It t r l n th n f nd n f b l , r d d d n h t . h r n n l d f th nd f t b l l r n r tl pl t th ppl t n f th n pt f " pl nt r r ." W r bl d t n l z th r lt nt f t n nh r t d d n nt r t n th p h n t xp r n nd th n t t t n l n t n t l nt n t . h d ff lt n h n nv t t n r d t th f t th t d n t h v n t "b h v r l r r " v l nt t h t r r l r bl ndn nd h ph l . th r d p h n l t r th nd v d l f ff nt n t h n t ( x pt t n t d ff r nt t b n t fr p h n t . n ll , p h n l t nn t t p xp r nt n h h p r t v l h n p p l t n n b r r d n t nv r n nt , h ff r n n f ntl d ff r nt p h n t nfl n ." W n r t d l b t h n t n t l dr v r nfl n d b p h n t , d v l p nt l nd nv r n nt l f t r . W nn t d t nt t t v rr l t n x pt n r l t v t r . h xp r nt l v d n fr n l br d n nd fr th l l r r h pp rt th h p th f th nh r t n f b h v r b d n r v dr v . h th r f t r t b n d r d r th v l t h h nfl n d th h f t n th r b . K n h p pr , h l thn r ph ll p rt nt, r n t d t l p rt n nt. h ld r n th r b , nt rv d b , tr d th p rt n f th t h nt r nd pr v d r. n , th
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SY EY G. MA GO I 0
f l f n t nl n xpr n f r v t , b t b th d t r n nt f nd d t r n d b th pr f n t r l l t n. In h rt, th r pl nt r b n t r nf r nt f r n. Up t th p nt, I h v tr d th b n t r n t p l f t r n r v dr v nd f d pt v r ph n t p l r t n th t nt r d nt th pr f n t r l l t n. h r n dd t n l nd n t bl p h n t r nf r nt f r v dr v , n l , h ld r r n pr t n th Ind n . In th n d , f d th r n n , t l t n th r b , th b rth f h ld n t th h hl nt nt l z d, d l z d n th t t h b n r l f d pr d n n f pl nt . It n r t, h v r, th t r n b rth r t nd h ld r pr t r nt t t v l ff t d b th h n nd t t f r n . h r dr t ll d nt d nd ll tr t d d r n th p t r p r d f n E r p n ntr . Ch ldr n r b nd n d b f l nd b t . A th n r v r d, d d r p n bl tt t d t rd h ldr n. th f d th r r, th b rth f h ld nt th t th v r , lf ff nt f d th r n t v t f th th r r d r d. M r v r, b l t , n t f r rv v l, b l t d p rtl b h r n t p r r p t p rt t t , b t tl b f th n d t tr n p rt th nf nt, f d t, nd n n r l b n rn d b t t lf r . It n v bl d r n p r d f dr ht f r x pl , h n nd v t t n ld b r , th b rth f th h ld ld b l t . h r r n ll n n l nd , f l t r nd nt r t n l n h, n dr , t th ff t th t n h rd t r b nd n nt b t , nf nt d nd nn b l ld b pr t d. In n v nt, nd r f v r bl n r t n , th h ld ld b n r d t b n t n n p bl . h h n r th t th rl lf ff n ld r h t ft r 8 nth f , h n th h ld t ddl n b l t ld b ll t bl h d. M n f th Ind n t ll pr t r dl n . In th nn t n, th ff t f r dl n — ntr v r l bj t— t b n d r d." W th th d v l p nt f d r f lf t v t d b l t , th h ld t l t n t n r l t n h p th t b l l th r. h th r thdr fr th h ld t r h r f d th r n nd x l t v t . S h p r t n t th l b d n l ph f d v l p nt, th r t ll pr nt b t n 8 nd 24 nth f , ld t f x t n p nt. h n t ff t ld b th nh n nt f th tr t th t nd bt dl h r t r z d th f l h nt n , r d n , n d tr b l Ind n. h b l ll , ll , nd th r pr h n v l n d h ld t nd d t b h t r r l t d t th l ph ll nd x ll t v r nd th r r t n ld r, t rn l nt. nd l r , h v r, th h ld b l n d t th r p nd pp r ntl nt n d n n l r l t n h p t f l f r n h p r n . It ht b p t d th t lth h th h ld n t tr t d p n t v l r th t v h t l t r r j t n ( nl h t n , h rt nl n t v n n d n tr t n f ff t n. h h ld n ff t, h l t pl t l n . h b n f r tr t n nd p n h nt nd th pp r nt xtr t l r n h b n nt rpr t d h ld p r d pr v d d b l v n , ll pt n p r nt . It ld pp r fr th pr nt
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CO S I U IO A AC O S I AGG ESSI I Y p t r th t th p th nt nt l v n t t r l t . h nd rl n tt t d t th h ld nd ff r n , l r d b th r l t n t t ntr p f r n. In br f, n h p th z th t th l b d n l f x t n f th h ld r r n pr t t nd d t r nf r th n t r l l t n f t r f r n nd r v t . h d r t nd n f t xpr n f th f x t n ld b n n l d h t l v l . Und r th r r v nfl n f ppr n f th n f t t n f h n l n t n t , ld pr d t th h r t r tr t f r l d h , p bl f r d pt t n t r rv t n x t n . d , n th rv t n, th r b nt n h t nt t th tt t d t rd th r h ldr n Ch ldr n r r th r ll r rd d. h A n p pl nd th tr b l Ind n h r lf r nd d p nd d d l f th r t r n h ldr n fr th r p r nt , f nd n f t r h f r th , r r n tr t n th r thr t n n th nd ff r nt r n l nt p r nt . h Wh t n r l nd th l t nt t h ld n t h r t r t f th lt r n th p t, nd rt nl n t t h r t r t f th r lt r n th rv t n. It th h th h ld r r rd d h n l —th t t , th v l nt n v r f n d lt, lb t t n n . C n ntl , t ft n d ff lt t t p r nt f th r b t v th r l l n nt f r v r d l pr d r nd p h l l x n t n th t r nd t d f r th h ld. h r b p r nt, r ft n th n n t, t th p t n th t t f r th h ld t d d nd n t th p r nt. h p t t n f r f d nd rv v l n th n d d , t th r th th d v l p nt l f x t n , t nd d t f t r nv , l tt n , r v n , l fn , thdr n b h v r, b n f p r n l t nd rn nd p th , n h rt, d nt r t n r p t v t p rt fr th t f t n f th h hl n r t tr t . v r l r xt nt, th p r n l t tr t r p r t n th rv t n n v r n d r f d . h Ind n t t p ll d n t h lp h th r t, r n t n l n d t b nv lv d n r p t v t , x pt f r d f n v p rp , nd rt n r l r n , h th S n n . h r t nt r dv nt f th r f v r t r th r d pr v t n. h tr t f nd f h ldr n r nd r fr nt lt b th p r nt h f nd t d ff lt t nd r t nd th n pt th t th h ld nt tl d t th n r t th p r nt th h pr nt p r p t p nt. h v r tr b l Ind n n th rv t n t ll n t r n h r r f r r, r p bl f p t t v n lf ff n n r lt r . d n t n pt f p t l nd f t r r t rn . pr p d th th h r nd n . l n d n t v n nt n th t r th t ld t p bl t xpl n n th r n t h . h , h v r, d nd r t nd th f d pr d n n , b t t ll t th tt t d f th f d th r r . h n t r l r th l p t n— t th p r t n f n n hr n t d f d pt t n. Wh th r t n t t t n l r b l l n t r n t b n." h Ind n r rd f n th h r nt pr r rv t n f r b r r rd d f t nt l p r b ff l . It t b n d r p dl p bl .
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SY EY G. MA GO I 2
is apparently no more inclined to use the reproductive ability of money than he was to use the analogous capacity of the animals he hunted. Even today, ranching and sheep herding must be subsidized or it would be a total loss. The Tribe is enthusiastic about owning race horses, mostly because of the anachronistic prestige that many horses meant a successful hunter and raider, but also partly because of their passion for gambling.2' The Tribal Council and associated committees make up the executive, judiciary, and legislative institutions of the Tribe. This is a system that the United States Government installed about 30 years ago to encourage experience in democracy. The various members, however, are concerned about their functions during office hours almost exclusively. Outside of that time, they withdraw into themselves, are difficult to find, and are relatively indistinguishable from the other tribal members. Under the conditions of reservation life their aggressions may not be directly expressed and consequently we see several individual and some corresponding group pathological solutions. One is regression, and here we note the tendency to gluttony, alcoholism, and obesity so characteristic of these people. Secondly, there is the overt indifference to feces and dirin Thirdly, under the stress of self-imposed inhibition of manifest aggressivity, we see the psychosomatic problems of obesity, diabetes, and hypertension. In the psychological sphere we see the seclusiveness, asocial behavior, indifference to the welfare of the fellow tribal member, hidden reliance on magic and ritual, accident proneness and self-destructive behavior. Suicide and homicide occur under remarkable circumstances. This Tribe, despite all of its withdrawn behavior, indifference to other members and conflicted aggressivity, finds it almost impossible to commit intraspecific homicide." Diabetes and hypertension are model diseases for the demonstration of psychogenetic and biogenetic factors. Both have psychosomatic etiological hypotheses based on aggression. As far as this Tribe is concerned, another contributing factor to the diabetes and hypertension, in addition to psychosomatic and possible endocrine pathology, is based on the very high incidence of consanguinity among these people. Reservation life has created two conditions that favors consanguinity. First, it impaired or destroyed the tribal marriage and kinship customs. Second, the population decreased rapidly from what may have been as high as 10,000 to possibly 1,500 or 2,000. Under the circumstances of a reduced population, the destruction of a method for avoidance of consanguinous marriages and some opposition to exogamic marriages, consanguinity in varying degrees became inevitable. We have documented this by detailed family trees of members of two of these Indian Tribes. It is well known that diseases such as hypertension and diabetes can follow certain inherited patterns that will influence both their incidence and severity. These Indians appear to have an excessive incidence of congenital disease. Those which I have begun to follow are musculoskeletal, such as congenital hips and muscular dystrophy. I have family histories of marked incidence of hypertension often associated with other congenital anomalies. The effect of this inbreeding on behavioral traits among these Indians remains to be evaluated. One might expect that the problems of aggression would be intensified, a hypothesis that is impressionistically confirmed by White "old timers" and
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CO S I U IO A AC O S I AGG SSI I Y
interestingly enough by the older Indians, many of whom are in their 80s. The reliability of these informants is suspect for many reasons, not the least being envy and resentment over the affluence and tribal influence of the younger tribal adults.
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t . h rt r r r , n nd r r d t t C l b Un v r t , I tt nd d l t r n Anthr p l b r nz nd th n d t. At th t t , th n nt nthr p l t nd t h r l ft th l r n pt f th f ld f nthr p l nd f th r f n nthr p l t. S n th n th n h n n th bj t tt r f nthr p l nd n th t hn d b nthr p l t h v l ft f r l nf d nt b t th n pt t d . v rth l , rd n t d nv nt n ,I n t n nthr p l t, d p t th f t th t nthr p l d v l p n r nd r b p lt n f h h r l l r l t d t n pr f n l xp r n nd nt r t . I h v n nd h b p lt n t nthr p l nd bl d r p t d , b h l nthr p l nd nd r n pr f l , p h l l nthr p l nd th lt r p r n l t ntr v r , pr h t r nthr p l nd th r n nd v l t n f n, t nt n b t f . A r l , th b p lt v lv d n n f dv n n nt f d pl n th r th n nthr p l . h pr v d d n n pt nd t l , nd r d b nthr p l t t tt n rr f n lv d pr bl . In dd t n t th h n n t hn l f nthr p l th r h l b n tr n f r t n n th bj t tt r nd n th nthr p l t r l t n t t. I th n t f r t th t t n x pt n l t t n t d h n n nthr p l t n t d tr l b r n l p pl th t , th r p n t nv t t d b nthr p l t r pl x b l l, p h l l nd lt r l xt r f b r n l nd th f r n lt r . h d v l p nt n t hn l nd h n n bj t tt r h v bl rr d th b nd r b t n nthr p l t nd th r b h v r l nt t . M r nd r nthr p l t t th r b p t nt n t r r d pl n , r r th ll b r t r h th d l h n t nd r t nd nd d th n t nd r t nd h . Wh n lt d pl n t ppr h d t ft n d ff lt t d d n tr l pr f n l r nd h h r pr nt t v f h t d pl n h ld b th r p n bl nv t t r. In n v nt, th r r fr th d pl n r bl d t tr l n t t nd n t v r t t th ht f th r d t nd ntr b t n n p r n th th f th r t b r . h l t r f r Cl d Kl h ln, h nv l bl n lt nt nd r r p r n b th t th pr j t nd t , ph z d th t th pr bl f th nt r t n f lt r , p r n l t nd p h l f ll t th nthr p l t tl b d f lt. h nthr p l t n t ff ntl pr p r d b tr n n nd xp r n t ppl th th r nd pr t f l n l p h l n l d n p h n l nd l n l p h tr . 2. In 6, h n th Ind n r j t f th Un v r t f C l r d S h l f M d n b n, r. n M d l r t r f lth Un t. W th t h p r pt v d n nd x ll nt r l t n h p th th p pl , t d btf l h th r th pr j t ld h v tt n nd r . . S d t , r n , r t , nd nt pt r r ft n p th p nt f j , r p rt , r th t l f b nt r. h f "bl d n ff" f r n n th n f r d " h p th l f Ev r d f " n b ll tr t d b th f ll n t n d t . h r v r n th v ll h h nt n d th Ind n r rv t n, b n t fl d. h t r r r n r p dl nd b n t v nt th r h r n Ind n f l r l v n . I ff r d t r l r 4 h l dr v Ar v h l v l bl f r n t n r r th t ht h v t b d . h tr b l l d r h r p nd d d th t th Ind n ld t r f th lv . A t h d th r n , fl d n r v r, I d n tr b l l d r b t h t t f th p d f th r h n t r. d,
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SY EY G. MA GO I 4
"I ld thr n nd ld b th f nd t." On n th r n, ft r nf r n n h h I tt pt d t xpl n h th ld f th r b p pl r h dd n n th v r pr bl th t th r b l C n l h d d t t d , th r d d l f pl r n t v r l f th Ind n p rt p nt v r r n z n th p nt th t I h d d . On f th Ind n , th h I h v v r d r l t n h p pt l n t th th t tt t d nd xpr v l n h h nd t d th t h r h n f r rd th h h t th n . Wh n I d h h t h th n n b t h f n ll d n h tr b l l n , "I ld l t h v f r tr ph ." h r r n p rt pl nt nd n f t d p t th bv p r n l d dv nt t n b n nv rt d t tr ph . It nt th t I h d "p r" h h th Ind n ld n r t t ll r ll r b p n t r l p rt f , h lp. h r l t n h p f th x d l b d n l nd r v r t f t n t pr n t l n t n t nd t th d f n h n f n rp r t n nd ntr j t n rth f n t . 4. h Ind n f l h d h n t l d b t b th r . r x pl , h b t ld th t h th n h t d, r t p rt nt, r t r h, t b l th r t f h tr b . l rn th t h b h v r n t Wh t p pl th t h t p d, h lpl , dr n rd, f l, t . h t t nt ll b tr f v n nd v d l, b t th b h f l nl p n xp r . h nt l l nt th t th f l n f h f ll p nl t t d r t , thr t f r j t n, nd d pr v t n. h p h d t r n nt f th h n th rl thdr l f th th r fr h r h ld, f ll d b th l tr n f r f h r f n t n t th r n th r b . Sh r rd d nd d b th r nd n t n n f th h d nd v d l b h v r. h r d f r h n t t h n n b h v r b t t d f th b h v r f th r t . h l d t xt rn l z d r nt rn l z d r v t n, t b d d f rth r n. . h rv pl t d n 4. Arr n nt r rr ntl b n d t r p t th n h r xt n v f r . 6. W th t n nt l n t n l f th f r nd tr t r f th r l n , ff t t th t n th l v l f n t n th l n r r bl f r t f t r . h f r t , th t t nn t nv r d l n pt b d n b tr t n r n r l z t n . h Ind n r bl d t t r f fr h h th b tr t n r n r l z t n n b nf rr d. h nd th t th d n t t v nd nn t t v v l f t r r r l t d t l nt l n d nd th r r t f t n . r x pl , bj t r d f n d b h pr p rt th r r l v n t t r, f d, h lt r, b ttl , h nt n , r d n , t . A v n p f tr ld b v n n nd t n th pr x t t t r r th f t th t t ld n d bl f d. Of n d r bl nt r t r th r l t n h p f th l n t pr p rt t th dr r f p h n l . h l nt f dr r n f t d b ll n , , nd r pr nt t n f th p rt f r th h l , ll r n z d r nd n n t f d n d r h. . h p pl r ll d r r n b d , l th r, nd b tr ll h h, f r th t p rt, th r d fr th Ind n tr b th h th nt nt t. A f r n n, th d d n t l r r p tt r . h r r n ph t r ph , n r nt r , f th p pl dr d n l rf l f th r , b d d l th r r , lv r rn nt . It pr b bl th t th d Ind n r th t n r n l n th th , lf n d S t r b r f n Ind n l r r p, n l , th t h r n t . 8. I p ll nd bt d t th l t r. Cl d Kl h ln f r h xtr rd n r nd p r pt v d n . G rd n M Gr r h p rf r d l r rv f r h d d f r Er Er n b h lp n t l r f pr f n l d nt t th r p t t nthr p l n p rt l r. . A d fr rdl , Al , ( h l l nd M d l Ob rv t n A n th Ind n f S th t rn Un t d St t nd rth rn M x , r f A r n Ethn l , ll t n . 4, 08, d t n th ph l nd d l h r t r t f th r b r r, nd d. bl lth r rd d t b t b t 46. h r , f r th t p rt, n d t nd d ff lt t nt rpr t p nt l b t 4. S n th n, t f t r r rd r v l bl . Mr. C n n, S p r nt nd nt f th A n , h b n f nv l bl h lp n nn r bl d n th b t th tr b . bl lth ff l nd IA ff l n th r ff ld n t ntr b t h n t r f th r t l xp r n th th r b . h d , f r th t p rt, t th h t l , h t n t v tt t d h h th Ind n d t t t rd r pr nt t v f th G v rn nt. 0. h r b l C n l pr v d d th b l n l nt rpr t r . r th t p rt, th r Ind n n nd n f th r b h h d b tt r th t v r d t n, th t , p t th h h h l r ,
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CO S I U IO A AC O S I AGG ESSI I Y
nd h h d l v d fr th rv t n f r p r d f t . h r nd f En l h x ll nt, lth h th r v b l r nd d f n t n r l f bl t th l r ddl l r r h l d t n l l v l. All nt rv r r rd d n t p . A r l , th r ph n th nl n th t th d n b n r rd d. h t p r rd r l t d n n f r v h l t n d r bl d t n fr th nt rv . h v h l pp d th p r ppl , ll p r t d nd n t r d b n t nt. h nt rpr t r v n l t f p f t n t b d f th bj t nd l t f t p t b d d th th bj t. Alth h I pr nt thr h t, I p f ll r t d th t n tr n l t n b d d r n th nt rv . I d d n t , h v r, n th ff t f d pl f th t Ind n . ll n th nt rv , h h ht r n f r v r l h r , th nt rpr t r r t rn d th t h d rt r nd pr d d t n t tr n l t th nt rv nt En l h. h tr n l t n nd t n n th r f t r ll r rd d n t p . It n b pp r nt th t th tr n l t n r v l d n p h l l n n t n nd p n r d. W th n rr n d f r th t p r rd n f th nt rv t b tr n l t d b th r b l n l Ind n f th r b h d d n t h v th l t f t n nd t p th t r d b th r n l nt rpr t r. h ll d "bl nd" tr n l t n f th nt rv l r v l d th d t rt n , r pr nt t n , nd tt t d b th f th nt rpr t r nd f th bj t b n nt rv d. It pp r nt th t b th th nt rpr t r nd p ll th bj t nt rpr t d th t n nd th t p nd r d n n t r f t r t p f th Wh t n. b n th, th d d n t h t b h d n t r f x l tt r , p r n l l nl n , th nd r l t . h r d t b n xtr rd n r ff rt t pl b ff r n nf r t n h h th f lt I nt d. h n l f th t p pr v d d p n tr t n n ht nt nfl t nd nx t th n th nt rpr t r. h nt rpr t r h d, n ff t, d th t n f h lf r h r lf th r lt n nn r r p n d th t n th r t b d t rt d r d th nt rpr t r t t n r t th bj t. . Of n d r bl nt r t th Ind n r l t n h p th . All th Ind n n th t I ph n nd th t, n t r p t , I f n t n d l n n th t I d d ph l x n t n, pr r b d d t n, d d n r r r , n ll t fr t r , nd r d d d l t n . In dd t n, I d n r l l nd p h tr n lt nt b pr t n ph n n th r f th rv t n nd th bl lth S rv . h r n th r f t r, h v r, th t br ht th Ind n nd t th r th n d ff r nt fr f r f r n . h h d t d th th r r l z t n th t I n , nd r t d, nd t l d t th n t r f th r v l t , th r n pt f h lth nd d , th r p r t t n , th r f nt f f n t n nd tr t r f th r n b d . I h v b n v n n Ind n n , th n r l n n f h h ld b tr n l t d "th d t r h p th h nd n r " n x pl f p h n l t b 2. h f t th t lt r t n t b d ff r nt t d fr l t n h v n r t n d r bl nt ntr v r . In lt r t n l pr , th r p pp r t nt n th r d nt t th v r n d r f p t b l t . In l t n, n r p l t d nt f bl h r t r t nd th r b t x t. . n f th bl nd pr t t v h lp f th G v rn nt nd th r nt r t d pp rt r n l d n l r , th Ind n r b h v d nd rr n nt th v r p n t xpl r nd xtr t n r l fr th r r rv t n . h n h v r lt d n th tt n p f b t nt l tr t f nd f r th r b h l nd p ll f r th Ind n h ldr n th b f r ll r t r d n th tr b l r ll . All Ind n r v p r p t p nt h h v r r nd $ , 00 r, th r b r v n h t l . h Ind n h ldr n r v b t 40 f th p r p t , th r nd r b n h ld n tr t nt l th r b t 8 r f . h n th t Ind n h ldr n b rn n th p r p t p nt t h b n n t ll d, ll r v d h $ ,000 t $ 8,000 t f th r tr t f nd h n th b 8 r f . 4. h Ind n b lt th r tr th th r n f nd lth, n t nl b th r d pl nt r t d n h r , b t l b f th r p n f r bl n . h h v v r t f bl n , pl n rd b n th t p p l r. . h r r n n d t l nt nd d r pt n f th b h v r f th n n r. h h v b n d r b d f ht n d b d th th n. h r n t d f r th r l t n t v t d r n nd ft r b t n f t, th r n d n n n th n n h h th t r n , d t rt d p t r f th n r nt nd d t r pr nt th n r b rd n f l t r lt n fr f l r d nd b t. 6. h r r v v d d r pt n b Ind n nd Wh t pr n r f th r b r d n th
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SY EY G. MA GOU 6
pr p r d th lv f r b ttl . On h d r pt n f n h h rr d n th 880 t ll f th tr b l r d n p rt th t nt nd t t Un t d St t Ar n t . h n f r f v lr ld r pl d n p l f br h, th d n n Ind n r l d r nd t th n r n n f h t l t nd r , f n ll l n t n n n xpl v tt th dr n n v nd th r r p n th n f r . h nt nd th r d r pt n t th t th b h v r n r d t r n t r . . In th nn t n, th pr j t n d n r l nv t t n th t h lp t h d l ht n th d t n t n b t n b n t nd p h n t f t r . r r n h v n t d th n Ind n nd ff r n t h ldr n, th r r b t 60 Ind n h ldr n fr th r b th t r b n r r d n Wh t , ddl l , f t r h . h xp n f r th b rn b th tr b l f nd . h r p f h ldr n ll b p r d th Ind n h ldr n fr th r b b n r r d n Ind n f t r h nd th h ldr n b n r r d n p r t v l nt t Ind n f l t t n . It h p d th t th nv t t n ll pr v d nf r t n t th d f b l t f th b h v r f th r b . h h ldr n n th Wh t f t r h r pl d th r t d ff r nt b nn n th b rth. In th v nt th t d f b l t p bl , bt n f rth r nf r t n t th ft r h h d f b l t d r . 8. W r p r n th d v l p nt f th r b h ldr n b n r r d b r dl n th r p f nf nt h r n t b n r dl d. h t d n l d v l t n f th th r nd f th f l l f . . S ndn t n b r 8, b v n rn n th tr b l Ind n f t r h ld pr j t. 20. h Ind n f th r b l t h r th t r nl n ll d f r th r l t d h rd n n r n h n . Or n ll , h r pr v d d th b l t r r d f r nd r n , h nt n , r d n , nd th th r n f n fr th r tr b . h n b r f h r p d b n Ind n f th r b th b th n f f ll r t f d r n nd x l t . h n n hr n t ll p r t n pr t v , r t l z d f r f p n h r . A nt n d b v , th Ind n d n t br d h r f r th p rp f d v l p n n p rt l r t r bl dl n . h h r , th r f r , h b b l nd n th tr p h n l t n t l n t th p t ( . ., th b n pt f p h n l t b l d r b d b n nd S h nd l b r t d b n n th t, b t n, t r pr nt f l h nt n , r d n , f ht n , " n lp ," h f d nd l t n f n. 2 . In th nn t n, th f ll n n d t ll tr t v . In th r f d n th tr b l l d r t h t nt b nd r t nd n th p pl , h r r d r n ll nd r t ll , "S th n nd r t nd th p pl ? t f th t . S pp nt t nd (I p t d t n h t th tr b l l d r h d n nd, f r nd t t nd n v n n th p pl f r th nt f f l ffl v fr n l nd h n r n th pr p rt r nd h h nd d t h , l n p r nd , nd h d, n , nd th n d t h , l n p r nd , nd h d, n , nd th n d t h , h n t? nd h n r d, b I b r f th r b ." h tr b l l d r nt n d b n ld I nd r t nd th . I h t r p nd b th th d f n l ft n d b th p pl h n th h t nv n r l z t n r n b tr t n. I d, " , t l t ll n n fr th r b t l v n nd t t n n t d." n dd d n r nt. h n tr n pp rt r f t v t n h p pl . 22. ll n th p p r r r f br f h t r d l n th th pr bl f d nd h d . [Ed t r n t : h h t r r f r n d b r. M r l n r n t pr nt d th th rt l . t nt nf d nt l t nn t b r nt d n th b n f th th r.] h p pl h v d p t d, nfl x bl f r f n , p pl , d n nd d th. S n ft n n p n h nt, th ff t f r v n thr h l n , nd b v ll, th t v t f h t . h h t f d d p r n, p rt l rl f th r b , p r t n n . ( n b r l t , p n t v f r p r t n nd r th l f l n. h h t pp d b h l t , d t , b rd n t n f pl r f th fl h, nd b th r t rn f p n th t n b l n d t th h t. (b h h t ll l v n p pl r v l h r v t r n r n n l v . C n ntl , h d t nn n ntl nv nd v n f l. n f t h lf b nt rf r n th th l xp t t n . d nt , n , p n n f f d nd t r, d pp r n f , th l f n r rt l , f nt n p ll , p n f v r rt , n , n r x , n n , t rr f n dr , t . A h t p ll l v l ntl n l n d t rd n n h n n ntr b t d t r r p n bl f r h t t , r h pp r t b nj n h t th h t l ft b h nd. ( A h t l v n nd f l b
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CO S I U IO A AC O S I AGG ESSI I Y
f r n r t r , d r n h h h p ll d n r b t ft r h h h thr t n r ll d n h . h h t th p t f th nv nd r v lr , r nt nt, nd h t l t h p rt f th h r t r tr t r f th p pl f th r b . h l r t t th p h n t r n f th h t nd h f n t n n xt rn l ntr l n b rt v p r , t p . h h r t r tr t r r l t d t th pr n t l f x t n f h ld f th r b . In f t, th p r d f t th t th h t d n r rr p nd t th nt rv l th t th nf nt b l ll d p nd nt n th th r n n t n b . In n th n, th h t h d bl n n n , th d n r f th d pr v d th r t th h ld, nd t , th d n r f th d pr v n h ld t th th r. (d h d tt pt b b r f th r b , h n n f th h t r , r l rl r l t d t th r l f th h t n xt rn l z d r th r th n n nt rn l z d bj t. In r th th p pl I h v n t d v r d n h h d n n l r th n nd pt f b n l p l v n r r f b n l p l v h r t r d rd r . th r h v I n n f tr d pr n h r t r z d b f l n f n rth n , n d nd h p l n , p h t r r t rd t n nd lt r n t n . In h rt, p h p th l b d n v r p r nfl t pp r ntl n n. A I h v p nt d t n th d r pt n f h ld r r n , th r l t n h p f h ldr n t p r nt r th r rr t d n t f v r th nt rn l z t n f tr t r d p tt rn f pr h b t n nd p r n . E d l r h hl n r t nd t b b d p n th f lf ll nt f l nt l n d f f d, dr n , nd t r l p n . h l nt f h , h h I h v d r b d b v , l t th l l nt f th p r . It th h t, h v r, th t b th r l t r f ntr p f h d nd d . A th th h t, th l v n Ind n n r ll nt l r nt f n npl nt ff t t d th fr tr t n nd t r l d pr v t n, h nx t , nv nd h . h ff t r d lt th b l h l r v r h p h ndr nd n f t r n.
References
r d, S. ( 6 . C v l z t n nd d nt nt. In . Str h (Ed. nd r n . h t nd rd d t n f th pl t p h l l r f S nd r d ( l. 2 , pp. 4 . nd n: rth r . (Or n l r p bl h d n 0 r d, S. ( 0 . Totem and taboo. NY: W.W. rt n. Kr b r, A. . ( 0 . Journal of American Folklore, 14, 2 2 28 . , b rt . ( 24 . Sh h n n t l . Journal of American Folklore, 37, 242.
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SPECIAL COMMENTARY
On May27 ,1988 , the University of ColoradoHealthSciences Center's Department of Psychiatry assisted the Select Committee on Aging with an important field hearing entitled, "Mental Health and the Elderly: Issues in Service Delivery to the Hispanic and American Indian Communities." The thrust of the hearing was to gather data from various experts and witnesses concerning the Committee's intention to develop a multidisciplinary approach to a community-based mental health policy and legislative program to address certain issues in service delivery to American Indians and Hispanic elderly. The following expert witnesses gave their testimony: Spero M. Manson, PhD, Associate Professor and Director, National Center for American Indian and Alaska Native Mental Health Research, University of Colorado, Denver, Colorado; Mr. Curtis D. Cook, Executive Director, National Indian Council of Aging, Albuquerque, New Mexico; Mr. James Berg, Chairman of the Board, Denver Indian Center, Denver, Colorado; Mr. Fred Acosta, MSW, MPA, Division of Mental Health, Denver, Colorado; Mr. Jose Mondragon, MSW, Servicios de la Raza, Denver, Colorado; Sheila Baler, PhD, Executive Director, Mental Health Corporation of Denver, Denver, Colorado; Priscilla Gallegos, Acting Director, Division of Mental Health, Denver, Colorado; and Molly Snyder, Assistant Director, Area Agency on Aging, Denver Regional Council of Governments, Denver, Colorado. The Denver hearing was the second in a series of field hearings focusing on the mental health needs of older American minorities. The hearings are part of a major Committee push on elderly mental health, whose centerpiece is mental health legislation sponsored by Chairman Roybal. Upon completion of the collection of field data, the Committee plans to issue a report on its findings entitled, "Mental Health and Minority Aging: The Need for an Expanded Federal Response." In this vein, The National Center has invited Chairman Roybal to give a brief synopsis of the Committee's effort to address the mental health needs of this special elderly population—Journal Manager.
Mental h lth n rn nd r h v b n n l t d pr r t n A r n h lth r . h ld rl h l , nd p rt l rl A r n Ind n nd p n ld rl , r pr nt dr t ll nd r rv d p rt n f r p p l t n h n t t nt l h lth. h p rp f th rr nt h r n t br n t th tt nt n f th p bl nd C n r th n d f r tr l pr h n v t f nt l h lth rv nd t ll t n t b d d t n th nt l h lth n d f ld r p n nd A r n Ind n . M j r pr v n f th Eld rl M nt l lth In t t v r f ll . v l p n r ff t v rv t n l d : 1. In r M nt l lth l Gr nt nd n b $ 00 ll n nd t d f nd f r h ldr n nd th ld rl .
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
2. Exp nd f d r l nd t t r nt pr r f r d v l p nt nd rd n t n f n t b d rv nd p bl d t n ( n r f d r l f nd n b $ 0 ll n . . In r b d l, pr v nt n, tr t nt, nd rv r r h ( IM , IA, A A f nd n b $42 ll n b . 4. In r nt l h lth tr n n f nd n b $ 0 ll n b . . E t bl h t n l M nt l lth Ed t n r r . f r n M d r nd M d d rv nd t nt n nt n l d : . Ch n t n xt nd bl 60 d nn l l t n np t ntp h tr tr t nt. 2. Ch n t 20 p nt nd n xt nd bl 20 v t nn l l t f r tp t nt rv . . Ext nd M d r nd M d d v r f r n h r p t r ( 20 h r p r r , fr t nd n nt l h lth l n , l n l p h l t, l n l l r r, nd p h tr n r p l t rv . 4. In r n r n h nt l h lth nt nd t rv . . In r M d r t nt n nt thr h nd t r n nt, t l z t n r v , nd pr p t v nd nd x d pr n f nt l h lth rv . I pr v n l t r n nd pr t t n: . In r nd t n f p rt p t n, O r v , n t n , nd O b d n r v . 2. r v d nd nf r M nt l lth C r C n r ll f ht . . v l p t d n l t nd . Alth h th pr p l h r n t t t n "Eld rl M nt l lth In t t v ," th nt l h lth n d f ld rl r b t n p n nt f br d r, n t n l pr bl h h ff t p pl f ll . h r f r , th n t t v h ld b n n t j t r f pr p l t h lp ld rl p r n , b t th f r t t p n r f r n th nt l h lth d l v r t f r ll A r n , r rdl f r b r nd.
h n r bl Ed rd . b l Un t d St t f pr nt t v Ch r n f th S l t C tt n A n
American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)