Measuring the Burden of Historical Trauma
For 500 years, Native Americans have suffered drastic and often violent changes in their lives because of European colonization. The effects of this epic disruption have persisted down the generations. One term often used to describe this long-running tragedy is historical trauma.
A previous post in Native Health News described a program by Dr. Maria Brave Heart to help Native people cope with historical trauma. Her efforts have helped people from many tribes work through the pain they feel because of past events. But what is the evidence behind such programs? How can historical trauma be defined and measured in Native people today?
Developing the Measure
A small but growing body of research seeks answers to these questions. Ten years ago, Les Whitbeck and colleagues published the first scales designed to measure historical trauma in American Indians. They began this work by conducting focus groups with elders (aged 55 and older) on two reservations in the Midwest. Group discussions had two goals: “identify the kinds of losses associated with historical trauma” and “identify the types of emotions” triggered by these losses.
To fulfill the first goal, Whitbeck’s group developed the Historical Loss Scale. To fulfill the second, they developed the Historical Loss Associated Symptoms Scale.
Both scales were created in response to the elders’ recommendations. Then they were reviewed by the elders, revised in response to their feedback, and ultimately approved for use in tribal communities.
Each scale has 12 multiple choice items. On the first scale, people indicate how often they think about each of 12 types of loss:
Loss of land
Loss of language
Loss of culture
Loss of traditional spiritual ways
Loss of family ties because of boarding schools
Loss of families because of government relocation
Loss of self-respect because of poor treatment by government officials
Loss of trust in Whites because of broken treaties
Losses due to the effects of alcoholism
Loss of people to early death
Loss of respect for elders
Loss of respect for traditional ways
On the second scale, respondents indicate how often they experience 12 different emotional states because of their consciousness of these losses. The states include sadness, anger, anxiety, shame, rage, fear, mistrust, isolation, avoidance, loss of concentration, loss of sleep, discomfort around White people, and the feeling that past losses are happening all over again.
Using the Measure in Native Communities
Whitbeck’s group tested these two scales by administering them to Native people on reservations in the Midwest and in First Nations reserves in Ontario, Canada. Across all communities, the measure was completed by a total of 32 men and 111 women aged 28 to 59 years. All respondents had children between 10 and 12 years old at the time of the study. By now these children are young adults.
Results demonstrated that Native parents in these communities were powerfully affected by historical trauma. One-third of the people who responded thought daily or several times a day about the loss of their traditional language. A similar proportion thought at least daily about the loss of traditional culture and spirituality. More than half thought at least weekly about these losses, while almost one-fourth thought at least daily about broken treaties. Although people tended to think about loss of traditional lands a little less often, fully three-quarters reflected on lost land at least yearly, particularly at special times.
Other losses were even more troubling. Regarding the effects of alcoholism, almost one-half thought about these effects at least daily, and two-thirds thought about alcoholism weekly. Fewer than one in ten respondents said they never thought about the bad effects of alcohol on their communities.
Two-thirds also thought about loss of respect for elders at least weekly, and more than half thought at least weekly about loss of respect by children for traditional ways, and about loss of community members to early death.
The emotional effects of these losses were profound. Fewer than 20% of respondents reported that they never felt anger or sadness about historical loss, while more than 10% reported that they often experienced these emotions. One-third reported feeling, from time to time, that past losses were still happening today.
In reviewing these results, Whitbeck and colleagues noted the “remarkable prevalence” of historical trauma among Native people in the twenty-first century, even in adults who were never forced to attend boarding schools. As the researchers put it, “the holocaust is not over for many American Indian people.” They concluded their study by quoting one of the elders who contributed to the work:
“I feel bad about it. Tears come down. That is how I feel. I feel weak. I feel weak about how we are losing our grandchildren.”
Past, Present, Future
Three notable studies on historical trauma have appeared since Whitbeck’s group developed their measure. One is a theoretical discussion by Teresa Evans-Campbell (2008), a member of the Snohomish Tribes and an Associate Professor at the University of Washington. The second is a follow-up study by Whitbeck and colleagues (2009), who assessed children aged 11-13 in the same tribal communities where they previously assessed adults (2004). The third is a survey of historical trauma conducted with American Indians in California by Cindy Ehler and colleagues (2013). This growing body of research is recommended reading for everyone interested in the health and well-being of Native communities (bibliographic information with links to their abstracts appears below).
Whitbeck’s follow-up study of tribal children (2009) was designed to validate their existing measures and explore the persistence of trauma across generations. The investigators adapted the Historical Loss Scale for administration to 459 American Indian children aged 11-13, along with their mothers or female caretakers. The researchers found that consciousness of historical trauma was very common in young adolescents. The frequency of their thoughts about past losses was similar to that in adults. In fact, the investigators were surprised to find that some children thought about historical losses more often than their parents did. Nevertheless, more children than adults reported never thinking about such things. Overall, about one-fifth of children in these tribal communities thought about historical losses every day.
A key objective of the follow-up study was to settle a fundamental question: Were Whitbeck’s measures truly assessing Native people’s consciousness of historical loss, or were they were just measuring symptoms of depression? In the “depression” alternative, the concept of historical trauma might vanish. Native people would feel anger and sadness about past losses only if they were depressed. If and when they recovered their emotional health, past injustices would no longer seem painful.
Whitbeck’s study had a large enough sample of participants to answer that question. Feeling historical trauma is not the same as feeling depressed, although the two constructs are related. Native people who are depressed often feel past losses more acutely than those who are not depressed, but the consciousness of historical loss persists in most tribal members, regardless of their emotional health.
Historical Trauma in Southern California
The most recent study of historical trauma, by Dr. Ehler’s group, expands the application of Whitbeck’s measures to a very different tribal population. For several years, Dr. Ehler and colleagues have studied risk factors for substance abuse in eight contiguous reservations in Southwestern California. For the historical trauma survey, they recruited 306 reservation residents aged 18-70. These participants represented a significant fraction of the total population of about 3,000 American Indians across all eight reservations. Dr. Ehler’s group administered both Whitbeck scales to all participants. They also administered measures of identification with traditional lifestyles, experience of stressful life events, and substance dependence.
Higher scores on the Historical Loss Scale were associated with stronger identification with the American Indian way of life, a higher percentage of Native American heritage, being unmarried, and having an annual income below $20,000. However, only the last two characteristics were associated with higher scores on the Historical Loss Associated Symptoms Scale, which measures emotional reactions.
Like the Midwestern and Canadian tribes surveyed by Whitbeck’s group, these California tribes were especially likely to think about loss of land, language, and traditional spirituality. In addition, more than half thought at least monthly about loss of respect by children for elders, and a similar proportion thought at least monthly about the bad effects of alcohol and the loss of tribal members to early death.
As in the Midwest and Ontario, the most common emotional responses to these losses were sadness and anger. Overall, however, the California tribes thought about their historical losses less often than the Midwesterners, and they experienced emotional responses less frequently. The investigators suggested that different tribal communities have different experiences of historical loss, even though all communities have suffered past injustices.
Ehler’s group was unable to estimate the link between a personal experience of traumatic events and the likelihood of historical trauma. Their inability stems from the fact that 94% of tribal members in their study had a personal history of life-threatening trauma: a stunningly high percentage that may not be unusual among American Indians.
The investigators did find a link between substance abuse and emotional responses to historical trauma. They proposed that “individuals with substance dependence experience more distress related to historical losses” than people who are not dependent on alcohol or drugs.
Notably, Ehler’s group found no association between historical trauma and age. The scores of people younger than 30 were very similar to those of people older than 30. As the investigators concluded, “thoughts of losses do not seem to be waning in the younger generation.”
This finding, like many others from their study, confirms the results of Whitbeck and colleagues. As Whitbeck’s team concluded in 2009:
“The historical losses experienced by North American Indigenous people are not ‘historical’ in the sense that they happened long ago and a new life has begun. Rather, they are ‘historical’ in that they originated long ago and have persisted.”
All this work has established the reality of historical trauma in Native Americans. These studies have begun to explore the links between consciousness of loss and various public health issues, such as depression, substance abuse, and suicide, both in adolescents and in adults. Future research will continue to refine these measures of historical trauma and apply them more widely in efforts to enhance the health and quality of life of Native people everywhere.
Ehlers CL, Gizer IR, Gilder DA, Ellingson JM, Yehuda R. (2013) Measuring historical trauma in an American Indian community sample: Contributions of substance dependence, affective disorder, conduct disorder and PTSD. Drug and Alcohol Dependence 133, 180-187. Abstract at: http://www.ncbi.nlm.nih.gov/pubmed/23791028
Evans-Campbell T. (2008) Historical Trauma in American Indian/Native Alaska Communities: A Multilevel Framework for Exploring Impacts on Individuals, Families, and Communities. Journal of Interpersonal Violence 23, 316-338. Abstract at: http://www.ncbi.nlm.nih.gov/pubmed/18245571
Historical Trauma and Unresolved Grief Intervention: Homepage at http://historicaltrauma.com/ Wisdom of the Elders: http://discoveringourstory.wisdomoftheelders.org/resources/transcending-historical-trauma
Whitbeck L, Adams GW, Hoyt DR, Chen X. (2004) Conceptualizing and measuring historical trauma among American Indian people. American Journal of Community Psychology 33, 119-130. Abstract at: http://www.ncbi.nlm.nih.gov/pubmed/15212173
Whitbeck L, Walls ML, Johnson KD, Morrisseau AD, Cindy M. McDougall CM. (2009) Depressed affect and historical loss among North American indigenous adolescents. American Indian and Alaska Native Mental Health Research 16, 16-41. Free full text at: http://www.ncbi.nlm.nih.gov/pubmed/20052631