The Toxic Effects of Stress on American Indians
We know that acts of genocide were perpetrated on our people because we refused to be separated from our lands. Tremendous harm was done by those who would prevent us from speaking or learning our language; by those who would prevent us from practicing our ancient rituals, our healing and doctoring ceremonies, our celebrations, our condolences. The spiritual cloak that was our shield from unrelenting grief and loss from one generation to another was torn from us leaving us vulnerable to what science now calls “over-activation of our fight or flight response” and “toxic stress.” Though we are now relatively free to practice our ancient ways, the trauma has not stopped and many of our people have drifted far from ceremonial circles.
Our old ones passed down to us the stories of our beginnings. Our Creation story described where we came from, how we arrived here and gave instructions on how to conduct our ceremonies and be grateful. Our old grandmas and grandpas told stories that taught about life and the most important ones centered around the behavior and care of our children and pregnant women and the responsibilities of their partners. Nothing says that we can’t incorporate those teachings in health care and then remind our patients why it makes sense. (Remember some of our people had little exposure to the old ways.)
Research is showing that stress and traumatic events experienced by an unborn baby in the womb through the mom and during early childhood can alter the genetic makeup of the fetus and child. These altered genes can have adverse impact on their health in the future. To start these babies may grow to be prone to depression and more reactive to stress or less stress resilient. Researchers are also finding that some of these altered genes are passed on to the next generation. In the past this mechanism was crucial for the survival of the species during times of extreme environmental changes on the planet.
Toxic stress experienced by children can alter their brain, their genes and organ development if they do not have the caring support of an adult. So a young girl’s childhood experiences, her health and her diet will not only effect the outcome of her future pregnancies but also can effect her future grandchildren. She is not alone in this as the genes that come from the father have also been imprinted by his childhood and his environment in his mother’s womb. Combined, the mother and father lay the groundwork for their baby to grow and still the actual outcome can change depending on the environment in the womb. Imagine no worries or concerns, having nutritious food, adequate exercise, a loving partner, happiness and peace. The baby would form itself based on that particular environment as opposed to an environment laced with anger, fear, frustration or grief.
Our women suffer twice the rates of physical and sexual assault as Caucasian women. The children who witness these violent acts suffer unseen damage that will affect their health later on in life. Research by the Centers for Disease Control and Prevention and Kaiser Permanente have shown that adverse childhood events including physical abuse, addiction in the family, divorced/separated parents among others can result in poor health across the life span. Suffering abuse early in life causes the development of unhealthy behaviors such as smoking, drinking, overeating and so on but it also compounds the effects of persistent stress response in our bodies which can alter the development of the brain, change genetic expression and adversely impact the immune system. Persistent stress response is being in “fight or flight” mode for long periods of time.
Imagine the health consequences for the boarding school survivors who are currently in their 60s and older? I once heard a health-care provider at a conference say, “The story doesn’t matter, just treat the symptoms.” I find that offensive.
There are real physiologic manifestations of trauma, generational and otherwise that begins in the womb and calls for us to listen closely to the story because these issues require intergenerational prevention not merely a Band-Aid. Our responsibility as service providers, no matter what field we’re in, is not only to the individual in front of us but should encompass the immediate family and the generations standing behind them, the ones that are coming toward us; something our traditional healers and elders have always understood. Change is difficult, but evidence is mounting in research-based practice, that it is time to acknowledge the importance of the spirit and the mind and incorporate that understanding as an integral part of our health-care delivery practices. As the saying goes: “If nothing changes, you’ll only get what you’ve always gotten.” Patients (our people) will continue to “fail treatment” or “fail to comply.” Maybe the problem is that the provider “failed to listen” or “failed to understand” or “failed to change.” For Native people among other cultures changing the face of medical institutions from disapproving frustration to one of unconditional personal regard would be one barrier to care resolved.
Beverly Cook, Wolf Clan Mohawk, is the mother of three daughters and has three grandchildren. She has worked as an RN and family nurse practitioner at the St. Regis Mohawk Health Services in Akwesasne for more than 27 years.