Tag Archives: native american therapy

Native American therapy

Native American therapy: how can Westerners adjust?

Hello all!

As you might know, I am a mental health professional trained in psychology who has worked in various settings with various populations. I have conducted therapy sessions, assessment and just helped or listened to individuals ranging from children to incarcerated adults. I currently work with individuals who have reached their last resort, oftentimes homeless, mentally ill or presenting with brain injuries or substance abuse issues. My work in jails has taught me to practice my profession in a more culturally sensitive manner. It is also something I have researched in graduate school as well. So this article will focus on some points to consider when offering counseling or therapy to Native American people. Here we go!

The importance of spirituality and the belief system

The importance of spirituality in the life of most Aboriginal people and how the practice of dreamcatchersspirituality is embedded in the Aboriginal lifestyle is something to remember. The Native American belief system is not always linear or rational and thus it requires the therapist to rethink psychotherapy, how help is provided and how one’s worldview is defined. Traditional ceremonies (including peyote ceremonies, fasts and vision quests) can also play a big part in American Indians’ lives.  However, as the world is not a linear world within the Native culture, there is not really a standardized way of rendering therapy (due to variations in experience, skills and abilities). However, there are several principles that one can consider.

Some guiding principles

So if one thinks of the Western world, we live in a very structured world, in which everything has a time limit (especially in therapy sessions). We are supposed to be done when we are supposed to be done, to stick to the schedule at hand and do the same thing all over again the next day. If one thinks of the Native world, especially before the arrival of Europeans, well it was quite different. There was no watch to tell you when to go, no GPS to tell you where to go, no phones so someone could tell you where to go. They had the sun, Father Sky, Mother Earth, nature and the animals to guide them. They relied on their relations. And they got there when they got there. “Indian time” we call it. Well maybe there is something in there that we can learn from.

Meeting the patient where he or she is

This is a principle I would apply to any clients I have to say. Imposing an agenda never works in canyonmy experience. It just leads to frustration on both sides. When working with Native clients, it might mean to be open to looking at the client’s dreams, visions or signs received. Dream interpretation, also used in psychodynamic and analytic therapy, can be so useful. As all our defenses are down when sleeping and things that would normally be blocked from our consciousness come to the surface. It does not mean that things will come to the surface in a very clear way. Some interpretation will certainly be required. The same could be said of visions.

Trance states in non-Western reality

Trance states are present in many traditional ceremonies. They can be induced by repetitive chanting, drumming or rituals for example. I have gone in a trance-like state in a few ceremonies due to the repetitive drumming and chanting. Some might say “a trance like state, are you crazy?”. But when I say, “go in a trance”, I mean a very deeply calm state. Somewhat similar to a meditative state. Images can emerge from those states and the therapist has to have the willingness and ability to interpret them. It also means that the therapist might need to enter in a trance state him or herself to understand the reality of the client in the moment (concept of immediacy: what is going on in the moment). It can actually deepen the therapeutic alliance because it helps the client feel understood and validated.

Inupiat drummers

Time limitations

Western standard 50 minutes sessions might be difficult to follow with Aboriginal clients, especially if ceremonies are involved. Or if states such as trances are entered. Therapist needs time to safely bring the client back to the reality. If you have ever been to a Native ceremony, you know that knowing the exact time it starts at and ends is basically impossible 😉 There will be a start time but you would be very lucky if it actually began at that time….However, within the therapeutic context, you might be in control of when the ceremony begins (unless it is attended somewhere else in the community). But a ceremony is a process. Placing a time limit on it would defeat its purpose.

Ritual and prayer in the therapeutic encounter

Symbolic rituals such as prayer constitute a part of many Native Americans’ life. Therapists must understand and validate those rituals. However, certain rituals, depending on the setting might feel offensive to others in the setting. Like smoking of tobacco or smudging. Nonetheless, therapists must still include those rituals if appropriate, as they can ensure that therapy is effective. It does not mean that the therapist is a medicine person though and should not act in that role. I personally smudge my office every day. The smell of sage is not a smell that everyone likes but we talk about it. I know that clients appreciate it and with the amount of trauma and negativity that is brought in that office, it needs to be cleansed! I also have my own ritual of smudging myself while praying in the morning. I think it is important as a therapist to cleanse yourself, to find ways to do so, as our work can weigh heavy on our shoulders at times.


The therapeutic use of synchronous events

In the Western culture, synchronous events are often thought of as “chance events” (e.g. coyote crossing in front of one’s car). The therapist must be willing to entertain the idea that the event might not be a coincidence. I personally do not believe in coincidences. And if we think of all our relations, we know that they talk to us, might they be animals, birds or trees. They guide us, like our ancestors. If an eagle is flying above your head, that is no coincidence. To learn more about the symbolism of animals and birds, see my pages here and here.


So what are your thoughts? Anything you would add or take out? Do you agree with those points?

All my Relations