Abstract
Background:
Canadian First Nations (FN) people have experienced and continue to experience significant adversities, yet many demonstrate aspects of resilience.
Aim:
The aim of this qualitative study was to specifically understand Cree adults’ meanings and mechanisms of resilience following maltreatment.
Methods:
Ten Cree adults were interviewed individually. Modified grounded theory was used to interpret the transcribed interviews.
Results:
Participants discussed resilience as a journey of ‘survival’ and ‘overcoming’ and pathways to healing that were multifactorial and included traditional teachings.
Conclusion:
Mental health providers should consider and incorporate these mechanisms into treatment for Cree people, when appropriate, to aid recovery.
Introduction
Psychiatry has traditionally focused on diseases of the mind, but recovery must also consider resilience and factors that enhance it. Definitions of resilience have evolved from predominant views of resilience as innate to perspectives that resilience can be acquired (Cicchetti & Garmezy, 1993; Hunter & Chandler, 1999; Luthar, 2006; P. A. Rutter, Freedenthal, & Osman, 2008). Recent work suggests that resilience is a dynamic process where psychological, social, environmental and biological factors interact enabling individuals at any life stage to develop, maintain or regain their mental health (MH) despite exposure to adversity (PReVAiL Research Network (PRN), 2011).
Resilience has been identified as being especially important in Aboriginal 1 people who suffer from many past adversities, current structural stressors (Aboriginal Healing Foundation (AHF), 2003; Kirmayer, Gone, & Moses, 2014) and continued MH challenges (Gone, 2013; Royal Commission on Aboriginal Peoples (RCAP), 1996). For reference, the term Aboriginal includes First Nations (FN; original inhabitants of Canada), Metis (person of mixed FN and Euro-American ancestry) and Inuit (Indigenous people of northern Canada and parts of Greenland and Alaska). Adversities in Aboriginal environments include Indigenous historical trauma such as colonial injury by European settlers and collective experiences of these injuries by communities with cumulative effects that have snowballed across generations (Brave Heart, 2003; Hartmann & Gone, 2014). In Canada, this includes a history of assimilation attempts, compulsory removal of many children to residential schools, the creation of reserves and so on (AHF, 2003). High rates of depression, anxiety, posttraumatic stress disorder (PTSD), suicide, substance abuse and family violence have repeatedly been shown in epidemiologic studies (First Nations Centre, 2005; Health Canada, 2003).
How might resilience fit into this context? Indigenous researchers have indicated that ‘resilience is not a new concept to our people; in fact it’s an ancient principle in our philosophy of life. This principle teaches us to stand strong, to try hard, and to never give up hope …’ (HeavyRunner & Marshall, 2003, p. 1). Furthermore, social and cultural factors are understood to play a formative role in determining outcomes, creating a crossroads between culture and resilience (AHF, 2003; Ungar, 2003; Wexler, 2014). For example, some Aboriginal people consider the Seven Sacred Teachings of love, respect, courage, honesty, wisdom, humility and truth to be intrinsic to a healthy life (Many Good Teachings, n.d.).
Previous qualitative assessment of resilience among North American Aboriginal peoples has gained perspectives from American Indian families (Denham, 2008), leaders (Cloud Ramirez & Hammack, 2014) and elders (Grandbois & Sanders, 2009); from Alaska Native communities and Arctic youth (Ulturgasheva, Rasmus, Wexler, Nystad, & Kral, 2014; Wexler, 2014) and from Canadian FN groups (Andersson & Ledogar, 2008; Goin & Mill, 2013; McGuire, 2010).
Recognizing that Aboriginal groups are unique and diverse, specific FN-voiced (vs researcher-driven) definitions of resilience are important in understanding and contributing to a locally relevant framework of resilience. This article provides a distinctive contribution to resilience research by exploring meanings and mechanisms towards resilience with a group of FN adults who experienced maltreatment and were from four unique Cree communities within the Swampy Cree Tribal Council (SCTC) in northwestern Manitoba, Canada. This research is a component of ongoing community-based suicide prevention initiatives of the Swampy Cree Suicide Prevention Team (SCSPT), a university–FN community partnership (Isaak et al., 2009; Katz et al., 2006; SCSPT, 2008). This study received approval from the University of Manitoba Health Research Ethics Board.
Methods
Qualitative research makes a substantial contribution to MH policy, psychiatry (Goering, Boydell, & Pignatiello, 2008) and more specifically to resilience research, giving voice to participants (Wexler, 2014). Consistent with Aboriginal storytelling approaches to sharing knowledge (Smylie et al., 2009), in-depth interviews were used to collect data. Interviews were unstructured apart from asking participants what the word ‘resilience’ meant to them, what resources within or around them helped them to cope and regain a sense of balance and well-being after serious negative life experiences and whether they thought there were differences between men, women and cultures in resilience.
Purposive sampling (Polit & Beck, 2004) was used to ensure inclusion criteria of experienced maltreatment, followed by snowball sampling (Morse & Field, 1995; Patton, 2002) whereby conference attendees and the SCSPT community facilitator recommended others from their communities. A description of the study and invitation to participate was given at an annual SCSPT conference in October 2012 where three interviews were conducted in-person. Interviews continued with seven participants by telephone over the next 9 months until theoretical sufficiency was reached (Dey, 1999) based on no new patterns emerging in the data, together with the researchers’ sensitivity and experience with this FN group. Interviews lasted between 30 and 90 minutes. Trained graduate-level members of the SCSPT (C.I. and N.M.) with previous experience interviewing members in the SCTC communities (Isaak et al., 2009) conducted the interviews. All participants provided written informed consent. Interviews were digitally recorded and transcribed verbatim.
Using a modified grounded theory approach (Charmaz, 2006; Corbin & Strauss, 2008), a coding scheme was developed and reviewed by three of the authors (C.I., D.S., J.S.). Transcripts were analysed manually using a constant comparison method (Strauss & Corbin, 1990) to identify patterns in participants’ experiences of trauma and descriptions of support mechanisms used during recovery and to compare and contrast perspectives of resilience between women and men and cultures.
Results
Sample
Analysis was based on interviews with 10 adults (seven women and three men) aged 24–70 years who self-identified as either Cree, mixed ancestry of Cree and other FN tribe or Metis. Of the 10 adults, 8 identified English as their primary language and 5 endorsed Cree or ‘some Cree’ as secondary. Nine participants had a post-secondary education and were employed full-time in their FN community, seven of whom were in a helping professional role. These characteristics provided unique insights from participants, having left their communities for post-secondary education and then returning, thus knowing ‘both worlds’.
Themes
The coding resulted in three main themes: (1) Range of Abuse, both personally and collectively, (2) Pathways to Healing, including meanings of resilience and experienced journeys towards recovery and (3) Perceived Differences in Resilience, between women and men as well as FN and non-FN.
Range of abuse: ‘holistic’ abuse and its sequelae
To appropriately situate resilience, an understanding of participants’ past experience is essential
Participants described a range of maltreatment suffered at the hands of a partner, peer, parent/step-parent or relative. Men and women reported physical, emotional and sexual abuse, referred to by one participant as ‘holistic abuse’, during childhood, adulthood or both:
Extremely physically abusive, we went through a lot of sexual abuse in the family. Emotional abuse, and finally, every kind of abuse that you can possibly think of we went through as children.
During the interviews, several participants recalled suppressed feelings of intense anger towards their perpetrators and a desire for ‘revenge’:
One of the guys hit me with a two by four [wooden board] and I have scars here. I had this rage, uncontrollable rage. I was thinking [of] you know seriously hurting him and getting even and I carried that for the longest time.
The sequelae of abuse and violence took different paths for individuals. While some turned to drugs and alcohol, nearly half said they had thought of suicide, particularly women who had experienced long-term intimate partner violence (IPV):
There is no escape to that [IPV]. And many times I felt suicidal because of that because I thought I was going crazy, I thought there was no escape even though my family tried to help me.
While none of the participants were residential school survivors, several indicated that because of the residential school system and then the effect on parenting and the sexual and physical and all the holistic abuse that happened to them (parents), there were lasting impacts:
I don’t know if there’s one native person who has not had some kind of abuse because we’ve been abused for so many generations.
This shared sense of trauma was reiterated in participants’ meanings of resilience.
Pathways to healing
Meanings of resilience
When asked about meanings of ‘resilience’, participants shared ideas relating to resilience in response to adverse experiences as a process over time, being able to, overcome it and to heal from it, and moving forward, thus using the metaphor of ‘healing journey’ both personally and collectively as FN people:
I was trying to come up with a word [for] resiliency in Cree. The closest one I could come up with was, patience [Sasi ben da sasi ben tiogea, sasi ben tum win]. It’s a description of an action where you’re bearing up against troubles. And you’re patient about it. Resilience to me is survival. It’s surviving the negative lifestyles that First Nations were brought into.
For nine participants, their journey was made up of step-by-step learning and choices, along with significant support from individuals, families and programmes:
Being resilient is to choose your journey you want to be on and stay focused, and to have short attainable goals. It takes small little baby steps.
Participants identified three major subthemes as being integral to their pathways to healing: (a) turning points, (b) connections and reconnections and (c) moving forward.
Turning points
Eight participants spoke of specific points in time when they made a decision to move beyond their current life situations, setting foot on a new path. For some, this meant enrolling in a treatment centre or a women’s shelter outside their home community, or pursuing further education as adults. For others, it was tapping into social support networks such as family, friends or MH services. The following excerpt describes how one man navigated his journey from depression and substance abuse towards seeking help and healing:
Well you know that when I was [in my teens] I tried committing suicide. And just one day I was so depressed, so bored, and then I must have been thinking about that for probably for a long time, I didn’t know that my neighbor had seen me carrying a gun down towards the river. All of the sudden some voice from behind me says ‘What are you doing?’ So he spoke to me for about two hours, telling me about his life, what he went through it was basically the same what I was going through in my life. I seen that he was a strong-willed person and I wanted to be that person. I wanted to have that strong will. So anyways it ended up that he talked me out of it; I never tried it again. But I started thinking about being a more productive person. I started looking at all the issues that I was facing and I went for treatment … I ended up talking about my issues, my concerns … and that really helped me out because they were really supportive and trying to get me sober and getting on that right path.
Three women spoke of how ‘going back to school’ played a pivotal role in their pathway towards wellness:
I went to [another province] to go back to school for [a degree]. When I got there I didn’t know what I was getting myself into because after being out of school for so many years, getting married and raising, having my children. So when I went there, I knew it was a cultural school, but I didn’t know what I was going to be expecting. So that’s where I started my healing.
Regardless of the mechanisms, these were first steps that became ‘turning points’ on participants’ pathways to regaining a sense of balance.
Connections and reconnections
In the process of moving beyond violent life situations, eight participants spoke specifically of how connections or reconnections with their culture, traditional teachings or spirituality were central to their healing:
And it always comes down to my belief in a higher power. I think that’s our connection, that’s our gift we have been given as First Nations people, is our spirituality. And that makes us, makes me, resilient as a human being … I know we talk about the Seven Sacred Teachings and how important they are and to use them in everyday life, and do prayer. I do self-meditation, I go to sweats (lodges), and I can share that with others that are willing to listen and want to know more. People can turn their life around, and start to heal … I like to use God in everything I do … The most [helpful support] was finding my native spirituality of who I am as a Cree woman, …
Three older participants spoke of the teachings they had received from their mothers as children and how this had carried them through difficult times in their lives:
I grew up with a lot of violence around me … inside the home, but we also seen it outside the home within different families. And I think with the development of myself from my mom, her teachings were stronger than those ones [abuses] that I went through as a child … I was able to maneuver around the negativity within the community, within the household.
Moving forward
Part of moving forward beyond the experiences that haunted participants was acknowledgement of their resulting emotional pain. Four participants mentioned that forgiveness of their perpetrators was important and effective for healing:
A few years later I was able to go to the person that did it to me and say, ‘you know what, I know what you did, I just want you to know that it is bad what happened’. And I basically just forgave, right? Because you can’t harbor bad feelings for the rest of your life because that just brings you down. It’s forgiveness that’s the most important thing … My cultural identity is to have that forgiveness in order to move on. So what happened there was, after I forgave the persons that had such a negative impact in my life, I turned it into a positive, because there was a teaching there.
Perceived differences in resilience
Near the end of the interviews, participants were asked about differences in ability to demonstrate resiliency between women and men, and between FN and non-FN people.
Differences between women and men
Perspectives on differences between women and men were mixed. Half of the participants (both men and women) considered women to be more resilient than men. Women were perceived as stronger because they won’t give up and are able to express emotions more easily, allowing them to deal with their trauma by communicating more effectively than men, but also due to the perceived social barriers for men not to display emotion:
To be brutally honest I think it’s a lot easier for women. They’re the strong ones; they’re the backbone of the family unit. And they’ve taken more than us men can handle, and the floodgates are easier for them to open. They can express themselves, … well that’s again our upbringing right, us men don’t cry.
Three participants were undecided whether there were any differences between men and women, while two others felt that women and men had similar capacity for developing resilience:
I think resilience between men and women is probably the same. Cause I mean, it all comes down to supports and who you can talk to and what can be done and how you approach the situation.
Cultural differences
Participants also had differing but resonant reflections on whether resilience was different for a FN person versus a non-FN person. Three participants thought resilience would be the same, describing resilience as a characteristic held by all people, white, yellow, red, black, there’s no boundary and believed resilience is resilience.
One participant expanded further to account for the sheer extent of trauma and grief that FN people have been exposed to and how that has impacted them collectively:
I think that our spirits all hurt the same when we experience a trauma, and our grief is the same. I really don’t believe that there’s that much difference in our being First Nations, other than it seems like we’ve experienced more, more trauma and more grief and more, we’re lost.
Half of participants, however, felt that resilience would be distinctive between FN and non-FN people. Some reflected that because of the significant long-term trauma, minimal resources and social support, and the need to survive, FN people had become even more resilient:
So there is a big difference. For First Nations people or for Aboriginal people, you become even more resilient.
Yet, some felt that it would be more difficult for a FN person to become resilient due to their extensive experiences of trauma, racism and loss of identity:
For First Nations people their baseline … it’s such an early age when they start experiencing trauma. And depending on how healthy the community or their environment is that they live in, they may have a really rough time bouncing back. Especially if they have lack of medical services or even lack of resources for example and or even lack of healthy people to feel safe to turn to. I think it makes it a little more harder for them to be resilient because they don’t have the coping skills and there’s just so much trauma in their life because of the cycle that happens through the generations … Whereas the general population, have more of an advantage because they’re used to the Western, modern way, whereas we’re still having difficulties even trying to find out who we are and where we came from and our way of life.
Two others had difficulty deciding whether resilience was different between FN and non-FN people either because of how they had experienced resilience themselves – regaining identity through ‘reconnecting with their culture and native spirituality’ – or because they recognized that other cultural groups had also faced immense trauma:
I know that a lot of people in other cultures, like in other nationalities also suffer from the same things native people do, like say with the Holocaust, you know the Jews. I know they have a lot of difficulties with resilience too because of what they went through and their families and their ancestors and the effect the intergenerational effects that it has on them. So maybe there is no difference, I don’t know.
Discussion
Fundamental within these findings is that participants wrestled their way towards resiliency despite realities of dysfunctional family and community environments. This often meant seeking support outside their own communities in an effort to at least temporarily change their circumstances, similar to what has been reported in other Canadian studies on FN resilience (Kirmayer, Dandeneau, Marshall, Phillips, & Williamson, 2011). This supports M. Rutter’s (1990) argument that resilience goes beyond risk and protective factors, as these do not always create resilience and demonstrates that individuals can demonstrate resilience even if the communities or environments they live in have low or negative social capital (Ledogar & Fleming, 2008). Recent research suggests that combinations of individual and environmental factors contribute to resilience (Hermann et al., 2011). Clearly, the circumstances participants were exposed to were usually neither conducive to growth nor provided nurture; yet participants survived and overcame tremendous adversities.
Despite exposure to a range of hardships, participants discussed resilience using the metaphor of a ‘healing journey’, a process that occurs over time and requires not only personal strengths but also family and other social supports, including those in the community. This aligns with previous research among Canadian FN people where similar ‘healing journey’ discourses were prevalent (McCabe, 2007; Waldram, 2013). Furthermore, participants’ accounts were indicative of adaptation and growth, of transformations, as opposed to the notion of resilience as ‘bouncing back’ to a previous state, similar to the discussion on Aboriginal resilience in Kirmayer, Sehdev, Whitley, Dandeneau and Isaac (2009).
While several younger participants found dominant approaches like social supports and MH services helpful, most others sought cultural teachings to first find, and then understand, their identities as FN people. Although there is significant diversity within the SCTC communities regarding the degree to which traditional Aboriginal teachings are known, being taught or practised, participants drew from within themselves as well as their belief in something larger than themselves, using sacred teachings, spirituality and forgiveness as has been previously linked with healing, resilience and positive MH outcomes (Manning, 2013; Tuck & Anderson, 2014).
Also evident in participants’ accounts was the traditional role of FN women as foundational within the family and community, being transmitters of cultural beliefs and customs to the younger generations (Guimond, Guthrie Valaskskis, & Dion Sout, 2008). Similar to results found by Cloud Ramirez and Hammack (2014), relational connections with women and cultural foundations played a pivotal role in the manifestation of resilience among many participants and are essential to include in future interventions.
Notwithstanding distinctions in strategies, significant personal growth (Vizenor, 2008) was described in participants’ journeys towards resilience, illuminating what has been characterized as a legacy of trauma and abuse but also survival (Grandbois & Sanders, 2009). For numerous participants, the mechanisms for developing resilience included increased awareness and personal acceptance of identity as a FN person and then regular practice and reliance on traditional teachings and/or spirituality. Participants advanced beyond adversity and emerged resilient enabling them to support others in their FN communities. Having supports and caregivers with lived experience may be especially critical in FN communities, allowing more resilient community members to potentially become therapeutic agents and walk alongside others in their journeys.
Participants perceived resilience as having both similarities and differences among FN and non-FN peoples. While some participants thought the extensive experience of trauma made it more difficult for FN peoples to become resilient, others felt the traumas had caused them ‘to become even more resilient’ illustrating M. Rutter’s (2012) concept of the steeling effect of adversity, the notion that exposure to repeated stressors can decrease vulnerabilities. This certainly appears to ring true for participants, as increased exposure seemed to strengthen them creating a resolve to survive as individuals. Collectively though, FN communities and nations appear still to be seeking their way towards healing. Previously, comparisons have been made regarding the impacts of historical experiences such as the Holocaust on Jewish people to that of historical trauma among Aboriginal peoples in North America (Fassin & Rechtman, 2009); however, Kirmayer et al. (2014) point out that there are striking differences, due to ongoing structural violence being experienced by Aboriginal people. The historical trauma referenced by study participants and use of ‘we’ in participant stories suggest interventions focusing primarily on individual-level solutions may be insufficient; thus, approaches focusing on ‘community resilience’ which both recognize shared experiences and draw upon community strengths may be required to develop healing (Goodkind, Hess, Gorman, & Parker, 2012; Khanlou & Wray, 2014). Furthermore, recognition of ‘cultural resilience’ which encompasses the role that culture and cultural identity can play as a resource for resilience and source of strength in both the individual, whole communities and entire cultural systems is key (Healey, 2006; HeavyRunner & Morris, 1997). While each FN community is unique, a combination of approaches using both traditional healing and Western models to address various preferences of community members is suggested with more focus on strengths versus deficits (Layne et al., 2009). Further research should explore more collective aspects of FN resilience (family and community) within the SCTC and beyond to assist in prevention and healing.
Conclusion
This study provides unique insights specific to experiences of Cree individuals, which may have wider implications given that many FN people in Canada and beyond have had similar life experiences. Although the sample size was small and recruited from a defined tribal region with similar background, education and employment status, which may limit transferability to other FN groups or cultures, the findings provide vital tribal council- and community-specific insights that may be used to support community members along their pathways towards resilience. Also, the use of qualitative methods allowed for understanding of the participants’ entire experiences of their journeys towards wellness and regaining balance and can afford caregivers a holistic understanding, which can be used to meet complex needs of FN communities and their members.
Footnotes
Acknowledgements
The authors wish to thank the participants of this study who openly shared their experiences and perspectives.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by funds from the Canadian Institutes of Health Research (CIHR); Institute of Gender and Health, and Institute of Neurosciences, Mental Health and Addictions awarded to PreVAiL (Centre for Research Development in Gender, Mental Health and Violence across the Lifespan); and the Institute of Aboriginal Health awarded to the Swampy Cree Suicide Prevention Team (Dr J Sareen, principal investigator; #POH 123774).