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Returning to our medicines : decolonizing and indigenizing mental health services to better serve Indigenous… Fellner, Karlee Dawn 2016

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    Returning to Our Medicines: Decolonizing and Indigenizing Mental Health Services to Better Serve Indigenous Communities in Urban Spaces  by Karlee Dawn Fellner čaŋté hówašte wíŋyaŋ  B.A. University of Alberta, 2007 M.Ed. University of Alberta, 2009  A DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT OF  THE REQUIREMENTS FOR THE DEGREE OF  DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Counselling Psychology)  THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) April 2016   © Karlee Dawn Fellner, 2016      ii Abstract While mental health services continue to make efforts toward greater cultural sensitivity, research, education, and practice in these fields remain grounded primarily in Western Eurosettler principles that have been applied in colonization. Addressing the dearth of culturally relevant and appropriate research in Indigenous mental health, the current project applied isîhcikêwin – the author’s Indigenist nehiyaw-otipemisiwak (Cree/Métis) research paradigm to address the question: How can mental health services (be shaped so as to) better serve Indigenous peoples living in urban spaces? isîhcikêwin is based in the author’s lived experiences as a mobile nehiyaw-otipemisiwak woman who is an oskâpêwis (helper) and participant in traditional ceremonies. This framework draws on Wilson’s (2008) conceptualization of research as ceremony alongside the work of other Indigenous scholars (e.g., Archibald, 2008; Castellano, 2000; Graveline, 2000; Holmes, 2000; Kovach, 2009; Marsden, 2005; Smith, 1999).  Following isîhcikêwin ethics and protocols, the author had conversations with sixteen Indigenous mental health professionals and hosted a talking circle. The author used Indigenous holistic meaning making in coming to understand iyinisiwak (knowledge holders’) perspectives, weaving together the stories of iyinisiwak, her interpretive synthesis of their knowledges, and her own personal narratives. The findings comprise a decolonizing framework that is presented as a braid of sweetgrass consisting of three strands: (a) what isn’t working in mental health service provision, (b) restor(y)ing approaches to wellness as ways forward in Indigenous health service provision, and (c) how services can make these transformations. Findings address how approaches to Indigenous wellness in urban spaces may be transformed through the adaptation and application of a medicine bundle framework that incorporates community-based perspectives on love, good relationships, Indigenous knowledges, living a good life, responsibility, identity     iii and belonging, and land. These findings include critical implications for researchers, educators, theorists, practitioners, policy-makers, and other stakeholders whose work involves an aim to contribute to healing and wellness with Indigenous communities.  Consistent with isîhcikêwin, the current dissertation alternates between a scripted dialogue and a conversational style with the reader. This form of representation honours the voices of the author and iyinisiwak, and contributes to research that is congruent with isîhcikêwin from conception to completion.     iv Preface This dissertation is original, independent work by the author, K. D. Fellner. The current study involved human participants, and was therefore reviewed and approved by the University of British Columbia Behavioural Research Ethics Board prior to the commencement of the research. The number of the original certificate pertaining to this research is H13-01948. A version of the coyotewolf stories included in the Prologue (p. 2) and Conclusion (p. 327) has been submitted for publication as part of a chapter in an edited book (Fellner, in review). In addition, modified excerpts and passages included in Chapter 2 have been submitted for publication as part of a co-authored chapter in an edited book (Fellner, John, & Cottell, in review). The majority of the excerpts and passages that were taken from the current document are the original, independent work of the author, K. D. Fellner. However, the author made edits to the current document based on manuscript contributions and feedback from co-authors John, R. and Cottell, S.  v Table of Contents Abstract………………………………………………………….………………………………... ii Preface………………………………………………………….………………………………... iv Table of Contents………………………………………………………….……………………… v List of Figures………………………………………………………….……………………….. viii List of Characters………………………………………………………….……………………. ..ix List of iyinisiwak………………………………………………………….…………………….... x List of Indigenous Vocabulary………………………………………………………….……… xiii Glossary………………………………………………………….…………………………...… xvi Acknowledgements………………………………………………………….………………... xviii Dedication………………………………………………………….……………………………. xx Prologue: Preparing for the Journey………………………………………………………….…... 1  tan’si! Greetings………………………………………………………….…………………... 1  tawâw! Welcoming………………………………………………………….……………….. 2  Orienting to the Landscape: (Re)claiming Voice in Writing………………………………… 5 Chapter 1: The Journey Begins………………………………………………………….………. 10  Introduction………………………………………………………….………………………10   Indigenist Research………………………………………………….……………… 10   Articulating a Mobile nehiyaw-otipemisiwak Research Paradigm………………….13  Rationale and Purpose for the Current Study………………………………………………. 20   Research Problem………………………………………………….……………….. 20   Situating the Research: Socio-Political-Historical Contexts…….…………………. 21   Mental Health Service Provision with Indigenous Peoples…….…………………... 34   Mental Health Services in Urban Spaces………………………….………………... 35  Research Question………………………………………………………….………………. 37 Chapter 2: Navigating the Literature………………………………………………………….… 38  History of Research with Indigenous Peoples……………………………………………… 38  Culturally Appropriate Research with Indigenous Peoples………………………………… 44  Mental Health Service Provision with Indigenous Peoples………………………………… 46   Counselling with Indigenous Peoples………………………………………………. 48     vi   Indigenous Healing in Mental Health………………………………………………. 53  Conclusion………………………………………………………….………………………. 58  Returning to the Dialogue………………………………………………………….……….. 59 Chapter 3: A Ceremonial Quest for Understanding……………………………………………... 61  isîhcikêwin (The Way Things are Done, Ceremony, Culture)……………………………... 61   Setting an Intention…………………………………………………………………. 63   A Mobile, Métis (Mixed) Paradigm………………………………………………… 64   isîhcikêwin in the Western Academy………………………………………………..68   Mapping a Ceremonial Quest for Understanding…………………………………... 69   A Seven Directions Paradigm………………………………………………………. 70   An Ethical, Relational Paradigm……………………………………………………. 74  kiskêyihtamowin (Coming to Know) ……………………………………………………… 79   Recruitment…………………………………………………………………………. 79    Criteria for Participation……………………………………………………… 81    Informed Consent…………………………………………………………….. 84   Ethical Considerations and Protocols………………………………………………. 85    Potential for Harm……………………………………………………………. 85    Confidentiality………………………………………………………………... 86    Cultural Ethics and Protocols………………………………………………… 86   kiskêyihtamowin……………………………………………………………………. 87    Phase I: Research Conversations……………………………………………... 89    Phase II: Talking Circle………………………………………………………. 92    Phase III: Internship Experience at the Indian Health Board of Minneapolis... 97   Meaning Making……………………………………………………………………. 98    Indigenous Holistic Meaning Making………………………………………... 99    Synthesis-Analysis of Recordings, Transcripts, and Internship Experiences. 106    Encircling: tâpwewin, Authenticity and Credibility through Talking Circles.113 Weaving a Story: Integrating Themes, Conversations, Talking Circles, Experiences, Reflections, and the Literature…………………………... 118  Representation of Findings………………………………………………………….…….. 123 Chapter 4: Listening, Learning, and Returning to Our Medicines…………………………….. 125  Introduction: Sweetgrass………………………………………………………….………..125  Strand 1: Deconstructing What’s Not Working…………………………………………… 127   Barriers to Good Work…………………………………………………………….. 128    Ongoing Colonization………………………………………………………. 128    Child Welfare……………………………………………………………….. 130    Justice System………………………………………………………………. 131    Education System…………………………………………………………… 132    Systemic Racism……………………………………………………………. 133    Colonial Policies and “Liability” …………………………………………… 134    Resistance to Indigenous Approaches to Wellness and Healing……………. 137    Funding and Accessibility…………………………………………………... 137     vii    Staffing Practices and Policies……………………………………………… 139    Ethical Conflicts…………………………………………………………….. 142    Conventional Training and Education………………………………………. 143    Providers’ Lack of Critical Reflection and Awareness……………………... 144    Existing Structure of Mental Health Services………………………………. 146    Internalized Oppression and Lateral Violence……………………………… 149   Harmful Practices in Mental Health Service Provision…………………………… 150    Psycholonization……………………………………………………………. 153    Psychotropic Medication……………………………………………………. 160    Racism, Stereotypes, Prejudices, and Judgment in Practice…………………162 Patronizing and Racist Attitudes Toward Indigenous Approaches to Wellness and Healing…………………………………………………………….. 167 Colonial Impacts on Culture and Spirituality………………………………. 170   Conclusion………………………………….……………………………………... 172  Strand 2: Indigenizing Through Restor(y)ing Perspectives……………………………….. 173   sâkihitowin (Love)……………………………………….………………………... 176   miyo wicehtowin (Good Relationships)…………………………………………... 183   iyiniw kiskêyihtamowin (Indigenous Knowledges) ……………………………… 203   miyo pimâtisiwin (Living a Good Life) …………………………………………... 239   nâkateyimowewin (Responsibility) ………………………………………………. 251   awînawa (Who is this One?) ……………………………………………………… 267   askîy (Earth) ……………………………………………….……………………… 282  Strand 3: Transforming Indigenous Wellness Services…………………………………… 293   Funding……………………………………………….…………………………… 295   Policy…………………………………………….………………………………... 300   Indigenizing Organizational Wellness…………………………………………….. 303   Advocacy…………………………………………….……………………………. 305   Education and Training…………………………………………….……………… 306   Professional Development…………………………………………….…………... 314   Elders and Healers…………………………………………….…………………... 315   Models of Practice…………………………………………….…………………... 319  Conclusion: The Journey Continues…………………………………………………………… 321  Summary of Recommendations………………………………………………….………...321   Education and Professional Development………………………………………… 323   Practice and Programming…………………………………………….…………... 326   Organizational Development, Policy, and Funding……………………………….. 329  mahtahitowin (Sharing)………………………………………………………….………... 333  Study Limitations………………………………………………………….………………. 335  Significance of the Study………………………………………………………….………. 337  Reflections on the Journey………………………………………………………….……... 340 References………………………………………………………….…………………………... 344  viii List of Figures Figure 1: Cart Tracks Connecting the Red River in The United States Around 1869…………...65 Figure 2: Map of Ceremonial Dissertation Journey……………………………………………...70 Figure 3: Seven Directions Framework…………………………………………………………. 70 Figure 4: Infinite Spirit – Holistic Meaning Making In-Relation………………………………110 Figure 5: Seven Ways Mental Health Services (can be shaped so as to) Better Serve Indigenous Peoples Living in Urban Spaces in Seven Directions……………………………………...175 Figure 6: maskihkîwiwat – Seven Ways Mental Health Services (can be shaped so as to) Better Serve Indigenous Peoples Living in Urban Spaces……………………...………………... 175 Figure 7: Summary of Recommendations…………………………………………….……….. 322 ix List of Characters Me: The voice of myself, Karlee Fellner.  Dr. Ruth: Her full name is Dr. T. Ruth, though she has removed the capital T with a post-modern slash. Dr. Ruth is a professor and academic. She identifies as a feminist, and is (semi)critical in her academic work. Dr. Ruth’s mentors have been well known since the enlightenment in Europe, though she scoffs at them, “those men sure thought they were something,” reassuring us she knows better. Dr. Ruth has asserted her own ways, creating       movement, change, acknowledgement, and empowering herself and her people. But she may have forgotten some of her relations – I’m not sure she remembers the place where her roots are planted. Some say she can be a bit egocentric, maybe also a bit burned out.  Cog: Dr. Ruth’s protégé. He works in the university, and enjoys learning. He prefers to keep the peace and tries to mediate, yet is always ready and willing to please his mentor.  miskinâhk: The turtle. She represents the very diverse, yet unified, Indigenous voices that emerge through the land. She’s very well versed in her original instructions, in the (l)iterature, heart knowledge, ancestral memory, and story.  Beezy: A young girl, 5 or 6 years of age. My nana’s childhood nickname for me, she is the voice of myself as a child. Her ears, eyes, nose, heart, and spirit are open to the land, to the voices of her ancestors and helpers. She is a teacher, carrying an owl feather in her hand.  Gizmo: Beezy’s puffy fluffy jokester Pomeranian. Always close by her.  Earthdiver: An Indigenous transformer and trickster. Voices of coyote, wolf, coywolf, owl, hawk, buffalo, raven, crow, rabbit… Some say as well-versed as turtle. S/he is intelligent, witty, and “cuts the fat” – s/he tells it like it is.  mahihkan: The wolf. He is a master of navigating through the woods. Knowledgeable on Indigenous ways of coming to know. He’s very well versed in his original instructions.  Elder: The kihtehayah who facilitated the talking circles in Phase II of the research. Though she was not a formal participant in this research, brief direct quotations of her words from the transcript have been included in the dialogue given their important contributions to this work.    x List of iyinisiwak askîy: “Kamiosit Iskwew ekwa Ka Nikanit Kihew” nit chi kason, ochi Alberta nitchi nihihewan apito kosan iskwew, ekwa Haudenosaunee. I was given two names: one is a traditional name from one of my grandmothers and the other is a ceremonial name. I am from Alberta and I am Cree Métis and Mohawk. I am 56 years old and have lived across three provinces: Alberta, Saskatchewan, and now, British Columbia. I spent a number of years going back and forth in the care of the ministry. I have dedicated my life to reclaiming my place within my culture to learn and to pass on the teachings of our Elders and medicine people. I am a helper in ceremony, a Sundancer, and a Pipe Carrier. I have specifically trained in Native Human Justice, Native Youth Work, Aboriginal Leadership, and Aboriginal Focusing-Oriented Therapy for Complex Trauma. I’ve also taken numerous courses in substance abuse, mental health, and FASD. In the last 18 years, I have worked simultaneously as an outreach worker on Vancouver’s Downtown Eastside, a counsellor with First Nations youth, and through the last 15 years I developed and supervised a treatment program that revolved around tradition, culture and ceremony for First Nations youth.  âsokanihkêw: (M.A/M.S.W/R.S.W) is of Kanien'kehá:ka (Mohawk), Irish and Italian descent. She currently works as a psychotherapist with urban Indigenous adults in an Aboriginal-specific Counselling program in Unceded Coast Salish Territory (British Columbia). She has also worked in Aboriginal organizations in Montreal, QC and in community-based clinics in Los Angeles, CA, where the largest concentration of urban Indigenous people live in the U.S. Her clinical and academic specializations are in Indigenous Historical Trauma, Intergenerational Trauma, and Complex Trauma. A central aspect of her work is to decolonize and Indigenize individual and group trauma therapy. Bob: is Kwakwaka’wakw from Vancouver Island. He has worked in direct service provision in Vancouver’s Downtown Eastside for the past 16 years. Bob is a father, ceremonial drummer and singer, and participant and helper in a number of traditional ceremonies. He is also one of the founders of the Culture Saves Lives movement, which aims to reconnect people with their cultures as a means of harm reduction and health intervention.  Decolonize: is Nehin/yaw Anishnabe Midequay from Treaty #1 and Treaty #5 territories. She has been living as a visitor on Coast Salish territories since 1990. Decolonize has 25 years of experience working with Indigenous holistic health modalities and complex trauma. She specializes in body-centered psychotherapies, body-mind therapies, and expressive art therapies. Decolonize is an Indigenous ceremonialist practitioner, trainer, and mentor.  ekâ kakisipahk: is a Métis counsellor who works with Indigenous people of many backgrounds. She has 16 years of experience in the counselling field, including work as a counselling therapist and university instructor.  Karl Lee: is from Tsleil-Waututh in BC. He has worked primarily with families and youth for four years. He believes in holistic healing and also strongly believes in using culture as an intervention in his daily work and personal life. Kink’inap: My ceremonial name is Thunder Eagle Woman. I am Xaxli’p from St’at’imc territory in Lillooet, BC. First of all, I would like to acknowledge the Squamish, Musqueum, and     xi Tsleil Waututh unceded Coast Salish territories on which I live and work. I have over 12 years’ experience supporting my community on their journey to healing and wellness. I believe in Indigenous ways of healing through culture, ceremony, body-centred, and land-based approaches. Within an empowering and holistic framework I am able to work in a culturally appropriate manner. Using holistic practices through traditional medicines and ceremonies, we are healing from traumatic events; people are finding their voices and standing strong in their power.   mistahaya: is St’at’imc from Tsalalh, or the Seton Lake Band in BC. He began his career in front line social services with an Indigenous non-profit agency. He has worked in a post-secondary environment for the last 17 years, both as an Aboriginal Student Advisor and as an Assistant Professor in a graduate level Indigenous counselling program. He is currently a PhD Candidate in Counselling Psychology at an accredited university. His areas of interest include Indigenous concepts of well-being and/or mental health; effectively synthesizing Indigenous and mainstream healing approaches; inner resilience activities that sustain Indigenous men; Indigenous Research Methodologies and Somatic Transformation. At the conclusion of his doctoral studies it is his intent to pursue registration as a psychologist, to train Indigenous counselors, and to work with Indigenous clients, families and communities. onîkânew: is a community organizer and spiritual leader from the Tsleil-Waututh Nation in BC. For over 20 years, onîkânew has been involved with the conceptualization, design, and implementation of a number of healing centres and programs based in First Nation’s culture and spirituality. He has facilitated workshops on healing and wellness with Indigenous peoples across Canada and the United States for a number of years. In addition to his work in healing, onîkânew is heavily involved in community organizing and advocacy in relation to global Indigenous sovereignty, climate change, and environmental justice. onîkânew is also a Sundance Chief, Pipe Carrier, sweat lodge leader, and participant in his people’s Winter Spirit Dancing Ceremony.  opakahamâw: is an Elder, healer, medicine man, and residential school survivor from Xaxli’p First Nation near Lillooet, BC. opakahamâw has been working in the field of mental health and addictions for over 20 years, and has been working with traditional medicines and ceremony for decades. He works in schools, hospitals, and mental health and addictions. opakahamâw is a sweat lodge holder, Pipe Carrier, teacher, cultural mentor, and counsellor. He also carries a healing drum that he uses in his work throughout the urban Indigenous community of Vancouver. pisim iskwew: is a Cree woman who has been working with individuals who have participated in and adopted ceremonial and spiritual practices to address the impact of  trauma and addiction in their lives. She has supported spiritual practitioners who facilitate healing through ceremony.   pisim iskwew has directed organizational development through an Indigenous lens grounding policy and practice development within a restorative framework over a period of 25 years. pisim iskwew has a graduate degree in social work.  Rain: I am a mother, wife, daughter, sister, friend, therapist, teacher, and researcher. I have been working in the field of mental health and addictions for 15 years. I work with diverse populations, but have been involved in the Aboriginal community for many years. I maintain an     xii active therapy practice and have experience working with:  trauma, mental health issues, abuse, grief and loss, stress, residential school issues, the impact of colonization, relationship challenges, domestic violence, substance misuse and addictions. I am grateful to be immersed in the urban Aboriginal community and for the teachings and traditional ceremonies and practices in my life.  Resurgence: is from the Sts’ailes Nation, unceded and occupied territories, in BC. He is an Elder spiritual advisor with Corrections Canada. Resurgence has been working in the fields of mental health, addiction, and Indigenous health for 25 years, with a focus on developing and delivering holistic programs that combine traditional Indigenous healing practices and ceremonies with various client-centered therapies. He has worked with provincial and federal governments and educational institutions. Resurgence is a Pipe Carrier, sweat lodge leader, Mediwiwin ceremonialist, and has been a Sundancer for almost 20 years. He is also a Sundance Red Blanket Man and holds many Coast Salish songs. Running Two Bears: is a Canadian of mixed ancestry. His mother is Métis from Manitoba, and his father was born in Germany. Running Two Bears was born and raised in Vancouver, British Columbia, in unceded Coast Salish territory. He holds a BA in anthropology from the University of British Columbia, and an MA and PhD in anthropology and education from Columbia University. Running Two Bears has conducted community based participatory research with Indigenous communities in Canada, the United States and Central America. His dissertation research focused on Indigenization, exploring the complexities delegated Aboriginal agencies for child and family service face in implementing culturally restorative services within the Aboriginal diversity of urban British Columbia. Water: is an Elder and Métis knowledge keeper and Registered Clinical Counsellor who has been working internationally with communities and survivors of Indian Residential Schools, childhood sexual abuse, torture, and Post Traumatic Stress Disorder (PTSD) for more than three decades. She is a pioneering activist in the areas of complex trauma, therapeutic treatment, and program development for Aboriginal and non-Aboriginal communities. Water is a strong advocate for land-based knowledge and Indigenous perspectives on health and wellness. She is a recipient of numerous awards for her work in these areas. Whale: is an Elder whose mother’s family is from the Kwadacha Nation of the Fort Ware area in BC. She is Beaver and was raised in the care of the ministry. Whale has been in the counselling and service field for 31 years. She went to school for Child and Youth Counselling at Douglas College. She has attended countless workshops, conferences, and courses related to working with families, children, and youth. Whale has worked as a social worker and cultural coordinator in child welfare for a number of years, and continues to deepen her skills in this area through her ongoing work in Indigenous psychotherapy. xiii List of Indigenous Vocabulary alperta ohci niya: Plains (y) Cree for I come from Alberta  âpokeyihtamowin: Plains (y) Cree for faith asemaa: Anishinaabe for tobacco askîy: Plains (y) Cree for Earth  astum: Plains (y) Cree for come âtayôhkanak: Plains (y) Cree for spirit beings/powers/animals/guardians awînawa: Plains (y) Cree for who is this one? čaŋté hówašte wíŋyaŋ: Dakota for Good Hearted Woman canupa: Lakota for sacred pipe ekosi maka: Plains (y) Cree for “well, that’s it” gitchi gami: Anishinaabe for “big sea,” the body of water commonly known as Lake Superior isîhcikêwin: Plains (y) Cree for the way things are done, ceremony, culture  kahkiyaw ni wahkomâkanak: Plains (y) Cree for all my relatives kakehtaweyimowin: Plains (y) Cree for wisdom  kihci manitow: Plains (y) Cree for greatest mystery or great spirit, i.e., Creator kihtehayah: Plains (y) Cree for Elder (singular) kihtehayak: Plains (y) Cree for Elders (plural) kinanâskomitin: Plains (y) Cree for thank you  kisê-pîsim: Plains (y) Cree for Great Moon (i.e.: January) kisewâtisiwin: Plains (y) Cree for compassion or kindness  kiskêyihtamowin: Plains (y) Cree for learning; coming to know; knowledge kisteyitamowin: Plains (y) Cree for respect     xiv kwayaskâtisiwin: Plains (y) Cree for honesty  innii: Blackfoot for buffalo iyinisiwak: Plains (y) Cree for people who are wise (plural), i.e., knowledge keepers iyiniw kiskêyihtamowin: Plains (y) Cree for Indigenous knowing or knowledges  iyiniw pimâtisiwin: Plains (y) Cree for Indigenous ways of living  mahtahitowin: Plains (y) Cree for Spiritual Law of sharing manitow: Plains (y) Cree for mystery or sacred power, i.e., spirit (singular) manitowak: Plains (y) Cree for mysteries or sacred powers, i.e., spirits (plural) maskihkîwiwat: Plains (y) Cree for medicine bundle  maskihkîy: Plains (y) Cree for medicine  miyo pimâtisiwin: Plains (y) Cree for living a good life  miyo wicehtowin: Plains (y) Cree for good relationships  mitakuye oyasin: Lakota/Dakota for “we are all related” mnisota makoce: Dakota for “the land where the water reflects the skies,” the land commonly known as Minnesota mônîyâw wihowin: Plains (y) Cree for white name nâkateyimowewin: Plains (y) Cree for responsibility   nehiyaw-otipemisiwak: Plains (y) Cree for Cree-Métis (nehiyaw-“person”; otipemisiwak-“people who rule themselves”) nehiyawak: Plains (y) Cree for people (Cree) nehiyawewin: Plains (y) Cree for Cree language nîsohkamâtowin: Plains (y) Cree for helping one another nohkom: Plains (y) Cree for my grandmother     xv ohkomimâwak: Plains (y) Cree for grandmothers  omosômimâwak: Plains (y) Cree for grandfathers oskâpêwis: Plains (y) Cree for a person who helps with ceremonies (singular) oskâpêwisak: Plains (y) Cree for people who help with ceremonies (plural) owihtamâkewak: Plains (y) Cree for advisors pimameyimowin: Plains (y) Cree for humility  pwâtimowin nitisiyihkason: Plains (y) Cree for they call me in the Dakota language sâkihitowin: Plains (y) Cree for love  sôhkeyitâmowin: Plains (y) Cree for courage or bravery tan’si: Plains (y) Cree for how are you? tâpwe: Plains (y) Cree for truth tâpwewin: Plains (y) Cree for telling the truth tawâw: Plains (y) Cree for welcome wahkohtowin: Plains (y) Cree for kinship, being related to each other xʷməθkʷəy̓əm: hən̓q̓əmin̓əm̓ for Musqueam meaning People of the River Grass   xvi Glossary All my relations: A phrase that acknowledges our relationships with our families; clans; nations; communities; the natural world, including earth, sky, water, and all of the plants and animals that inhabit them; and the spirit world, including the Creator, our ancestors, and the spirits who help us. Ally: An ally is considered by the Canadian Race Relations Foundation (CRRF) to be a member of an oppressor/privileged group who actively attempts to abolish particular forms of oppression that give her/him privilege (2005). In regard to the Indigenous peoples of Turtle Island, this typically includes individuals of Eurosettler background (though it may also include members of non-European settler/immigrant/newcomer groups) who work to support Indigenous agendas as determined by Indigenous peoples themselves.  Eurocentric/Euro Western: These terms are used interchangeably to refer to approaches to research, theory, or practice that are grounded in the colonial worldviews of Western Europe, and as such, have a tendency to interpret the world in terms of these values and experiences. This is differentiated from the term “Western Eurosettler” (see definition below). Given the diversity of European worldviews, the adjective “dominating” is used to qualify instances where the author is referring to European worldviews that are currently dominant (i.e., hold power and privilege) in Canada and the United States. Indigenous peoples: The terms Indigenous and Aboriginal are used interchangeably throughout this paper in reference to Indigenous peoples in Canada unless otherwise specified (e.g., Indigenous peoples of Turtle Island, Aboriginal people of Australia). These terms are meant to be inclusive, referring to people who may identify as First Nations, Métis, Inuit, Non-Status, Aboriginal, Indigenous, Indian and First Peoples of Canada. While the term Indigenous is not defined by the Canadian government, the United Nations states that “Indigenous communities, peoples and nations are those which, having a historical continuity with pre-invasion and pre-colonial societies that developed on their territories, consider themselves distinct from other sectors of the societies now prevailing on those territories, or parts of them. They form at present non-dominant sectors of society and are determined to preserve, develop and transmit to future generations their ancestral territories, and their ethnic identity, as the basis of their continued existence as peoples, in accordance with their own cultural patterns, social institutions and legal system…On an individual basis, an indigenous person is one who belongs to these indigenous populations through self-identification as indigenous (group consciousness) and is recognized and accepted by these populations as one of its members (acceptance by the group)” (International Labour Organization as cited in United Nations, 2004). Mental health services: In this paper, the term mental health services refers to any services acknowledged by wider Canadian society as being focused on directly supporting the psychological well-being of people through treating mental illness or improving an individual’s mental health. This includes psychiatrists, psychologists (clinical, counselling, school), psychotherapists, counsellors, therapists, social workers, and psychiatric nurses. Original Instructions: This term is used by some Indigenous groups to refer to ways of living with the land that we believe have been given to us by the Creator, and include specific ethics,     xvii protocols, and practices that maintain good relationships with the human, other-than-human, natural, and spiritual worlds (Nelson, 2008). Relationality: This term is used throughout this document as an alternative to the term “identity,” as I consider myself-in-relation as opposed to an individual independent of all my relations (Cole, personal communication, 2011). Turtle Island: This term is used throughout this paper to refer to the continent of North America. This term is connected with traditional creation stories of specific First Nations, and is used widely today across groups to refer to the continent of North America.  Western Eurosettler: This term is used in reference to research, theory, or practice that is based specifically in colonial worldviews of Eurosettler populations in North America; that is, the values and ideologies characteristic of and emerging from the populations that colonized Turtle Island beginning in the late 15th century. Given the diversity of Western Eurosettler worldviews, the adjective “dominating” is used to qualify instances where the author is referring to Western Eurosettler worldviews that are currently dominant (i.e., hold power and privilege) in Canada and the United States. xviii Acknowledgements This work is a reflection of many people’s efforts, teachings, love, and encouragement. kinanâskomitin (thank you) to my family for surrounding me with love and support through all the ups and downs, multiple relocations, and personal transformation. I thank you for the values and teachings you’ve instilled in me that have helped me persevere and stay strong in my path. A special thanks to my late Nana, Sharon Roose, as so much of her is reflected in this work. kinanâskomitin to all my Elders, cultural teachers, and mentors for sharing your teachings with me throughout this journey, and contributing to my immense personal growth and learning. Many thanks to Alannah Young-Leon, Art Leon, Dorothy Christian, Fred John, Keith Pashe, Richard Wright, Maria McCoy, Ida Downwind, Nelda Goodman, Donna LaChapelle, Linda Eagle Speaker, Nancy Bordeaux, Dorene Day, and all my beautiful grandmothers at the Elder’s Lodge in St. Paul, Minnesota. kinanâskomitin to the iyinisiwak (knowledge holders) who so generously shared their insights and wisdom with me for this project. kinanâskomitin to my Elders and mentors in the field, particularly those I’ve met through the Society of Indian Psychologists and Indigenous conferences around the world. Many thanks to my Indigenous and allied relatives from Turtle Island, Australia, Aotearoa, Hawaii, South America, and beyond – you continue to inspire me with your amazing work. kinanâskomitin to the many clinical supervisors, psychologists, and practitioners who have nurtured my development as a clinician over the years. kinanâskomitin to my Ph.D. cohort at UBC and training cohort at the Indian Health Board for all of your love and support along the way. A special thanks to Roger John for helping me (re)connect with who I was meant to be and see the open pathways before me, and to my brother Joel Harris for always reminding me to keep the faith. Many thanks to those who have challenged me along the way for helping me grow.     xix kinanâskomitin to my friends and colleagues for your encouragement, humour, patience, and love as you’ve seen me through this journey. kinanâskomitin to everyone I worked with through Supporting Aboriginal Graduate Enhancement (SAGE) at UBC, and to those I met through the Aboriginal Student Council at the University of Alberta who inspired this work. Many thanks to those who have collaborated with me, brainstormed with me, and pushed my scholarship along the way. kinanâskomitin to my research supervisor, Dr. Ishu Ishiyama, and my committee members, Drs. Jo-ann Archibald and Marla Buchanan, for your guidance and support throughout this project. You have helped me become a stronger researcher and scholar, and have supported me in learning how to (re)claim my voice within the academy. I am immensely grateful to have had the opportunity to work with and learn from each of you. kinanâskomitin to the Coast Salish peoples, the Blackfoot Confederacy, the Tsuu T’ina, the Stoney Nakoda, and the Dakota and Anishnaabe for hosting me on your territories throughout this project. kinanâskomitin to kahkiyaw ni wahkomâkanak (all my relatives), including kihci manitow (the Creator), my ancestors, and my relatives of the natural and spirit worlds who have provided direction, support, and good medicine to me along the way. I am so grateful to be blessed with this work. ay ay      all my relations  xx Dedication Dedicated to my Nana, Sharon Roose. To all of our ancestors and relatives who have kept our cultures, languages, and teachings alive. To the future generations who will carry our cultures, languages, and teachings forward. ay ay    1 Prologue: Preparing for the Journey TAN’SI! GREETINGS  tans’i!1 čaŋté hówašte wíŋyaŋ2 pwâtimowin nitisiyihkason.3 Karlee Fellner mônîyâw wihowin.4 niya neyihaw niya otipemisiwak.5 alperta ohci niya.6 Hello! How are you? They call me Good Hearted Woman. My given name is Karlee Fellner. I am Cree/Métis from central Alberta, where vast fields of canola   barley   wheat stretch to the ends of the earth beneath a vibrant blue sky. Since beginning my PhD in counselling psychology at the University of British Columbia (UBC) in September, 2010, I have lived and worked as a grateful visitor on the traditional territories of the Coast Salish peoples, the Blackfoot Confederacy, and the Dakota and Anishnaabe. All the while, I’ve also spent time in the lands of my Cree and Métis ancestors where I grew up, and have retraced their footsteps as I’ve lived and travelled along their historic trade routes – the lands where the Métis came to be through creating relationships and families along the way.  Before we embark on this journey together, I must introduce myself. Introducing myself in this way is important in both respecting protocol, and in positioning myself as an Indigenous researcher carrying out research with Indigenous people (Absolon & Willett, 2005; Kovach, 2009; Steinhauer, 2001). My mother’s mother, my nana, was Cree, Métis, Polish, and Norwegian; her father, my poppa, is Swedish. My father’s mother was Czech and Hungarian from the former Czechoslovakia, while his father was German and Austrian. As I acknowledge                                                 1 Plains (y) Cree greeting meaning “how are you?” 2 Dakota for Good Hearted Woman 3 Plains (y) Cree for they call me in the Dakota language 4 Plains (y) Cree for Karlee Fellner is my white name 5 Plains (y) Cree for I am Cree I am Métis (nehiyaw-“person”; otipemisiwak-“people who rule themselves”) 6 Plains (y) Cree for I come from Alberta     2 all of my ancestries, I also acknowledge “that one cannot be part first nations  because the designation lies in the heart and spirit not in a multiple choice test or blood quantification assay   to be first nations is    to be    first nations” [sic] (Cole, 2000, p. 19). Thus, while I honour the diverse places where my ancestors come from, I experience myself as a whole person – a primarily urban-based, mobile Cree/Métis woman learning my original instructions.7  I was born on a frosty January morning    kisê-pîsim8    in Camrose Alberta – a 20 minute drive southwest of where nohkom9 Elizabeth Jane Pruden’s scrip was issued near Round Hill. I was raised an hour’s drive northwest of Camrose in the small town of Devon, which rests on the banks of the North Saskatchewan River. I grew up with a vague sense of my Indigenous ancestries, stories that were tucked away beneath my family’s dominating narrative of Scandinavian and Central European farmers. I was raised with little knowledge of or connection with my Indigenous cultures or languages. It has been through the work presented in this dissertation that I have been learning my family histories and ancestries and have found myself on a journey (re)connecting with my Indigeneity and all of my relations.10 TAWÂW! WELCOMING tawâw!11 I’d like to welcome you and let you know a bit about the research journey that lies ahead… wayyyyy ya wayyy ya ho way haaaaaaaa boom     boom    boom    boom  wayyyyy ya wayyy ya ho way aaaaaaaaaaa boom     boom    boom    boom                                                  7 See Glossary for definition of original instructions 8 Plains (y) Cree for Great Moon (i.e.: January) 9 Plains (y) Cree for my grandmother 10 See Glossary for definition of all my relations  11 Plains (y) Cree for welcome     3 wayyyyy ya wayyy ya ho way yahaaaaaaa boom     boom    boom    boom  my nana and I were picketing a furrier in the downtown eastside   one afternoon when a young native woman approached us tearfully ‘astum   my friend   nistow   go downtown      there is a coyoteperson down there in a steel cage she is your sister and she is calling your name’  I wasn’t too sure what kind of state my informant was in but we were getting tired of picketing this rich person’s store and were ready for a crusty bun and some tim horton’s soup so we jumped on the number 22 downtown    got off at west georgia and burrard actually     to set the record straight    nana had her walker and wasn’t jumping anything and I had sprained my angle powwow dancing and was wearing a tensor bandage  sure enough     there she was     that incarcerated coyoteperson in front of the art gallery     she looked sad the chain-link cage wasn’t even big enough for her to pace back and forth     and there was razor wire around the top  I looked at the coyoteperson     she was not your typical downtown vancouver variety I knew her kind     âpihtawikosisân    half-breed     coyote father    wolf mother imagine that     I thought white with gray markings     bright blue left eye     brown right I could feel her strong spirit  I wanted to be with her    to keep her company I squeezed into the cage with her      initially worried that she would be afraid of me     or bite me     or maybe both  but she seemed at ease when I entered     so was I      being with her filled my heart  I stayed with the coyotewolf in that cage for a few days      getting to know her I was overjoyed     I did not want to leave her     but I knew I had to so she could be freed      my presence was an enabling mechanism  I climbed the chain-link cage      maneuvered over the razor wire     eased my way down the other side     my tensor bandage coming unraveled I looked through the links at her    she told me ‘you go now my sister   tell the people I am here’  she said     settler philosophy did not understand that she was not wild and my freeing her would change things        people would see this was not okay       others would be freed from their cages      4 Following the guidance brought to me by coyotewolf, I am articulating a nehiyaw-otipemisiwak research paradigm that has emerged through my learning and experience. Thus, my dissertation journey is intimately intertwined with my personal journey of coming to know the landscapes of my relationality12 as a primarily urban-based, mobile Cree/Métis woman who is learning my original instructions. The understandings presented in this dissertation have come through teachings I’ve received from diverse Elders and knowledge holders, participating in ceremony and cultural activities, drumming and singing, learning nehiyawewin,13 and opening myself to revealed knowledge “acquired through dreams, visions, and intuitions” (Castellano, 2000, p. 24). Further, they are shaped by my lived experiences, both personally and intergenerationally. I am grateful to have had opportunities to incorporate such diverse teachings and understandings into my experience of the world and my own contemporary Indigenous relationality. Thus, as with other Indigenous paradigms, this work is subjective and partial (Kovach, 2009). I am articulating a nehiyaw-otipemisiwak paradigm in-relation to whom and where I am at this particular time in my life (Kovach, 2009). Thus, I do not speak for other Indigenous peoples or for others with Cree, Métis, or Cree/Métis ancestry. Rather, I speak from my current lived experience of nehiyaw-otipemisiwak knowing in the context of my personal and collective histories, and multiple intersecting past, present, and future relationalities. Further, my own understanding of a nehiyaw-otipemisiwak paradigm will transform as I transform throughout my life, as Indigenous epistemologies are relational, developmental, contextualized, and dynamic (Cajete, 2000; Dei, 2011; Lane, Bopp, Bopp, & Brown, 1984).                                                 12 See Glossary for definition of relationality  13 Plains (y) Cree for Cree language     5 By opening myself to “heart knowledge, blood memory, and the voice of the land” (Holmes, 2000, p. 37) through practices such as quiet reflection, meditation, ceremony, and dreams, I have learned that my ancestors and spirit helpers have called me to this work. This research journey is a ceremony (Wilson, 2008), and like many of our traditional ceremonies, involves a commitment guided by ethical principles embedded in our original instructions. In times I’ve felt discouraged or hesitant, the coyotewolf has reminded me of the importance of this commitment as an act of resilience, resistance, and healing in the face of the colonial cages that have long burdened the Indigenous peoples of Turtle Island.  In this work, I am accountable to kahkiyaw ni wahkomâkanak,14 kihci manitow,15 ancestors, future generations, âtayôhkanak,16 Elders, mentors, family, friends, colleagues, animals, plants, insects, earth, water, air – all of creation, as well as to the iyinisiwak17 in this project and to you, the reader. I will do my best to remain respectful and accountable in all of these relationships as we embark upon this journey. ORIENTING TO THE LANDSCAPE: (RE)CLAIMING VOICE IN WRITING For me, voice is central in decolonizing and Indigenizing my work in the academy. As Indigenous peoples of Turtle Island, many of our ancestors were forced to be silent to survive in the face of assimilationist policies and practices, while others may have been silent out of a desire to protect their children and grandchildren (McNab, 2007; Wilson, 2004). I have personally experienced the intergenerational impacts of this silencing. Thus, Indigenous voice is critical in my own decolonizing, Indigenizing, and healing. I am (re)claiming my voice and honouring the voices of my Cree and Métis ancestors through integrating Cree language,                                                 14 Plains (y) Cree for all my relatives 15 Plains (y) Cree for greatest mystery or great spirit, i.e., Creator 16 Plains (y) Cree for spirit beings/powers/animals/guardians 17 Plains (y) Cree for people who are wise (plural), i.e., knowledge keepers      6 transforming the English language, and writing outside of dominating academic structures in this dissertation. First, language is important. “Our laws, teachings and ways of life are contained in the nuances contained and held within the Cree language” (Makokis, 2005, p. 119), and are thus integral in our survivance and resurgence (Alfred & Corntassel, 2005; Wilson, 2004). Therefore, I am learning nehiyawewin and using it when possible in my writing. Given that I have been colonized with English and am just (re)learning nehiyawewin, I am only able to use Cree for certain concepts, and apologize for any mistakes. I also use words in other Indigenous languages when appropriate, which reflects the territories I’ve lived on and the diverse teachings I’ve received as a mobile Indigenous person. I intentionally do not capitalize Indigenous terms so as not to create a hierarchy between letters in these oral languages (Cole, 2006). I’ve also chosen not to italicize or set these words apart in any way so as not to stylistically marginalize them from English words. Second, writing primarily in English, I am learning to “use it as I need to   for my speaking and writing   even if it means I must write chaos  chance  trickster   even if it means I must bring words into existence which thencetofore were naught” [sic] (Cole, 2006, p. 22). Therefore, I will introduce new terms along the way. Congruent with an oral style of writing, I also intentionally remove punctuation between words in certain cases where it would otherwise stand between words that I believe ought to flow together, and sometimes use spacing to create visual/auditory effects while reading. While using English to articulate Indigenous philosophies is contested, it becomes necessary for translation and inter-knowledge sharing (Dei, 2011). Using both English and Indigenous languages enables me to converse with/in both worlds, not unlike     7 my Métis ancestors who integrated the languages of their Cree and French relatives, creating Michif (Métis Nation of Alberta, 2016). Finally, another important aspect of (re)claiming my voice comes through  spirit   heart   body   mind  writing. Rather than continuing to privilege ‘objective’ mind writing, I am allowing myself to write in alter/native ways that allow communication to flow naturally through my holistic interconnected being – storying    dialoguing    experiencing. Spirit   heart   body   mind  writing takes a form more congruent with orality and iyiniw pimâtisiwin,18 and thus is consistent with a nehiyaw-otipemisiwak paradigm. Indigenous philosophy is embedded in the way this dissertation is written. I also hope writing through embodied holism will be more accessible than conventional academic writing, and will engage a greater diversity of readers. When I first sat down to write my research methodology, I struggled to fit my work into a conventional academic format – I was trying to force the coyotewolf into the cage. Feeling stuck, I prayed for the help and guidance of manitowak,19 and my writing began to flow out in the form of a scripted dialogue. This dissertation alternates between this scripted dialogue and the current format of my conversations with you, the reader.  Just as this writing generally is not in a conventional academic format, the scripted dialogue is also not in the conventional format of a play, theatrical script, or any other form of established writing. Rather, I’ve allowed my voice to emerge naturally, perhaps in the form of a dream – a journey, a living story and experience engaging the reader, the voices in the literature, the voices of the iyinisiwak, and various aspects of myself-in-relation.  My conversations with you, the reader, are fairly straightforward. This is it. Sometimes I include stories and poems, indented as freestanding, italicized blocks of text. I will also introduce                                                 18 Plains (y) Cree for Indigenous ways of living 19 Plains (y) Cree for mysteries or sacred powers, i.e., spirits     8 you to each of the chapters and check in along the way. When we shift into the script, there are three columns. The first column contains subheadings that provide markers as to where we are within the chapter. The second column contains the dialogue, non-verbal information, and context. Speakers’ names are bolded, non-verbal and contextual information is italicized within parentheses, and the dialogue itself is in plain text. The third column contains citations for information provided in the dialogue. Citations also refer to relevant literature that supports and expands upon the narratives of iyinisiwak and myself, situating our contributions in this literature and engaging readers and myself in learning from existing knowledge in the field. Citations are located beside the information they refer to in the columns. The exception to writing through embodied holism is my literature review, which is written in a conventional academic format in order to best satisfy requirements. I invite you to bring along your imagination, and allow yourself to experience this journey as it unfolds… I invite you      to join this journey meandering through different writingscapes             salty sweet    shores   of the great Pacific  fragrant      red cedars     stretching tall     earth to sky over ancient rocks  roots     winding up through the giants     ohkomimâwak20  omosômimâwak21           they call the rocky mountains across foothills of medicine      running alongside powerful innii22       trails     twisting    turning   opening to    flat     expansive plains of      sweetgrass   tobacco   sage                father sky     mother earth     meet in all 4 directions down those well-trodden       red river trails    hop in!    ox cart    canoe    4x4 truck       bright red maples   woodlands of birch and pine    cedar      mnisota makoce23      serenity   power   medicine     waves washing the sacred shores of gitchi gami24                                                  20 Plains (y) Cree for grandmothers 21 Plains (y) Cree for grandfathers 22 Blackfoot for buffalo 23 Dakota for “the land where the water reflects the skies,” the land commonly known as Minnesota  24 Anishinaabe for “big sea,” the body of water commonly known as Lake Superior     9  ‘such journeys are best undertaken with an openness     to all that unfolds       in all senses       mind  body  heart  spirit’       coyotewolf is right        after all    it is by this same process that this writing has emerged   astum!25 Let’s go!                                                 25 Plains (y) Cree for come     10 Chapter 1: The Journey Begins  Our story begins on the traditional, unceded territories of the hən̓q̓əmin̓əm̓ speaking xʷməθkʷəy̓əm26 people, on the land now commonly known as Vancouver, British Columbia. Dr. Ruth and I are standing having a discussion in a cold, white classroom in the Neville Scarfe building at UBC. Cog is sitting nearby at a table taking notes. As we converse, other characters gradually enter the room. I’m feeling frustrated trying to write my dissertation according to Dr. Ruth’s standards. I have a number of books and resources around me, but am feeling stuck in my work.                                                  26 hən̓q̓əmin̓əm̓ for Musqueam meaning People of the River Grass INTRO-DUCTION Dr. Ruth: (Arms crossed) You must have each specific detail of your research spelled out in a strictly structured, linear format. There is an established order to things.   Me: (Wincing) That’s difficult if I am to stay true to my voice. My axiology ontology epistemology methodology are relational and process-oriented. I am journeying with/in various landscapes of Turtle Island. The stories are not linear. The journey cannot be confined within colonial cages…   Dr. Ruth: (Annoyed) What does that even mean? I don’t have much time for this. And neither do you. A good dissertation is a done dissertation.   Indigenist Research Me: (Shaking her head) It is very important to me to honour      11                                                 27 See Glossary for definition of Western Eurosettler. Please note the author acknowledges the diversity of Western Eurosettler worldviews. Thus, the adjective “dominating” is used to qualify instances where the author is referring specifically to Western Eurosettler worldviews that are currently dominant (i.e., hold power and privilege) in Canada and the United States. my voice and carry out Indigenist research.  miskinâhk: It is important, Karlee. “There is a need for methodologies that are inherently and wholly Indigenous.” Particularly in the field of psychology…  (Kovach, 2009, p. 13)  Me: (Smiles) Thank you, miskinâhk. (Turns to Dr. Ruth) You see, one of my primary intentions with my research is creating spaces for Indigenous voices in counselling psychology. Accordingly, these spaces must be created Indigenously. Just as Western Eurosettler27 research articulates findings congruent with its own paradigms, Indigenous paradigms are pathways to Indigenous knowings.            (Kovach, 2009; Wilson, 2008)  Dr. Ruth: (Lets out a sigh of frustration and looks at her watch) I’m not following what you’re wanting to do here.   Cog: (Looks up from his notepad where he has been furiously taking notes) I have an idea: why not use a critical paradigm?    Dr. Ruth: (Smiles) Great. Thank you – finally some sanity in this dialogue. Karlee, you have many possibilities: anti-racist, post-colonial…there are many anti-’s, de-’s, and post-’s out there. Just perfect for what you’re looking for. Now, if      12 you’ll excuse me, I’ve got to grab a coffee and prep for my next meeting. (Satisfied, she turns to leave)  Me: Wait! (Dr. Ruth faces Karlee again, annoyed) Those approaches won’t work for me. (Dr. Ruth rolls her eyes and lets out a sigh) While aspects of these paradigms may seem to seep into my work and I respect the great contributions of the people who use those approaches, they are not for me. In the case of my research, I feel such a paradigm would place Indigenous knowing in opposition to dominating Western Eurosettler knowing, and that’s not what I’m trying to do. I’m not trying to oppose. I don’t want to de-, anti-, or post- anything, quite frankly.   miskinâhk: It’s also important to acknowledge that critical Western paradigms claiming to be empowering Indigenous voices sometimes are a means to silence them. Furthermore, “in resisting and subverting oppressive power, we cannot simply seek to position ourselves as wielders of that same power.” If we do, we’re just perpetuating the same cycles of power and oppression.          (Murad, 2011, p. 425)  Me: (Thoughtful) Also, as Maggie Kovach writes, “regardless of whether research emerges from a positivist, constructivist, or transformative paradigm, it is still ‘researching’ Indigenous people, and it is still deeply        (Kovach, 2009,     13                                                 28 See Glossary for definition of Eurocentric/Euro Western political.” p. 29)  miskinâhk: (Nods) Mm hmm. Fitting our Indigenous frameworks into Western Eurosettler lenses only serves to reinforce Eurocentric28 dominance. Eurocentric standards cannot be the measure of our worth.        (Dei, 2011)  Me: I couldn’t agree more. For this particular work, I want Indigeneity at the centre. (Lets out a sigh of relief, smiles and looks content as Beezy walks up and enters the conversation, her little dog Gizmo close behind)   Beezy: What’s wrong with our aunties? I don’t get it.   Me: (Giggles and runs her fingers over Beezy’s hair) Not aunties, silly…   Dr. Ruth: (Sits down, letting out a frustrated sigh. Cog sits next to her, continuing to look down as he takes notes) All right, then. Tell me about this ‘Indigenous paradigm’ you speak of…or whatever it is. (Mumbles under her breath) Clearly I’m not getting out of this one very easily.  Articulating a Mobile nehiyaw-otipemisiwak (Cree/Métis) Research Paradigm Me: (Smiles) Great. Well, first it’s important for me to say that there is no one Indigenous paradigm….   Dr. Ruth: Oh for crying out loud… (Rolls her eyes)      14  Me: (Choosing not to acknowledge Dr. Ruth’s reaction, continues) …so while there have been Indigenous scholars doing Indigenous research before me, it doesn’t feel right to follow exactly what they have done. My paradigm – my axiology ontology epistemology methodology – comes from myself-in-relation as a primarily urban-based, mobile nehiyaw-otipemisiwak woman in this moment. My “scholars,” if you will, are my Elders, mentors, and cultural teachers. That said, my approach also draws on the work my academic predecessors have done. It is important to acknowledge those who have opened paths that enable me do this kind of research.    (Beezy is playing quietly with Gizmo in the background, Dr. Ruth is half-listening, still resting her head in her hands – her eyes tired, while Cog continues to take notes and miskinâhk listens intently)    Linda Smith has been a real leader in the through the contribution of her seminal piece, “Decolonizing Methodologies.” Peter Cole ‘dissertated’ via canoe journey, and Jo-ann Archibald through storywork. Both Peter and Jo-ann have been influential mentors to me, as I’ve had the opportunity to work with them here. (Motions toward being in the Neville Scarfe building)     (Archibald, 2008; Cole, 2006; Smith, 1999)            15 Others who have really influenced my work include Maggie Kovach and Shawn Wilson, who wrote specifically about Indigenous research and methodologies. There are many other Indigenous scholars who’ve articulated and employed their own Indigenous paradigms, but these are some of the few who’ve had a profound direct influence on my work.    (Kovach, 2009; Wilson, 2008)  miskinâhk: (Toward Cog and Dr. Ruth) As much as dominating Western Eurosettler systems may want one, there is no singular theory or formula. As with other ways of knowing, Indigenous perspectives cannot be homogenized. There are thousands of Western theories – why would Indigenous people have only one?         (L. Pihama, personal communication, May, 2011)  Me: Precisely! (Smiles)  Indigenous knowledges are dynamic and diverse, emerging through individual and collective experiences in-relation to place. So I guess on that note, I best introduce myself so you know where I’m coming from first – myself-in-relation. (Dr. Ruth’s expression has lightened and she’s sitting slightly more upright, Cog continues to furiously write notes, very attentive to the conversation) Beezy, would you like to start?    (Dei, 2011; Kovach, 2009).  Beezy: (Looks up from playing with Gizmo) Okay sure! (Stands up and proudly walks beside Karlee, addressing Dr.      16 Ruth) My name is Karlee. Mom told me she named me that after a little girl she met in the dental office she used to work in. She doesn’t work there anymore, though; she works with my dad at his machine and welding shop. Umm I also have a little sister, Shelby, and a really little brother, Landyn. I’m the oldest. My last name, Fellner, is the same as my dad’s last name, and the same as his dad – grandpa Fellner.  Me: (Looking down at Beezy) That’s right. And dad’s dad was German and Austrian, and dad’s mom was Czechoslovakian and Hungarian. Mom’s mom, nana, was Métis, Polish, and Norwegian, and mom’s dad, poppa, is Swedish. Our Métis ancestors, nana’s grandma Elizabeth Jane Pruden, and her ancestors before her, have neyihaw – Cree – in them, along with a mix of French and English. And exactly seven generations back, we have an Anishinaabe ancestor from Grand Portage. That makes us otipemisiwak. Métis. The people who rule themselves.   Beezy: (Grinning) I knew it! I knew I was an Indian!! otipemisiwak.   Me: Well, I’m glad I told you now because it took me 25 years to realize it. (Rolls eyes, grins).      17  Beezy: (Surprised) REALLY?! What the heck? Man…I’m sure glad you told me this now … I got to get back to my whittling! (Sits down abruptly and starts whittling a poplar branch; looking up at Karlee) …So what’s your story then?  (All in the room are very attentive, including Dr. Ruth – she likes stories)   Me: Well, at some point I stopped the whittling and crafts – I don’t remember when – and stopped listening to my dreams and conversing with nature. (Beezy looks up at Karlee with disappointment in her eyes, then returns to whittling; Karlee looks down at Beezy sadly, sighing) Well, I shouldn’t say I stopped. I never completely stopped…I just stifled those parts of me, quieted them down so they wouldn’t ‘interfere’ with doing what I had to do the way I was told to do it. (Sighs) Ew…that sounds awful.  Anyway, at some point I realized I had to let go of what I learned were “childish” feelings and beliefs so I could get high marks and “achieve” in the dominating Western Eurosettler education system. As the years went on and I moved on up through high school and into university, I had less and less time for any kind of creative endeavours, and instead had to focus on the mastery of working within the box. There was no time for the kind of mystical foolishness      18 that came with conversing with nature and creating artistically. (Beezy shakes her head – in her personal opinion, that’s actually quite foolish)  miskinâhk: (Nodding knowingly) “Historically, Indigenous knowledge systems have been confined to ‘conceptual reservations’ as primitive, mythological, prelogical, and closed systems of thinking, that is, as nonscientific views regarded at most as confused systems of classification, a logical mode of reasoning but with a closed set of unscientific premises, or an intuitive, even ‘mystical’ awareness as an alternative to Western rationality.” It is not uncommon for us to find ourselves living within those reservations…              (Anderson, 2011, p. 96)  Me: As Melissa Nelson says, we become members of the split-head society!! (Laughs) So now, I’m in the process of mending my split-head with trickster consciousness. In other words, I’m decolonizing my mind, living between/with/in Indigenous and dominating Western Eurosettler worlds, trying my best to negotiate the interconnections with/in them. It sure can make your head spin!   (Nelson, 2008)  Earthdiver: (Pops in – mischievous grin on his furry face; prancing around the room as he speaks) Well isn’t this perfect, otipemisiwak! (Chuckles) During the fur trade, the           19 Métis acted as the “mixedblooded middlemen,” dancing around between the Euros and the Natives – buffering and translating between the two. Sounds like I might be hearing a bit of that in your voice, otipemisiwak! (Pokes Karlee on the nose and winks; Beezy giggles and claps as Earthdiver prances around the room, pats her on the head, and disappears) (Vizenor, 1981, p. x)  Me: (Laughs) Well, yes, that’s pretty much exactly it! (Looks at Dr. Ruth, who appears somewhat interested in the story. Cog is continuing taking notes. miskinâhk is quietly smiling as she listens) It’s funny how no matter when, where, how I branch away, I am always pulled back to this centre: the centre of being otipemisiwak. As much as I have moved away in different iterations in my life, I have also been moving toward this métissage all along.               (Donald, 2012)  (Voice over: Peter Cole’s voice echoes through the room): What was the first Métis research project?  (P. Cole, personal communication, October, 2011)  (Voice over: An Indigenous woman’s voice echoes through the room): “Never forget you have the spirit of two people inside you. Trust in them both and you will find your way.”        (Bailey, 1986)  (Karlee feels the presence of Elder Thelma Chalifoux in the back of the room, looking at her with gentle, knowing eyes;         20 she has told Karlee she will find what she is looking for when she finds where ‘Western psychology’ and Indigeneity intersect) (T. Chalifoux, personal communication, December, 2010)  Me: (Smiles, comforted) I mean, yeah. That’s it. I hope to negotiate communication between/with/in “Western psychology” and Indigenous healing so we can move forward from there…ideally toward enhancing healing with all, with a particular focus on Indigenous peoples.  RATIONALE AND PUPROSE FOR THE CURRENT STUDY Dr. Ruth: (Realizing she became engrossed in what was happening, clears her throat and straightens herself up, brushing out the slight wrinkles that have formed in her shirt) Ahem. Okay. So you’ve told me who you are, where you’re coming from, and something of this Indigenous paradigm. Let me know about the problem. What problem do you propose to address?   Me: No problem… (Giggles; Dr. Ruth looks unimpressed, so Karlee stops laughing. As she begins to continue, she is interrupted by a representative of the Canadian government)  Research Problem Gov’t: (Slides through doorway with puffed out chest, standing tall, wide grin, winking) Let me address this! Why the problem is simple, you see. Aboriginals in Canada experience a range of mental health issues at higher rates than the general population: depression, anxiety, suicide,               21                                                 29 See Glossary for definition of Indigenous peoples substance abuse, domestic violence … the list goes on! (He nudges Karlee, winking; she looks at him, unimpressed) Actually, suicide and self-injury were the leading causes of death among First Nations people aged 10 to 44 in the 1999 census. (Nods at the others) (Government of Canada, 2006; Health Canada, 2003; Mental Health Evaluation & Community Consultation Unit, 2001)  Me: Um…okay, let’s just pause for a moment here, Gov’t, I think it’s important to situate those stats in some historical context first…   Gov’t: Let’s leave history in the past, where it belongs, eh? (Karlee narrows her eyes at Gov’t, shaking her head; Gov’t’s eyes dart back and forth nervously as he looks at his watch)  Oh shoot, would you look at the time – I’m late for a meeting, gotta go!! (Hurries back out the door; Beezy sticks her tongue out behind his back; Karlee sighs, shaking her head, turning back to Dr. Ruth and Cog, continuing)  Situating the Research Problem: Socio-Political-Historical Contexts  Me: Let’s locate the “problem” where it belongs, shall we? Colonization has imposed centuries of oppression, forced assimilation, and marginalization on Indigenous peoples29 in Canada, resulting in what is referred to as historical, intergenerational, and/or colonial trauma. Which brings me to a story…    (Duran, 2006; Duran & Duran, 1995; Kirmayer, Tait & Simpson, 2009)        22                                                 30 See Glossary for definition of Turtle Island How the First Peoples of Canada came to be in Turtle Island30 remains up for debate in Euro Western scientific research, though many Indigenous groups in Canada have stories of our presence on Turtle Island since time immemorial. As I understand it, kihci manitow gave us original instructions to govern our relationships with mankind and nature, including a respect for and obeisance to the universe. The development of Indigenous societies and cultures occurred within geographical cultural areas in according to climate and regional resources, and has always been intimately connected to the land. Within the universe, everything is connected and interdependent; it is important to maintain balance and harmony among all parts. Spirituality pervades every aspect of life and is a part of everything in the universe, including beings that Euro Western science classifies as inanimate. (Dr. Ruth and Cog are very attentive, listening, interested) In my understanding, many traditional Indigenous beliefs hold that kihci manitow gave us the right to self-determination, as well as our cultures, spiritual beliefs, and languages, which have existed since time immemorial. Although each individual is respected in his or her own right,        (Francis, Jones & Smith, 2004)    (Alberta Mental Health Board, 2006)     (Francis et al., 2004)   (Lane et al., 1984)  (Burke, Chauvin, & Miranti, 2005; Lane et al., 1984)        (Alberta Mental Health Board, 2006)        23 the main focus is on the collective. Family is primary, and goes beyond biological blood ties – as beings of the universe, we are all related. Actions are taken in consideration of the greater good, as the group supersedes the individual. Relationships among individuals, nature, and the universe as a whole are strengthened through traditional ceremonies and spiritual rituals. (Directly addresses Dr. Ruth and Cog) A basic understanding of some of these beliefs underlying the diverse cosmologies of many Indigenous groups on Turtle Island helps us understand the relationship between colonization and “mental health issues” among Indigenous peoples in Canada. So: contact. While Western scientists have found evidence of some contact between the Beothuk and Inuit peoples and the Norse around 1000 CE, ‘continuous contact,’ for lack of a better phrase, between the First Nations and Europeans didn’t occur until John Cabot landed on what he called “new found land” in 1497 and claimed the land for King Henry VII. (In a joking, sarcastic tone) ‘Cause, you know, you can just do that when you see yourself as superior to other peoples and your relatives of the natural world…   (Burke et al., 2005; Lane et al., 1984)      (Lane et al., 1984)                        (Trigger, 1986)  (Voice over: Earthdiver’s chuckle echoes through the room)      24  Historian: Allow me, Karlee. (Strolls through the door, smoking a pipe; he is very expressive, with an English accent and fluctuations in vocal tone that capture the attention of those in the room)  This is my area of expertise, you know. (Karlee nods, sceptical but willing to give him the benefit of the doubt) Cabot’s arrival marked the beginning of European colonization of the land that would eventually be declared the nation of Canada, though Spanish colonization of the Americas had already begun following Christopher Columbus’ arrival in the Caribbean in 1492.  Soon after their arrival in what is now known as Canada, the Europeans began trading tools, knives, beads, and metal ornaments for furs from the Aboriginal peoples. The fur trade continued for over 300 years, bringing with it Jesuits whose sole purpose was converting the First Nations to Chrrrristianity.  Colonization decimated Indigenous populations and brought drrrrrrastic changes to First Peoples’ societies through acts of genocide, including the intentional introduction of infectious diseases, warfare, murder, and ongoing attempts to suppress and eliminate culture and identity. Collectivist Indigenous communities were increasingly fragmented as the Great Nation of Canada began                     (King, 2012)      (Trigger, 1986)     (Kirmayer et al., 2009)       (Gray, 2011; King, 2012; Kirmayer et al., 2009)        25 to form. (Pulls a very old, crumbling document out of his pocket and holds it up; pieces of the document fall on the floor as he moves with his speech) The first piece of legislation to overtly oppress the First Nations was the Rrrroyal Proclamation of 1763. To ensure the colonizers could establish settlements, they paid the First Nations lump sums of money for pieces of land. (Historian appears annoyed with the paper in his hand and crumples it, brushing it off of his clothes as it scatters to the ground in dust)             (Gray, 2011)   (Voice over: Earthdiver’s voice echoes through the room): Settlers! Do you not remember the original instructions you were told? Land cannot be bought or solddddddd!!   miskinâhk: (Shaking her head) It was only the beginning of severing the relationships between Indigenous peoples and our ancestral territories. Severing us from our first mother…   Historian: (Nodding, recomposed) A series of treaties with a number of First Nations followed, which further limited their freedoms.  Into the late 20th century, the colonial government continued to take more Indigenous land through forced removals and relocations, and the creation of federal reserves that confined First Nations communities to small areas of                 26 land. (Nods toward Karlee) Colonial cages, if you will.  Often located in remote areas and on non-agricultural land without proper infrastructure, many communities where forced to live far away from their traditional territories. (Gray, 2011)      (Gray, 2011)  Me:  The impacts of these colonial processes remain a source of social inequity and health disparities among Indigenous individuals, families, and communities today.   Historian:  The British North America Act of 1867… (Pulls another aged document out of his pocket, accidentally tearing it) …oh shoot… (Shrugs) …ah well… (Throws torn bits of paper to the floor; Gizmo comes over, sniffs the papers, and pees on them; Beezy giggles) …where was I? Oh yes: The British North America Act. This document (points to the bits of paper covered in dog pee) gave the government official control over the Aboriginal peoples. The prime minister moved First Nations to smaller reserves, with explicit intentions of assimilating and enfranchising them into Euro-Canadian society.  The INDIAN ACT… (Historian grandiosely pulls another document from his pockets, this time his exaggerated movements lead him to accidentally throw it across the room; Gizmo runs after it and the document becomes his chew toy; Beezy tries to get the document from Gizmo but he                (Canadian Institute for Historical Micro-reproductions, 2005)                27 will not give it up; quiet laughter echoes throughout the room) …of 1876 officially made Aboriginal peoples legal wards of the state. Afforded the same status as children and the “mentally disabled,” they were not permitted to possess alcohol, and were not allowed to leave their reserves without government issued identity cards.  With this Act, the explicit intention to assimilate First Nations people into colonial society was written into legislation. The Act defined who was considered an Indian, restricted the nature of economic activity available to Indigenous peoples and disrupted traditional governance models with mandated male Band Councils.  First Nations people could have their status removed from them or they could voluntarily surrender their Indian status through enfranchisement. The government could also harvest resources off of reserve lands.           (Gray, 2011)                    (Gray, 2011)  miskinâhk: (Sighs) This exacerbated already impoverished reserve conditions, and further disconnected our peoples from our traditional foods and ways of life. This imposed shift in lifestyle and diet forced our peoples to become dependent on the Euro-Canadian market economy, contributing to the negative health and social outcomes we see in communities today.            (Kirmayer et al., 2009)     28                                                 31 See Chrisjohn et al. (2002) for an extensive description of how many aspects of Canada’s Indian Act meet the criteria for the UN definition of genocide.   Me: (Shakes head sadly) The buffalo disappeared from the prairies…   (The faint sound of a big drum beats in the background)   Historian: (Nodding) Yes, yes.  Numerous amendments throughout the late 19th and early 20th centuries, many of which meet the requirements for the United Nations definition of genocide,31 progressively limited Aboriginal rights.  For example, in 1884, the Indian Act banned the practice of traditional customs and ceremonies. That meant no powwows, sweat lodges, potlatches, Sundances, among others! An amendment in 1905 allowed the removal of Indigenous people from reserves near settler towns of more than 8000 people.  While the first overhaul of the Indian Act in 1951 lifted the bans on ceremonies and traditional activities, it brought the creation of a central registry for status Indians and the requirement that women who married non-status or non-Indigenous men give up their status. Until the late 1960s, First Nations could have their Indian status revoked for a number of reasons, including, but not limited to, getting a                     (Gray, 2011)         (Gray, 2011; Palmater, 2011)           29 university degree, voting in a federal election, becoming a lawyer or clergyman, and serving in the military.  The formulas for registering under the Indian Act continue to “reflect a basic concept of blood quantum or descent-based rules designed to assimilate all Indians through legislative extinction.”  (Gray, 2011; King, 2012)       (Palmater, 2011, p. 29)  Me: (Sighing and shaking her head) And never mind the fact that the Inuit and Métis haven’t even entered into the equation yet!   Gov’t: (Pops his head in) The Inuit are Aboriginal people from Arctic Canada –Nunavut, Nunavik Quebec, Nunatsiavut Labrador, and the Inuvialuit Settlement of the Northwest Territories! And Métis…?! (Chuckles) We let them figure that one out!! Ha! (Quickly disappears)     (Aboriginal Affairs and Northern Development Canada, 2010a)  Me: (Rolls her eyes) Definitions of who we – the Métis – are and are not are controversial. Historically, we emerged as a culturally distinct group in the late 18th century – typically descendants of Indigenous women and European fur traders. Today, definitions vary between Aboriginal Affairs and Northern Development Canada, the Métis National Council, provincial and other Métis associations, and people’s definitions of themselves. Either way, regardless of how we’re being defined and      (Beal & Macleod, 1984)       (Palmater, 2011)     30 despite each nation’s/band’s/group’s/sub-group’s unique histories and experiences in-relation with settlers and the government, Indigenous peoples in Canada have shared experiences of attempted genocide.  Dr. Ruth: (Shaking her head) My goodness… (Cog nods in agreement)   Historian:  Ah, but wait – there’s more! The attempts at assimilation and extinction did not end there! (Historian looks around the room to ensure he’s captured the attention of his audience, smiling, content, when he realizes people are listening to him) From the 1840’s to 1996, over 150,000 Indigenous children were removed from their families and communities and forced to attend residential schools run in collaboration between the Government of Canada and the United, Presbyterian, Catholic, or Anglican Churches. There, children were stripped of their identities and forced to give up their cultures, languages, and beliefs in exchange for the colonial culture, English language, and Chrrrrrrrrrristian beliefs! (In a sarcastic tone) Allow me to directly quote the one and only, beloved Prime Minister Harper. (Historian clears his throat as he pulls out Harper’s Statement of Apology from June 2008) “Two primary objectives of the Residential                     (Aboriginal Affairs and Northern Development Canada, 2010b)              31 Schools system were to remove and isolate children from the influence of their homes, families, traditions and cultures, and to assimilate them into the dominant culture.  These objectives were based on the assumption Aboriginal cultures and spiritual beliefs were inferior and unequal. Indeed, some sought, as it was infamously said, “to kill the Indian in the child.’”        (Aboriginal Affairs and Northern Development Canada, 2010b, para. 2)  Cog: (Shaking his head) Oh good grief!   Historian: (Ignoring the interruption) In 1850, attendance in residential schools became compulsory for Indigenous children aged six to 15. Parents who resisted the forced removal of their children were subject to punishment by imprisonment.  “Schools insisted that the children not have any extensive contact with their families or home communities. Students were forbidden to speak their languages or practise any part of their culture…Diseases flourished. Sexual and physical abuse was common. The children received neither proper nutrition nor proper clothing.” As a result of this abuse and neglect, thousands of children died in residential schools. There were no reunification policies when children left the schools, leaving many with foster or adoptive families where they continued to be isolated from their         (King, 2012)           (King, 2012, p. 113-114)    (Gray, 2011)     (Kirmayer et     32 cultures and often abused.  Although residential schools began to close in the 1950s, the last residential school did not shut its doors until 1996. al., 2009)   (Gray, 2011; Regan, 2010)  Cog: (Intrigued, looking upset; shakes his head) Wow…no wonder there are so many social and psychological issues…   Historian: (Unimpressed by the interruption) AHEM. Anyway, with the closure of many residential schools, the child welfare system became a tool to continue the government’s mandate of assimilation. The imposition of Eurocentric child welfare laws took thousands of children from their families, disregarding the devastating effects of residential schools and withholding supports that could have facilitated the healing of Indigenous families and communities at the time. Many children were placed in homes outside of Canada, and most were adopted into non-Indigenous families.  Due to the sheer numbers of children apprehended upon implementation of these policies during the 1960s, this period in Canadian history has become known as The Sixties Scoop. Current child welfare practices continue this legacy of assimilation and contribute to the significant over-representation of Indigenous children in care. (Looks at his watch) Oh dear! I’m due for tea. Well folks, it has been a                     (Gray, 2011)            (Gray, 2011)     33 pleasure. I must be off. (Sweeps out of the room abruptly)  Me: (Surprised at the sudden entrance and exit of the mysterious Historian) Oh, okay… (Recomposes herself) Well…yeah. That’s the gist of the socio-political-historical context we’re living in. As you can see, the history of interactions between the Indigenous peoples of Canada and Euro-Colonial dominating society is coloured with centuries of oppression, marginalization, murder, and cultural genocide.   (Voice over: Earthdiver’s voice echoes through the room): Canadian holocausssttttt!!   Dr. Ruth: (Thoughtful) Hmm okay. So now today, we’re seeing these higher rates of mental health issues among Aboriginal peoples, as Gov’t said. Hmmm…okay…so my question, then, is given that Aboriginal peoples have had their rights and freedoms restored… (Discontented murmuring echoes throughout the room) Okay, let’s say partially restored… (Murmuring again) Well, you get what I mean. Anyway, I’m just wondering what they are doing to get help with these issues? My understanding is there are ample services available…   Gov’t: (Pokes his head in the door quickly) Dr. Ruth, Aboriginal people underutilize mental health services!  (McCormick, 1997, 2009)     34 (Quickly disappears; Indigenous eyes roll in room) Mental Health Service Provision with Indigenous Peoples Me: Again, important to contextualize. Many Indigenous peoples report a preference for traditional healing, or alternatively, an Indigenous therapist. Only thing is, there are few Indigenous psychologists in Canada and some Indigenous peoples prefer not to seek traditional resources. So, the primary alternative is to obtain services through therapists from the dominating culture who are trained in conventional, Euro Western programs. Unfortunately, these experiences may be unhelpful due to Eurocentric treatment regimes and practitioners’ limited knowledge regarding best practices with Indigenous clients.        (McCormick, 1997, 2009)  (France, McCormick & del Carmen Rodriguez, 2004; Trimble & Thurman, 2002)    (Duran, 2006)  miskinâhk: To put it bluntly, “the therapist’s insistence on imposing a different worldview on the patient can be understood as a form of violence against the patient’s knowledge life-world…‘epistemic violence.’”  (Dr. Ruth looks at miskinâhk, surprised by her forwardness) “The mental health profession is basically a tool of social control. After the church began to fail to control people, because they were gaining access to written material, it became necessary to implement another form of control. The medical profession, including the original doctors of the mind, took up the power to control.”      (Duran, 2006, p. 9)             (Duran, 2006, p. 9)     35  (Voice over: Earthdiver laughs and his voice echoes through the room): Hell yeah, my turtle friend!!! Wooooeeeeeeeeeee!!!   Me: (Nodding) Mmhmm. Not to mention colonial trauma and the associated mistrust of the dominating culture.  (McCormick, 2009)  miskinâhk: Clinical racism is embedded in the system. What we need in psychology is a healthy integration of Western and traditional Indigenous healing ideologies, such that there is harmony and fluidity between the worldviews. (Duran, 2006)  Me: (Smiling) Trickster consciousness. (Nelson, 2008)  Beezy: (Smiling a huge smile) otipemisiwak!!   (Earthdiver dances into room; giggles echo throughout in reaction to his eccentric dancing and singing; he dances up to Beezy, tosses her in the air as she giggles, and gently puts her down) Earthdiver: Bah bah bah, dah dah dah…red and white and white and red…bah dah dah… (Lightly punches Karlee on the shoulder) You rascally little half-breeds “wait above the chaos at common intersections in the cities for the white animals to return with the earth…”  (Smiles and winks at Karlee with a twinkle in his eye; suddenly disappears)                (Vizenor, 1981, p. xvi) Mental Health Services in Urban Spaces Me: (Smiling very wide as she takes a few moments to reflect within herself) Ah yes, cities. So this “problem” that we’re         36 discussing may be particularly relevant in urban environments.  More than half of Indigenous people in Canada live in urban areas, and that number is expected to continue increasing. Indigenous people living in urban spaces also tend to exhibit greater biopsychosocialspiritual concerns than those in rural and reserve communities, which are in part related to ‘residential instability’ – migration between cities and their communities, and within cities. Dang, don’t I know what that’s like! (Laughs) Anyway, Indigenous people in urban spaces may also find it more difficult to find traditional healing resources, more likely having access to readily available Eurocentric mental health services. Perhaps not surprisingly at this point, “many urban Indians sense that mental health services are not responsible to their unique cultural needs.” Considering the need for adequate mental health services for Canadian Indigenous people, we need culturally appropriate research to explore Indigenous perspectives on mental health service provision. (Returns her attention to Dr. Ruth)  So, there it is. The problem and rationale that my dissertation work aims to address. I intend to contribute to original research through using a nehiyaw-otipemisiwak        (Kirmayer et al., 2009)       (Kirmayer et al., 2009)            (Trimble & Thurman, 2002, p. 63)     37                                                   32 See Glossary for definition of mental health services paradigm to explore Indigenous mental health professionals’ perspectives on how mental health services can better serve Indigenous peoples living in urban spaces. RESEARCH QUESTION Dr. Ruth: (Nods, hand on her chin, thinking. Cog looks up from his notebook, dishevelled, as Dr. Ruth speaks) Okay, so what is your clear, succinct research question? (Points Cog toward his notebook, indicating he should continue taking notes)   Me: How can mental health services32 (be shaped so as to) better serve Indigenous peoples living in urban spaces?   Dr. Ruth: (Nods) Okay. Clear, succinct. Good. From here, we need you to situate this research in the existing literature. Let us know what’s out there.   Me: (Nods) You’re in luck! I’ve gotten a literature review all nicely written up for you in conventional academic format. Two copies, at that. (Karlee pulls two stapled packages of paper from her bag) Here you go! (She smiles and hands a package to Dr. Ruth and to Cog)   LIGHTS DOWN.      38 Chapter 2: Navigating the Literature  tan’si! I hope you’re enjoying the journey so far! It’s always tricky navigating the waters of the academy as an Indigenous researcher, but I think I’ve gotten Dr. Ruth and Cog to open up a bit. Now I don’t want you to miss out on the literature review. So, for your reading pleasure, I’ve included the document I gave to Dr. Ruth and Cog in the form of this conventionally written chapter. Here, I contextualize the current study through presenting the evolution of research with Indigenous peoples since contact and the current literature regarding ethical and culturally appropriate research with Indigenous peoples. I then provide a synthesis of the culturally relevant literature on counselling with Indigenous peoples, as well as the emerging body of literature on Indigenous ways of knowing, being, and doing in mental health service provision. Taken together, this literature review provides the foundations for this study through an exploration of how Indigenous ways of knowing may be brought into mental health research and practice to end the cycles of colonization historically reinforced in this field.  Enjoy the read! ekosi maka!33 HISTORY OF RESEARCH WITH INDIGENOUS PEOPLES  Historically, research with the Indigenous peoples of Turtle Island has not only been exploitative and unethical, but has also played a key role in colonization and imperialism (Deloria, 1991; National Aboriginal Health Organization, 2005; Smith, 1999). Until recently, researchers treated Indigenous peoples as objects to be researched, extracting information and knowledge and distorting it through lenses of dominating Eurocentric scientific paradigms, only to use it to their own advantage without regard for benefit to communities (Deloria, 1991; National Aboriginal Health Organization, 2005). While these practices continue today, their                                                 33 Plains (y) Cree for “well, that’s it”     39 acceptability is decreasing and Indigenous communities and scholars are increasingly defining culturally appropriate research (Deloria, 1991; Kovach, 2009; Smith, 1999; Wilson, 2008). Martin (2003), an Aboriginal researcher from Australia, has detailed the chronology of research with Indigenous people in six phases: terra nullius, traditionalizing, assimilationist, early Aboriginal research, recent Aboriginal research, and Indigenist research. Although these phases were developed within an Australian context, they may be discussed in relation to Indigenous research in Canada given the similarities in colonial and scientific histories between these countries (Wilson, 2008). The terra nullius phase began in Australia when Captain James Cook declared the land to be terra nullius (empty land), completely disregarding the presence of Indigenous peoples (Martin, 2003). This phase lasted from 1770 to 1900 and was characterized by European settlers’ observations of “primitive” Aboriginal peoples throughout the process of colonization (Martin, 2003; Smith, 1999). This occurred on Turtle Island as well, where the “research” of Europeans took the form of drawings, writings, and removal of artefacts and people that were sent to Europe. To this day, Indigenous peoples are trying to acquire these artefacts and our ancestors’ remains from overseas (Smith, 2012). In the Canadian context, in addition to the colonial legislation invoked during this time, a head bounty was placed upon Indigenous peoples and smallpox infested blankets were distributed among communities with the declared intention of wiping out the population (Wilson, 2008). The research of the settlers reinforced the image of Indigenous peoples as subhuman savages to be removed from our land, enabling colonizers to harvest the resources of “the new world” without the original peoples in their way (Wilson, 2008).     40 The traditionalizing phase lasted from 1900 to 1940 (Martin, 2003), and in both Canada and Australia, the government and church increasingly researched Indigenous peoples in an attempt to address the “problem” of the peoples as barriers to progress (Wilson, 2008). Racially-based research, much of which was carried out in psychology and psychometrics, was conducted in order to reinforce an image of the inhuman savage (Wilson, 2008). For example, in a study intended to compare “Mixed and Full Blood Indians” (Garth, 1921, p. 360) on their performance on psychological tests, Garth concluded: The Mixed Bloods tend to excel the Full Bloods on a score of averages…Furthermore the scores of the Mixed Bloods is favoured by their superior social status and educational opportunity. However, the writer doubts if an equality of school attainment would remove the indicated differences. (p. 363) In a later study using the Binet-Simon to carry this work forward with various comparison groups, Garth (1923) concluded, “the measure of intelligence indicates the following sequence: first, mixed-bloods; second, Mexicans; third, Plains and Southeastern Indians; fourth, Pueblo Indians; fifth, Navajo and Apache Indians” (p. 400). Numerous similar studies with overtly racist outcomes and implications were published during that time and are available through PsycINFO (e.g., Garth & Smith, 1937; Hunter & Sommermier, 1922; Jamieson & Sandiford, 1928; Telford, 1938). Disturbingly, similar comparative research has continued to be published into the 1990s (e.g., Davidson, 1992; Whorton & Morgan, 1990). During the traditionalizing phase, researchers treated Indigenous peoples “as evolutionary quirks, curiosities of nature” (Wilson, p. 48), using empirical data collection as a means through which to reinforce Indigenous people as targets during the eugenics movement (Grekul, Krahn, & Odynak, 2004). The health and living conditions of Indigenous peoples were used as further     41 evidence for our inability to care for ourselves (Martin, 2003; Wilson, 2008). The legacy of these research projects is seen today in intelligence testing and outside researchers focusing on “Aboriginal issues” [sic] such as substance abuse, suicide, fetal alcohol spectrum disorder, and other physical and mental health issues (Wilson, 2008).  Another defining characteristic of this phase was the traditionalization of Aboriginal peoples in anthropology. The belief that Indigenous peoples would soon be extinct led to a frenzy of research intended to record our traditions before they were “lost” (Smith, 1999; Wilson, 2008). This gave birth to problematic pan-Indigenous stereotypes that continue to this day, as well as categories of how traditional, acculturated, bicultural, or assimilated an Indigenous person was (Wilson, 2008). Unfortunately, these same categories are perpetuated in modern multicultural counselling literature. For example, scales intended to classify Aboriginal peoples continue to be developed in American counselling research (e.g., American Indian Enculturation Scale (AIES; Winderowd, Montgomery, Stumblingbear, Harless, & Hicks, 2008); the Traditionalism Scale for Parents (TSP) and Traditionalism Scale for Children (TSC; Morris, Crowley & Morris, 2002)). This continued colonization within the literature emphasizes the importance of familiarity with this history and its ongoing influence. Martin (2003) defined the assimilationist phase as the period between 1940 and 1970, wherein research of the traditionalizing phase continued with an additional emphasis on solving “Aboriginal problems” [sic]. Non-Indigenous researchers adopted roles as “Indian experts” [sic] even though many had never had direct relationships with Indigenous people (Wilson, 2008). This continues in academia today, as researching “Aboriginal problems” [sic] has become a profitable career path and method of procuring research grants (Deloria, 1991). It was during the assimilationist phase that assimilation via residential schools and other forms of legislative     42 control were emphasized as means to ‘educate’ and ‘rescue’ Indigenous peoples from themselves (Wilson, 2008). It was within this phase that the Sixties Scoop occurred, wherein Indigenous children were taken from their families and adopted out to Eurosettler families in Canada, the United States, and overseas (Kirmayer, Simpson & Cargo, 2003; Wilson, 2008). It was during this period that medical experiments and other harmful research was carried out in Indigenous communities. For example, a number of studies in Indigenous communities and residential schools between 1942 and 1952 conducted extremely harmful nutritional experiments that involved dietary manipulation and malnourishment (Mosby, 2013). Mosby writes: These experiments therefore must be remembered and recognized for what they truly were: one among many examples of a larger institutionalized and, ultimately, dehumanizing colonialist racial ideology that has governed Canada’s policies towards and treatment of Aboriginal peoples throughout the twentieth century. (p. 172) In the early Aboriginal research phase (1970s to 1990s), research focusing on Indigenous peoples continued as the human rights movement spread. Research increased “as structural relations turned welfarist in nature” (Martin, 2003, p. 15) and researchers in a variety of disciplines set out to “rescue” Indigenous peoples. However, this research continued to pathologize Indigenous peoples and interpret and represent Indigeneity through the dominating colonial research discourse, and thus only data that was understood through the dominating Euro Western worldview entered the research literature (Wilson, 2008). The negative portrayal of communities and unethical misuse of data and biomedical samples in studies during this period has had further detrimental impacts (e.g., see Drabiak-Syed, 2010; Foulks, 1989). Martin (2003) defines the 1990s to the 2000s as the recent Aboriginal research phase, in which there was a significant movement within both qualitative research and Indigenous rights.     43 In Canada, an integral part of this was the Royal Commission Report on Aboriginal Peoples (RCAP; Indian and Northern Affairs Canada, 1996), a thorough report on how the structural relations established through colonization ought to be addressed in Canadian society. This opened up space for Indigenous voices in research (Wilson, 2008), and for the first time, Indigenous peoples such as Linda Tuhiwai Smith (1999), wrote about research from their own perspectives. Community-based initiatives such as OCAP (the principles of Ownership, Control, Access and Possession) began to emerge to address myriad concerns about research in Indigenous communities, including stigmatizing and stereotyping communities, pressuring communities to support projects, disrespect toward traditional culture and beliefs, lack of benefit to community, lack of community involvement, absence of informed consent, externally motivated research agendas, and “lack of community ownership of data and research results” (National Aboriginal Health Organization, 2007a, p. 3). The recent Aboriginal phase has given way to the Indigenist phase (Martin, 2003). Indigenous researchers in the British colonies are now articulating Indigenous research paradigms that privilege Indigenous ways of knowing, being, and doing (Wilson, 2008). In addition to Linda Smith (1999), examples of other influential scholars who have published books based in research using their peoples’ epistemologies include Jo-ann Archibald (2008), Peter Cole (2006), Margaret Kovach (2009), and Shawn Wilson (2008). A number of Indigenous peoples have also used Indigenous epistemologies and methodologies in their unpublished graduate research (e.g., Lee Brown (2004), Dawn Marsden (2005), and Alannah Young (2015)). Further, a number of guidelines governing ethical research with Indigenous peoples have been established, including the CIHR Guidelines for Health Research Involving Aboriginal People (Canadian Institutes of Health Research, 2007) and NAHO’s Considerations and Templates for     44 Ethical Research Practices (National Aboriginal Health Organization, 2007b). This optimistic shift in research with historically oppressed peoples is captured in Castellano’s (2004) quotation of an Elder at the Royal Commission on Aboriginal Peoples: “‘If we have been researched to death,’ he said, ‘maybe it’s time we started researching ourselves back to life’” (p. 98). CULTURALLY APPROPRIATE RESEARCH WITH INDIGENOUS PEOPLES  Considering the historical context of research with Indigenous peoples in the British colonies, it is essential for non-Indigenous and Indigenous researchers alike to engage research in ways that do not perpetuate colonial dynamics. As a first step, an understanding of the historical context of colonization and research on First Peoples is essential. This enables us to relocate the research “problem” in processes of colonization and ongoing social and systemic issues. This is key, as the idea of the “Aboriginal problem” remains firmly embedded in the Eurosettler psyche (Martin, 2003; Smith, 1999; Wilson, 2008). “For many Indigenous communities research itself is taken to mean ‘problem;’ the word research is believed to mean, quite literally, the continued construction of Indigenous peoples as the problem” (Smith, 1999, p. 92). From here, one must understand that what is considered Euro Western research draws from systems and beliefs about knowing that expand beyond the boundaries of science to the entire socio-political-economic structure of the dominating Western Eurosettler system (Smith, 1999).  In response to these systems and contexts, the recent Indigenist research phase has sparked a movement centering tribal epistemologies, valuing previously silenced Indigenous ways of knowing as scientific research in their own right (Kovach, 2009; Smith, 1999; Wilson, 2008). Kovach (2009) writes about qualitative research and Indigenous methodologies as having an insider/outsider relationship. The “insider” space may be used to assist non-Indigenous researchers in beginning to form an understanding of what Indigenous research is. Keeping in     45 mind fundamental differences in cosmology and epistemology, the closest approximation of Indigenous research in Euro Western discourse would be a transformative paradigm, drawing on phenomenology, narrative aspects of constructivism, decolonizing perspectives, and incorporating a participatory methodology (Kovach, 2009).  Although it is important for researchers to have an understanding of these theoretical issues, it is not necessary for practical implementation to be as complex as these issues may suggest. When it comes to actually formulating and carrying out research with Indigenous peoples, the priority is adapting an approach that is not extractive and that honours the worldviews and standards of the communities involved (Castellano, 2004; Deloria, 1991; Kovach, 2009). A number of authors and organizations have published on how to engage in research that is defined as ethical by communities themselves. First and foremost, researchers must observe the ethics of relationship referred to as relational accountability (Wilson, 2008), or miyo wicehtowin.34 Relationships are at the heart of Indigenous worldviews, necessitating research that is based in community relationships and prioritizes reciprocity, respect, relevance, and responsibility (Archibald, 2008; Kirkness & Barnhardt, 1991; Wilson, 2008). This also goes beyond the immediate research and applies to being ethical in-relationship with all of one’s relations, including the natural world, the cosmos, all the people one has relationships with, one’s ancestors, and future generations (Wilson, 2008).  Castellano (2004) identifies five major themes from the literature that guide ethical research with Indigenous peoples in Australia, Canada and the United States: 1. Consultation with the community when developing research protocols and keeping them informed during implementation.                                                 34 Plains (y) Cree for good relationships     46 2. Informed consent from community leaders prior to approaching individuals … 3. Community involvement in conducting the research and transfer of skills and expertise to the community. 4. … Community consent to additional use of [data and] samples beyond the original project and agreement on storage and subsequent destruction of samples … 5. Advance drafts of research reports should be distributed to the community to identify community views. (p. 108) In Canada, participation of Indigenous groups as full partners in research projects is heavily emphasized (Castellano, 2004). It is essential that research with Indigenous peoples follow an ethical methodology (Deloria, 1991; Kovach, 2009). A number of research protocols have been created to guide researchers working with this population. This includes the RCAP Ethical Guidelines for Research (1996), the guidelines set out by CIHR (2007) and NAHO (2007b), the Tri-Council Policy Statement’s Research Involving the First Nations, Inuit and Métis peoples of Canada (Government of Canada, 2010), and ethical protocols established by specific groups, such as the Mi’kmaq Ethics Watch (as cited in Kovach, 2009, p. 143). At a minimum, researchers working with Indigenous peoples must observe these protocols and collaborate with the community throughout every phase from conceptualization to dissemination (Deloria, 1991). In truly giving back to the peoples it is meant to serve, such research must focus on mobilization, transformation, decolonization, and healing (Smith, 1999). These ethics and values are at the centre of Indigenist research (Kovach, 2009; Smith, 1999; Wilson, 2008) MENTAL HEALTH SERVICE PROVISION WITH INDIGENOUS PEOPLES Given that developments in Indigenist research are so recent, the majority of the research regarding mental health services with Indigenous peoples to date has been carried out within and     47 articulated through positivist and post-positivist Euro Western paradigms. This has imposed significant limitations on the application of empirical research with Indigenous peoples, and may be related to the relative prominence of practical/theoretical publications guiding Indigenous approaches to counselling and service provision. That said, the recent Aboriginal and Indigenist research phases (Martin, 2003) have seen an increase in primarily qualitative culturally appropriate and relevant methodologies that are contributing Indigenous voices to the literature (e.g., Gone, 2013; Gone & Calf Looking, 2015; McCabe, 2007; McCormick, 1997; Reeves & Stewart, 2014). This emphasizes the need to engage the existing literature critically, mindful of how projects were carried out in-relation with communities from conception to dissemination, and whose voices are privileged in findings and conclusions. With these considerations in mind, the current literature review draws primarily on publications that demonstrate ethical research processes with communities, as defined by existing guidelines regarding such processes (e.g., Castellano, 2004; CIHR, 2007; Government of Canada, 2010; NAHO, 2007b).  In order to supplement gaps in culturally appropriate research, this review further draws upon practical and theoretical publications from reputable Indigenous and allied35 scholars in the field. As with empirical resources, theoretical sources must be critically engaged. Familiarity with authors’ community relationships and experiences facilitates this. Further, congruent with the Indigenous principle of relational accountability (Wilson, 2008), culturally appropriate literature is often endorsed by Indigenous peoples knowledgeable in the field. This process is aided by the relatively small community of Indigenous and allied authors publishing in applied psychology, and by the web of connections among them. Therefore, included sources are written                                                 35 See Glossary for definition of ally     48 by Indigenous peoples and allies who have established credibility among the communities of Indigenous scholars, educators, and practitioners in mental health on Turtle Island. The current section explores the existing culturally relevant empirical and theoretical/practical literature on counselling with Indigenous peoples and the incorporation of Indigenous approaches in mental health services. Despite the differences between Canadian and American contexts, literature from both Canada and the United States is reviewed in this paper given the dearth of literature in this area in Canada. Further, the United States-Canada border is a colonial border that has been imposed on previously sovereign First Nations. This border has divided these Nations of Turtle Island, and thus has no inherent implications for differences among Indigenous peoples ourselves. Unless otherwise qualified, the term “Indigenous peoples” in the remainder of the current chapter refers to the Indigenous peoples of North America. Counselling with Indigenous Peoples  In the literature addressing psychological practice with Indigenous peoples, it is widely acknowledged that psychotherapy is often not effective for this population (Duran, 2006; Duran & Duran, 1995; Trimble & Thurman, 2002; Wendt & Gone, 2011). In addition to the lack of empirical literature guiding clinicians (McCormick, 2009), a number of reasons for this have been hypothesized, including colonial trauma and mistrust (LaFromboise, Trimble & Mohatt, 1990; McCormick, 2009), clinical racism (Duran, 2006), stereotypes and racist/patronizing attitudes held by clinicians (Trimble & Thurman, 2002), lack of theoretical and clinical relevance of Euro Western psychotherapies (Gone, 2013; Duran & Duran, 1995), an emphasis on the individual (LaFromboise et al., 1990; McCormick, 1997), cultural misconceptions of normality (McCormick, 2009), patronizing attitudes toward Indigenous clients (LaFromboise et al., 1990), disregard for the socio-political, historical, and cultural realities faced by Indigenous peoples     49 (McCormick, 2009), and a general lack of experience, knowledge, and cultural sensitivity in working with Indigenous clients (Trimble & Thruman, 2002). These factors are further exacerbated by the foundational values of psychology as a discipline (Duran & Duran, 1995). At a fundamental level, mental health services are grounded in dominating Western Eurosettler values, ideologies, and ways of being (Duran, 2006; Duran & Duran, 1995; LaFromboise et al., 1990). Even multicultural psychology often fails to acknowledge, “that the modern psychotherapies are cultural tools or artefacts that preserve in enduring fashion the semiotic signatures of their sociohistorical contexts of origin” (Wendt & Gone, 2011, p. 211). Thus, it is important to acknowledge the role psychology plays in the historic and contemporary colonial system. Left unchecked, psychotherapy may perpetuate neo-colonialism through a process Duran (2006) refers to as epistemic violence. This occurs through the therapist’s imposition of Eurocentric worldviews onto the client (Duran, 2006; Lavallée & Poole, 2009; McCabe, 2007). In other words, psychotherapy affirms the very values that have colonized and oppressed the Indigenous peoples of Turtle Island since contact, as it involves “a therapeutic system that has its root metaphors deeply entrenched in the causes of the presenting problems themselves” (Duran & Duran, 1995, p. 18). The mental health system represents the present-day method of social control, having taken over the historical function of the church in the colonial project (Duran, 2006). Accordingly, particular therapeutic orientations enforce adaptation to serious social issues, “[serving] to pacify and eliminate legitimate anger and political initiative” (LaFromboise et al., 1990, p. 634). This works against Indigenous agendas of cultural and linguistic revitalization and resurgence that often directly address the roots of the problems experienced by communities (Alfred & Corntassel, 2005; Kirmayer et al., 2009), and may harm Indigenous clients.      50 Scholars in the field have attempted to address this through articulating guidelines to more culturally sensitive practice with Indigenous clients. However, this literature typically maintains Eurocentric psychotherapies as the basis for practice, and is often characterized by the issues of essentialism and homogenization encountered in much of the multicultural literature (Moodley, 2007; Wendt & Gone, 2011). This literature continues to homogenize groups based on a select few characteristics, reinforcing an “us” versus “them” approach, often neglecting the diversity in attitudes, knowledge, and practices among individuals whose cultures are constantly changing (Kirmayer et al., 2009). Further, it “often provides advice to counsellors so that they can be more effective with Aboriginal clients, but it does not provide empirical evidence to support such advice” (McCormick, 2009, p. 341). Despite these issues, this continues to comprise the majority of literature related to counselling with Indigenous peoples, and contains guidelines that may be helpful when contextualized within a specific therapeutic relationship.  As a starting point, many authors speak to the importance of clinicians’ understanding of Indigenous cultures, colonization, self-locations within the colonial relationship, and how these dynamics influence the therapeutic process (Duran, 2006; Nuttgens & Campbell, 2010; Olson, 2003; Trimble, 2010a). Regardless of whether one’s ancestors played direct roles in colonization, it is critical for therapists to consider their locations within current colonial contexts and question, challenge, and discard beliefs that reinforce colonial ideals (Lawrence & Dua, 2005). Therapists must locate themselves within the contexts of their societal privileges and oppressions, aware of their own beliefs and assumptions so they engage reflexive practice around relational dynamics and processes with Indigenous clients (Hays, 2008; Nuttgens & Campbell, 2010; Olson, 2003). Awareness of the cultural assumptions that inform therapeutic practice is also essential so as to avoid ethnocentric frameworks, assessment tools, and diagnostic practices     51 (Duran, 2006; Hart, 2002; McCormick, 2009; Morrissette, 2008; Trimble & Thurman, 2002; Wendt, Gone & Nagata, 2015). Engaging in this personal and professional development provides the foundation for cultural safety for Indigenous clients (Mental Health Commission of Canada, 2012). Remaining mindful that the appropriateness of such recommendations depends on the specific client, other suggestions for mental health professionals working with Indigenous people include: therapist self-disclosure (Garrett & Garrett, 1994; Lokken & Twohey, 2004), openness to spirituality in session (Lokken & Twohey, 2004; Olson, 2003), directive therapeutic approaches (Trimble & Thruman, 2002), humility (Morrissette, 2008), a social justice lens (Nuttgens & Campbell, 2010), humour and storytelling (Brass, 2009; Garrett, Garrett, Torres-Rivera, Wilbur, & Roberts-Wilbur, 2005; Hart, 2002; Lavallée & Poole, 2009), art (McKenna & Woods, 2012; Trimble & Thurman, 2002), empowerment (LaFromboise et al., 1990; Poonwassie & Charter, 2001), working with dreams (Duran, 2006; Hart, 2002), a family/community orientation (LaFromboise et al., 1990; McCormick, 2009), caution with assessment and diagnostic data (Trimble & Thurman, 2002), and flexibility in session times and locations (France, Rodriguez & McCormick, 2013; Trimble & Thurman, 2002). Further, Lokken and Twohey (2004) found that therapist trustworthiness was of central importance to Indigenous clients, and was conveyed by counsellors’ concern, respectfulness, authenticity, slow pace, self-disclosure, and listening behaviour. It is also imperative for therapists to create a culturally safe space to explore and validate clients’ personal and cultural identities (France et al., 2013). This safe space is critical given the disruption of cultural pride, identity, and self-worth that generations of colonization has imposed on Indigenous peoples (Duran, 2006; Lavallée & Poole, 2009). Counsellors must therefore     52 understand the diverse traditional worldviews of their Indigenous clients, which is necessary if communication is to take place within the therapeutic relationship (McCormick, 1996). A process of respectful inquiry enables providers to gain insight into clients’ unique worldviews (McCormick, 2009).  Therapists may thus come to understand how clients relate to Indigenous lifeways in regard to: cultural and tribal affiliation, understanding of presenting concerns, Indigenous language(s), ceremonial practices, and potential solutions they envision in addressing their presenting concerns (Duran, 2006). A respectful, relationally-based approach to cultural inquiry is preferred to conventional approaches to assessment of Indigenous clients’ levels of acculturation and ethnic identities often found in the literature (Gray & Rose, 2012; Nuttgens & Campbell, 2010; Rayle, Chee, & Sand, 2006; Trimble, 2010a; Winderowd et al., 2008). As in the therapeutic literature more generally (e.g., see Wampold, 2001), there is also considerable debate over whether certain therapeutic approaches are more effective than others, or whether there are counsellor characteristics that promote overall effectiveness with Indigenous clients (Trimble & Thurman, 2002; Wendt & Gone, 2011). Given the lack of empirical literature addressing these questions with Indigenous clients, the literature recommends that the therapist embody the generally effective qualities of congruence, respect, concreteness, genuineness, empathy, warmth, and availability, being sure to listen to clients “without judging the credibility of the belief systems associated with healing ceremonies, Indian medicine, and spiritual quests” (Trimble, 2010a, p. 250). In a brief synthesis of the literature, Trimble (2010a) found that the major themes generally “emphasize the need for counselors to be flexible in their counseling style, relational approaches, recognition and appreciation for deep cultural lifeways and thoughtways, identification of counseling goals and procedures, and the course of the counseling process” (p. 245). Unfortunately, these themes do not extend beyond recommendations for     53 general clinical competence (Wendt & Gone, 2011). Further, this literature has continued to repeat these same general guidelines for decades without an associated increase in therapeutic effectiveness with Indigenous clients (Duran & Duran, 1995; Trimble, 2010a; Wendt & Gone, 2011). In response, scholarly conversations are increasingly turning toward Indigenous models of healing. Indigenous Healing in Mental Health  One way that Indigenous healing has been addressed in the literature is through discussing the integration of Indigenous approaches with conventional Eurocentric therapies. For example, Rayle and colleagues (2006) present a case using a “culturally specific counseling approach” (p. 73) that draws on Indigenous knowledges in case conceptualization and intervention. Heilbron and Guttman (2000) integrated a healing circle with cognitive therapy, while Garrett, Garrett and Brotherton (2001) present a potential approach to group therapy modeled after traditional healing circles. Subia Bigfoot and Schmidt (2006) proposed a cultural adaption of trauma-focused cognitive behavioural therapy.  Although some authors maintain that this integration is preferred to either modality individually, attempts at synthesis must be made with caution given that Euro Western psychotherapy is supported by the law, medical system, and government, and is therefore likely to overtake and assimilate traditional Indigenous healing practices (McCormick, 2009). Further, the theoretical underpinnings of some conventional therapies are at odds with Indigenous ways of knowing, being, and doing. For example, Indigenous perspectives on spirituality, ritual, and interconnection are regarded as “magical thinking” [sic] from numerous Euro Western theories of psychotherapy, including cognitive (Trimble, 2010b). Such a conceptualization is patronizing, pathologizing, and culturally insensitive.      54 Incorporating traditional Indigenous healing also holds dangers of appropriation and misuse of these healing methods by non-Indigenous practitioners (LaDue, 1994; Trimble, 2010a). Further, McCormick (1994) found that the “most successful Aboriginal healing programs have been run using Aboriginal values and approaches” (as cited in McCormick, 2009, p. 343). Therefore, rather than aiming toward the consolidation of Euro Western therapeutic practices and traditional healing, these approaches may best compliment one another through a collaborative relationship (McCormick, 2009). For clinicians, part of this collaborative relationship involves working with Indigenous healers, referring clients to healers, or supporting traditional Indigenous healing practices as a viable option (France et al., 2013; Lavallée & Poole, 2009; Trimble & Thurman, 2002). There are also organizations and programs that are based in Indigenous ways of knowing, being, and doing, and draw upon culturally adapted techniques as part of their holistic approaches to wellness. For example, Tsow-Tun Le Lum on Vancouver Island (Fiske, 2008), The Pisimweyapiy Counselling Centre in Manitoba (Gone, 2008a), and Anishnawbe Health Toronto (Reeves & Stewart, 2014). Increasingly, Indigenous scholars are articulating how Indigenous approaches to healing and wellness may provide the basis for counselling practice with Indigenous clients. Although concepts of mental health and psychology as a discipline are deeply rooted in Eurocentric colonial worldviews (Duran & Duran, 1995), Indigenous peoples have practiced our own culturally based forms of ‘counselling’ since time immemorial (Brass, 2000; McCormick, 2009; Poonwassie & Charter, 2001). Prior to European contact, Indigenous peoples maintained communal ways of living that were inherently healing and preventative (Native Women’s Association of Canada, 2007; Poonwassie & Charter, 2001). In Cree, we refer to these ways of     55 living as miyo pimâtisiwin36 (Hart, 2002). As I understand it, many Indigenous languages have a word or phrase to represent living a good life. It is important to acknowledge that Indigenous nations, and the families and individuals within them, vary widely in respect to traditional healing methods and concepts. However, commonalities among many Indigenous groups may be drawn upon in articulating Indigenous approaches to healing and wellness (Lane et al., 1984; Native Women’s Association of Canada, 2007). Indigenous approaches to healing and wellness are typically holistic, incorporating the spirit, heart, body, and mind as equally important in maintaining wellness (Deloria, 2006; Hart, 2002; Lane et al., 1984; McCormick, 1996; Mehl-Madrona, 2003; Native Women’s Association of Canada, 2007). The aim of healing is to restore balance among these aspects of being, which often involves ceremony and spiritual faith (Lane et al., 1984; McCormick, 1996; Mehl-Madrona, 1997; Mehl-Madrona, 2003; Native Women’s Association of Canada, 2007). Decolonization is also an important part of healing (Native Women’s Association of Canada, 2007; Poonwassie & Charter, 2001; Smith, 1999). Within Indigenous cosmologies, people are always connected with all of our relations, including the human, other-than-human, natural and spiritual worlds, and the universe as a whole (Hart, 2002; McCormick, 2009; Simpson, 2000). Thus, healing and wellness are related to the healing and wellness of one’s relations, and are not considered to be isolated within the individual as they are in conventional Euro Western models of mental health (Duran, 2006; Hart, 2002; McCormick, 1996). It is no surprise then that McCormick (1996) found that First Nations peoples living in British Columbia described spiritual transcendence, balance, and connectedness as important goals and processes of counselling and healing. Spiritual transcendence refers to incorporating spirituality as an integral                                                 36 Plains (y) Cree for living a good life     56 component of the healing process, for example, through participation in traditional rituals and ceremonies. Balance emphasizes attending to mind, body, heart, and spirit in therapy through, for example, exercise and healthy eating, learning to express emotions constructively, psychoeducation regarding intergenerational and collective trauma, and incorporation of traditional spiritual practices. Connectedness in healing involves facilitating connection to friends, family, community, and culture (McCormick, 1996). These goals and processes starkly contrast existing Eurocentric approaches to mental health, which focus on strengthening the ego (rather than transcending), privileging only one dimension of the person (i.e., mental or emotional rather than holistic balance), and increasing autonomy (rather than connectedness; McCormick, 1996). From this perspective, it becomes clear why Eurocentric approaches to mental health are very limited in their effectiveness with Indigenous clients. Important factors in maintaining wellness for Indigenous peoples include connection with nature, participation in ceremony, strengthening social connections, understanding presenting issues and inner experiences, learning from role models, obtaining support from others, helping others, challenging oneself, learning sacred and traditional teachings, spiritual connection, self-acceptance, and holistic self-care (Duran, 2006; Hart, 2002; Lane et al., 1984; McCormick, 1994; Mehl-Madrona, 2003; Poonwassie & Charter, 2001). These factors are associated with wholeness, balance, connection, harmony, growth, and healing as dynamic processes that comprise a life long journey of miyo pimâtisiwin (Hart, 2002). Thus, Indigenous healing and wellness are grounded in how we are living on a moment-to-moment basis. Inevitably, we experience periods of imbalance, disconnection, and disharmony (Hart, 2002; Lane et al., 1984; Lee, 2006). From an Indigenous perspective, these experiences are not pathologized or blamed on the individual as they are in some dominating Western Eurosettler models of mental health,     57 nor is wellness viewed as an outcome that is achieved through a linear healing process (Hart, 2002; McCormick, 2009).  Rather, Indigenous wellness and healing are considered to be life-long, relationally-based processes that are facilitated through particular culturally-sanctioned lifeways (Hart, 2002; Lane et al., 1984). Traditional protocols and structured relationships, such as those with healers, family members, and Elders, provide guidance in times of difficulty or transition, and strengthen balance, connectedness, and transcendence (Hart, 2002; Lane et al., 1984; Lee, 2006; McCormick, 1994). Accordingly, healing facilities that base their approaches in Indigenous lifeways tend to demonstrate the greatest effectiveness with Indigenous clients (McCormick, 2009; Wendt & Gone, 2011). Unfortunately, such facilities are rare, and are often not accessible to potential clients due to factors such as geographic location, funding limitations, or intake restrictions. While some communities are addressing this gap by revitalizing traditional lifeways, many communities continue to deal with disruptions in the languages, teachings, practices, geography, and relationships that once supported miyo pimâtisiwin due to the processes of colonization and cultural genocide detailed above (Duran & Duran, 1995; McCormick, 2009; Poonwassie & Charter, 2001; Trimble & Thurman, 2002). Further, these same processes and growing urbanization have disconnected many Indigenous individuals from their communities, making it increasingly difficult for them to connect with their traditions, languages, and cultures (Kirmayer et al., 2009; Marsden, 2005). In consideration of these factors, mental health professionals may offer an alternative through centring Indigenous approaches to wellness and healing in their practice. For example, emerging therapeutic approaches such as Aboriginal Focusing-Oriented Therapy (Turcotte & Schiffer, 2014) provide Indigenous-based alternatives that may be learned and implemented by     58 providers of any ethnocultural background. Services that offer access to traditional Indigenous healing practices, particularly in urban environments, may provide access to culturally relevant healing that has tremendous potential to contribute to personal and collective healing and wellness (Reeves & Stewart, 2014; Ross, 2014; Waldram, 2008). However, there is little research guiding practitioners in how to do this work, particularly within Eurocentric systems (McCormick, 2009). Theoretical and practical sources offer some guidance for clinicians, but continue to emphasize the need for empirical research in this regard (e.g., Duran, 2006). There is also a need for research validating the effectiveness of implementing Indigenous approaches within Eurocentric systems (Gone, 2013; McCormick, 2009). Such research would provide an empirical foundation to inform the development of culturally appropriate mental health services that effectively serve the needs of Indigenous peoples. CONCLUSION Considering the literature on counselling with Indigenous peoples, it is critical that one be familiar with the historical contexts of colonization and the evolution of research with Indigenous peoples since contact. A keen awareness of culturally sanctioned ethics and protocols is necessary to engage in research that truly gives back to the communities it is meant to serve (Castellano, 2004; Kovach, 2009; Smith, 1999; Wilson, 2008). Observing these guidelines and conducting research that is centred in Indigenous axiologies, ontologies, epistemologies, and methodologies is one way to create space for Indigenous voices in psychological research (Smith, 1999; Wilson, 2008). Further, researchers and practitioners alike must remain aware that mental health services continue to work from systems of thought that are deeply embedded in the colonization and oppression of Indigenous peoples (Duran & Duran, 1995). This calls for a significant shift in the field, from embeddedness in dominating Eurocentric paradigms toward     59 embracing diverse Indigenous cosmologies, providing a culturally relevant empirical base for the integration of Indigenous approaches to healing that disrupt cycles of intergenerational, historical, and colonial trauma. The current study will contribute to original research through implementing an Indigenous paradigm to explore Indigenous mental health professionals’ perspectives on the creation of more effective mental health services for Indigenous peoples. RETURNING TO THE DIALOGUE So there you have it! My literature review. Cog, Dr. Ruth, miskinâhk, Beezy, Gizmo and I are still in the classroom in the Neville Scarfe building at UBC. Beezy and Gizmo are playing quietly with miskinâhk, who is showing them magic tricks. I’m seated at a desk near Dr. Ruth and Cog as they finish reading the literature review.   Dr. Ruth: (Finishes reading the literature review and sets it down in front of her. She nods, satisfied.) Great, thank you Karlee. On that note, I’ve got other business to attend to. (Stands up) Cog, I would like you to continue from here. You have the documents. (Cog nods, flustered. Dr. Ruth turns to Karlee) From here, we need to know what your theory and methodology are.  What guides your work and how will it be carried out? (She taps her index finger on the table beside her as she annunciates) Step. By. Step. (Dr. Ruth looks back at Cog, nodding. Cog tentatively nods toward Dr. Ruth in response. Dr. Ruth straightens her shirt and slacks, turns, and exits the room.)   Cog: (Somewhat nervously) Okay so, yes. Theory,      60   methodology, and methods.  Me: (Walks up to Cog and places her hand on his arm, helping him up) Come with me, Cog. I can’t just tell you, I need to show you. (Gestures to others in the room) You are all welcome to come along too. (Back to Cog, who is slowly standing up) Let’s go outside. I’m going to take you on a journey.   Beezy: (Hopping around excitedly with Gizmo) Yayyyyyyyy!!! Let’s go Gizzy!! (Gizmo jumps around, panting happily)   (Karlee leads Cog out the door, with the others following close behind. Beezy and Gizmo exit the room last and shut the lights off)   LIGHTS DOWN.      61 Chapter 3: A Ceremonial Quest for Understanding  Our story continues among the plains, forests, and Rocky Mountains of the land now commonly known as Alberta, meandering through the traditional territories of the nehiyawak and otipemisiwak people, occasionally dipping down to the territories of the Siksika, Piikani, Kainai, Tsuu T’ina, and Stoney Nakoda peoples. To begin, I am walking alongside Cog through the forest in the mountains. Various animals occasionally fade in and out of the scene, interconnected with the surrounding environment. miskinâhk walks beside me throughout the journey. Beezy and Gizmo are always close by, running and playing in the areas around us.                                                 37 Plains (y) Cree for the way things are done, ceremony, culture ISÎHCIKÊ-WIN37 (THE WAY THINGS ARE DONE, CEREMONY, CULTURE) Me: (Gestures to the sky, earth, trees, rocks, plants, and herself) isîhcikêwin. This is my nehiyaw-otipemisiwak research paradigm – the theory that encompasses my interconnected axiology, ontology, epistemology, and methodology. The Cree term isîhcikêwin refers to the way things are done, to ceremony, and to culture. isîhcikêwin describes the way I approach all aspects of my research. It is holistic, relational, and characterized by particular protocols and culturally-sanctioned ways of living.   miskinâhk: In isîhcikêwin, the axiology, ontology, epistemology, and methodology make up a circle. “The whole of the paradigm is greater than the sum of its parts.” Each component is based in relationships.    (Wilson, 2008, p. 70)  (Cog nods as he enjoys the hike, calmed and grounded by the      62                                                 38 Plains (y) Cree for kinship, being related to each other surrounding environment)  Me: wahkohtowin. 38 We are all related. For me, that’s what isîhcikêwin is about; it is ethical and grounded in relational accountability to all my relations. Shawn Wilson talks about that, and how it is critical to enact respect, reciprocity and responsibility throughout the research process.         (Wilson, 2008)  miskinâhk: “Research is a ceremony…the purpose of any ceremony is to build stronger relationships or bridge the distance between our cosmos and us.” And so, like any ceremony, research is transformative. Carried out as a ceremony, it will change you.    (Wilson, 2008, p. 137)    (Wilson, 2008)  Me: (Smiling) Exactly. And so it has! So coming from my personal experience of isîhcikêwin, I have questioned the word “research” itself.   I am reminded of Linda Smith’s words: “the term ‘research’ is inextricably linked to European imperialism and colonialism. The word itself, ‘research,’ is probably one of the dirtiest words in the Indigenous world’s vocabulary.” And how could it not be given the history of research with Indigenous peoples? When I think of what research means to me as an Indigenous person, I see it as learning, and I see learning as            (Smith, 1999, p. 1)              63                                                 39 Plains (y) Cree for people (Cree) living. And so my research journey started before my physical birth in this lifetime, and will continue after I am physically gone. Thus, moving away from that term “research,” this work is about isîhcikêwin. This work is ceremony. For nehiyawak,39 ceremony is our epistemology and methodology. It is how we come to know. (miskinâhk smiles knowingly. Beezy and Gizmo continue to frolic happily. Cog is in deep thought, appreciating the nature around him as well as the conversation)          (Makokis, 2005)  Cog: (Suddenly realizing he has assigned tasks to complete and has been too absorbed in the moment, shakes his head and looks at the papers on his clipboard) So I need you to describe more about your theory…uhh this framework…uhh paradigm. You know…  Setting an Intention               Me: (Smiling) Absolutely! As a mobile nehiyaw-otipemisiwak woman, I experience my methodology as a ceremonial journey. My ‘research question’ is the question I am hoping to gain greater understanding of through this ceremony – it is an intention. So I’ve set this intention for the ceremony I am undertaking, in the same way that I might pray for guidance when entering into a sweat lodge.  This ceremony is a personal quest for greater                     64                                                 40 oskâpêwis: Plains (y) Cree for a person who helps with ceremonies                  A Mobile, Métis (Mixed) Paradigm understanding. I have set out on a journey seeking to learn from those who have come before me – i.e., iyinisiwak or knowledge holders – and to use this learning to give back to Indigenous communities in a good way. In this work, I am a learner and a helper, an oskâpêwis,40 who has been given this task by kihci manitow and my ancestors. I have come to understand this through opening myself to the voice of the land, blood memory, and heart knowledge. Opening myself to these Indigenous ways of knowing, I’ve sensed into what the experiences of my ancestors may have been like. I remember being at Le Musée de Saint-Boniface Museum in Winnipeg in October 2014. I was living in Minneapolis at the time, visiting Winnipeg for an international Indigenous health conference. I was wandering the museum and noticed a map of some Red River Trade Routes. (Pulls a small map from her pocket and hands it to Cog)               (Holmes, 2000)                (Figure 1)     65  Figure 1: Cart Tracks Connecting the Red River in The United States Around 1869     Seeing that map was significant for me, as I realized I had, quite literally, retraced the steps of my ancestors back across Turtle Island. My ancestors were trappers and traders, and lived a mobile lifestyle along various trade routes, having babies along the way. (Giggles jokingly)  In the past, I grieved my ‘placeless Métis-ness’ as a deficit. Though nohkom was born in Lac La Biche, I wasn’t raised with any connection to that community. Plus, she had ancestors from along the way, from Minnesota to Red River to the Rockies and woodlands of Alberta, and everywhere in between! So much of what I’ve learned about Indigeneity is connected to place. What does that mean for a Métis woman      66 living primarily in urban spaces, with no single specific Indigenous rural or reserve community to call home?  So for a long time, I felt this emptiness inside – a hole that could only be filled if I just had an identifiable place I could say I originated from.   Beezy: (Looks up from the ground where she has been making a mud pie, smiling) Yeah! I’m whole too! ‘Specially when I’m here in these mountains. It’s my most favourite place to be ever!   Me: (Laughs) Well that’s just it! I realized that I’ve been whole all along. That hole is something that’s been created through colonization, ancestral displacement, and my own internalized, colonial notions of Indigeneity that rely on ties to specific non-urban Indigenous communities. Afterall, cities are located on Indigenous land too! As I’ve travelled from place to place, much the same way my ancestors did, I’ve realized that I belong to all these places. Ancestrally, I’ve originated in transit. (Laughs) I have ancestors from all over. And sensing into the experiences of my Métis ancestors, I can imagine the relationships they formed in various communities along the way. I belong to each of these places that I’ve been blessed to call home, and have made home and family in each urban-based Indigenous      (Peters & Andersen, 2013) (D. Christian, personal communication, 2016)                     67 community I’ve been a part of. So I feel a sense of grief – I experience that hole forming – anytime I leave a place…only to realize that it is immediately filled again in the next place I come to. Each place I visit, each place I live, is filled with experiences and gifts that teach me so much. And so it is with isîhcikêwin – this nehiyaw-otipemisiwak ceremonial journey. This framework pulls from the diverse teachings I’ve learned in various places along the way. As a primarily urban-based, mobile Indigenous person, my Elders and cultural mentors have come from many different nations, including nehiyawak, Anishinaabe, Métis, Secwepemc, St’at’imc, Sts’Ailes, Dakota, Lakota, Blackfoot, and Cherokee. And many of them have had Elders and cultural mentors of diverse nations. I can only speak from the teachings I’ve received, and will do my best to share where I’ve received them.  So along the way, I’ve taken what fits for me and incorporated it into my ways of knowing, being, and doing. These diverse teachings inform my understanding of isîhcikêwin, not unlike my ancestors who blended multiple cultures and languages in who they were. And that included a blend of colonial cultures and languages. So, as a nehiyaw-otipemisiwak woman of multiple ancestries, who was born                                                   68 and raised into a colonized society, speaking the colonial language and participating in the colonial system, there inevitably is a blend of Western Eurosettler methods in this paradigm as well. The important piece is this paradigm is fundamentally centred in Indigenous ways of knowing, being, and doing, as this is who I am. So isîhcikêwin is guided by the teachings I’ve received through life experience and ancestral knowings.        miskinâhk: …heart knowledge, blood memory, and the voice of the land. (Nodding)   (Holmes, 2000) isîhcikêwin in the Western Academy Me:  Right. And, of course, this dissertation is being done within the context of the academy – a fundamentally European institution. So, again, I follow the teachings of my ancestors, who were liaisons between the First Nations and colonizers…    (Voice over: Earthdiver’s voice travels through the trees from somewhere far away): The University of Hudson’s Bay British Columbia Companyyyyyy!!!!!!!   Me: (Laughs) So I’m kind of like the liaison between the community and university, and in that, I must stay true to the teachings and values I’ve been raised and taught in.   Beezy: (Crawling around alongside Gizmo pretending that they are a pack of wolves) Nana always says be yourself.      69                                                 41 Plains (y) Cree for advisors And stick up for what you believe in. Woof! Woof!!                       Mapping a Ceremonial Quest for Understand-ing Me: (Smiling widely at Beezy) That’s right. (Looks at Cog) I come from a long line of strong women! So in this ceremonial journey, there are some “strategic concessions” that must be made to satisfy the requirements of the system, while staying true to my intention and learning in a good way that will ultimately serve the community. My committee are owihtamâkewak41 – advisors – on this journey. They understand the ways of the colonial system, and are sensitive to the needs of the community. They are there to help guide me in this ceremonial quest. And for that I am so very grateful. (Looks at Cog, and chuckles at herself)  So I hope this is all making sense. The dissertation is a ceremony. The journey is the form that this particular ceremony takes. It is the methodology I have chosen in my quest for understanding. This journey has brought me to many places and in contact with many people who have offered teachings and wisdom connected to my intention to learn how mental health services can (be shaped so as to) better serve Indigenous people living in urban spaces. isîhcikêwin is holistic, relational, and process-oriented.  Here is a map of this ceremonial journey. (Pulls      (Kovach, 2009, p. 40)    (Wilson, 2008)                            (Wilson, 2008)  (Figure 2)      70                                                 42 Plains (y) Cree for mystery or sacred power, i.e., spirit another map out of her pocket and hands it to Cog) The buffalo is me. (Smiles)  Figure 2:  Map of Ceremonial Dissertation Journey   A Seven Directions Paradigm As I understand it, isîhcikêwin emerges through seven directions (Karlee stops and gently draws the cardinal directions in the earth with her finger, indicating earth below and sky above, and manitow42 in the centre of the four directions) – East, South, West, North, earth, sky, manitow. (Karlee draws a circle around the four directions, creating a medicine wheel nestled between earth and sky. Cog is observing, very interested. Beezy is sitting in the dirt listening and watching intently, petting Gizmo who sits very calmly and content. miskinâhk is listening, smiling)         (Figure 3)         Figure 3: Seven Directions Framework      71   A medicine wheel can have many different teachings, and is often used as a conceptual framework. Therefore, there is no one medicine wheel, no particular right or wrong way. So isîhcikêwin is guided by the medicine wheel as I understand it, and the teachings about the seven directions that I’ve come to learn through ceremony.  For me, spirit is in the East. (Indicates the Eastern quadrant with a small stick) I understand that this aspect of being is infinite and eternal. Our spirits exist before they come into our bodies, and continue to exist once they leave. (Karlee uses the stick to indicate the corresponding quadrants around the circle as she speaks to them). Body is in the South, heart in the West, and mind in the North. I’ve been taught that these are the four interconnected aspects of     (e.g., Hart, 2002; Lane et al., 1984)                      (Lane et al.,     72 the self.  Each of these entities must be equally developed for us to be healthy and to be in the world in a good way – miyo pimâtisiwin. isîhcikêwin involves opening my awareness to physical and metaphysical senses, learning through all aspects of my being-in-relation.  The in-relation piece refers to the remaining three directions: (Indicating them with the small stick as she mentions them) earth, sky, and manitow. I am constantly in-relation with all of my relatives in the natural and spirit worlds. The earth includes the earth herself, other people, four-leggeds, six-leggeds, eight-leggeds, crawlers, finned ones, plant people, the grandfathers and grandmothers or rocks. The sky includes the sky himself, the winged ones, grandmother moon, grandfather sun, the star nation, cloud people, and thunder beings. manitow is mystery, which includes Creator, spirits, and generations of the past and future. These lists are not exhaustive, they are just some of the relatives I think of in these three directions. In our everyday lives in dominating capitalist society, we live primarily in the mental and physical quadrants, unbalanced. As nehiyawak – Cree people – we must strive to be balanced in the four directions of the medicine wheel. Diverse Indigenous nations and peoples often have similar 1984; Lee, 2011; Hart, 2002)   (Castellano, 2000; Brown, 1983; Lane et al., 1984; Wilson, 2008)       (D. Christian, personal communication, 2012)                        (Lee, 2011)        73 teachings.  Allowing these entities to harmonize and flow enables us to open our awareness to what the holistic self-in-relation is telling us. We may think of something, we may have a physical sensation that carries us somewhere, an emotion that drives us in a particular direction, or a spiritual experience that calls us a certain way. When we’re in balance, these four entities will guide us in a good way. We further draw on our relationships with all of our relations for this guidance. That’s how I’ve been navigating this journey so far, Cog. Experiencing through these seven interconnected directions is like a compass guiding this ceremonial journey.     (Hart, 2002; Lane et al., 1984)      (M. McCoy, personal communication, 2015)  miskinâhk: (Smiling) And so through this seven directions knowing, knowledges that must be respected and included in answering the research question include empirical observations, traditional teachings, and revelation.  Empirical knowing comes through careful observation representing “a convergence of perspectives from different vantage points, accumulated over time.” Traditional teachings are knowings that are handed down through specific tribal groups intergenerationally, often through oral tradition. And revealed knowings come through visions, dreams, and intuitions that are spiritual in origin.      (Castellano, 2000)     (Castellano, 2000, p. 24)       (Castellano, 2000)     74               An Ethical, Relational Paradigm Me: (Nodding) Right. In isîhcikêwin, and thus, in this dissertation, each of these forms of knowing are considered valid and integral in knowledge gathering and meaning making processes. (The group continues walking. As they carry forward, they emerge from the woods and are walking through a vast plain, occasionally passing by buffalo and wild horses) This entire journey is centred in relationship. isîhcikêwin is fundamentally ethical, grounded in miyo wicehtowin and relational accountability, which necessitates respect, reciprocity, and responsibility at all times. In my work – and life in general – I am accountable to kahkiyaw ni wahkomâkanak, including myself, my family, the communities I am engaged in, the natural world, and the spirit world – all of creation. I work to maintain miyo wicehtowin through following the original instructions of miyo pimâtisiwin as I understand them. For example, for me that includes smudging every morning with traditional medicines and putting out tobacco each day in prayers for all my relatives and I. As in any traditional ceremony I participate in, following my original instructions also involves me offering tobacco and asking for help with this dissertation work. I have made such offerings countless                     (Wilson, 2008)               (A. E. Young, personal communication, 2012)   (D. Christian, personal communication, 2013)      75                                                 43 Plains (y) Cree for telling the truth 44 Plains (y) Cree for courage or bravery 45 Plains (y) Cree for honesty 46 Plains (y) Cree for humility 47 Plains (y) Cree for respect 48 Plains (y) Cree for wisdom 49 Plains (y) Cree for love times. Living these protocols and teachings has guided me throughout this process. The primary guiding framework for isîhcikêwin that emerges through these original instructions are the seven teachings of the nehiyawak, or the seven grandfather teachings of the Anishinaabe. These teachings are tâpwewin43 – truth, sôhkeyitâmowin44 – courage or bravery, kwayaskâtisiwin45 – honesty, pimameyimowin46 – humility, kisteyitamowin47 – respect, kakehtaweyimowin48 – wisdom, and sâkihitowin49 – love. I’ve acknowledged these teachings as both nehiyaw and Anishinaabe teachings because I have learned most of what I know of these teachings from Anishinaabe Elders and cultural mentors, though I understand these teachings to have the same meaning in both traditions. I try my best to live these teachings each day, and certainly, these teachings have been applied through all phases of this dissertation ceremony. (The group continues walking and have re-entered the forest. Cog appears thoughtful and engaged. Beezy and Gizmo play as they listen.        (Blue Quills College, 2009) (Benton-Banai, 2010)       (Blue Quills College, 2009)   (I. Downwind, personal communication, 2015; D. R. Wright, personal communication, 2014; A. E. Young, personal communication, 2011)          76 miskinâhk listens and smiles as she takes in the surrounding environment) miyo pimâtisiwin requires that my topic, question, and methods be grounded in local ethical protocols and community relationships. So this ceremony, as all do, started in relationship. At least as important as the ‘problem’ and ‘rationale’ based in the literature, a great deal of my motivation to engage in this journey has come through many people who have been a part of it. The initial idea originated while I was studying my master’s degree in counselling psychology at the University of Alberta. My good friend Sarah Carr and I set out to learn how counsellors ought to work with Indigenous clients in Canada as part of a project in our multicultural counselling class. We had the opportunity to connect with the Aboriginal Student Council (ASC) at the university, attend a seminar held by one of the school’s Cree Elders, and attend an Elders’ Conference.  Several relationships grew and flourished out of that project, and to this day I remain in touch with some of the people we spoke with at that time. Through these relationships and my experiences engaging with the community, I learned that mental health professionals needed better ways of working with Indigenous clients.  Most people     (Castellano, 2004; Deloria, 1991; Smith, 1999; Wilson, 2008)     77 we spoke with said many people they knew would probably not seek Euro Western counselling services. However, they also said they know some people do seek those services, as sometimes that is the best option available, particularly when living in an urban environment.  I carried those lessons with me when I went on to do my PhD a couple years later. When I moved to Vancouver, I immediately connected with Indigenous communities at UBC and in urban Vancouver. There, the ceremonial question was re/formed and strengthened through my relationships with colleagues and friends at UBC, instructors and mentors in my life, members of Supporting Aboriginal Graduate Enhancement (SAGE) at UBC and Simon Fraser University, and Elders who expressed their feelings of the importance of this work.  I spoke openly of my ideas in many contexts, and through peoples’ feedback and stories, came to understand that my topic is relevant and important. Thus, my ‘research question’ was formed in-relation. This was only further validated by my experiences working directly in urban-based Indigenous mental health service provision during my internship in Minneapolis. Now, I have multiple communities of people who are waiting for me to get the     78                                                 50 Plains (y) Cree for helping one another findings out – relational accountability!  miskinâhk: (Smiles and nods) Mutual nurturance.  (Apffel-Marglin, 1998)  Me: (Smiles back) Exactly. nîsohkamâtowin50 – helping one another. This is important throughout the ceremony, every step of the way…and really, throughout my life. It is part of  isîhcikêwin and miyo pimâtisiwin. (Silence for several minutes as everyone is being with nature, feeling connected, grounded, and whole. Karlee breathes deeply and smiles, content) So, Cog, what do you figure?  (A. E. Young, personal communication, 2013)  Cog: (Smiles slightly, thoughtful) Karlee, I’m not sure what to say right now. You’ve given me a lot to think about, and being out here, in this place… (Gestures to the nature around him, which is alive and vibrant; ecosystems-in-relation working to support life) …I think I’m starting to understand.           Though of course, I’ve come here with a folder of requirements, and I can’t leave without having you answer them – Dr. Ruth wouldn’t let me. (Sighs, looking at Karlee with a half-grin, she nods and smiles back at him) So I suppose we ought to have some discussion about all these forms. Well…(pulls out his folder of papers) you’ve given me a fairly good sense of your motivations in pursuing this      79                                                 51 Plains (y) Cree for learning; coming to know; knowledge resear…I mean, ceremony. And you’ve helped me understand the overarching theory, or paradigm – isîhcikêwin. I have a sense of the methodology as a journey. So I guess the next question is how did you go about the journey? In other words, what happened next – once you clarified the research question? KISKÊYIH-TAMOWIN51 (COMING TO KNOW)                       Recruitment  Me: (Smiling) Mmhmm. The journey continues! (Suddenly the group is walking on trails among the temperate rainforest along the coast of the Pacific Ocean in lower mainland BC. Cog jumps, startled as he realizes they’re no longer in Alberta)  kiskêyihtamowin is the Cree word for coming to know, and refers to the entire process of coming to know through isîhcikêwin. As I embarked upon the journey, I followed the seven teachings and my seven directions framework, and the pathways and directions unfolded through listening to the voice of the land, blood memory, and heart knowledge. I also turned to the existing literature in Indigenous methodologies to help guide the way. So the first step was to find the iyinisiwak, referred to as ‘participants’ within dominating research paradigms.                        (Holmes, 2000)       Earthdiver: (Flies over the group, and while passing      80                                                 52 Plains (y) Cree for Elders shouts:) At least we’ve moved on from “subjects”! Ha!! (His laughter echoes through the forest as he disappears into the sky)  Me:  (Laughs) Very true! At least we are ‘participating’ rather than subjecting/objecting.  And that is important, Cog, the we. As with any ceremony, as the oskâpêwis I am as much a participant as the iyinisiwak who share their knowings. We are all contributing to the ceremony. Shawn Wilson acknowledged this in his work, writing about how he and his ‘participants’ “all learned and grew as a result of exploring [their] relationship with [the] topic.” iyinisiwak are more than participants; they are mentors, Elders, colleagues, and friends.  I sought iyinisiwak through existing relationships I had within the urban-based Indigenous communities in Vancouver, in much the same way I would go about seeking iyinisiwak or kihtehayak52 when looking for help or ceremony in the community. The main difference, of course, is that in observing Euro Western ethical protocols, I emailed a formal letter of invitation. A strategic concession. (Winks at Cog) I contacted Indigenous mental health professionals who I thought may be interested, many of whom had already                (Wilson, 2008, p. 69)     (Kovach, 2009; Wilson, 2008)             81                                                 53 This includes people who self-identify as belonging to one or more Indigenous groups of Turtle Island, including people who may identify as First Nations, Métis, Inuit, Non-Status, Aboriginal, Indigenous, Indian, Native American, Alaska Native, and/or First Peoples of Turtle Island.  expressed interest when I was speaking about my upcoming project in the community. I also invited them to forward the invitation along to anyone they thought might be interested.  miskinâhk: Ah yes, the “moccasin telegraph” or “Indian hotline.” The Indigenous version of opportunistic snowballing. (Smiles and winks)  (Marsden, 2005, p. 8)                   Criteria for participation. Me: (Smiles) So I sent out my emails open to seeing what came back. Within isîhcikêwin, an important part of finding iyinisiwak was offering tobacco to manitow, specifically asking that I connect with the iyinisiwak who are meant to be a part of this project. So I had faith that both the iyinisiwak and I would be guided to come together, and I ended up connecting with 16 amazing iyinisiwak. Based on relational accountability, each of them are known and trusted in the communities they serve. The criteria I initially identified for iyinisiwak was self-identified Indigenous persons53 living in the Greater Vancouver Area – GVA – who have worked in the field of Indigenous mental health in an urban environment in Canada for at least five years, so they could speak from their                                  82 experiences as Indigenous mental health professionals in this context. When seeking to learn from iyinisiwak or kihtehayak in the community, it is not typical to identify objective criteria in this way. Rather, the iyinisiwak or kihtehayak are found through trusted relationships.  And so in following nehiyaw-otipemisiwak protocols of miyo wicehtowin, I compromised on my criteria in three cases. To ensure this would be okay, I consulted with one of the owihtamâkew – my supervisor, Ishu – who reminded me that the quality and relevance of what I would learn from the iyinisiwak was most important. Two iyinisiwak live just outside the GVA on Vancouver Island, where they work in an urban community. Given they are still relatively local and work with Indigenous peoples living in urban spaces, I chose to include them, knowing that they had valuable knowledges to share.  Another iyinisiw had two years of experience when he first contacted me. At first, I told him I would not be able to include him in the study. After letting him know this, my intuition was telling me this was not right, that I had gone against miyo wicehtowin in prioritizing objective Euro Western criteria over relational accountability with someone who could offer valuable knowings in this work. Listening to                 (I. Ishiyama, personal communication, September 2013)                              83 this guidance that came to me through spirit is part of isîhcikêwin. I knew I needed to include this person in the study – that kihci manitow brought him to me for a reason. I could not be more grateful I listened to this guidance, as this iyinisiw shared very valuable teachings and understandings from his experiences. Otherwise, the other 13 iyinisiwak met the original inclusion criteria. (Castellano, 2000; Holmes, 2000)          miskinâhk: (Nodding) I am glad that you listened, Karlee. That is a form of revealed knowledge, and is an important way of knowing within an Indigenous paradigm.    (Castellano, 2000)  Me: (Nodding at miskinâhk) Thank you, miskinâhk. As I’ve gone through this journey, I’ve learned a lot about having faith in and trusting both the manitowak that guide me, and myself. Hence the importance of following the protocols of miyo pimâtisiwin as much as I can – doing what I need to do to ensure I am as open as possible to the guidance that comes to me this way. And so I’d met each of the 16 iyinisiwak in the community at least a couple of times before this project. Some of them were close Elders, mentors, friends, and ceremony family. Others who I didn’t know as well at first, I’ve become closer to through this ceremony. It has been wonderful!      84  miskinâhk: Including family, friends, and other relations as iyinisiwak places you “within a circle of relations,” which is important. Relationship is central in selecting ‘participants’ – a number of Indigenous researchers have used relationship in various ways to this end. As in your case, participants may include people who researchers already have pre-existing relationships with – they may be family members, friends – any number of relations.  (Wilson, 2008, p. 129)            (Kovach, 2009) Informed consent. Me: So once iyinisiwak agreed to share their knowings with me, I asked them when and where they would prefer to meet for a conversation, and sent them the consent form to review in advance. I also went over the consent with them when I met with them in person and had them sign. Again, obviously it’s not typical to obtain consent from an iyinisiwak when seeking understanding in the community or engaging in ceremony with one another, (smiles at Cog) but it’s also not typical in those contexts that the information would be disseminated within the dominating system or published. This was another strategic concession as a nehiyaw-otipemisiwak liaison between the community and the system – attending to both community and research ethics is critical.                        (Kovach, 2010)  miskinâhk: An Indigenous paradigm is an ethical       85 paradigm… (Wilson, 2008) Ethical Considera-tions and Protocols     Potential for harm.                                   Me: Absolutely! Given that isîhcikêwin is a fundamentally ethical paradigm grounded in relational accountability, or miyo wicehtowin, ethics have been infused throughout the journey every step of the way.  The potential for harm for iyinisiw is very limited, as they are experienced Indigenous mental health professionals speaking about their perspectives on how mental health services can be shaped to better serve Indigenous peoples living in urban spaces, as informed by their experiences and expertise in relation to working with this population. As such, iyinisiwak are considered knowledge holders on Indigenous mental health, and are in a similar position to me.  However, given the history of unethical and exploitative research with Indigenous peoples, I’ve taken great care to follow established ethical guidelines for research with Indigenous peoples, as well as appropriate cultural protocols. Formal ethics that I followed throughout this project are guided by the Tri-Council Policy Statement’s Research Involving the First Nations, Inuit and Métis peoples of Canada, CIHR’s guidelines, RCAP’s guidelines, NAHO’s guidelines, and Castellano’s work, which I discussed in my literature review.      (Wilson, 2008)                    (Deloria, 1991; NAHO, 2005; Smith, 1999)      (Canadian Institutes of Health Research, 2007; Castellano, 2004; Government of Canada, 2010; National Aboriginal Health Organization,     86 Confidential-ity.                         Cultural ethics and protocols.  Names and other identifying information about iyinisiwak have been kept strictly confidential through using pseudonyms. I asked iyinisiwak to self-select pseudonyms, and have assigned pseudonyms in nehiyawewin to those who did not provide one. This is culturally appropriate practice with Indigenous participants, and considered empowering and respectful. I’ve saved pairings of iyinisiwak names and pseudonyms in a password-protected, confidential spreadsheet stored electronically on an external hard drive. All transcripts have been encrypted and password-protected, stored on my password-protected personal computer. All consent forms and hard copies of documentation are kept in a locked filing cabinet in my faculty office in Calgary. Importantly, this study is also guided by cultural ethics and protocols I have learned both through written sources by Indigenous scholars, and through my own experiences as an oskâpêwis and learner in the traditional ceremonies and cultural practices of my people, my mentors’ peoples, and the peoples whose spaces I am living with/in. Again, these practices are guided by isîhcikêwin, including the seven teachings I’ve mentioned, as well as the protocols for miyo pimâtisiwin and miyo wicehtowin that I’ve learned.  2007; Royal Commission on Aboriginal Peoples, 1996)       (Graveline, 2000; Wilson, 2008)                  (e.g., Archibald, 2008; Battiste, 2008; Kovach, 2009; Lane et al., 1984; Wilson, 2008)  miskinâhk: In maintaining relational accountability, respect,       87 reciprocity, and responsibility are key.  There are many questions you must ask when enacting an Indigenous paradigm: “How do [your] methods help to build respectful relationships between the topic [you] are studying and [yourself] as a researcher? How do [your] methods help to build respectful relationships between [you] and the other research participants? How can [you] relate respectfully to the other participants involved in this research so that together [you] can form a stronger relationship with the idea that [you] will share? What is [your] role as a researcher in this relationship, and what are [your] responsibilities? [Are you] being responsible in fulfilling [your] role and obligations to the other participants, to the topic and to all of [your] relations? What [are you] contributing or giving back to the relationship? Is the sharing, growth and learning that is taking place reciprocal?” (Wilson, 2008)                             (Wilson, 2008, p. 77)           Me: Mmhmm. Thank you. (Turns to Cog) Those are all very important questions that I’ve continued to constantly revisit throughout the process. I hope the answers will be clear as I continue to describe the journey. Hold me accountable to them. (Winks at Cog)  kiskêyihta-mowin Cog: (Nodding) Hmm. That makes sense. (Turns attention back to his forms) So how did you collect your data?      88  Me: Again, I use the Cree term kiskêyihtamowin, which refers to the active process of learning and knowing that we engage in. (Gestures to the sky, earth, trees, rocks, plants, animals, insects) Out here, we are navigating pathways and opening our senses to knowing in the moment – the natural environment contains many teachings – we can’t extract, but we can learn. As Peter Cole taught me, ‘knowledge’ is never a noun – knowing is a verb that exists in the present.  So, what has this learning process looked like? As a ceremonial journey, my nehiyaw-otipemisiwak learning been open and multisensory.           (P. Cole, personal communication, September 2011)  mahihkan: (Appears from deep woods. He smells of earth, plants, water) Mind if I join? (Grinning)   Me: (Smiling) Oh, please do mahihkan! Good to see you.   mahihkan: (Speaking to Cog) Listen, I know you’ve got all those papers and things there – a job, maybe a family, day-to-day pressures of the rat race – but forget that stuff right now. Look around you… (Gestures to the environment) There is so much going on here. You’ve got to clear your mind. “Don’t separate yourself from nature. Embrace it and allow yourself to be embraced by it.”  When we open our awareness, nature is experienced in each of the senses: sight, touch, taste, sound, and smell. Learning is multisensory…            (Brown, 1983, p. 27)    (Brown, 1983)     89 (Breathes in deeply and closes his eyes)  Me: (Smiling) That’s a big part of this, Cog. All along the way, I’ve reminded myself to follow the process and take my time – allowing myself to trust and be a part of the journey – keeping my senses open to what happens along the way. isîhcikêwin is multisensory. I have had to attend to my physical senses, intuitions, and other experiences emerging through my heart, mind, body, and spirit as I engaged in knowledge gathering. (Cog looks thoughtful, then takes some notes)   mahihkan: Anddd the way to really get to know nature is to follow your heart. When you clear your mind and are able to be with nature without all the mental baggage and distorting lenses, you can clearly listen to and follow your natural inclinations…          (Brown, 1983)               Phase I: Research Me: (Nodding) And so I have all along the way, and kiskêyihtamowin has gone beyond my relationships with the iyinisiwak. It includes relational knowing with all of creation: with the ancestors, future generations, all of this. (Gestures to the sky, earth, ocean, trees, rocks, plants, animals, insects) Including the metaphysical, of course. The seven directions. I’ll begin with kiskêyihtamowin with the iyinisiwak.                     90 conversations. First, I met with all 16 iyinisiwak for individual conversations. Two of the conversations were actually with couples, as that was how they preferred to meet. Otherwise, the rest were individual. I chose the conversation method due to its congruence with Indigenous ways of coming to know more broadly, and due to its natural fit with this isîhcikêwin and a ceremonial journey aimed at learning from iyinisiwak.        (Graveline, 2000; Kovach, 2009; Wilson, 2008)     Cog: (Looks up from his papers) But the conversation method is a qualitative research strategy…?  (Roulston, 2008)  Me: (Nodding) Certainly, the conversational method is not unique to Indigenous research… (miskinâhk begins speaking)    miskinâhk: “The conversational method is found within Western qualitative research. However when used in an Indigenous framework, a conversational method invokes several distinctive characteristics: a) it is linked to a particular tribal epistemology (or knowledge) and situated within an Indigenous paradigm; b) it is relational; c) it is purposeful (most often involving a decolonizing aim); d) it involves particular protocol as determined by the epistemology and/or place; e) it involves an informality and flexibility; f) it is collaborative and dialogic; and g) it is reflexive.”                     (Kovach, 2010, p. 43)  Me: (Nodding) Exactly. And that is how these conversations       91 were within my nehiyaw-otipemisiwak paradigm. I met with iyinisiwak in a setting of their choice, which included meeting people in their homes, coffee shops, offices, and restaurants. I reviewed written consent with them when we met up, including consent to be digitally video-recorded. I chose to video-record so I had as much non-verbal information as possible to consider in meaning making. Everyone agreed to be recorded, though a couple iyinisiwak requested to be outside of camera range, which I offered to everyone as an option. (The group is walking along the coast of the Pacific ocean. The sounds of waves and seagulls fill the background)                      Cog: But certainly recording conversations is not a traditional Indigenous method?                    Me: (Nodding and smiling) Absolutely! Normally one would not record his or her conversation with a knowledge holder, but again, this is nehiyaw-otipemisiwak research – we are navigating within a colonial system that has certain requirements. Recording is another strategic concession to aid in the writing of the dissertation. So once I obtained consent, I offered each iyinisiwak a pouch of tobacco and a culturally appropriate gift. This is congruent with the protocols of reciprocity and miyo         (Kovach, 2010)         (V. Rain,     92                                         Phase II: Talking circle. wicehtowin that I’ve been taught when requesting an iyinisiw share his or her knowings. This also ensures validity within a isîhcikêwin, as I understand the exchange of tobacco to mean that the words that are meant to be shared will be shared – this is a spiritual exchange. Offering the tobacco and gift following consent ensured that iyinisiwak did not feel obligated to participate. I then introduced my motivations, intentions, and the research question, allowing the conversations to flow naturally from there. All of the conversations came to a natural closing, and ranged anywhere from 50 minutes to two hours. I invited iyinisiwak to contact me if they thought of anything they wanted to add or wanted to meet again, but no one requested follow-up, so I only met with iyinisiwak for conversations once. After each conversation, I audio-recorded my feelings and experiences at the time, so I could come back to them later. (The travellers have emerged from the trails along the coast and are walking through urban Vancouver. Life is going on busily around them; people are taking no notice of the group.) kiskêyihtamowin with the iyinisiwak continued with a second phase – a talking circle. I invited iyinisiwak to come together as a group to converse about the research question personal communication, 2008)   (F. John, personal communication, 2013)                        (Kovach, 2009)             (Marsden,     93 using a collective storywork circle method. I sent the invite through email and asked iyinisiwak which dates and times worked best for them. I scheduled the circle at a time that was convenient for most, and was able to find a private communal space at a conveniently located Indigenous health organization in East Vancouver.  2005)  Cog: (Looking up from his notebook) Hold on a second – this is sounding like a focus group. Bringing partici…I mean knowledge holders together for a discussion as part of data coll…I mean “coming to know.”    (Morgan, 2008)  Me: (Smiling) There are some similarities, so I can see how focus groups and talking circles might sound similar at first. However, there are a number of critical differences.  The first thing that comes to mind is that talking circles originate in Indigenous lifeways, and thus hold sacred meaning among many Indigenous groups. They also have the potential to contribute to the transformation and healing of those participating, and all of their relations. Further, talking circles are holistic, engaging spirit heart body mind, and all of our relations.             (Lavallée, 2009) (Nabigon, Hagey, Webster, & MacKay, 1999)     94 364 fyre jean gravelineI envision a uid patternMedicine Wheel as ‘‘paradigm’’.Paradigms are beliefs that Guide ‘‘action taken in connection with disciplinedinquiry, ’’ Guba says (1990, p. 17).Teachings of the Sacred Circle.CircularFlowingIntegrativeHonoring Interconnectedness of AllBalancing MentalSpiritualEmotionalPhysical DimensionsHow do I get from here to there?Pray to the Grandmothers.Phase Two began.Ten Talking Circles planned and held.Students and Community guestsAboriginalAfrican CanadianAsianWhiteInvited to Participate.Themes a Carefully Constructed Weavejournalled words and my reections.ConsciousnessContextCommunityChangeVisionsTalking Circle as Methodology Enacted.Traditionally a Sacred ceremonya Gift from the Ancestors.A physical realitya Metaphysical experience.An egalitarian structureeach voice acknowledgedheard in turn.To choose words with care and thoughtfulnessis to speak in a Sacred manner.We can each have our own Voicespeak our own Truth.Tell our own Story.In Circle all participants are encouraged to BeSelf-reectiveCulturally located.To Listen Respectfully to Othersprovides another lens to view our own Reality.Downloaded by [The University of British Columbia] at 20:51 01 December 2011 364 fyre jean gravelineI envision a uid patternMedicine Wheel as ‘‘paradigm’’.Paradigms are beliefs that Guide ‘‘action taken in connection with disciplinedinquiry, ’’ Guba says (1990, p. 17).Teachings of the Sacred Circle.CircularFlowingIntegrativeHonoring Interconnectedness of AllBalancing MentalSpiritualEmotionalPhysical DimensionsHow do I get from here to there?Pray to the Grandmothers.Phase Two began.Ten Talking Circles planned and held.Students and Community guestsAboriginalAfrican CanadianAsianWhiteInvited to Participate.Themes a Carefully Constructed Weavejournalled words and my reections.ConsciousnessContextCommunityChangeVisionsTalking Circle as Methodology Enacted.Traditionally a Sacred ceremonya Gift from the Ancestors.A physical realitya Metaphysical experience.An egalitarian structureeach voice acknowledgedheard in turn.To choose words with care and thoughtfulnessis to speak in a Sacred manner.We can each have our own Voicespeak our own Truth.Tell our own Story.In Circle all participants are encouraged to BeSelf-reectiveCulturally located.To Listen Respectfully to Othersprovides another lens to view our own Reality.Downloaded by [The University of British Columbia] at 20:51 01 December 2011   miskinâhk:   “                        …                    ”                             [sic] (Graveline, 2000, p. 364)  Me: (Breathes deeply, smiling) mmm…thank you, miskinâhk: a beautiful method congruent with my paradigm.  And so in the talking circle, all are equal and all share, including myself. Importantly, our ancestors and kihci manitow are present in the circle as well, so the process and energy are guided by spirit. There are also important protocols to follow. In following the teachings of isîhcikêwin      (Lavallée, 2009)   (Nabigon et al., 1999)         95                                                 54 Plains (y) Cree for Elder that I’ve received, I approached a kihtehayah54 in the community with tobacco requesting that she facilitate the talking circle. This kihtehayah was recommended to me upon consultation with four Elders in Vancouver’s urban Indigenous community, two male, two female, and two of whom were from local Indigenous nations. I also offered the kihtehayah financial compensation for her time and contributions using research grant monies. When we came together for the circle, I presented the kihtehayah with a gift, and offered each of the iyinisiwak tobacco as per cultural protocols. Six iyinisiwak attended. I reviewed informed consent before recording, though each iyinisiw had already signed during their individual conversations. Consent is also important, as unlike a traditional talking circle ceremony, talking circle as a research method allows the stories shared in the circle to be retold for the purposes of giving back to community through the project. That said, confidentiality was maintained through de-identifying iyinisiwak information. In accordance with my understanding of protocols, I provided coffee, tea, water, and varied and healthy finger foods throughout the circle. I also invited iyinisiwak to come     (Wilson, 2008)   (A. Young, personal communication, 2013)         (Lavallée, 2009)             (Nabigon et al., 1999)     (F. John, personal communication, 2012)      96 and go as needed, though all stayed for the duration of the 2.5 hour circle. The kihtehayah opened the circle with smudging, and had an altar of medicines set up in the centre of the circle throughout. In observing her teachings and protocols, the kihtehayah asked one of the iyinisiw, also a respected kihtehayah, to open the circle with a prayer. She shared her understanding of teachings and protocols of talking circles, reminding iyinisiwak and myself of protocols of respectful listening, non-interruption, and confidentiality. She opened the circle and I was the first to speak. I opened by introducing myself, then sharing a brief beginning story about the origin of this project, the purpose of it, and its meaning and significance to myself, my relations, and the field of psychology.  We proceeded in a clockwise manner, and iyinisiwak expanded on my story through sharing their own stories and ideas regarding the research question/ceremonial idea. We continued speaking until the kihtehayah and iyinisiwak generally agreed that we had discussed what they felt were the most critical suggestions for how mental health services can (be shaped so as to) better serve Indigenous peoples living in urban spaces. The kihtehayah then closed the circle,  (Marsden, 2005)                                         (Marsden, 2005)      97 and I did a small giveaway, inviting iyinisiwak to choose a small gift on their way out as reciprocity for their time and generosity in sharing their knowledges.  (D. Christian, personal communication, 2012)  Cog: (Looks up from taking notes) Wow. Fascinating! So how did you go about data analysis?   Me: (Smiling, shakes her head. Giggles.) Not so fast! Remember that map I gave you? (Karlee nods toward Cog’s clipboard, where he buried the maps Karlee handed him. Cog pauses to think, then goes through his notes and pulls out the second map Karlee handed him)           Cog: (Holding up the map) This one? (See Figure 2 above)                 Phase III: Internship experience at the Indian Health Board of Minneapolis.  Me: (Smiling and nodding) You bet! (Nods toward the map) Notice there’s a place on there we haven’t been just yet… (Suddenly the travellers are walking on East Franklin Ave in South Minneapolis, Minneapolis, Minnesota, through the area called “the cultural corridor.” They walk past Franklin Street Bakery, Northland Visions, Powwow Grounds coffee shop and the All My Relations Gallery, and the Minneapolis American Indian Center)  kiskêyihtamowin on this ceremonial journey was not restricted to my conversations with iyinisiwak. I was blessed that manitow brought me to the Indian Health Board – IHB – in Minneapolis for my doctoral internship. I spent the entire                             98                               Meaning Making               year living my dissertation! There I was, working directly in an urban-based Indigenous health agency and – can you imagine – I ended up working with the agency and local community to transform some of the work they were doing to better serve the needs of the community. It was phenomenal! Don’t get me wrong – it was extremely difficult at times – but it was truly amazing. I learned and grew so much! As with any ceremony we enter into with open hearts spirits minds bodies, we never know where it will take us. I couldn’t have possibly anticipated this ceremonial journey would take me to IHB, and certainly could not have anticipated all the experiences I would have during that year. As part of kiskêyihtamowin, I tracked my experiences during internship through journaling and audio-recordings so I could refer to them for reminders as needed. And so, as with other Indigenous paradigms, meaning making – what is conventionally referred to as ‘data analysis’ – through isîhcikêwin involved integrating my life-long learning, particularly what I learned during internship, with intuitive logic and a synthesis of iyinisiwak knowings. A number of Indigenous researchers using Indigenous paradigms have used the terminology of ‘meaning making’ in order to get away from the language of ‘analysis.’ Rather                                         (Wilson, 2008)   (Kovach, 2009; Marsden, 2005)      99                                 Indigenous holistic meaning making. than breaking down iyinisiwak knowings analytically, isîhcikêwin involves synthesis – being with holistic systems of relationships, and building new relationships with the ceremonial idea. Thus, meaning making has occurred throughout the journey – kiskêyihtamowin and meaning making are intimately intertwined. (After walking through many of the parks throughout Minneapolis – the trails past Bde Maka Ska, Lake Nokomis, Minnehaha Falls – the travellers leave the city. They are walking among the boreal forests and along the cold, fresh water of gitchi gami – Lake Superior – in Northern Minnesota) Perhaps not surprisingly, as axiology ontology epistemology and methodology are interconnected within Indigenous research, my method of meaning making involved applying the seven teachings and seven directions framework throughout this journey. This method of meaning making was informed by Dawn Marsden’s method of Indigenous holistic meaning making.        (Wilson, 2008)    (Wilson, 2008)                (Wilson, 2008)       (Marsden, 2005)  (Voice over: Earthdiver’s voice travels through the trees from somewhere far away): Holllllllllllllllismmmmm!!!   miskinâhk:  Indigenous holistic meaning making involves “a subjective and interconnected process whereby knowledge from all aspects of being – mental, physical, spiritual and           100 emotional – and knowledge from other beings, influences understandings about what’s important, common or thematic.”     (Marsden, 2005, p. 50)  Earthdiver: (Swirls into the scene, flitting around as he sings) MENTAL. Mental, mental, mental!! (An echo from elsewhere in the forest follows: “mental, mental, mental”) I think we can say if a particular meaning is repeated – MENTAL – ringing among the diverse iyinisiwak – MENTAL – it may be importantttttt!!  (Brushes past Beezy, who is giggling wildly. Gizmo looks irritated watching Earthdiver, and emits a low growl)  And what about the physical? And what about the physical? (Earthdiver dances eccentrically, Beezy shrieks in excitement as she giggles) Well if I feel SICK, if my throat is TIGHTENING, if my heart starts RACING, if my toes start TINGLING…It may indicate “IMPORTANCE, COMMONALITY, or THEME”!!! (Earthdiver swoops through the trees, singing non-sense syllables before circling back. Upon his return, he stops moving, and whispers as he sings, changing his facial expressions to correspond with his emotion words)  And what about emotion…emotion…emotionnn?? (He raises his voice gradually) Happy, sad, FRUSTRATED,          (Marsden, 2005)             (Marsden, 2005, p. 51; capitalization added)                  101 GLAD!!! INTENSITY – on a continuum of course – also tells us what to know!!  (Earthdiver slows and addresses Cog directly, singing in a calm, female voice)  “Spiritually, metaphysical processes may guide the physical, mental or emotional experiences towards specific conclusions.”   GEEEEEE-GAAAAAAA-WABAMUN NIIJIS!!! (Earthdiver disappears again; the journeyers laugh and chat, happily continuing forth; Beezy prances around attempting to imitate the movements of Earthdiver; Gizmo trots beside her)    (Marsden, 2005)         (Marsden, 2005, p. 51)  Me: (Laughing joyfully) That pretty much sums it up! Indigenous meaning making “incorporates and makes use of Indigenous embedded, Indigenous sanctioned and Indigenous promoted tools for knowledge generation, which will vary according to each person, their cultural origins and their current context.” Indigenous knowledges are dynamic and diverse, emerging through collective and individual experiences in-relation to place. This is beautifully congruent with the living process of meaning making I engaged in throughout the journey.          (Marsden, 2005, p. 51)   (Dei, 2011; Kovach, 2009)          102 So I drew from the four directions – mind body spirit heart – as Dawn writes about, as well as understandings from the direction of earth and sky – my other-than-human relatives of the natural world, and understandings from manitow – the spirit world. Specifically, some additional sources of knowing and understanding – i.e., kiskêyihtamowin – throughout this journey have included dreams and spiritual visions I’ve had, prayer, relationships with other-than-human natural and spiritual worlds, other kihtehayak and iyinisiwak I’ve encountered throughout the journey, and participating in traditional ceremonies and cultural events along the way. (As they’re travelling through Northern Minnesota, the travellers happen upon a powwow at Cass Lake. Cog does a double take, as he is certain he saw Karlee dancing in a jingle dress in the arbour, though she has continued to stand next to him)                         miskinâhk: As we discussed earlier, traditional, empirical, and revealed knowings…  (Castellano, 2000)  Cog: (Nods, looking slightly overwhelmed) Wow. I must say this whole experience is really messing with my head. (Chuckles, looking exhausted) Ohhhh boy.   (Voice over: Earthdiver’s laugh pierces through the forest):  EEEEEEEE HEHEHEHEHEHEHE!!!      103  Cog: (Mumbles) I could do without that… (A pinecone flies from somewhere within the forest, hitting Cog on the side of the head and bouncing off) Gah! Okay, okay, geez. (Looks around, but Earthdiver is nowhere to be seen) With what you’re describing, Dr. Ruth is going to want to know: how will your subjectivity influence your interpretations in this research? (Karlee smiles. mahihkan grins, rolling his eyes)   mahihkan: Allow me. It is simple. “A method based on Traditional knowledge is the beginning of an active incorporation, recognition and use of one’s own perspective as a critical source of inquiry and means of knowing. The sensing of the ‘self’ and one’s cultural intuition are what necessitate a different approach because in various Aboriginal cultures this method is a fundamental way of knowing; a fundamental epistemology, the absence of which would render one’s study invalid. This method is about coming to objective truths through a subjective method of inquiry and analysis not explicitly characteristic of any Western systems, but of various Aboriginal cultures. Like many Traditional Aboriginals, I have learned that it is not possible to separate myself from this world; I am a spirit walking in this world.” (Karlee smiles widely; miskinâhk grins, looking up at Cog)                            (Rheault, 2000, p. 4)     104  (Voice over: Earthdiver’s voice rings through the trees):  Woooooooeeeeeeeeeeeeee!! Spiritual beings having human experiences!!     HUMANS do research! Feeling-living-breathing-thinking humans Feeling-living-breathing-thinking humans Feeling-living-breathing-thinking humans  (Earthdiver’s voice fades as he continues chanting)          (Hampton, 1995)  Me: (Looks at Cog, kind yet firm) So, Cog, “to embrace Indigenous methodologies is to accept subjective knowledge.” The simple answer to your question, then, is within isîhcikêwin, my subjectivity is my interpreta…    (Kovach, 2009, p. 111)  Cog: (Waves his hand as he scribbles notes and shakes his head) Yeah… I get it. I have no idea how Dr. Ruth is going to respond to this. (Looks up, dishevelled and concerned) I might lose my job!   (Voice over: Earthdiver’s voice echoes through the trees): Oh, what a shame to be freed from the shackles!!!  Eeeeeeeee hehehehehe!!!   Me: (Looks into forest, chastising Earthdiver) Oh shhh! (Turns to Cog, putting her hand on his shoulder) Listen, I understand. Like mahihkan said, this subjectivity piece isn’t characteristic of any Western system, at least explicitly manifesting in this form. One thing I hope you’ve learned,               105 and which I think you have, is “the Indigenous” is a different cosmology. The dominating Euro Western system sets out to homogenize – it doesn’t like diverse ways of seeing/hearing/feeling/tasting/smelling/intuiting the world. That is, and has always been, the force of and reasoning behind colonization. (Pauses, reflecting on her words)  Indigenous research is decolonizing, so it doesn’t make sense for it to be forced into dominating Euro Western boxes. That’s colonization: oppression of who I am, and of my people and Indigenous people globally who sense and experience the world in this holistic way.    (Chomsky, 2010)         (Kovach, 2009; Smith, 1999)     (Adefarakan, 2011)  (Voice over: Earthdiver’s voice echoes through the trees): Resssssssssssidential universities!!!!!   Cog: (Looking at Karlee, concerned look on his face) You’re right. You’re completely right. God (shaking his head)…I do not want to replicate that colonial system. Just listening to the stories of the history was almost traumatic in and of itself.   (Earthdiver flits by, stopping quickly to address Cog directly, looking in his eyes) Earthdiver: And you haven’t even heard a fraction of it, ma dude! (Flits away. Earthdiver’s voice fades into the distance:) Never mind the experience…!!      106  Cog: (Sighs) Yep, yep he’s right. Ugh… (Shaking his head) So back to your process of meaning making…  Synthesis-analysis of recordings, transcripts, and internship experiences. Me: So I had transcribed conversations and the talking circle with iyinisiwak verbatim back when I was living in Calgary during the 2013-2014 academic year, prior to my internship. I took notes of multisensory information – visual and non-verbal cues in the videos, as well as my personal spiritual emotional physical mental experiences – as I transcribed. Transcribing was another strategic concession using a Euro Western method to assist in the interpretation and writing required for this dissertation. I was making meaning – forming understandings – all the while, building on what I had already learned from the conversations and talking circle I had experienced with iyinisiwak in person. Following transcription, I went through the transcripts again to put together some preliminary findings to present at a couple of conferences that summer before internship. This was a pretty informal process, but it helped me to understand some of the main themes iyinisiwak were sharing – an experience that would prove invaluable when I completed my internship in Minneapolis. (The travellers have made their way back to Minneapolis. They are sitting at a picnic table at Mashkiikii Gitigan – medicine             (Kovach, 2010)     107 garden – in South Minneapolis, across the street from the Indian Health Board)  miskinâhk: (Looks toward Cog) You can see how “the methods of data collection and the data analysis [blend] into one…the analysis [is] collaborative and ongoing. It shape[s] the direction of the research, and the results of the research in turn [allow] further analysis.”        (Wilson, 2008, p. 131)  Me: (Nodding and smiling) Right, so when I was doing my internship here, (gestures to the garden and IHB building) I noticed that IHB had a lot going for it – I mean, this garden for one – and services that well addressed the body and mind, even the heart – but there was one really important component missing that the iyinisiwak had talked about: spirit. There wasn’t a lot offered in terms of cultural and spiritual programming. I didn’t jump on this right away, as I knew I was coming from a different place and did not want to assume the things I had learned from iyinisiwak and in my life so far applied here. However, it was not long before my clients and the women in the groups I was co-facilitating were asking for the very kinds of services that iyinisiwak had spoken with me about during our conversations and the talking circle. I started having conversations with people in the          108                                                 55 oskâpêwisak: Plains (y) Cree for people who help with ceremonies community here, and they were sharing similar thoughts and feelings to iyinisiwak, the clients, and myself. Turns out we have a lot in common across Turtle Island. (Winks at Cog, smiling) So I began having conversations with my colleagues at IHB, sharing some of what I had learned through the stories of the iyinisiwak. Weaving together understandings from the stories of iyinisiwak, the needs of the community, and oskâpêwisak,55 iyinisiwak, and kihtehayak at IHB, we developed a number of cultural and spiritual programs and began the amazing – yet difficult– (laughs) process of transforming IHB to better serve the needs of the Indigenous community in Minneapolis. Again, I was living meaning making. It was phenomenal! Truly holistic meaning making in-relation, listening to knowing through the seven directions, and following the seven teachings. isîhcikêwin.  Cog: (Nodding, interested) So can you tell me how those seven teachings informed your meaning making process?   Beezy: (Petting Gizmo. Looks up at Cog sternly) Shhhhh! We’re trying to listen to the story.   Me: (Giggles) Absolutely. The teachings will come out in the story of the journey. (Winks at Cog, who smiles and nods, understanding by this time that Karlee’s stories are not           109 linear) So having allowed myself to fully experience and embrace the journey, living the teachings, the end of internship crept up all too quickly. As per Customs and Border Protection regulations, I flew out of the country after work my last day of internship and went home to my family. I spent some time in Alberta, where I completed meaning making with the conversation and talking circle transcripts. I did this through observing protocols for miyo pimâtisiwin, smudging and offering tobacco each morning, praying for guidance in articulating themes. It felt important that I was doing that work where I was. I had returned to the place where my story, my journey started – the plains, forests, and Rocky Mountains of Alberta. I literally completed my meaning making outside – both nestled in the Rockies southwest of Nordegg, and on the banks of the North Saskatchewan River in Devon, where I grew up. I have no doubt those landscapes were infused in the meaning making. The sky, earth, and manitow, interconnected with my holistic, four directions being, flowed into the themes I heard iyinisiwak speak of. (Karlee reaches into her backpack and takes out a painting, handing it to Cog.                  (A. Young, personal communication, 2011)                    (Figure 4)     110  Figure 4: Infinite Spirit – Holistic Meaning Making In-Relation              This is a painting I did at the end of July 2015, following an extremely profound experience in a supervision session with my primary supervisor, Dr. Laiel Baker-DeKrey. It is called “Infinite Spirit.” I won’t share the whole story of this painting here, but it came through a profound                111                                               spiritual experience where, with the support of my ancestors and spirit helpers, I intentionally accessed and experienced the infinite and interconnected nature of my spirit. I came to understand on another level how I am always connected with all my relatives of the natural and spirit worlds around me, and how these relationships impact and influence everything. And so it is that the themes emerged through the seven directions as I lived the seven teachings. When I reflect on the story behind this painting, I think of the teaching of kwayaskâtisiwin honesty. I understand this to be about being honest with myself, both in working through personal struggles and in maintaining integrity in expressing my gifts. That is how the experience that inspired this painting came to be. It is also being honest with others regarding this process of holistic meaning making, and offering my honest understanding of the themes I heard in iyinisiwak stories. And in this honesty, I find the teaching of sâkihitowin love. I understand this to be about loving all my relations and myself such that I do this work in a good way. My genuine love for the community and for the work the manitowak have given me is the driving force behind meaning making. It is that love that radiates from the centre of my being through                      (S. Roose, personal communication, 1995)                     (C. Pompana,     112                                               spirit. This love is perhaps one of the greatest gifts of my name – čaŋté hówašte wíŋyaŋ. And so I carefully reviewed transcripts with sâkihitowin for the iyinisiwak and their words, valuing all that they shared with me. I offered this same sâkihitowin to my own experiences, valuing what my stories and experiences could offer in this dissertation.  That said, throughout this ceremonial journey, I’ve also continually reminded myself of my purpose and place as an oskâpêwis. I am a learner in this process, and do not claim to be an expert. This is the teaching of pimameyimowin humility. In articulating themes, I am not making generalizable truth claims. Rather, I am presenting the knowings of the iyinisiwak as I understand them so that they may be adapted and implemented in ways that honour specific needs of the communities who may find them useful.    Throughout meaning making, I have paused to question and check myself, doing my best to ensure my interpretations emerged from my holistic understandings of the stories of iyinisiwak. An important part of keeping myself in check has been conversing with various Elders and community members about emergent themes throughout the process, then meeting with the iyinisiwak who contributed their knowings to this dissertation and asking them whether personal communication, 2012)               (S. Roose, personal communication, 2013)                   (A. Young, personal communication, 2012)        113     Encircling:  tâpwewin (truth), authenticity and credibility through talking circles. they felt my interpretations accurately represented what they articulated – they are the knowledge holders in this.  And so, once I completed the work of identifying themes in Alberta, I returned to Vancouver so I could meet and consult with iyinisiwak before moving forward in my writing. I wanted to ensure that, as much as possible, my understanding of the themes that iyinisiwak shared in their stories was congruent with what they felt was important in shaping mental health services to better serve Indigenous people in urban spaces. I sent an email invitation inviting iyinisiwak to come together for a talking circle to share their perspectives on the themes I came up with. I scheduled two talking circles to accommodate as many iyinisiwak as possible, and had nine of the 16 iyinisiwak attend. Both circles were held in private communal spaces in local Indigenous health organizations in East Vancouver.  I followed the same protocols of providing refreshments throughout both circles, offering tobacco to each iyinisiw before beginning, obtaining permission to record, and offering each iyinisiw a gift during a small giveaway following the circle. However, this time I did not ask an Elder to facilitate the circles, as these circles had a                   (Wilson, 2008)                (F. John, personal communication, 2012)             114 different intention and were less formal. I offered tobacco to kihtehayak at each circle to give an opening and closing prayer. I took around the smudge to each iyinisiwak prior to the prayer, and opened and facilitated the talking circle guided by the teachings I’ve learned as an oskâpêwis in community, and through facilitating many talking circles over the last couple of years. We opened each circle with introductions and a check-in, following which I shared the themes and asked for feedback.   (D. Christian, personal communication, 2013)   (F. John, personal communication, 2011; M. McCoy, personal communication, 2015)  miskinâhk: (Nodding) An Indigenous process of establishing authenticity and credibility that Shawn Wilson refers to as ‘encircling.’      (Wilson, 2008)  Me: (Nodding) Absolutely. And enacting relationality through the talking circle, which he talks about as an Indigenous-based alternative to reliability. Encircling is also an important part of observing the teaching of tâpwewin truth. This teaching is about understanding the meaning of the teachings, and living in a way that is true to my purpose. tâpwewin guides this ceremonial journey – every step of this dissertation has come from my heart, living my truth. Engaging in holistic meaning making and using these teachings is being true to my understanding of the stories.     (Wilson, 2008)     (D. R. Wright, personal communication, 2015)     115  miskinâhk: “When a storyteller uses the term tapwê (truth), it means that the storyteller is telling the truth according to how she or he heard it. As Indigenous researchers, we are bound by this cultural imperative.”      (Kovach, 2009, p. 103)  Me: (Nodding) Exactly. And so I have chosen to focus on the Cree concept of tâpwewin rather than Euro Western concepts such as validity and rigour that are not inherently found in nehiyaw-otipemisiwak ways of knowing.  tâpwewin does not refer to objective truth or accuracy in describing a phenomenon, rather it refers to honesty and accuracy in describing my experiences of the set of relationships surrounding the research idea. This involves ensuring my own personal integrity throughout the ceremonial process – being vulnerable, honest, transparent, self-reflexive, and genuine – ethical imperatives from my position in this project.  I lived tâpwewin in this journey through constant self-reflection, as well as ongoing conversations with Elders, mentors, family, friends, and colleagues to ensure I was upholding these teachings in my work. This can be understood as a form of credibility-in-relation. tâpwewin is central in representing my understandings of iyinisiwak knowings in ways that maintain relational accountability. So               (Wilson, 2008)        (Wilson, 2008)  (D. Christian, personal communication, 2012; A. Young, personal communication, 2013) (Wilson, 2008)        116 this is another reason why I engaged iyinisiwak in the encircling process.  Cog: Dr. Ruth is going to want you to articulate how this encircling is any different than a member check in qualitative research…    (Sandelowski, 2008)  Me: (Smiling) Well, it’s quite similar to a member check. There are some key differences though. For one, encircling is not about validity, which is what I understand member checking to be about. But perhaps a greater distinction, similar to the differences between talking circles and focus groups, are the protocols involved, the explicit presence of ancestors and spirits, engaging the holistic self and all of our relations, and at least in the case of this particular project, the overall intention of the gathering…     (Wilson, 2008) (Sandelowski, 2008)  mahihkan: You see, analysis that breaks down stories into themes is not entirely congruent with holistic Indigenous epistemologies. Traditionally, it is up to the listener or reader of the story to make meaning in-relation to who and where they are in that moment, and in direct relation with iyinisiwak who are telling the story.          (Kovach, 2009; Wilson, 2008)  miskinâhk: And at the same time, themes can be integrated with story and self-in-relation interpretations, providing a more holistic picture.    (Kovach, 2009)     117  Me: Plus, using a system of holistic meaning making that involved a seven directions framework enacted through observing protocols and the seven teachings, made for an Indigenous method of articulating themes. These themes are important to present in this work in furthering a decolonizing aim.  That is, explicitly identifying what iyinisiwak shared about how mental health services can (be shaped so as to) better serve Indigenous peoples is important, as this information can be immediately applied in furthering what Linda Smith identifies as an Indigenous research agenda: self-determination, development, recovery, and survival through healing, decolonization, transformation, and mobilization. The themes will tell us what needs to be put into practice! (Smiling) (Marsden, 2005)         (Smith, 2012)                (Smith, 2012)  Earthdiver: (Flying in quick circles above the group, so quickly he is difficult to see)  Trannnnnnnsformation!! Mobbbbbbbbbbilization!! Decolonnnnnnnnization!! Heeeeeeeeeeeeeealing!!!!! Eeeeheeheeheeheeeeeeee (Quickly flies away laughing. Beezy is giggling again, while Gizmo emits a low growl in           (Smith, 2012)     118 Earthdiver’s direction) Weaving a story: Integrating themes, conversations, talking circles, experiences, reflections, and the literature. Me: (Laughing) Yes, so, while I’ve articulated themes I noticed, rather than speaking for iyinisiwak in explaining them, I’ve condensed direct quotes from our conversations and have woven them together into a dialogue that is part of an interconnected whole – a process that, for me, brings to mind the weaving of a Métis sash.  The different colours of wool that make up the sash include condensed excerpts my conversations with iyinisiwak and the talking circle, the themes I came up with through Indigenous holistic meaning making, my own experiences, reflections, and personal journey as an Indigenous mental health professional, and the existing literature.  So, I’ve kept the original words of iyinisiwak when possible, doing my best to accurately present their voices and allow readers to take what they need from the teachings. I’ve also maintained the nuances of the non-verbal aspects of conversations by including non-verbal information such as laughing, smiling, and gestures in the woven dialogue.  Weaving these four components together forms a greater whole – the sash – which is represented in the form of a dialogue. A dialogue, Cog, that you will be a part of. That                  (Kovach, 2009; Marsden, 2005)        (Kovach, 2009)    (Wilson, 2008)    (Kovach, 2009)              119 conversation is yet to come. (Winks at Cog) Having woven these different colours of wool into a sash, the learning I’ve experienced through this ceremonial journey can be put into action that immediately benefits the community – in much the same way the sash was traditionally used for practical purposes, whether it be to carry objects or keep one’s pants up. (Giggles)  In this way, I am sharing the tâpwewin of themes as I understand them, as confirmed by iyinisiwak that they would understand them, and I am respecting the tâpwewin of the stories of iyinisiwak by allowing them to speak for themselves through condensed stories. Rather than speaking for iyinisiwak, I am speaking with them. Also, once I was finished weaving the story into my Chapter 4, I sent the entire chapter to iyinisiwak inviting their final feedback and welcoming any changes to their respective excerpts. I also requested they send me brief personal profiles so they could describe themselves in their own words in the document.  So the encircling and follow-up processes were an important part of implementing these teachings. In both circles, iyinisiwak collectively agreed that the findings I had articulated accurately reflected and built upon our relationships with the “research question.” In fact, the                   (Wilson, 2008)    (Kovach, 2009)           (See List of iyinisiwak)                120 overwhelming sentiment in the circles was “yeah, of course. We’ve been saying these things for years. When is something going to be done about it?” Ideas that were shared during encircling were primarily iyinisiwak reinforcing what they had already shared with me, and emphasizing implementation. So I left those circles with a definite sense that I needed to take responsibility to put these knowings into action ASAP. And didn’t I know it! My experience at IHB had taught me just how useful a practical tool that helped organizations apply these knowings would be. And so, before we move on to the next phase, our remaining teachings. kisteyitamowin respect for iyinisiwak and their teachings, as well as the teachings I received throughout my internship and in community, was essential in weaving together condensed conversations and the talking circle, the themes that stood out to me, and my own experiences, reflections, and personal journey as an Indigenous mental health professional. Respect is also about doing my best to speak to all of what iyinisiwak shared with me, ensuring each voice was heard in how themes were articulated. And in that, it took sôhkeyitâmowin courage to undertake this ceremonial journey I’ve been describing. The                        (A. Young, personal communication, 2011)                        121 teaching of courage is about being myself and standing up for what I understand to be right for me, iyinisiwak, and the communities served by this dissertation. In meaning making, this involved the courage to advocate for a nehiyaw-otipemisiwak approach, and to write in my own Indigenous voice.  It has also taken courage to write my own thoughts, feelings, and experiences, and the direct words of iyinisiwak that I know may be upsetting to some people. For example, it took particular courage to be honest about some of the practices iyinisiwak identified as not working, as it requires those of us in psychology and health professions to critically reflect on our research, training, and clinical practices. I have also had to enact courage to work through my own intergenerational, collective, and personal traumas and emotions that arose during this ceremony to ensure that they did not interfere with courageously articulating the stories of iyinisiwak. I’ve had to overcome my own fears to stand strong in what I believe in.  (S. Roose, personal communication, 1997)  Beezy: (Smiling up at Karlee, places her hand on Karlee’s thigh) Nana would be really proud.   Me: (Smiling down at Beezy with tears in her eyes) Thanks, Beeze. I know she’s been helping me all along the way.         122 (Takes a deep breath and looks up at Cog) She passed on into the spirit world in August 2014, just 10 days before I left home to begin my internship. I have no doubt she has had a tremendous role in all of this…(Smiles down at Beezy again, pats her on the head, then addresses Cog) And the final teaching, kakehtaweyimowin wisdom. I’ve done my best to live by the teaching of wisdom throughout this journey, and feel I have become much more wise as a result of it. I understand this teaching to be about cherishing knowledge and using my gifts and what I learn through my experiences to better myself, my loved ones, and my communities. And so I have done my best to use all I have learned through my life, education, and everything I’ve experienced in this journey, to articulate themes and weave them into a conversation that will ultimately give back to the community. Wisdom is also knowing my limits. And so I know that I am not perfect, and this ‘research’ is not perfect, but I know that I have done my best by living the teachings and staying true to myself as a nehiyaw-otipemisiwak woman. I also want to acknowledge that these teachings are learned and understood through living isîhcikêwin – community relationships, protocol, and ceremony, so what I’ve offered                    (D. Christian, personal communication, 2012)                     (Blue Quills, 2009)     123 here using English words could not possibly capture the depth of these teachings as experienced holistically, spirit body heart mind. This is just my best attempt at sharing my understandings of these teachings formed in-relation. Others may have different interpretations.  Cog: (Sighs) Wow. Sounds like a very rigorous process in lots of ways – just maybe not in the way rigor has been defined in the academy. (Smiles at Karlee) So I’m interested in this Métis sash you mentioned – it sounds like that’s the representation of your findings?  REPRESENT-ATION OF FINDINGS Me: (Smiles) You bet! If we were speaking in conventional Euro Western terms, my “results” and “discussion” are integrated because I’ve chosen to weave the literature into the “sash.” The integration of these conventionally separate elements fits with the holistic, interconnected nature of isîhcikêwin. It felt unnatural for the discussion to be separated from the findings – it was important that the existing literature enter into the conversation around the themes. I completed this weaving on the shores of gitchi gami – Lake Superior. Following my time in Canada, I returned to Minnesota in the fall. Following guidance that had been brought to me through spirit, I knew that was where I needed      124  to go to write my dissertation. I was blessed to live on the lake for a month, weaving and writing so close to the very place my Métis ancestry began. The place my people first came into being. (Smiling) The land is deeply woven into the dialogue. Coming from a nehiyaw-otipemisiwak paradigm, it was important to me that the findings be represented in a way that retained the voices of the iyinisiwak, and honoured my own voice. This involved engaging in an honest relationship with readers and resisting forces of colonization and oppression that dictate textual frameworks based in dominating Western Eurosettler values and ideals. Writing through embodied holism – engaging spirit heart body mind – the sash has taken the form of a dialogue. So…shall we continue? (Karlee winks at Cog, and as she winks, the lights go down)  LIGHTS DOWN.      125 Chapter 4: Listening, Learning, and Returning to Our Medicines Our story continues in an open prairie in Alberta. It is a warm, sunny autumn day. In this short scene, it is only Cog and I walking through the prairie grasses. I pause and take some tobacco out of a buckskin pouch in my purse. I hold it in my left hand, praying. I place the tobacco down next to some tall grass and begin to pick the grass. I lead Cog along as we speak, walking and pausing to pick more grass.                                                 56 Plains (y) Cree for medicine 57 Plains (y) Cree for faith 58 Plains (y) Cree for compassion or kindness  INTRODUC-TION: SWEET-GRASS Me: (Picking grass) I’ve learned much through this research journey, this ceremony. The knowings the iyinisiwak shared with me are powerful medicine – maskihkîy.56 Much like this sweetgrass. (Cog nods; Karlee continues to pick sweetgrass until she has a good-sized handful. She ties off one end of the sweetgrass and hands it to Cog to hold. As she speaks, Karlee carefully begins to braid the sweetgrass) I remember one time learning a Cree teaching about braiding. It was about how we get strength from our hair. The teaching was that individual strands of hair are weak on their own, but braided together, are very strong. The teaching said that the three strands of the braid represent sâkihitowin – love, âpokeyihtamowin57 – faith, and kisewâtisiwin58 – compassion and kindness. I think about that as I braid this                        (B. Charles, online communication, 2013)       126 sweetgrass, which I’ve been taught is the hair of our mother earth.  These qualities, these prayers, are important for what this braid represents for us here today. The iyinisiwak discussed three main topics in our conversations, each represented by a strand of this braid that we create by working together. (Karlee continues braiding as she speaks) The first strand, what isn’t working in mental health services. The second, the medicines we need to use to transform services to better serve our people – the ways forward. And the third, how we make these transformations. As I reflected on each of these strands, I realized the iyinisiwak were describing a decolonizing framework in answer to my research question. (Karlee finishes braiding the sweetgrass and ties the end, taking it into her hands and holding it up before Cog) Marie Battiste talks about decolonizing as a “two-prong process” that involves both deconstructing colonial ideologies and their manifestations, and reconstructing dominating discourses with counter-stories from the perspectives of colonized Indigenous peoples. Through our conversations, iyinisiwak described this process in urban-based Indigenous mental health care, adding a third strand (F. L. Brown, personal communication, 2011)                                     (Battiste, 2012)          127  STRAND 1: DECONSTRUCTING WHAT’S NOT WORKING Cog and I are standing in front of an iron gate that is connected to a concrete wall with razor wire around the top. The concrete wall surrounds a building that, from a distance, looks strikingly similar to the Hiawatha Asylum for Insane Indians (see Hopkins, 2011). The weather that brings the process to life and creates a strong framework – this braid. (Continues walking through the prairie, holding and running her hands down the braid as she speaks) Decolonizing is no easy task, particularly as we continue to live in a colonizing society that is supported by colonizing systems – including mental health care. And so those nehiyaw teachings of the braid can support us as we embark on this challenge. In my experience engaging in decolonizing at IHB, it was love, faith, and compassion in-relation to myself, the work, and whoever I was braiding – or decolonizing – with, that kept me strong and focused. Those values helped me as I encountered the many barriers to change and tests of my own strength along the way. And so it is with this framework and these values that we begin to undertake this crucial work of decolonizing and Indigenizing mental health services. (Turns to Cog and smiles)  Off to our first destination!                   LIGHTS DOWN.      128 is drizzling and grey. There is very little colour in the scene. A number of tools, including a sledgehammer, chisel, ball-peen hammer, drill, jackhammer, and shovel lie in front of the wall next to a wheelbarrow. As we converse, various iyinisiwak join the conversation and pick up tools to dismantle the wall. miskinâhk rests next to us, overseeing the deconstruction as it unfolds. Beezy runs around throughout the scene, helping deconstruct as she plays. Gizmo plays with her, occasionally digging holes next to the wall.  Cog: (Looking frightened) Now why on earth have you brought me here?                      Barriers to Good Work  Ongoing colonization. Me: (Nods and shivers) I know it’s not pleasant, but this is an important reality for us to face. Strand one: what isn’t working in mental health services. (She gestures toward the wall and building that stands behind) You’re looking at it! (Karlee reaches into her backpack and pulls out the braid of sweetgrass she and Cog made. She smudges herself off, handing the braid to Cog to smudge. When he is finished, Cog passes it back to Karlee, who wraps it through her belt loop)  And phase one, the deconstruction, begins. Starting with this concrete wall here. (Karlee pats the wall)  iyinisiwak discussed a number of barriers that prevent us from doing the good work we need to do to help Indigenous people. The wall as a whole speaks to the impacts of ongoing colonization generally. (Steps back and gestures to the wall in its entirety) While these impacts go beyond mental      129 health service provision, they came up repeatedly as critical considerations in what’s not working in the systems our services are embedded within. Colonization also continues to act as a barrier to wellness among Indigenous peoples generally.  iyinisiwak talked about pervasive colonization through child welfare systems; the justice system; education at all levels – primary, secondary, and post-secondary; the language we use in terms of multiculturalism and Indigenous/non-Indigenous dichotomies; ongoing occupation of Indigenous lands and environmental destruction; and the continued dominance of the development narrative, which marginalizes Indigenous ways of knowing, being and doing and dictates limitations on how Indigeneity can manifest in organizations.  miskinâhk: “Colonialism remains an ongoing process, shaping both the structure and the quality of the relationship between the settlers and Indigenous peoples.” Colonial systems continue to perpetuate intergenerational and collective trauma and associated health disparities. Understanding both historical and contemporary influences of colonization on mental health service provision and presenting concerns is critical in better serving Indigenous peoples. (Truth and Reconciliation Commission of Canada, 2015a, p. 45)    (Duran, 2006; Kirmayer et al., 2009; The Royal Commission on Aboriginal Peoples, 1996)  Running Two Bears: (Sizing up the wall and browsing at      130 tools as he speaks) Most Aboriginal organizations are dealing with a very political context, and a lot of times their livelihood depends on playing certain political games. Even independent Aboriginal organizations are delegated through government authorities, so if organizations start getting really “crazy” from their perspective, they can have that delegation taken away. So we're still at a place in Canada where we can be as Aboriginal as we want within the confines and spaces that are provided for us by the government. As soon as we start going outside of that, that's when the trouble starts to happen.  (Running Two Bears picks up a drill and begins working at the wall)  Decolonize: (Striking the wall with a sledgehammer as she speaks) My greatest fear is, say, Round Lake or some treatment facility which starts out as a great thing, space is there, ceremony is there, access, outside, then the health system comes along, “we won't pay for it if it looks like this,” and slowly it's just looking like a treatment centre anywhere with a little bit of brown on the side.  Child welfare. Resurgence: This funny thing another person said, “you work with the department of Family Services and Colonization.” (Everyone laughs) I said, "no." He said, "but that's what it is. Their way is just taking the child out of the home, taking them      131 into a foster home, when all foster care does is lead them into another doorway in a circle that they end up in jail. That's all it is." I said, "yeah it is. And jail is only an extension of residential school.” So we got a lot of work to do. (Walks over to a jackhammer and begins to work on taking down the wall)  Me: (Nodding) And the Truth and Reconciliation Commission Report speaks to those connections. (Truth and Reconciliation Commission of Canada, 2015a)             Justice  system. onîkânew: (Lifting dislodged concrete bricks from the wall into a wheelbarrow) Those systems fail miserably and it sucks that our communities are made to follow by it or not receive funding. I think everything around that – the court system, the foster care system – they're all failing. Their intentions are to help, and in a lot of cases, it does more damage than good.  I would go to court with a client – their first appearance – you have a doctor, a psychologist, counsellors, lawyers, police, social workers, and the judge, sitting in the room with a parent whose kids were apprehended. And they'd say, "you're an alcoholic, you're a drug addict, you're a bad parent, you can't have your kids, we're gonna keep ‘em, ‘cause you're bad." Right then and there it started horribly and the client would swear at ‘em, "fuck you," get up and walk out.  And that's where it started, so the court system to the      132 social workers to the probation officer. And the programs that they run are far from culturally relevant – it's like an assembly line.   Running Two Bears: (Continuing to drill) We're always undercut by enlightenment ontology and epistemology and by the framework of the Canadian state. I don't really see any change happening there until the leaders in Canada are willing to give up power, which is something that colonial folks don't really like to do. So I personally think that we need another phase of activism.  (Running Two Bears grabs a sledgehammer and begins to swing at the wall. The concrete cracks and crumbles as he works)  Education system. miskinâhk: And these systems are further maintained through education, which continues to perpetuate colonial ideologies and marginalize Indigenous peoples.    (Battiste, 2013)  onîkânew: Universities and colleges are set up to educate us and help us fit and work in a dysfunctional society…They're saying, “okay this is a holistic model,” but your Dean, supervisors, colleagues, are entrenched in how they created something in their doctrines or thesis, which they believe to be factual. But how factual is spirit? Our holistic approach?   askîy: One of the reasons I haven't done school is ‘cause I'm      133 scared of the conditioning – I don’t wanna do that. (Motions a top down, pressing motion) I spent so many years out on the street resisting. I didn't want mainstream thought, right?  Me: So the colonial nature of education is a barrier with far-reaching implications, not only in its direct impacts on Indigenous people’s wellness, but also in how it deters Indigenous people from attaining education that may help them serve their communities.    (Battiste, 2013; The Royal Commission on Aboriginal Peoples, 1996) Systemic racism. Running Two Bears: (Pausing between sledgehammer swings to wipe his brow and speak to Karlee and Cog) I think we're still at a place where Aboriginal policy makers and decision makers don't really respect Aboriginal ontology. I think that's the fundamental thing. We're one of the last countries in the world to have legislation at the federal level that's race-based. And that race-based law is attached to a set of discourses and ideologies and understandings about what that race is. Indians in Canada are still very connected to this notion of "Indian problem," Indians are still this noble savage and can't do anything themselves and need money and help and need to be saved and developed.  White folks still go all over the place to help people "develop themselves," and this is still happening in ways that don't fully respect local ontologies. So we're gonna go to      134 Africa, we're gonna educate people, we're gonna open schools. What are we teaching in those schools? Are we teaching local epistemology? No. We're teaching mathematics and Shakespeare. And sure, math is important, but there's a lot of Indigenous things from that locale that we can incorporate into what we're doing.   Me: (Nodding; chipping away at the wall with a hammer and chisel) So it’s all connected. Mental health services cannot be separated from these larger colonial systems.  And within these colonizing systems, iyinisiwak mentioned all kinds of issues: (Karlee passes Cog chunks of wall as she speaks; Cog looks at them and throws them in the wheelbarrow) from policies to staffing to the structure of services to using “liability” as barriers. (Karlee rolls her eyes and hands a large concrete block to Cog; he falters under the weight and nearly drops it)  Colonial policies and “liability.” askîy: You hear there's so much programming for First Nations people. They fail to recognize that all the money that's going into all of these things are from the very entity that started the trauma. And so within, you only get this much room to move (motions to a finger tip-sized crack in the wall) ‘cause you have to do it with their policies and their protocols, and you can't do this and you can't do that. Like our      135 ceremonies, right?  So if you take a youth out to fast on the mountain, "OH MY GOD there might be bears there!" And then you gotta have a policy around what you're gonna do around that, right? I got a lot of flack from our ceremonial people because we had flu transferring, so then the policy was keep the youth disconnected from the community, don't let them share cigarettes, don't do this and that. So now they’re at a sweat lodge and cigarettes got shared. I had to say, “this can't happen because we can get shut down,” so then I got flack like it was me who was putting that there, but it's not, it's this whole thing that kind of pushes us down. (Motions pressing down) It's divide and conquer. (Shakes her head and begins working at the wall with a jackhammer)  Rain: (Wiping sweat from her brow as she chips away at the wall with a chisel) I never did ceremony because the organization I was in did not allow for it, which I just thought was ridiculous, but they had all these issues around liability and blah blah blah. But I mean therapy's a liability. Who's to say Western forms – but that's never an issue - "Oh! We can't do it cuz it's a liability!"    Earthdiver: (Flies overhead, circling and squawking)  LIE-ability! LIE-ability! LIE-ability!          136 suicide … substance abuse … self destruction … watch them disappear! (Flying overhead singing the song “Savages” from the Disney film Pocahontas) “What can you expect  From filthy little heathens?  Their whole disgusting race is like a curse  Their skin's a hellish red  They're only good when dead!” (Flies away)                (Menken, 1995)  Me: (Shaking her head, disgusted and sad) People are dying in our communities, and no one in the mainstream seems to be talking about the liability of not offering ceremony to our people. What about the lives that can be saved by offering a sweat lodge? Taking people to Sundance? So all kinds of institutionalized discrimination get in the way of us doing what we need to do. Culture saves lives. (A large chunk of the wall iyinisiwak have been working on cracks and falls down, Karlee perks up)             (See  miskinâhk: And, indeed, cultural continuity has been shown to have a significant impact on suicide rates in Indigenous communities. Culture is further often cited in the literature as integral to Indigenous people’s wellness, and this includes participation in ceremony, strengthening social connections,   (Chandler & Lalonde, 1998)   (Duran, 2006; Hart, 2002; McCormick,     137 helping others, challenging oneself, learning sacred and traditional teachings, spiritual connection, and holistic self-care. 1994; Mehl-Madrona, 2003; Poonwassie & Charter, 2001) Resistance to Indigenous approaches to wellness and healing. Rain: (Continuing to chip away at the wall) I worked for an Aboriginal organization and we wanted to do a drum-making workshop. The comment I got was, "well you can't make drums just for the sake of making drums." I had to argue and make a point of why this is good for peoples' mental health and wellness – that it wasn't just a craft activity. We always had to constantly be arguing why something would be good for somebody's mental health and wellness.   Me: And that’s often the position a lot of us find ourselves in, having to defend and argue for why these cultural services are so needed. I was speaking with an Anishinaabe lawyer friend of mine one time about all the “red tape” that was being put up as we advocated for cultural programming at IHB, and she jokingly corrected me saying, “it’s white tape!” (Laughs; iyinisiwak nod and laugh) I encountered these same barriers in the U.S. And then there are issues with funding and accessibility…   Funding and accessibility. ekâ kakisipahk: (Chipping at the wall with a hammer and chisel) Non-insured health benefits only support crisis      138 counselling. It kind of is based on such a short-term model that it doesn't give the holistic perspective of lifetime healing, and that ability to build a long-term relationship, which would be more of an Indigenous way of doing it, right? Like knowing that you have this person in the community who you can go and talk to in times of difficulty. Well, only if you qualify, and then you have coverage of 10 to 20 sessions. And it's a hassle for the practitioner to go through the process of getting paid. And they pay…  mistahaya: …they pay a lot less. (Bent down, hammering at the foundations of the wall; Cog jumps as he didn’t notice mistahaya there) Like severely underpaid. And having to do all the massive amounts of paperwork that go with that. And they're slow with payments too, so if you're trying to make a career out of that kinda work, you might go bankrupt before you even get paid. It's a real risk. The whole system is just messed up.   ekâ kakisipahk: Yeah, limited and flawed and not very culturally appropriate.   Karl Lee: (Lifting chunks of concrete into a nearby wheelbarrow) They can't make money off of happy, healthy people. They can't keep you like this (presses downward thumb into his palm) if you're happy and healthy. If you're      139 oppressed, then they control everything you do, everything you say, everything you get. The Europeans haven't figured out how to make money off our spirituality or our ceremonies. Instead, they charge you $200,000 to go to university to learn how to heal people so you can write prescriptions that the government can tax and get rich off of.                             Staffing practices and policies. Me: (Shaking head) Ugh. (Looks at Cog) Frustrating, isn’t it? (Cog nods) This is why love, faith, and compassion are so important in this work. (Gestures to the sweetgrass hanging on her belt loop) Those values keep us going as we face this system. Many of the clients I worked with in Minneapolis were heavily medicated, and had to maintain their diagnoses of mental illnesses in order to receive financial support. This promoted a cycle of dependence on the colonial system, because getting well meant losing access to resources. Then there was the issue of people only being able to access certain resources if they had specific diagnoses, which was incredibly frustrating because I had clients who did not meet the criteria, yet so clearly required the services. (Shaking her head) iyinisiwak also talked about how there are not enough Indigenous mental health professionals available to meet the need, as well as the lack of recognition of and funding for      140 Elders and traditional healers. In my experience at IHB, demand for Indigenous providers often exceeded the number of us available. Not to mention that our gifted Elder and traditional knowledge holder spent most of his days at a computer writing chemical dependency assessments in the name of billable hours, when we really needed him for cultural and spiritual consultation.  mistahaya: (Continuing to hammer at the foundations of the wall) Recently I've had people I know asking me to refer them to Indigenous counsellors, but to my knowledge, there's only two that are certified and practicing in the area, and due to the size of the Indigenous community, it's not always possible for them to work with these people due to conflict of interest, so we just don't have enough Indigenous professionals who are certified to do counselling.    Me: Which ties back to what we were saying earlier about the colonial education system, and connects with staffing policies and other such barriers.   Bob: (Speaking as he uses a shovel to lift chunks of concrete from the ground into a wheelbarrow) Most social service agencies have mostly non-First Nations people ‘cause they may have a degree. Ideally you get a person with life experience, cultural experience, education.      141 … They're also looking for a certain type of sanitized individual. And we don't always come in that gift-wrapped package. We come with our bumps and bruises. But I think that adds to our life experience, our collective wisdom. I don't think they can always see beyond that. I think there's all kinds of racism that's mostly hidden, but sometimes it's pretty overt.  mistahaya: And policy-wise, if there would be increased recognition by health authorities, by the CPA, by BCACC, or by CCPA, for Indigenous specialists, because I think of friends of ours who are Elders and gifted healers and helpers, but because they don't have that master’s degree credential, they're not eligible for funding to work with people.   ekâ kakisipahk: …or they might even have the masters credential, but the hoops of getting through certification in non-Indigenous professional organizations that don't understand Indigenous training and Indigenous perspectives, it becomes so many barriers. (Chipping away at the wall beside mistahaya)   mistahaya: Yeah and if we're gonna have access to those cultural specialists, make sure that the system compensates them adequately, and that it doesn't compromise their living situations.      142 Ethical conflicts. ekâ kakisipahk: And sometimes the nuances of deciding who you're gonna work with and in what way really don't get supported by non-Indigenous ethical teachings. Like if you know someone quite well and a crisis situation comes up where they need immediate support, you don't shuffle them to a non-Indigenous counsellor that they don't know in a time of crisis because Western ethics say that I can't work with them, is just not culturally appropriate, it's not ethical. (Chunk of the wall that she has been working on falls down)   Me: (Lifting heavy blocks of concrete into a nearby wheelbarrow) Absolutely, so Western Eurosettler ethics and boundaries also came up as potentially problematic and/or limited. I’m grateful to have had a lot of support from my supervisors at IHB when it came to this stuff – the ethics just weren’t the same, and often we privileged community ethics in the interests of doing what was best for the people we were helping. Resources such as the Society of Indian Psychologist’s ethics commentary also speak to ways of navigating ethical barriers in mainstream psychology.                  (Garcia & Tehee, 2014)  Cog: (Listening intently as he puts broken pieces into the wheelbarrow then moves them into a concrete recycling bin. He groans as he dumps a large load into the bin) Wow, that is a lot of barriers!      143     Conventional training and education. Me: And we’re not done yet! (She gestures to another section of wall that has not yet been touched. She and Cog move there) iyinisiwak discussed conventional professional training as a barrier to good work, both in what it is lacking and the kind of education it does provide.   pisim iskwew: (Lifting concrete bricks out and placing them into a wheelbarrow as she speaks) I think the most experienced mental health practitioners are the ones that have not been tainted with mainstream education. The ones that really connect are the ones that are dancing in the lodge. Through mainstream education, I became more out of touch with my people. I went back into the communities with a BSW and I had a checklist for how to intervene in child abuse, and if I intervened that way, it would cause more harm in the community, and to the relationship between the service I represented in that community.    Kink’inap: (Working the land and planting seeds where the wall has been removed) There needs to be cultural competency, there needs to be training. There's just no knowledge. My son was in grade 11 when they talked about residential school, as like a paragraph in a textbook. And it looked like boarding school. He came home and told me that, and I'm like, "tell your teacher I'll come in there and teach that      144 class." (We laugh) There's no education around it, it's like Canada's dirty secret. They teach more about the holocaust than they do about what's happening in our own country.                       Providers’ lack of critical reflection and awareness. Me: (Nodding, taking down the wall with a sledgehammer) Right? So iyinisiwak also cited inadequate training in cultural competence, education that teaches us to focus on the individual and perpetuate colonial ideologies in practice, and, that even when we engage in critical education, we may become over-conscious of theoretical concepts that “de-humanize” us and interfere with our abilities to simply be genuine and present with the people we work with.  I believe our training programs have the responsibility to provide education that prepares clinicians to work in a culturally relevant way with communities. Which takes me to the next point that iyinisiwak mentioned as a barrier: practitioners not doing their own work. (Stands back and wipes her brow. With everyone working together, the wall is nearly taken down)   âsokanihkêw: (Picking up remnants of the wall from the ground and putting them in the bin) I think settlers literally look at it like I need to help or save the Native people, right? Anytime you have that dynamic, there's something pretty self-serving about that at the end of the day.      145  Karl Lee: It's even worse if that person looks uncomfortable when you walk in. Then you just get really self-conscious. Like why does this person look scared? Or they don't seem interested. Makes you feel insignificant right away because of your own issues already. Maybe they had a bad day, maybe they’re distracted, maybe there's problems at home, but you just assume it's you, right? (Lifting the last of the concrete into a nearby bin)   (Voice over: Earthdiver’s voice echoes from somewhere in the surrounding forest): Deal with your shit! (iyinisiwak and Karlee laugh, Cog tries to hold back a chuckle)                          Me: So iyinisiwak talked about how providers sometimes become defensive around and/or avoid dealing with the socio-political-historical realities of genocidal policy and colonization on Indigenous peoples; are disconnected from Indigenous communities; don’t locate themselves through acknowledging whose land they’re on and who they are in-relation to that place; fear working with the trauma many of our people have experienced; focus on the “script” for treatment that they’ve been taught through mainstream education; and put the onus for healing on Indigenous peoples they work with, rather than taking responsibility for participating in a greater process of reconciliation. And as      146                   Existing structure of mental health services. âsokanihkêw alluded to, particularly where providers of Eurosettler ancestry are concerned, iyinisiwak discussed how motivations to do this work that are self-serving or grounded in racism are barriers. For example, doing the work for money, guilt, romanticization of Indigenous peoples, and/or a saviour mentality. (Karlee gestures to Cog to follow her back over to the iron gate, which remains standing. As she speaks, she and Cog take down the gate, with iyinisiwak joining to help out.)  iyinisiwak also talked about the structure of mental health services as a major barrier to good work, from brief therapy models, the 50-minute therapy hour, 9 to 5 schedules, space, rigidity about parameters of our jobs, to the disconnected nature of services – how providers work in silos of practice, and focus on the mind as the source of “mental health,” ignoring the critical roles of body, heart, and, especially, spirit. The legacy of Cartesian dualism in our society, eh? (Running Two Bears and Karl Lee come up and help Karlee and Cog take down the iron gate)  Running Two Bears: We already know the literature well demonstrates the connection between mental wellness and physical wellness. We know that really depressed or anxious people will actually have physical impacts from that mental      147 state, and we can also say we understand that mental health involves emotional wellness – that seems to be the one that's easiest for mental health professions to make because we think of everything in the Western world as being generated through the mind.  But there's still the spiritual piece missing.  Karl Lee: The problem is everybody works in silos right now, and it doesn't make sense to Aboriginal people that everything is not connected. Everything we do in our life, we live in the seasonal realm, is connected in some way to everybody else. Mental health is only 1/4 of who we are. So if we're only dealing with 1/4 of who we are and not doing it well, you might be damaging the other 3 more than you think. If they're all going in different directions, they may not be strengthening each other, they may be hurting each other… Another challenge I had when I was going through counselling is the setting they do it in. They sit you in a tiny little office with a person. An office isn't a great place to meet First Nations people. (Lifting and carrying the iron gate away)   Bob: I also think lots of times we get so married to time, like 9 to 5, my shift's over I'm going home. I think they have to have more services balanced out in the evening and night … I guess just coming from a more person-centred model of care      148 that meets the needs of the service recipient rather than the service-deliverer. I think right now our system's set up to meet the needs of the service deliverer more. Sometimes people are in crisis and it doesn't take an hour. Or I've been with people 2 or 3 days, because that's how long it takes to solve their problem. If you have a huge caseload and you have an hour slotted 6 times a day, you don't have that flexibility. So I think you need a lot of flexibility in your work, depending what your role is.  And I think we have to wear a lot of different hats and be able to change roles, like say you're a nurse, you also have to have some counselling skills, you have to take people on outreach, you have to be able to do cultural stuff, you know. I think a lot of people get married to their roles and are like, “yeah this is the parameters of my job, I'm not doing anything more. We'll refer you on.” And they'll do it in 2 weeks, and by that time you've lost your window of change. (Picking up scraps from the ground and putting them into recycling bins.)  miskinâhk: Flexibility in session times and locations is an important part of culturally responsive service provision. (Trimble & Thurman, 2002)       Me: (Nodding) Right. iyinisiwak also mentioned how services tend to be reactive rather than proactive, and put up all kinds of barriers through system requirements to access services.      149                     Internalized oppression and lateral violence. For example, the oh-so-popular deficit-based problem checklist that we often require as part of an intake. Policies and procedures like this act as a deterrent to some Indigenous clients. You’re pathologizing and stigmatizing right away – something we’ll get to more when we go in there. (Nods toward the building ahead. Takes down the last of the gate, which iyinisiwak come and carry away to the scrap metal bin. The wall is now completely taken down, with only the razor wire remaining on the ground. Karlee pulls on a heavy pair of work gloves and starts to bundle the razor wire together) The last barrier iyinisiwak discussed was internalized oppression and lateral violence. Colonization has created some pretty unhealthy dynamics within and between individuals in Indigenous communities, so sometimes we create barriers to carrying this good work forward. (Running Two Bears and Karl Lee come and help Karlee gather and wrap the razor wire in a tight bundle)  Karl Lee: Rule #1 on the reserve: No good deed goes unpunished. You start trying to help people, it scares everybody. They're just not used to people being helped and being asked what they think and really need. They've been dictated to their whole life. Institutionalized. Every one of us.   Running Two Bears: It sucks because there's a lot of      150 Indigenous intellectuals working toward the kind of conversation we're having, and then we have these individuals who operate under the guise of being champions of the Aboriginal community, but they work to advance the university agenda. It's challenging for us, and this is what leads to all the ridiculous amounts of lateral violence that are stopping us from getting where we need to be, because we're always having to question each other's motives. Not to mention the layers of complex intergenerational trauma that Aboriginal people are dealing with. (Finishes wrapping up the razor wire)  Me: (Throws the bundle of razor wire in the scrap metal bin. iyinisiwak are moving toward the building ahead. Karlee puts her hands on her hips and lets out a large sigh. She nods at Cog, then toward the building) So, ready to take a peek in there?  Harmful Practices in Mental Health Service Provision Cog: (Wincing) I guess so…  (Karlee leads Cog toward the building, which resembles the Hiawatha Asylum for Insane Indians, a psychiatric facility in Canton, South Dakota where numerous Indigenous peoples were committed, abused, tortured, and killed between 1903 and 1934. This facility “was to be a hospital dedicated solely to the ‘mental illness problem’ within the Native American         (Fisher, n.d.; Hopkins, 2011)   (Fisher, n.d.,     151 Community.” However, most people committed to the asylum did not have mental health issues, and rather “were considered ‘problem Indians’ who opposed government interests or refused to give up cultural beliefs and practices.” As Cog and Karlee approach the building and it comes into greater focus, they notice it is a modern, updated structure. It is recently renovated and clean. The sign over the entrance reads “Institute for Indigenous Mental Health: Evidence-Based Services for Indigenous Communities” with a picture of a dream catcher beside it. It is clear that the people who designed the facility were well intentioned. There are no people in the building, and it appears as though it was abandoned suddenly, as furniture and internal décor remain. iyinisiwak are preparing to demolish the building.) para. 1)     (Hopkins, 2011, para. 7)  Me: (Reads the sign) Hm. (Looks back at Cog, opens the door, and motions him to follow her in. miskinâhk, Beezy, and Gizmo follow closely behind) So when the iyinisiwak talked about what’s not working, they not only discussed barriers to good practice; they also talked about practices that can be directly harmful: psycholonization, medication, and racism, stereotypes, and prejudices.             Earthdiver: (Dancing through the building, continuing to sing “Savages” from the Disney film Pocahontas)          152  “They're savages! Savages! Barely even human. Savages! Savages! Drive them from our shore! They're not like you and me, which means they must be evil. We must sound the drums of war! They're savages! Savages! Dirty redskin devils!” (Dances out the back door and runs into the forest)                    (Menken, 1995)  pisim iskwew: (Shaking her head at Earthdiver, smudging out the rooms in the building) I don't think all mental health therapists are effective working with our people. The people that can't work with our people are the ones who have never been exposed to our reality, so they haven't had any contact with Aboriginal people in their communities, they haven't known them as neighbours or friends, and their parents have never talked to them about the history of our people. So when they are working with our people, it's almost like they are observing them, and there's fear attached to their work, and sometimes there's a belief in the stereotypes. So they further perpetuate the trauma, the racism, the discrimination – and the      153 services that we offer our people often become one of the risk factors… I think that it's taken us a while as Aboriginal people to access mental health services simply because we don't want people to judge us.  miskinâhk: Colonial trauma and mistrust. The literature talks about this, alongside the clinical racism, clinicians’ deeply held stereotypes and racist attitudes, disregard for Indigenous peoples’ socio-political, historical, and cultural contexts, and a general lack of experience, knowledge, and cultural sensitivity in working with Indigenous clients.    (Duran, 2006; LaFromboise, Trimble & Mohatt, 1990; McCormick, 2009; Trimble & Thurman, 2002) Psycholoniza-tion. Me: (Nodding.) A number of iyinisiwak talked about that. So I’ve used the term psycholonization to talk about all the things iyinisiwak mentioned in relation to processes of colonization that are enacted, often unknowingly and unintentionally, through applied psychology. This includes colonizing clients through assessment, diagnosis, theoretical conceptualization that pathologizes trauma, patronizing attitudes toward Indigenous peoples and healing practices, therapeutic interventions, ways of being in the therapeutic relationship such as the “expert stance,” and other oppressive mechanisms employed from within Western Eurosettler frameworks. How does this happen? Basically through a lack of both critical reflection and understanding of the socio-political-Psycholoniza-tion has been introduced in the literature with varying definitions (e.g., see Todd & Wade, 1994 and Thira, 2011). Here, I present my understanding of psycholoniza-tion.                154 historical realities of genocidal policy and colonization that Indigenous peoples have survived and continue to face. iyinisiwak talked about how mainstream education rarely addresses this, which I can attest to as someone who has never been taught about residential schools, land appropriation, massacres, the 60s scoop, smallpox blankets, the decimation of the buffalo, targeted environmental destruction – the list goes on – in all my grade school education and post-secondary education in psychology.  I’m not saying this is the case for all programs, and certainly things are shifting as community-based movements such as the Truth and Reconciliation Commission and Idle No More impact education, but this was my experience. Without that critical lens and deep understanding of colonial dynamics, we are at risk of perpetuating acts of colonization in our work. (Leading Cog into the waiting room. The room looks like a standard health service waiting room – linear edges, white walls, waxed linoleum tile flooring, a variety of popular magazines on a coffee table among chairs. Motivational posters with cute animals and inspirational phrases smatter the walls, with a couple dream catchers interspersed between them)  (McCormick, 2009)                         (Duran & Duran, 1995)  âsokanihkêw: (Speaks in passing as she moves through the      155 room focused on a task) … that arrogant violence that comes with the field…    Karl Lee: (Taking posters off the walls and putting them and magazines in a recycling bin) A lot of it is taught in education. Just remove that stuff from the teaching would be the first step. Like to label and judge everybody, you wanna put 'em in a category right away. Who are we to judge people and say they're that broken? They're biploar, anorexic, they're this that, they’re FAS, ADHD? Just call them by their name, treat them as a person, not a disease or mental affliction. The worst thing you can do is treat them as something, not somebody… Every label limits people in their beliefs in their own outcomes, and they create negative outcomes. We don't have the right to do that to anybody. “Oh you're FAS, you're dyslexic, you're stupid. This is your limit. You'll be lucky if you can do this.” Then they're never gonna do that.    miskinâhk: “The effects of the genocide are quickly personalized and pathologized by our profession via the diagnosing and labeling tools designed for this purpose.”   (Duran & Duran, 1995, p. 6)  Me: Exactly. iyinisiwak talked about how many people won’t even seek services for fear of being judged, pathologized, and colonized in this way. They shared powerful personal and professional stories of these experiences.    (McCormick, 2009)     156  Karl Lee: I struggled with mental health issues through childhood and my teenage years and 20s, and dealt with them with drugs and alcohol, and it didn't work very well. (Laughs) Everything that my parents brought home from residential school got handed down to me…There was paranoia, guilt, shame, low self-esteem, poor self-image, resentment, anger, all the things I grew up seeing in the whole community. You cut through everything else, all the labels given to you, you know, I was hurt. I was mad, I was scared, I wasn't crazy. I was labeled psychotic in grade 5 or something. I was hurt and scared mostly, but it was just the hurt part. We still have a lot of hurt people out there. (Continues putting paper products into recycling bin)   Resurgence: (Smudging out the room with an eagle feather and abalone shell filled with burning sage) I was taking training once and this one man I talked to said, “one thing I’ve recognized with a lot of people, I don't think they really have mental disorders. I think they have a real connection with spirit. I think that they actually do hear voices of spirits on the other side and actually visualize and see spirits coming to them, but they don't know how to control it, so the first thing they do is tell a non-Aboriginal person that they hear voices and see people, and the first thing they do is give them      157 medication."  So, I warn people today about that over and over all the time. I tell them, “if you see a spirit or hear the ancestors talking to you, don't tell anybody unless they really have to know. Be careful who you tell. You can tell an Elder or spiritual person that you're having these experiences and they'll help you with your communication with the other side. But if you tell a doctor, the first thing he's gonna do is give you medication or put you in a white jacket and take you away.” That's not the way it's supposed to be. You help them control their connection with the spirit world. And that's what they really need. They don't need medication. They're not crazy. Like when [the colonizers] first saw us, they thought that we're doing ritual crazy stuff, right, but we were never crazy. We still aren't.  (Voice over: Earthdiver’s voice echoes from outside, singing): “They’re savages! Savages!”  (Menken, 1995)  miskinâhk: (Shaking her head) Cultural misconceptions of normality.   (McCormick, 2009)  askîy: (Pulling files out of desk drawers and putting them in recycling) When you think about mental health, (shakes head) it's created. Like a whole entity. Like it's a level of government…It's part of the colonization process.      158  Me: Which is congruent with what Eduardo Duran writes about mental health as a system of social control. Current manifestations of this may not be as explicit as they were, say, with institutions like the Hiawatha Asylum in the early 20th century. But for all intents and purposes, modern mental health practice continues to perpetuate oppression and assimilation. It’s just taken a more discrete form. (Shakes her head) Resurgence said it: “We were never crazy. We still aren't.” (Takes a copy of the DSM-5 off the front desk and puts it in the recycling bin)   (Duran, 2006)          (Gone, 2008b)  askîy: My husband was out in the Downtown Eastside for 7 years. He cleaned up – this month will be 21 years. So he'd be out in the alleys, and he says, "I went so deep into my addiction that I forgot who I was – I was lost." And then one day he got a memory trigger, and he's like, “(big gasp) I have a family!! And I have a wife!” And so he started getting really excited. That triggered a psychosis for him ‘cause he was also doing drugs. They wouldn't believe that he had a wife. Because he was so excited they couldn't calm him down, they called the mental health team and they came and (motions aggressively jabbing a needle into her arm) drugged him up. And he was begging them, "please don't do it, please don’t please don’t!!" Then they had him fully pinned and they      159 jabbed that needle in him.  So when he did start coming home, he started having to go to the mental health team. They were trying to get him into treatment. The worker at that time forgot to send his dates in, so he ended up not getting into treatment because his referral didn't get sent, and he ended up on the streets getting stabbed 4 times. How many stories are there like that, right?  I listen to stories from people and then service providers go, “(scoff) he's always complaining, she's always complaining." It's like such a disrespectful – I'm like, “even if this person is whatever, let's listen to them, right?” Because there has to be a thread of truth for them…I don't use "mental health." I use post traumatic stress disorder, because it's all the trauma and compression and suppression, right? (Continues recycling files from desks and filing cabinets)  Water: (Removing the dream catchers off the walls and collecting any natural items in the waiting room, including the few plants and stones that were tucked away) In the medical model, the Western model, if there's been a lot of post-traumatic stress, a lot of complex trauma, you're pretty well screwed. (We laugh) It's damaging and it's damaged you. But from an Indigenous perspective, it's not there to damage you, but to inform you and help you understand. It becomes      160 knowledge keeping. Your experiences are your knowledge, and the intergenerational experiences of your people are your knowledge, and that knowledge can help inform you in the steps you take ahead, rather than it reducing you to being broken.  Me: (Waves Cog to follow her along through the halls. They walk past numerous rooms that look fairly similar. All have four walls, computers, well-stocked bookshelves featuring prominent scholars in the mental health professions. The occasional pen, clock, notepad branded with the most recent psychotropic meds) So these processes of psycholonization happen through various means. And connected with that, many of the iyinisiwak discussed medicating people as an often-harmful and oppressive practice.   Psychotropic medication. askîy: (Walking alongside Karlee and Cog, gathering files out of offices to recycle) The biggest concern I have around pathologizing is that people are getting medicated and then they're really not able to heal…When I worked with youth, they'd come in with huge assessments and lots of medications that counteract each other. What I ask is that they don't come on any medication because it blocks the ability to be open to ceremony and to spirit.  We get youth who come in through the ministry or      161 through corrections, they say, "I don't want to be on this," and I’ll have social workers say, "well as long as they're in care, they'll always be on this," because they don't want to have to deal with whatever it is. When you're taking youth to ceremony, there's no way to connect with them when they're all medicated. The work I do with the youth is very emotional and spiritual.   Karl Lee: (Following askîy with the recycling bin, picking up recyclable products along the way) Overmedicating or medicating people doesn't help mental health issues – it masks them. And it can create an alternate reality where they're okay – they don't have this problem anymore or whatever. But there's long-term effects to every kind of medication. It's hard on the blood system, it's hard on the liver, it's hard on the lungs. Every medication will have 10 different side effects, then you take meds for those 10 side effects, then you have 50 side effects. Physically, mentally, emotionally, spiritually, you start to feel worn down and foggy, like what's real and what isn't?          Me: (Opens a back door and motions for Cog to follow her outside. The drizzle has stopped and clouds have parted somewhat – patches of blue sky are scattered between clouds. The iyinisiwak have cleared items from the building, and all             162                               Racism, stereotypes, prejudices, and judgment in practice. 16 are helping tear down the building using selective demolition, sorting materials into different bins for recycle and reuse. Karlee and Cog help by moving demolished pieces into the appropriate bins) So psycholonization and medication can be very harmful – oppressive, colonial, disabling. iyinisiwak also cited concerns that medication oppresses people’s spiritual gifts.  Reflecting on medication, Erick Fabris’ seminal work comes to mind. Though not Indigenous-specific, his research found that people experienced the effects of psychotropic medication as chemical institutionalization, interfering with identity and suppressing the self. The title of his book says it all – “Tranquil Prisons: Chemical Incarceration Under Community Treatment Orders.” Yet another form of continued colonization and oppression. (Shaking her head) iyinisiwak also told stories that conveyed how harmful racism, stereotypes, prejudices, and any kind of judgment, really, continue to be in organizations.                       (Fabris, 2006)    (Fabris, 2011)  Whale: (Hauling metal scraps into the metal bin) This young boy I met was 12. We sat and I talked to him about smudging and that his people probably did that – he’s Cree – and this is why, and this is my medicine bundle. Oh he really liked all of that, the smell, the feeling. I sat for a couple hours with him      163 and his dad, and then I put it all away and said goodbye.  I think he was FAS, and everybody in those days told me, "oh this kid's got FAS, this kid is FAE, this kid has whatever," always told me first instead of just allowing me to see the child. And it's like nobody will like them, or you may not like him ‘cause he's different. They also blamed me because I was like the only Native person that they've seen, "oh you guys drink and it's all you guys do.” I said, "well some of us smarten up," and I said, "it doesn't mean that we don't love our children.” And I had to say that for not only for me, but also for our organization ‘cause I believe that we love our children – they're sacred bundles.  askîy: (Taking down the outer structure of the building with a sledgehammer) I've worked with kids who come in from care who want so much to be where their families are, right? And you've got the social workers, the probation officers, everybody, "oh no no no that's not a healthy place to be." And it's like, “well how do you know?”    Running Two Bears: (Nodding as he helps pull down the demolished walls) We get new baby social workers coming in from university who may not have taken a course in First Nations social work, and people who are of that age now certainly didn't get anything about residential school through      164 high school or elementary school, so a lot of these people come and they're still working with a mindset of pathologizing their clients for being poor. In my opinion legislation for Child & Family Services continues to do that. Most of the removals of children from their families today is under the clause of “unwilling or unable to...” If an Aboriginal mother is perceived as being unwilling or unable to provide ample care for her child, her child can be taken away. And the unable in that clause can be not having enough money to provide what's considered important for that child.  So we're still basically punishing Aboriginal people for being impoverished, which is a direct result of colonization in Canada. So we get all these social workers not understanding that, so part of the work is trying to get people on the same page for what we're doing and who we're working with, and the other part is trying to develop those Indigenous systems to actually do the work. (Takes down an entire wall with the help of askîy and Whale; begins hauling it off to the appropriate bin)  Me: (Nodding, turns to Cog) Again, this speaks to the lack of awareness that providers have around intergenerational and collective trauma. Without understanding the socio-political-historical realities Indigenous peoples face, people default to        (McCormick,     165 the stereotypes and prejudices perpetuated in dominating society. It’s scary, because it has a real impact on the wellness of our communities. The ongoing removal of our children continues to perpetuate layers of trauma among our people. Child custody is something mental health professionals directly influence. (Cog takes a deep breath and sighs as he writes down some notes) The other impact of this lack of understanding that iyinisiwak pointed out is providers sending clients away because they’ve been using, which only further harms people through judgment, marginalization, and not giving them the services they need. (Helping iyinisiwak take down walls) 2009; Trimble & Thurman, 2002)  Rain: (Nodding as she tears down sections of the building) One time a client, her very first session, was drunk, which I was totally fine with. Other people aren't fine with that. It doesn't work if you're judgmental. I was meeting her where she was at. So what if she could not cognitively process or whatever? She needed to feel like it was okay to just be there. And she made it there – most people wouldn't have even shown up! So judgment of intoxication is a big one. So it might be a very different session if someone's intoxicated, but oh well, right? All the big things around just not feeling safe, so not feeling safe to come if they had a drink or whatever it      166 might be. Fears around being judged. That is a big one.  Me: (Nodding, putting building materials in appropriate bins) And why are we doing this work if not to help people who are struggling? This again connects with patronizing attitudes toward the people providers are working with. iyinisiwak spoke not only of those attitudes toward substance use, but also toward people who have been trafficked and toward Indigenous women in general. How many of our country’s missing and murdered Indigenous women reached out for help and fell through the cracks? Or didn’t reach out for help because they feared the way they would be treated in the health system? (Shaking her head) Lives are being lost.       (LaFromboise et al., 1990)  Kink’inap: (Picking up and tossing demolished chunks of building into appropriate bins) Like none of the women woke up one day and said, “I wanna end up on the Downtown Eastside and do this" when they were a little girl. Nobody dreams of that. It's a result of colonization – intergenerational effects of residential school, being displaced from the land, their family, foster care, 60s scoop, everything. Practitioners, police, everybody – people don't know. They see our people downtown and they have racist views, right? They don’t know there's a reason.  And the police don't do anything. When that woman      167 was pushed out the window of a hotel, the police just said "oh it's a suicide," that's all. So people went down there and protested, and four of them got arrested. Just like, "oh, ya know, another Aboriginal girl," right? If it wasn't an Aboriginal girl, things would've been different.     Patronizing and racist attitudes toward Indigenous approaches to wellness and healing. Me: (Shakes her head, continuing to help take down the building) And it is all connected. Cultural safety is paramount.  iyinisiwak also talked about patronizing attitudes toward Indigenous healing practices. I was doing a presentation on decolonizing health services a few months ago, and one woman said something to the effect of, “sure, we can do a smudge,” gesturing dismissively to an altar of traditional medicines, “but what does decolonizing actually look like?” As though the medicines are just something we have there for show – a superficial demonstration of “cultural competence” that doesn’t actually do anything. These plants have spirit! (Mental Health Commission of Canada, 2012)               (A. Young, personal communica-tion, 2011)  Earthdiver: (Prancing past Karlee and Cog, weaving through the iyinisiwak; tossing some made-in-China dream catchers and a ‘hipster headdress’ in the air; Water follows behind, picking up the items as she shakes her head and chuckles under her breath)  Dream catchers! Dream catchers! Get your dream catchers                 168 here! Pink! Turquoise! Green! ‘Buckskin brown’! How ‘bout an authentic NDN headdress! (Prancing away, laughing)    Me: (Giggles, shaking her head) So iyinisiwak talked about patronizing and dismissive attitudes toward our powerful medicines and ways of living.    miskinâhk: Such patronizing attitudes toward traditional approaches to wellness and healing permeate the existing literature on counselling with Indigenous people. These attitudes are a form of clinical racism, alongside both negative and romanticized stereotypes, and impede the effectiveness of psychotherapy with Indigenous people.    (Moodley, 2007) (Duran, 2006; LaFromboise, Trimble, & Mohatt, 1990; Trimble & Thurman, 2002)  Me: And as the iyinisiwak have mentioned, it’s okay to engage in certain practices, like “okay, we can tolerate smudging,” but then there’s continuing fear of ceremony and traditional healing. Some shared stories of having to hide their cultural healing work because of this racism, discrimination, and lack of acknowledgement…   opakahamâw: (Smudging the areas of land where the building has been taken down and removed) I've been helping doctors behind their back…I'm trying to bring our people back to the ways we used to be. We had healers, we were healthy,      169 we knew a lot. I can walk into any hospital and look at that client and see it work, and they can connect with me right now. But the non-Natives walk in there and say "oh yeah, it's black and white," you know, “I'll give ya to the doctors and give ya to the nurse." You should be able to go in there and heal that person yourself just by walking over there. I don't know non-Natives who like that. They don't like to hear that.  So there's gonna be a wall there all the time, so that's where we gotta work. I told ‘em you can be two people – you can be the healer on one side, and the public on the other side, and just flow with the public the way they like it. A lot of times we don't like the way the public flows, so I have to work behind the curtain to get it done.   Me: (Shaking her head) Reminiscent of the years where our people had to maintain our ceremonies and traditional practices ‘underground’ because it was illegal for us to practice them… So many layers of colonization permeate these systems! (Helping iyinisiwak pull down the outer walls of the building)   opakahamâw: It's coming really slow. Because they don't like to be told what to do or think we sound better than them. We've always had a label of knowing nothing, so that's where they're coming from. They’re having a hard time eliminating      170 that, so we got to be friendly. There's the negative and positive in life. In our life today, there's more negative, so what do we do? We got to turn that around. If someone comes at you that's really negative, you gotta challenge it, you gotta stop. I generally say my prayer to that person so that person will get well. (Begins planting seeds in the earth where he has just smudged)                 Colonial impacts on culture and spirituality.  Me: (Taking a deep breath) Those three values! (Gestures to the sweetgrass in her belt loop, takes another deep breath) Compassion, love and faith. Important to remember in this work.  And of course, we do have organizations where traditional healing is used. Amazing programs like Round Lake Treatment Center in Interior BC and Tsow-Tun Le Lum Society on Vancouver Island.  Though there’s always a cautionary note – spirituality and culture need to be engaged with carefully due to the complexities created by colonization. We can cause harm as providers if we are not conscientious about these dynamics. (Nods toward âsokanihkêw, who is breaking up and removing some of the foundations of the building)   âsokanihkêw: Yes – understanding and being sensitive or being open to the actual dynamics of colonialism, like      171 psychologically how they impact you individually in terms of your relationship to yourself, your relationship to your family, your loved ones, and the community. I think that gets really flattened in the literature, like, "oh we just have to reinforce community ties," well there's a whole bunch of complicated dynamics that go along with reinforcing community ties, family ties. So being sensitive to how colonial violence has actually impacted people.  There's a lot of survivors of sexual abuse, and a lot of people had to spend a great deal of time getting out of their families or communities, right? So with the literature saying, “be part of the family and be part of the community, because to be self-determining and to be healing from colonialism we have to heal all our relations,” yeah that's true, and that's a really complicated thing… Then the other complicated thing is so many people have been hurt by Elders, like, "oh you have so many spiritual gifts," and then they turn around and betray that trust. Or people who their parents are healers, traditional medicine people, Elders, knowledge keepers, pipe carriers, you name it, but they're getting beaten and abused by them at home. So how do we account for that when we're encouraging people to turn to ceremony? And like on the psychic level too, right?     172 How are you going to trust me? (Wipes the sweat from her brow as she heaves the last of the foundation into a wheelbarrow)  miskinâhk: A good reminder of the importance of meeting people where they are at, acknowledging the impacts of colonization on identity and cultural pride.   (Duran, 2006; Lavallée & Poole, 2009)       Conclusion Me: (Wipes her hands on her dirty jeans and stands back with Cog, looking over the land where the building was. iyinisiwak are conversing, laughing, smiling, as they work the earth and plant seeds to restore the land) So that’s the gist. Step one of decolonizing…    Running Two Bears: (Stands beside Karlee and Cog, smiling, satisfied) …trying to get rid of those epistemological orientations that continue to pathologize our clients and continue to enforce reductive notions of wellness like "mental health," which is basically reductive of wellness on the whole - ignoring the emotional and physical and spiritual…For me, decolonization is about getting rid of all of that is oppressive, inhibits understanding, and doesn't make room for the incorporation of alternate possibilities.  Then once we're there, it's about Indigenization…   (Karlee smiles at Running Two Bears and takes a deep breath; Running Two Bears nods at her, and re-joins the other      173 iyinisiwak restoring the land. Cog looks down, thoughtfully, then back up at Karlee. They exchange nods)  LIGHTS DOWN.   STRAND 2: INDIGENIZING THROUGH RESTOR(Y)ING PERSPECTIVES    Cog and I are sitting on a buffalo hide around a fire inside a tipi. Beezy and Gizmo are resting on the buffalo hide next to me. miskinâhk sits quietly beside them, while the iyinisiwak are sitting around the fire beside and across from us. Everyone is listening intently. iyinisiwak speak up occasionally to share their perspectives and stories as part of the conversation. I have a large bundle wrapped in a blanket to my right. I draw a medicine wheel in the ground to my left, between Cog and I. The fire crackles.  Me: (Speaking at a slow, even pace; her voice is calm) Indigenizing. “Step 2.” The second strand in the braid. Restor(y)ing. Indigenous narratives that restore and re-story. This formed the heart of my conversations with the iyinisiwak and the conversations in the talking circles. In their stories, I heard them identify seven ways we can transform our services to better serve our people. These seven ways are medicines – maskihkîy.  Each maskihkîy is considered in one of the seven directions. (Gesturing to the medicine wheel, she indicates the purple centre) At the heart of all we do in the direction of manitow, sâkihitowin, the spiritual law of love. A deep love                   (Figure 5)     174                                                 59 Plains (y) Cree for Indigenous knowing or knowledges 60 Plains (y) Cree for responsibility 61 Plains (y) Cree for Earth 62 Plains (y) Cree for who is this one? for one another grounded in spiritual connection. (Gestures to the different directions of the medicine wheel as she speaks) Here in the East, we begin with miyo wicehtowin, good relationships. In the South, iyiniw kiskêyihtamowin,59 Indigenous knowing or knowledges. The West, miyo pimâtisiwin, living a good life – our original instructions. In the Northern direction, we have nâkateyimowewin,60 responsibility. In the direction of the earth, askîy61 – the land. And in the direction of the sky, the stars, awînawa.62 This translates to ‘who is this one?’ It is about the importance of focusing on relationality – being-in-relation, identity and sense of belonging – in our work.      175                                                 63 Plains (y) Cree for medicine bundle Figure 5: Seven Ways Mental Health Services (can be shaped so as to) Better Serve Indigenous Peoples Living in Urban Spaces in Seven Directions   Together, these seven themes form maskihkîwiwat63 – a medicine bundle.  Each of these directions, each of these teachings, each of these maskihkîy, is sacred. Each comes with a gift that is part of this medicine bundle.       (Figure 6) Figure 6: maskihkîwiwat – Seven Ways Mental Health Services (can be shaped so as to) Better Serve Indigenous Peoples Living in Urban Spaces     176     sâkihitowin (Love)   (Lifts the bundle to show Cog, then places it on her lap, gently stroking the blanket it is wrapped in) A dear Anishinaabe Elder in Minneapolis gifted me with this blanket when I began jingle dress dancing. The blanket that holds the bundle together and protects each of the contents is sâkihitowin. It represents the deep spiritual love that surrounds and permeates the other six medicines.  The deep spiritual love iyinisiwak have for their communities and the people they serve was pervasive      177                                                 64 Lakota/Dakota for “we are all related” throughout their stories. There was a recognition and acknowledgement of our clients as our relatives – cousins, brothers, sisters, aunties, uncles – we are all related.  mitakuye oyasin.64 We are co-journeyers in this life together and there is no separation between us. Our ceremonies remind us that, and to be humble in this way.  Karl Lee: Clients are like family. That's a big part of mental health. You know that somebody cares about you, you matter to somebody. And it's hard, you're taught not to. You should be able to say, "I love you," "it's good to see you today," just express your feelings to somebody. You feel better and they feel better… We're not working with a disease, we're working with a person. We work with people because people matter. People come to us because we give them the perception that we can help them. That makes us matter to them. So it has to be okay to matter to each other.    Bob: You have to lead energy, and that's hard to explain. You have to create a safe, warm, loving climate for somebody, you know, make them feel like they're the most special person in the world in that moment. (Raises his eyebrows)    Whale: If you're a mom and you have a child who's FASD or      178 NAS, it's very difficult. Help people relax and just enjoy a child. Our way is different I think. We just sort of sit and we know they'll come around. Whereas non-Aboriginal people may not understand or view it like that. That complete acceptance of self can go a long ways with a child, instead of judging and fearing what that is.   Me: (Nodding. Cog appears thoughtful, nodding as well) And that love and acceptance is very spiritual. We come to understand the meaning of mitakuye oyasin through ceremony and cultural practices – isîhcikêwin.  (Makokis, 2005)  Whale: I've seen some fantastic things happen for some of our people with mental health or other disabilities. One of them was at a ceremony. We were all sitting around and this young man came in. And he had some mental health issues. He was walking around the room saying "hi," "hi," to everybody that he didn't know, and we all nodded and said hello, and other people, if you watched, they'd turn away from him.  But the best thing I ever saw was when the Elder came in. They brought this little Elder all frail into the middle of the room, and everybody got up and we had 50 cents we'd give him – we were acknowledging the Elder with this. Then along came this young fella, and he went to the Elder and bent down      179 to give him the 50 cents. Well the Elder got up, he was all shaky, everybody's helping him, and he bowed down to this young man. I wanted to cry. The elder gave the young man 50 cents and said, "thank you," and it was to say, you know, “I'm thankful you're here because you teach us. You teach us about ourselves – how we are in this world.” It was the best thing I ever saw. Whenever I’m with caregivers who have babies with a lot of issues I mention that. That’s what they love is love. We all love love.  askîy: I walk by people in the Downtown Eastside and I wonder about their story. You know, what happened? You have family. People who love you. And you're here. I always say we're all related, right? We can go to any urban reserve that's any drag in Turtle Island, and connect with people on a family level.   Me: (Nodding) A few times over the course of the year, one of my coworkers at IHB came out of his sessions and would say, “that easily could’ve been me.” He’d shake his head, deeply aware of those critical moments in his life that could have led him to end up on the streets or in prison.  There’s an acknowledgement that we’re all in this together, and it’s critical for us to remain humble and grateful to have the privileges we do as providers. Unconditional love      180 is powerful medicine. (Beezy and Gizmo shift as they sleep between Karlee and miskinâhk. Beezy is holding Gizmo in her arms, and Gizmo rests his head on her)  Bob: I had this epiphany once. Our four chief medicines: the earth, the air, the water, the sun – they give life to each and every person on the earth indiscriminately, no matter how good you are or how bad you think you are. So who are we to judge?  That came from visiting this one-armed man who wanted me to roll a joint for him. I was having this whole dilemma in my head, like, “oh can I do that? Well he certainly can’t do it! He’s only got one hand!” So I was like “yep,” so for that time I was just the extension of his hands. And then it became commonplace. Sometimes that’s the only reason he wanted me to visit him. That was prescribed by his doctors in the marijuana maintenance program, so who am I to argue? But he’d always want me to sing him a few songs first. It’d take care of something there. And then he’d have his little celebration after and I’d book it, like “okay I’m outta here!”   Karl Lee: Just let them know they're okay. The way you are, the way you think, the way you feel, has gotten you through every day up til now. You're still alive, so you're okay.   Me: (Shivers, covered in goosebumps) I truly believe that       181 sâkihitowin is the most powerful medicine we have available to us, and these stories demonstrate that. The iyinisiwak shared powerful stories of how such unconditional love and absolute non-judgment is critical in the wellness of our people. The guilt and shame that has been instilled through processes of colonization and their impacts melts away when we bring sâkihitowin to our work with people.  I carried these teachings of sâkihitowin with me when I did my internship, and had some profound experiences with clients who had grown accustomed to being judged by others, especially those who were actively using substances. A couple of clients shared with me how powerful it was to have someone treat them with such honour and respect – sâkihitowin. One middle-aged woman told me it was the first time in her life anyone had treated her with such love. As iyinisiwak pointed out, and I couldn’t agree more, we need to nurture complete self-acceptance and self-love in the people we work with. And as far as I know, sâkihitowin is the best way to do that. My internship was my first experience of having multiple clients tell me they loved me, and I was able to return that love. What a gift! After generations of having that taken from us …                                        182  Cog: (Looks at Karlee thoughtful, nodding) This almost sounds similar to Rogers’ theory around unconditional positive regard…?   Me: I understand how it would, as I believe complete acceptance of the client’s experience – unconditional positive regard – is part of sâkihitowin. However, sâkihitowin goes beyond acceptance and non-judgment, to a deep sense of interconnectedness and spiritual love. It is one of our four natural laws as Cree people.     (Rogers, 2007)     (Makokis, 2005)  miskinâhk: (Nodding) iyinisiwak are speaking of love from an Indigenous perspective. The importance of such love in mental health service provision has not been elaborated in the literature, although as one of the Seven Grandfather Teachings, it’s been cited as part of a wise practices model for addressing wellness in Indigenous communities in a culturally-based way. Glen McCabe also found empathy, acceptance, and respect to be important therapeutic conditions in traditional healing with Indigenous peoples – all aspects of sâkihitowin.           (Wesley-Esquimaux & Snowball, 2010)     (McCabe, 2007)     Me: (Nodding) In my experience, sâkihitowin radiates from the place my spirit comes from, from the centre of my being. It is from this centre of love and pure intention that we can use the other medicines in a good way. (Karlee carefully unwraps             183                                                 65 Anishinaabe for tobacco. I have chosen to use asemaa, the Anishinaabe word for tobacco due to my time living and learning on Anishinaabe territory and with Anishinaabe Elders and mentors up to this point in my life. I regularly use the term “asemaa” to refer to tobacco.       miyo wicehtowin (Good Relationships) the bundle and lays the blanket out on top of the medicine wheel. A number of sacred items lie on top of the blanket. Cog looks curiously; he has never seen these medicines before. Karlee picks up a small buckskin pouch. She carefully opens it and breathes the scent in deeply) In the East, the direction from which the sun rises, we begin with asemaa65 – tobacco. This maskihkîy represents miyo wicehtowin – good relationships. (Karlee hands the buckskin pouch to Cog. He very carefully holds it, tentatively smelling the medicine) My understanding about tobacco is that it was the first plant. It gave itself to the people so that we may use it to communicate with spirit. I’ve been taught to offer asemaa in many ceremonies, when picking medicines and food, when praying, when seeking guidance or help, and as an offering of gratitude. Using asemaa this way is following protocol, which maintains miyo wicehtowin. (Cog hands Karlee the pouch of tobacco. She takes a pinch and places it in her left palm) From a place of love and pure heart, we focus on miyo wicehtowin with the people we serve. iyinisiwak shared that healing takes place in good relationships.                    (D. Day, personal communica-tion, 2014; D. R. Wright, personal communica-tion, 2014; A. Young, personal communica-tion, 2011)     184  onîkânew: One of my teachers, when I was doing research like you, I said, "can you tell me the 3 strongest components of your program?" He said, "everything falls under one: when your soul connects with my soul, that's when the healing starts.”   Me: (Breathing in deeply) A powerful teaching. As with sâkihitowin, miyo wicehtowin is deeply spiritual. Coming from that place of sâkihitowin and non-judgment, iyinisiwak told stories of how we must be there for our clients as they need us – accepting and meeting people where they’re at in a truly client-centred way. (Nodding toward Cog) Here, we certainly see similarities with Rogers’ client-centred therapy.              (Rogers, 1949; Rogers, 2007)  Bob: Once you have the window of opportunity with people and it's sincere and genuine, that's really your best work. Something's just different with somebody when they're ready for change. And, like they say, two steps forward and one-step back. So just having to do that dance of change with people. Let them lead.   Rain: I had a client that just wanted singing and drumming the whole session. There's one client I sang with for yeeeeeeeears, and he just cried. Doing that allowed for a different relationship for us. He had different health issues      185 coming and going, so he'd be in and out of the hospital. He could have interpersonal issues with staff or whatever, but because of the relationship I had developed with this person, I could call him on when it was appropriate and when it was not. I could say things to him that other people couldn't because he had that safety, that trust, that relationship, which I'm sure would not have been the same had we not had that experience with singing.  And so with some people it could be that, or we might just go for a walk and look at the trees, and that could be really healing for somebody you know. So that openness.  âsokanihkêw: Listening. Not pushing things. Being humble. Showing respect by honouring the client in a true way, which is that they're wise, right? Like they've come through all of that and they've gotten here, so I'm not about to take that position where I'm telling you what you should do, especially as an Indigenous person. We're all struggling to figure out what that means to be Native in the context of colonialism. So much has been lost and it's complicated, so I try to take a really humble and slow approach with people and let them know that they're the wise ones in the room.    miskinâhk: Counsellors’ demonstration of genuine concern, respect, authenticity, slow pace, and listening is associated   (Lokken & Twohey,     186 with Indigenous clients’ abilities to trust their therapists. A client-centred approach is also characteristic of Aboriginal Focusing-Oriented Therapy. 2004)   (Turcotte & Schiffer, 2014)  Me: iyinisiwak also talked about being with clients’ cultural identities in a very client-centred way, which is congruent with the literature that asserts the importance of tailoring therapy to clients’ relationships with Indigenous ways of knowing, being, and doing. Again, flexibility is key.    (Duran, 2006; McCormick, 1996; Morrisette, 2008; Trimble, 2010a)  ekâ kakisipahk: Having the services that people can access whether they wanna see a non-Indigenous person or Indigenous person, if somebody is hesitant to access services with an Indigenous therapist because of identity issues or concerns.   Rain: You come across people with varying levels of connection to ceremony, family, traditions. And also in the urban context there are other scenarios – somebody's extremely culturally embedded and involved, but it’s not their own – it's a different culture, right? Because Aboriginal communities and cultures are extremely diverse within. Vancouver's a good example – tons of people who go to sweat lodge with different leaders who do sweat lodges based on different teachings, who have nothing to do with the sweat lodge, right? So you've got people who've been adopted,      187 who've been in foster care, who've got different kinds of backgrounds in that sense, so it's extremely diverse. That is a big thing: you cannot assume. You never know. Ask people what their needs are and what they want.   miskinâhk: This degree of diversity is a particular marker of Indigenous communities in urban spaces.  (Andersen, 2013)  mistahaya: It is around flexibility with the issues they're gonna walk in with. May not always necessarily be cultural issues, and they may have different ways of understanding and experiencing culture. I think that's one of the biggest things that a lot of Indigenous clients come in with, just having experienced colonization in their families for generations and not really knowing who they are as a cultural being, and ensuring the space that we work with them in, in investigating identity, is a safe space. Really being open to a broad gamut of things. It may not always be to do with things like lateral violence or colonization, but just the business of living. Like relationships or dealing with depression or anxiety, goal setting, career, relationships, sexuality, those are all on the table. Not everyone that comes in is gonna wanna talk about spiritual crises. At the same time, being ready for the times they do come in needing to talk about those things.      188  ekâ kakisipahk: …and at the same time not assuming that something of the everyday isn't a spiritual crisis. Being attuned.   Kink'inap: So it's all client-centred, what their needs are and what they want. I remember this one youth, "well I'm not gonna sweat, that's not my way, I'm not doing it, and I'm not doing this and I'm not doing that," and he was just adamant, right. By the end, he was sweating, he was the fire keeper, he joined a drum group, he was going to Sundance. It was fantastic!   Me: (Nodding, smiling) So really practicing cultural humility as providers – being familiar with cultural practices and nuances, and holding it all lightly – avoiding assumptions and allowing the client to guide the work that way. So we make cultural and spiritual practices available, and clients know that they’re there if and when they’re ready to pick those practices up. It all contributes to a culturally safe environment.  Cultural safety also involves addressing ethics in a culturally responsive way.         (Mental Health Commission of Canada, 2012)   (Garcia & Tehee, 2014)  ekâ kakisipahk: One thing I've found is it’s really important to address the nature of confidentiality beyond the limits to confidentiality in the Western context. So talk about, from the get-go, how the counsellor will navigate running into the      189 client in community or in another context. Often I say, "there's times we'll run into each other, and I won't ignore you because then I'd be ignoring a whole bunch of people, and that would be more suspicious. I generally just smile and say hi as if I was seeing anybody. You're welcome to initiate a conversation with me, but I do not initiate a conversation." I've found it's really important to talk about what will happen if there are overlaps with the people I work with. So I might be working with two people and figure out over several sessions that they're actually related, like either closely related, or I've been working with two people individually and then they've gotten together as a couple, but I can't disclose that there's a conflict. So navigating those sorts of ethical trickiness that happens in a small community.  Me: (Nodding) Absolutely. I often saw clients in the community during internship, so those conversations were always at the forefront. In my experience, people didn’t necessarily suspect I was someone’s therapist because I was so immersed in the community and talking to everyone. So often my conversations with clients in session were more around whether they felt okay that they’d be seeing me in community. All of them said yes. It ended up feeling totally normal for me to be around clients at community gatherings                       190 and events. iyinisiwak also talked about being flexible and client-centred in how we structure our services – from session lengths to the hours of our work day, to session location, to shifting organizational policies to meet client needs. This is also congruent with the literature that cites the importance of flexibility in session times and locations.           (Trimble & Thurman, 2002)  Karl Lee: Create a safe, sacred place outdoors or in an environment where they feel comfortable. No time limit. Some will talk for five minutes, some will stay for three or four hours. When dealing with an Aboriginal person, don't cut them off and say, “that's really important, but we'll pick it up again next week.” We've never worked that way.   Kink'inap: And what works with Aboriginal people is emotional support outside of hours. There's a few people that that need more than 9 to 5. Like this one woman I work with, she's having a really hard time, and I tell her, “I'm gonna give you some other options, but if you really need to talk to me, I have my work phone and you can phone.” And that's just kinda the way it is. I can't just turn my phone off and cut you off at 5pm on Friday. I have boundaries, you know, don't call me at 11 at night, but when there's crisis, you hafta be there, right?      191  âsokanihkêw: I think it'd be great to offer accessible, i.e., free, long-term counselling. Actually having somebody who's in your life who supports you and trusts you. People talk about residential school and how parenting skills were so damaged, but that's often what people go to therapy for, to get some form of supportive, affirming relational context. How are you gonna do that in 12 sessions? 26 sessions? I'm not sure. It's hard enough with the one-hour slots that we're working in.   Me: For sure. And offering that kind of relationship really facilitates a foundation of trust.   âsokanihkêw: We're often pressured to work in a brief counselling model, but when you're working on colonialism at the systemic level and how that impacts the individual in all their relationships, it's practically impossible. The trauma has impacted one's ability to trust for good reason, and to build a trust-based relationship is paramount. So in getting to work with Indigenous clients who have been severely traumatized, the ones that have the best outcomes, as they would put it, are people who built a relationship with me.  And when we're learning counselling it's like "oh this intervention or that intervention." I had to constantly be saying, “it's the relationship and be humble and be with that      192 person where they're at.”…We're all sort of rushing to "wellness" as they put it in settler terms, healing from colonialism. I feel like there's that real push, and I don't know if that gets us there any faster.  miskinâhk: Again, the importance of slowing the pace in establishing trust. (Lokken & Twohey, 2004)  Bob: I think one of the most important skills you can have is very empathetic listening and consistency. Say what you mean and mean what you say. Be there on time.   miskinâhk: It is critical that therapists demonstrate empathy, warmth, respect, concreteness, and availability with Indigenous clients.    (Trimble, 2010a)  Bob: For me, the most important thing when I'm workin’ with First Nations people, and especially if they have severe trauma, is that initial relationship building. I went to a workshop once, and this Elder explained it, “if you go to a restaurant for the first time and you get bad food and bad service, chances are you're never goin’ back. But if you go to a restaurant that you been going to for a while, and maybe that day the service ain't that good and the food ain't that good, but the other 10 times have just been great, you'll go back, you know.” It's the same with people. Those first initial meetings are crucial.      193  Me: That was a challenge during internship! We had to complete diagnostic interviews in our first couple sessions with people – a whole review of ‘presenting issues’ and nearly every intimate detail of the person’s life. That process has major potential to interfere with establishing a trusting relationship from the get-go.  I had to learn how to navigate those systemic requirements while prioritizing the relationship, which required lots of creativity. For me, this involved being transparent about the intake process and my feelings about it, and ensuring the relationship took priority over the intake interview, which often meant delaying the diagnostic evaluation. Fortunately, my supervisors were flexible and open to that.   Kink'inap: And just being really supportive and always being there and being consistent. Like I know a lot of times stuff comes up. Like with our people, people die, there's just so much shit that happens. So women miss appointments, so calling, saying, "hey, I know you missed your appointment, do you wanna reschedule? Don't worry about it, it's okay."   Me: (Nodding) A very different model than places that have penalties for no-shows! iyinisiwak cited this kind of flexibility and openness as key in miyo wicehtowin.      194 Another critical part of miyo wicehtowin that iyinisiwak talked about is being real. Being genuine and authentic and ditching the expert stance we may have been inadvertently – or directly – taught in school. Our people are perceptive, and hierarchies or pretences will only further colonial mistrust and relational trauma.   Bob: I'll give you an example. (Laughing) This guy came in the other day, wanted to teach a harm reduction course or something straight out of university. He's telling me, "I don't like to walk down here because I'm othering people," and I'm like, "what does that mean?" (Bob and Karlee laugh) I don't even know what that means, and it's like, when you have your Gucci bag and you're all dressed up – and I'm like, “oh god, I don't even think about that, just relax and be yourself.” (Bob and Karlee laugh)  I think the key is just being yourself, being a human being. If you're too stuck in your head, you're not in your heart, people can feel that. People are very sensitive and perceptive out on the street. They have to be. They can feel if you genuinely come from your heart. And how do you get to your heart? Well everybody has a different journey there.   Karl Lee: I don't need a video, I don't need a textbook or a manual, I just need the person sitting in front of me. Five      195 minutes in the chair gets you the next five minutes if you know what you're doing. They'll disengage right away if you ask the wrong question or make it too impersonal. Especially First Nations people. They want somebody who they can engage with, somebody they can trust, somebody they can have a conversation with… And don't be scared to offend people or trigger them, because if you're honest and you own up to it, they'll forgive you and they'll move on. It actually builds honesty, integrity, and trust, and shows that you're human. Shows that you do have feelings, that you do make mistakes, that you're not perfect.  miskinâhk:  Genuineness and congruence are important with Indigenous clients.   (Trimble, 2010a)  Cog: (Nodding) Another overlap with client-centred and humanistic therapies, as well as common factors research. (Rogers, 2007; Wampold, 2001)  miskinâhk:  In addition, there’s the importance of provider self-disclosure with Indigenous people. This is congruent with Indigenous approaches to healing, and promotes a trusting therapeutic relationship between the helper and the person seeking help.    (Garrett & Garrett, 1994; Linklater, 2014; Lokken & Twohey, 2004; Ross, 2014)    Bob: Sometimes I just try to normalize things. People will feel guilt and shame about something they've done, and      196 sometimes I’ll share my own story a bit.  I was talking to a girl and she was feeling bad ‘cause she was coming to visit her kids under the influence of alcohol and drugs. I said, "oh I remember one time when my kids were sick in the hospital when I was younger and I missed them, so I ended up scaling the wall of the hospital like to the 5th floor and sneaking through some doctor's offices to the maternity room, and caused all kinds of trouble and social work and security and everything else was called. But the bottom line, as a parent who missed their child once, it's the driving force. Your initial reason for being there was the love from a mother to a child.” So just really trying to normalize it and turn it around somewhat.  Me: (Nodding) At IHB over the past year, I self-disclosed more than I ever have in my clinical work in the past. Obviously it was done with clinical judgment and consideration, but it was an essential part of building trust with the people I was working with. Getting to know a bit more about me as a person was critical in establishing that healing relationship. Self-location was also a part of this – letting all my clients know who I am and where I'm from. Self-disclosure was a normal part of our therapy groups as well, as we used talking circles. As iyinisiwak described,           (Waldram, Innes, Kaweski, & Redman, 2008)     197 healing happens in relationships. So not surprisingly, they cited therapy groups and collective interventions as powerful places for healing.   miskinâhk: Group therapy and other collective approaches to healing are important with Indigenous peoples. Traditional healing often occurs in a group context. There are a number of Indigenous approaches to group therapy, such as medicine wheels, talking circles, and healing circles. Healing in circles is strength-based, and reduces therapeutic power dynamics by facilitating equality, humility, and respect.        (Ross, 2014; Warner, 2003)    (Ross, 2014)  Rain: I remember doing a domestic violence support group that was really powerful. We embedded a lot of women's teachings and had an Elder, things like that. I remember doing a group on learning values and what they mean, and that again was with an Elder and teachings that were traditional but diverse. Everybody brought in their different teachings ‘cause people were from different places, and that worked really well. Another group that was really powerful was sort of like life review, but where people would tell different aspects of their life story – so traditional in that sense.  I find people connect really well on that social level and learn from each other. It emphasizes the diversity, different teachings, different experiences, different levels of knowledge      198 and awareness. That was always nice because you have the people who may have grown up traditionally with people who are just becoming exposed, you know, that whole community relationship group. Everything was always done in a circle. We always had food. I've found groups really effective once you get people there, right, once they buy into it.   Kink’inap: We have a women's drum group. A lot of the women come in, and when they first come a lot of the women will pass. And then they learn and they'll sing. But it's about finding your voice, right?  We do a check in too, so you're able to talk about what's going on, having food, and coming together. A lot of the women have had similar experiences. We had a woman that was having a really tough time grieving the loss of her partner but she didn't wanna share. I'm like, "well you can just come and listen to the music, listen to the drums, and just be there. Instead of being at home alone, just come." And so she did. So when it was her turn to share, she just passed, and then someone else shared and shared the exact same thing she was going through. So they had a connection and then the healing just happens. And like I don't have all the answers, and other women can have input and just learn from each other.   Me: (Smiling) Building community. (Linklater, 2014)     199  pisim iskwew: This is the fourth, for some the fifth, generation that have experienced the policy of genocide. There have been horrors that people have been able to live with up to this point without having a total psychotic break. I have talked to our knowledge keepers and our Elders about what has held us together – it's our relationships, it's our family systems, it's our communities, and it's our worldview and our belief system.  When you move out into the urban system, you become vulnerable because you're leaving behind all those things that have kept you resilient. So that's something we have to recreate in any mental health service we develop. We need gathering places, and we really need to encourage our people to join groups wherever they go because it's the relationships that keep us well.   Me: So having that space to connect with each other and heal together – perhaps a particularly important consideration in urban environments. This brings to mind what we talk about in Aboriginal Focusing Oriented Therapy – AFOT – that collective connectedness, sharing our stories, is healing. It’s restor(y)ing. It’s very powerful to realize that the pain and grief we’re experiencing is shared. But more on that when we get to iyiniw kiskêyihtamowin the South… (Winks at Cog)     (Linklater, 2014)   (Turcotte, 2012)    (Ross, 2014)     200 iyinisiwak also talked about the importance of miyo wicehtowin beyond clinical relationships, extending to relationships among staff and between staff and supervisors, disciplines within multi-disciplinary organizations, the organization and the community, and the organization and other organizations in addressing the holistic needs of clients. These relationships must be healthy in order to provide the best care possible to clients.  ekâ kakisipahk: The same elements of what you would want in a non-Indigenous practitioner working with an Indigenous client are the same qualities with different nuances that you'd want with a non-Indigenous practitioner supervising or debriefing with an Indigenous counsellor. So really solid supervision that's culturally safe.   Me: Based on my internship experience, the importance of culturally safe and appropriate supervision can’t be overstated. It was key to my being able to work with clients in a culturally safe and appropriate way. Extending from good relationships between staff and supervisors, good relationships between disciplines and services is also critical.  At IHB, we strived for this, and strategized about ways we could collaborate more in coordinating client care between medical, dental, and      201 counselling. We also increasingly focused on cultural and spiritual service coordination as we worked to decolonize and Indigenize our services.  Karl Lee: To fit into our model of being healthy and successful, it would take a team of people. It takes a village to raise a child, right? If the physical, mental, spiritual, and emotional teachers are all different people who don't know each other, who never share notes, it's probably more hurtful than beneficial. You need all four…Nobody working alone in silos, everybody's on the same page so they're not getting four different teachings and going in four different directions. To address mental health, you need everybody networking together.   miskinâhk: A holistic approach to wellness is essential. As is providing services grounded in good community relationships. (Linklater, 2014; Ross, 2014)  askîy: We opened up a Native talking circle around things that need to happen on the Downtown Eastside that are stemming from the protocols of this territory, and what kinda services, who are the medicine people, who are the people that are doing good work – who's here, who's invested, and why?  We know who everybody is. We know who the Elders are and we know who the medicine people are because we do ceremony together all the time. So when we're gonna go ask      202 for something, we know who to go ask. We already have the pool of people to draw from.   ekâ kakisipahk: If there could be a web like that of all practitioners in an urban environment, that understanding and connection and ability to refer to different people based on what's needed, that would be amazing.   Me: So those community relationships are important so we can connect our clients with networks for their holistic wellness. These relationships also help us deliver services in a community-based way, respectful of protocols and responding directly to the needs of specific communities.        (Linklater, 2014; Ross, 2014)  Running Two Bears: So our organization is really lucky because it has a history of about 20 years and was started by Aboriginal people, and has maintained 50% or more Aboriginal staff throughout its entire history. That process has led to a network of Aboriginal Elders and knowledge keepers that staff and managers can draw on, so when we work with somebody of a particular Aboriginal ancestry, we almost always have somebody that we can talk to from that nation that's a vetted knowledge keeper that can help us develop that policy.   Me: Right. And iyinisiwak discussed the importance of good relationships with non-Indigenous people and organizations in         203 helping us do what we need to do to best serve Indigenous peoples.  (Linklater, 2014)  Rain: In one organization I was working we shared space with a non-Aboriginal organization. I remember there was a big issue about smudging – they were concerned their clients would get triggered by the smell. So there's those things you hafta navigate. I find one of the most powerful ways of doing that is through relationship. If you have a good relationship, it's a lot easier than doing it with anger and frustration.                          iyiniw kiskêyih-tamowin (Indigenous Me: (Karlee passes the pouch of tobacco around the tipi, and each person takes some) So miyo wicehtowin extends from the provider throughout the web of relations of the people we work with and the communities we serve. In the work I did with IHB’s strategic planning, we put miyo wicehtowin at the heart of the plan as our primary value. In the local languages of Dakota and Anishinaabemowin, da ya unk unpí and mino-inawendiwin. This is a critical ethic in Indigenous ways of knowing, being, and doing, and the tobacco helps us maintain that ethic. (Everyone offers his or her tobacco to the fire. Karlee sets down the pouch of tobacco and picks up a bundle of sage, cedar leaves, and a braid of sweetgrass) From the starting place of miyo wicehtowin, we move to iyiniw kiskêyihtamowin in the South, Indigenous knowings or                   (Ross, 2014)              204 Knowledges) knowledges – our original instructions. (Karlee picks up and smells each medicine, passing them to Cog) iyiniw kiskêyihtamowin is represented by sage, cedar, and sweetgrass. Along with tobacco, these plants are referred to as the four sacred medicines by some Indigenous groups. Honouring these four sacred medicines has been one of the teachings I’ve received. These maskihkîy teach us and help us to live healthy lives.      (Anishnawbe Health Toronto, 2000a)  (A. Young, personal communica-tion, 2011)  Cog: (Smelling each of the medicines) So these are traditional teachings?   Me: Good question! (Karlee and Cog exchange smiles) iyiniw kiskêyihtamowin refers not only to traditional teachings and knowledges, but also to contemporary Indigenous knowledges. Indigenous knowledges are fluid and relational. They are influenced by adaptation to current environments and contexts, which means they’ve changed with and consider colonial contexts. Plus, all we’ve experienced through colonization has become part of our knowledge systems and collective wisdom. (Smiles widely)       (Dei, 2011; Ross, 2014)        Water: So the idea of Indigenous perspectives is that we are a hardy people. We've had to be especially hardy given the mass amount of death and murder and mayhem caused by colonization. We've had to especially become hardy around      205 complex trauma, and we're just learning how to not only beat the odds, but to help those odds make the world even. Because our responsibility to humanity and to earth itself is profoundly alive in the roots of Indigenous peoples, and the complex traumas that we’ve undergone and survived can work towards better change for all peoples.  So it's recognizing that some of this Indigenous knowing not only just informs ourselves, but can inform the Western world. I like to think that we're the leaders of complex trauma. (Laughs) Not the victims of complex trauma – the leaders – because we've learned so much and have been through so much. And then with our deep philosophies, have the ability to not just make good mental health strides for ourselves, but for all peoples. So there's that sense of connectedness and responsibility to all peoples.  Me: (Eyes closed, smiling wide) Oh that gives me goosebumps! (Opens eyes and looks at Cog) iyiniw kiskêyihtamowin has so much to offer our world today.   askîy: I'm gonna start off with a story. All my life whenever I'd be around horses, their noses would flare and they'd be hittin the ground. My stepsister had horses, and she's like, "k c'mon, we're going horse back riding," so I'm like, "oh okay." So I get on this pinto, Sundance, and he bucked me off, eh?      206 When I got into recovery, my heart would start racing. What triggered it was I was helping some people push cars up a hill when it was snowing. Suddenly I just got panicky, and I got in my van and took some deep breaths. Then every once in a while, that panic would hit me. So the first year that we're going fasting, early that morning I sat right up in bed and I was like, "whoaaa, how am I gonna sit in that one little spot? Like I'm never gonna be able to do it.” And I'm like, "okay, okay.” I knew I had to take the staff and youth from work, and I had to sit there – there's no way I could leave even if I wanted to.  Before we go up, I’m sitting there with the medicine woman and her sisters. My daughter was beside me. When they got to my daughter my heart started to go, and I was quietly calming myself down, and they go, "when those horses came galloping in, we thought they were here for your daughter, but they were here for you. And you have a black, a brown, and a white horse that sits on your shoulder," and I was like, "ahhhh hiy hiy!!” It was like, I just totally understood, I knew then that those were my spirit helpers. I've never had a panic attack again. Every time that happens, I know they're coming in to help me. Had I gone to a doctor, we all know what would've happened. I would've got medicated,     207                                                 66 Plains (y) Cree for thank you gotten the handy old antidepressant, and I'd have never gone through that rite of passage.  I share that story when mental health comes up and tradition and Western medicine, because to me that's the most powerful way to say, you know, we have ceremonies – we have ways of dealing with the things that happen in our lives.  Me: kinanâskomitin66 askîy… Your story is such a beautiful illustration of iyiniw kiskêyihtamowin from conceptualization to ‘treatment’ from an Indigenous approach. These are the stories we must keep in mind when we engage iyiniw kiskêyihtamowin in our work.   miskinâhk: Such stories convey the deeply spiritual nature of working from Indigenous perspectives. Spirituality pervades all aspects of the work. (Duran, 2006; Linklater, 2014;  McCormick, 2009; Ross, 2014)  Me: (Nodding) It does. Spirit is the starting point, and is part of a greater relational, holistic approach to wellness. iyinisiwak talked about how iyiniw kiskêyihtamowin influences how we think about “mental health,” in that it is really about holistic wellness.   (Ross, 2014)  Running Two Bears: Aboriginal approaches to wellness in my understanding would never focus on mental health in isolation of the other aspects of health and wellness that are so      208 important to Aboriginal people and cultures. They would see mental health as something that's fundamentally connected to physical health, emotional health, and spiritual health, and so when we're addressing mental health, I think we need to understand that even though that's a buzz word and that's the way that the colonial institution of Canada has decided to build their institutions, it's not effective without addressing the other pieces.  Karl Lee: One of the best examples I heard is the four tires on your car. If one of your tires goes flat, the car rides lop-sided. It can damage the whole car, everything's uncomfortable, never runs right. If that tire wrecks, you go get it fixed that day. But you go through life like that (motions lop-sided car driving) without spiritual connection or mental health, where you're riding all lumpy your whole life. (Everyone laughs) It's hard to stay on the red road when your car's all over the place. So you have to look after all four for the whole to work successfully. All the smaller parts have to be taken care of on a daily basis.   Me: (Nodding) Exactly. This message was so pervasive among iyinisiwak that I’m no longer using the language of “mental health” with the exception of contexts within which it’s necessary for communication. iyinisiwak have taught me             209 that what we’re really discussing is the holistic wellness of Indigenous people, families, and communities. This holistic focus is consistent with the literature as well. So even though this research focuses on counselling and mental health, one of the primary lessons from this work is that we need to go beyond that. Fortunately for me, IHB provided medical and dental services, making this process easier at my internship. We also put flexibility and holism into practice at IHB, as our counselling department initiated and engaged in traditional medicine making, sweat lodges, drumming and singing groups, talking circles, and regular integration of cultural practices such as smudging. We also strived to offer healthy food options in our groups, and I had many conversations with clients about the importance of spiritual, emotional, mental, and physical wellness and their relationships with one another. I often used the medicine wheel as a framework to facilitate understanding of this. Along with this holistic focus, there remains an important place for psychology in all this…(Looks at Water, smiles and nods toward her) Particularly Indigenous, all my relations psychology. (Winks at Cog)   (Fiske, 2008; Hart, 2002; Linklater, 2014; McCormick, 1996; Mehl-Madrona, 2003; Ross, 2014)                        (Linklater, 2014)  Water: It’s really important that Indigenous perspectives of      210 attachment be forefront in practices. What that looks like for me is to approach things from an all my relations perspective, which means that within the helpers and those being helped, the feelings and emotions and triggers that come up don't necessarily just belong to them. They're intergenerational sometimes, and they're also the story itself.  In Indigenous belief systems, the story is very important. In story, the emotionality and reactivity and fallout that Indigenous peoples experience from both working with Indigenous peoples, and from having lived Indigenous experience, is a collective fallout. So it's a really shocking thing to say to somebody that the feeling you have in your body is not necessarily a you feeling, it may be an our feeling, or may be a feeling that comes up from the time where an experience was lived, and that feeling or fallout may be a collective fallout, not even your own, it may be vicarious.  So the whole idea of looking at psychology from an Indigenous, all my relations perspective is not as complex as people would like to believe. You can teach Indigenous psychology. We're just so not used to looking at psychology through an Indigenous lens, so it becomes confusing for people just starting, and you really have to step out of Western thinking and Western psychology in order to recognize what     211 even I'm talking about when I'm talking about Indigenous and all my relations psychology.  miskinâhk: Such an approach defies the individualism of dominating Western psychology through centring relational Indigenous perspectives on wellness and healing.     (Ross, 2014)  Cog: (Nodding, thoughtful) Wow. It may take a while for me to wrap my head around that. (Chuckles) My question would be, from what I’ve learned from you before, Karlee, and just kind of piecing together what I’ve learned from other critical scholars, isn’t “Indigenous psychology” kind of a paradox?   Me: (Laughs) The short answer is, kind of. Fortunately Indigenous psychology, and perspectives generally, embrace ‘and/and’ – paradoxes are part of life. Dichotomous, ‘either/or’ thinking is part of colonial philosophy.  Part of it goes back to what Water was saying about Indigenous peoples being the leaders of complex trauma. While psychology is founded in colonial epistemologies and has been a tool of colonization and oppression – a product and producer of colonization – in this way, it has become part of iyiniw kiskêyihtamowin. How psychology has impacted and continues to impact us has become part of our collective wisdom. This affords us the opportunity to take what is useful in psychology and apply it from Indigenous perspectives in a                          (Gendlin,     212 way that works for our communities. For example, the way AFOT has adapted Gendlin’s focusing. Further, articulating an Indigenous psychology is living contemporary Indigeneity. It is time for us to claim our own space in the field of psychology, to define an Indigenous psychology that has the potential to empower and heal our communities. To rise up and speak with our Indigenous voices, no longer allowing colonial psychology to speak about us or for us.  Many times during this journey, I have had people ask me why I’m in counselling/clinical psychology doing this work – why have I not chosen social work or community psychology? My first answer is that’s simply not my path – I’ve been guided to be here doing this work for a reason. My second answer is because the fields of counselling and clinical psychology have oppressed our people for too long, and it is time for us to claim Indigenous space in these fields. (A collective “yeah” echoes among iyinisiwak. People are smiling and nodding. Cog is smiling and nodding with tears forming in his eyes) 1981; Turcotte & Schiffer, 2014)  Water: People come in with their minds already made up that they're pretty fucked up. You have to unravel that colonized Western thinking to embrace what's really happening for      213 them. Once they get to the bottom of what's going on with them about a particular issue, it's quite surprising how basically well they are.  So we think of people as being well. We don't think of people as being broken or not well. I don't think of people as “needing healing.” I have trouble with those concepts. I always think of people as very well, and just maybe needing to be more informed about what's happening for them, and helping them come to the realization of their incredible interconnectedness, their knowing, their resilience, their incredible hardiness, their compassion, and their amazing spiritual abilities that might have been misunderstood as being illnesses.  So the framework about what is psychological wellness is up for debate. Indigenous psychology has a whole different framework. So if you're coming in rolling over in agony, you might be considered really unwell from a non-Indigenous perspective. If you're rolling over in agony from an Indigenous perspective, instead it’s, “oooh this is interesting. I wonder what's trying to get your attention? Let's see if we can see what's going on. Let's see if we can lay it out interconnectedly to find out what the message in all of this is, so we can help you along.”      214 A lot can happen in one single session, it's quite shocking. But right away we begin with, “you are a perfectly well, whole, interesting human being that is interconnected on many layers to many things, and there's a story in all of this that may be really helpful to you.” …So the idea that the intergenerational trauma is actually a teacher. The experiences you've had that were traumatic can actually inform you in a positive way.  miskinâhk: Such a strength-based perspective is characteristic of Indigenous approaches to healing, as is seeing the fundamental goodness in people. iyiniw kiskêyihtamowin involves de-pathologizing, focusing on and nurturing people’s gifts and strengths.      (Hart, 2002; Linklater, 2014; Ross, 2014)  Me: And while the argument can be made that certain approaches, such as those in humanistic and positive psychology, maintain strengths-based perspectives, it still stands that mainstream Euro Western psychology tends to approach clinical work from a deficit-based, problem-solving lens.           (Ross, 2014)  miskinâhk: “‘The mainstream is always talking about illness and sickness…’”  (Linklater, 2014, p. 79)  Bob: A long time ago our take on mental health was a lot different than it is now. I don't think we seen people in such a      215 diminished capacity. We really held them up as a gifted individual.  I remember this one Elder was telling me once, and she had a grandson with Down's syndrome, and she said, “they were one of the most sacred people on earth because they never have the capacity for evil. They always have the innocence of a child their whole lives.” I remember it really changed the way I looked at people. And I think the same with people who are schizophrenic, you know, they have a lot of gifts that maybe they don't know how to manage. One time there was people who would mentor them and coach them, you know, show them how to utilize their gifts so they weren't overwhelmed by them.  Resurgence: Maybe they have contact with the spirit world but they aren't able to control it. They start talking about hearing voices and having visions. At times, they're actually potent spiritual visions, where it's their ancestors telling them what to do, but they've been diagnosed during that time because if you tell a non-Native person that you hear or see things they think you're off the wall or crazy, and that's not the whole story. You have to find out. Not just commit them to psychiatric medication right away because it's like that medication makes them more psychotic. Drives them deeper.       216 Medication isn't always the answer. Ceremony a lot of times is. (iyinisiwak nod) But they don't go there. There's no pre-step. Maybe this person needs to see an Aboriginal counsellor before they see a non-Native psychologist or psychiatrist to determine if maybe they need to go on a fast, maybe they need ceremony to be able to go understand the visions and the voices that they hear.  miskinâhk: “Honouring the spirit and spirituality.” (Linklater, 2014, p. 82)  Karl Lee: Remove labels. They’re not Indian, they’re not FAS, they’re not ADHD, they’re not bipolar, they’re not anorexic. Just ask them what their name is, and whatever name they tell you, that’s the only label or marker you use with that person every time you see them. Historically in First Nations communities, there were no such labels. People were accepted for the gifts they had. Everybody was a blessing, everybody has their own teachings, everybody has different gifts. Their brain works in a different way, that’s all. And if you allow them to nurture that and feed it and use it, you can learn something from everybody.  Because if you remove the judgments and labels, everybody is worthy, everybody is valuable, everybody is capable of giving love, and everybody is worthy of receiving love.       217  âsokanihkêw: A lot of colonialism is about that intense devaluation. So it helps me in how I position myself relative to the client to be like, if colonialism hadn't happened I would be sitting in the presence of somebody who felt very valued, who had a whole bunch of knowledge, a whole bunch of skills and resources to get through life and to help people do that. The circle would be strong in that way. And when you treat somebody like that, you see them gettin’ that pride ‘cause it is ancestral too, right, like we all carry that strength in us, what has been handed down to us whether we know it or not.   Me: Ancestral resilience, survivance, strengths, gifts. We are so much more than collective and intergenerational traumas. And even still, those traumas become a part of our medicine, our wisdom. What a way to approach this work! (Smiling widely)   Karl Lee:  So make them grateful for what they have and what they know. You know, how to survive every day with a brain that thinks differently than 90% of other people. They probably have really incredible skills. Whatever they're good at, acknowledge and honour that and try to use that more.   If they're starting to show gifts, whether it's art, song, culture, whatever, and you don't know anything about it, somebody in your network probably will. Enhance those gifts,      218 encourage them to nurture them, to bring them forward, to allow them to be shown, to be shared, to be taught. It's huge for somebody to be able to pass on what they're passionate about, what they love, what they're good at, what they like to do all day. If somebody has these gifts and they're told they don't matter, they're not of any use, you can imagine the anger, the pain, the separation, the withdrawal, the closure and everything.   Bob: I share the perspective with people, like we hit over 7 billion mark in the world now, and there's a Maori saying, “there's never been one like me before, there will never be one like me again, I'm unique.” I always try to point that out to people – you have your struggles now, but you also have your strengths. For some people, I think they're kind of taken aback because they haven't really looked at themselves that way.   Me: (Taking in a deep breath, holding the medicines) So it’s critical to centre case conceptualization in Indigenous perspectives on giftedness, survivance, and resilience. These are restor(y)ing perspectives that re-author our individual and collective experiences, accessing, learning from, and transforming with the wisdom and medicine they bring us. (Nods toward Cog) This restor(y)ing is found in narrative approaches, which are congruent with Indigenous use of story                (Ross, 2014;     219                                                 67 Plains (y) Cree for truth in healing. And just as critical in iyiniw kiskêyihtamowin is acknowledging and honouring the death, destruction, and trauma that have occurred as a result of genocidal policy and colonization. This is tâpwe67 – the truth. It is essential in case conceptualization with Indigenous clients, as the individual cannot be separated from the influences of these contexts. Wade, 1995)       (Duran, 2006; Kirmayer et al., 2009; Linklater, 2014; Ross, 2014)  Running Two Bears: For me, addressing Aboriginal people needs to be done within a context of understanding the historical reality that's brought them to where they are. Understanding the legacy of colonization and all the stuff that comes with that.   onîkânew: Over a 500-year period, a lot of our nations went extinct. After that genocide happened, the residential schools happened…the abused became the abusers. So it was rampant with sexual abuse, physical abuse, mental abuse, alcoholism, drug addiction, all of those things that come out of trauma.    Karl Lee:  Through spirituality we're starting to recover again. We have more people who are realizing that drugs and alcohol aren't the way to deal with your feelings or your emotions, but ceremony is our way. My uncle used to say "our way is the best way for us.” He used to tell us, "drugs and      220 alcohol aren't for us – that's for the Europeans, they're the ones who brought it over. They're using it as a weapon against our people, and you guys are allowing them to."  You don't realize that at a young age, you think you're just partying, you're just having fun, but everything snowballs out of control, which just amplifies all the mental…I don't know if they're mental health issues – those are labels given to you by Europeans – you're hurt.  Me: As providers working with Indigenous clients, having an understanding of these histories and contexts is critical. And the literature has been saying that for a long time. Understanding tâpwe then connects back to our collective resilience and healing. (Duran & Duran, 1995; Duran, 2006; Kirmayer et al., 2009; Linklater, 2014; Ross, 2014; Truth and Reconciliation Commission of Canada, 2015a)  pisim iskwew:  Clients know they don't have to explain anything about their circumstances because you already know 90% of the circumstances of our people, so you're familiar with the history, you're familiar with the impact of that history, and there's a knowing that there's no shame. It's not internalized as being an individual problem – we're all in this together, and we've all been impacted the same way.  The way we work with the individual is not asking them      221 what's wrong with them, but it's approaching them from "what do you need today?" We're proud that we can move in this world and get the job done knowing that we have all these worries around us.   opakahamâw: We've got to learn to forgive too. Makes us stronger. Why do you think the Creator sent those people to this country? Because we were strong, we could survive what they've done to us.   Karl Lee: They keep doing stuff to try and break us apart, but our spirit is so strong it always backfires. It always pulls us together, makes us stronger. Colonization was supposed to destroy us and wipe us out. It pulled us all together. Putting us on reserves was supposed to destroy us. It made us so strong – we wouldn't have made it on our own – it’s what allowed my family to survive. Residential school was supposed to destroy our spirit and break us, and it pulled us all together. We just keep getting closer and stronger and healthier.   Me: Survivance, full circle! Colonization, trauma wisdom, healing – it is all connected. âsokanihkêw also raised the point that contemporary colonial contexts influence mental health concerns that would not otherwise exist, pointing specifically to the diagnosis of Dissociative Identity Disorder (DID).      222  âsokanihkêw: (Nodding) I had been looking through a lot of non-Native treatment approaches, but wanted to meld approaches to be effective, and this person said to me, "you should take this person to see a medicine person because that would be seen as a spirit that has infected and haunted the person." But to me that was kind of writing off the severity and complexity of the problem, and how experiences of captivity lead you to split – not something from the outside coming in – you just experience yourself as fragmented.  So something that really needs to be developed is an Indigenist approach to DID. Most people don't even see it though. Being Native practitioners, if we're always thinking in terms of culture and spirituality and how to restore what was traditional, we're gonna be missing certain things clinically that are a product of colonialism. So we can't necessarily be drawing so quickly on traditional practices for the solution because it's borne of a colonial problem.   Me: So, again, it’s important for us to hold all of this complexity in our work by meeting people where they’re at and not making assumptions, as we’ve discussed. (Smiles at Cog) So iyiniw kiskêyihtamowin informs case conceptualization, which then naturally flows into our interventions – from what we do in therapy sessions to holistic      223 service provision more broadly.  âsokanihkêw: One value of Native culture is that we all are interconnected, and there's something about us being human that connects us all. Insofar as that's the truth, there is something that's possibly useful from non-Native psychology, and I'm learning how to do that from a Native, humanistic, relationship-based approach. Like switching the metaphors so that they're Native.  I was working with this non-Native woman who I cold called one day and said, "I'm seeing DID in my office and I need some supervision." She gave me this containment exercise and it was in non-Native terms, and I switched it into a Native journey to safety. People really liked it. So just using the cedars, their grandmothers or their grandfathers, and having the eagles there – was an effective way of translating. But there's always that translation that has to happen.   onîkânew: I think it's important to be adaptable, to be innovative, to figure out what somebody might need and what's successful, to take what is successful, and put ownership to it by translating it to Native legends, stories, teachings. And then it resonates more.    Me: Existing organizations, such as Tsow-Tun Le Lum, Indigenize interventions in this way through adapting         224 interventions such as psychodrama, emotional freedom techniques, storytelling, and genograms as part of a greater program addressing Indigenous holistic wellness.   Indigenized interventions may also be applied within a framework of Indigenous, all my relations psychology that is grounded directly in iyiniw kiskêyihtamowin.     (Fiske, 2008)  Water: When I'm sitting with an individual or family, that individual isn't the only one there – it's everything that's connected and attached to that individual. So the therapy itself is collective, whether it's sensing into whether the ancestors are there, or whether the trauma piece is there, wherever we are in time – it's all that's related to that place and time.  So if somebody is coming in with intolerable despair, we break that despair down to see where that's coming from, and what it has in it that might be useful. You are not the despair, the despair is there – it’s a conversation and it wants to talk with you, and whether that's intergenerational despair or whether that's a despair coming, ‘cause from an Indigenous perspective it could be past, present, or future. And there's a way of being able to sit with a person, you can tell whether that's something that's from far away, or whether that's from the now, or whether that's a becoming. So whatever work we do in the now actually has an impact in other generations.       225 And it's amazing for the person sitting there because they realize that they're so much bigger than all that's happening. People come in with the idea that everything that's happening is all about them, and they're severely and seriously overwhelmed because they're so full of so much complication, complex trauma, memory, all sorts of things. Once you slow them down and help sort them out, they're so surprised and so relieved to find out that they're much more spiritual than they ever realized, and that they have a depth to them, and that their traumas are not there just to hurt them, but rather to help them.  So there's a whole different type of relationship with your complexities that you can bring to Indigenous psychology, that your symptoms are not necessarily your enemy. Your felt senses are creative ways of intergenerational conversations that might be very meaningful for the work you're up to now.  miskinâhk: This way of working is a very natural fit with existing conceptualizations of collective, ancestral, intergenerational, and historical trauma.  (Brave Heart, 1998; Duran & Duran, 1995; John, 2004)  opakahamâw: I tell them, “I'm gonna ask your permission to talk to your spirit so we can work on you.” So they say “okay.” I tell them, "you're a shell. Now we don't know who      226 you are, you're not the person you came to earth to be. We're gonna bring you into the person that you are really are supposed to be here.”  miskinâhk: (Nodding) Spirit is always at the centre. “With hard work we can nurture our spirit, learn to recognize our gifts and begin to honour our responsibilities.” (Linklater, 2014; McCormick, 2009) (Ross, 2014, p. 252)  onîkânew: I was pretty lucky to have a vast variety of Indigenous male teachers – South American, Mohawks, Ojibwe, Cree, Lakota/Dakota/Nakoda, Blackfoot, Haida Nis'gaa, Interior Salish, Coast Salish – so I sought these teachers and it all came down to the same thing. (Using his finger, draws a medicine wheel with four quadrants in the earth, gesturing to the quadrants as he speaks) Physically, spiritually, mentally, and emotionally, when we're born we're born perfect. (Points to the centre of the medicine wheel) Right there in the centre we're perfect – no prejudice, no anger, no hate, no judgment.  And that's a balance of these four things. (Gestures to quadrants of medicine wheel) And our ceremonies resemble, no matter what culture it is, that rebirth of what I'm talking about – the beginning.  When you're done Sundance, they say, "happy new year" – it's a new beginning. You go to sweat lodge, you leave refreshed and feelin’ good. And same with      227 the longhouse – you go for spirit bath or you go through some parts of the ceremony in the smokehouse, it's a new start. So is our potlatch.  What our ancestors did is they narrowed it down, so if we look at love and when a child is born, what are the things we need to feed our children when they're born?  What they didn't receive when they were 1 to 10 years old, let's figure it out. Were you loved, were you nurtured, or were you culturally spiritually mentally emotionally neglected? Were you hungry? Were you clothed?  Did you have stress? Were you abused? If those things have happened, let's replace it.   opakahamâw: Just be somebody to try and equal everything. Balance them. Back off if you think a person's getting nervous. Are they looking forward to your visit every week? Give them something, make them laugh. Laughter and enjoyment is good for them. Even when they're drunk and being angry, you still gotta do it ‘cause they never had that before.   miskinâhk: Humour is so important with our people.  And balance is synonymous with wellness from many Indigenous perspectives. Balance among spirit heart body mind, ourselves and all of our relations, light and dark – all (Hart, 2002)  (Deloria, 2006; Hart, 2002; Linklater, 2014; McCormick,     228 elements of creation. It is both personal and collective. 1996, 2009; Ross, 2014)  Water: You're not just dealing with the “I,” you're dealing with the “we.” ‘Cause they come in and it's all my, my, my, I, I, I, me, me, me. It's the whole foundation of Western psychology. And so coming from an Indigenous perspective, the narcissism of “I” is not actually in the room. And it's quite surprising because once it gets unravelled, they're only a small piece of what's going on – it's quite a relief. People who sometimes aren't even able to function set a lot of what they're holding down, and realize that they're in pretty darn good shape and begin to feel quite differently quite quickly. Indigenous psychology is very strength-, resilient-, hardiness-based. We just can't afford not to do that right now when so many children are floating between homes. Something like 40% of kids in care are Indigenous, like how could this be? We want our children home, we want our families well. But it's not quite there all the way yet, so all the more reason that we really need to lean into Indigenous psychotherapy and culturally relevant therapies for Indigenous peoples because we don't have a lot of the luxuries that exist for the rest of humanity.   Me: So that collective healing can take place even working with just one person. Whatever healing work the individual      229 does spreads throughout her or his web of relations, including generations past and future. Of course, collective healing can also take place working directly with the collective…  onîkânew:  This individual here (indicating centre of the medicine wheel he drew) has a relationship with their kids or grandparents or parents and everybody. So if we have a kid that's going through problems and we were giving them speech therapy, psychological therapy, everything that we could, but they go home to chaos, how are they gonna be when they come back even though we give them all the therapy? So then we said let's do a wrap around. Let's get everybody involved. Let's work with the whole community, the whole family. And we ended up creating a program that looked at the major characteristics that develop outta trauma: alcoholism, drug addiction, depression, anger, whatever, so we look at those for each individual family member too. Let's start them when they're kids, then when they're teenagers, then when they're adults, and feed them what they need – the fundamentals: love, courage, honour and respect. So we collectively do that with a whole family at different departments – employment and training, social development, education, prenatal – so babies not even born to Elders.      230 Taking a community approach. We went through that genocide, hurt, pain, ugliness, all together. It makes sense for us to heal all together too.  miskinâhk: (Nodding) Given that colonization has impacted the collective, social healing is important with Indigenous peoples. Healthy communities also provide healthy environments that support personal and collective wellness.     (LaFromboise et al., 1990; Ross, 2014)  onîkânew: (Points to medicine wheel) That could be the medicine wheel for the community. How did we collectively grow as a community? How did we maintain and love and respect and take care of our Elders, our children, the widowed, the parent of the children? They were part of the community and the family and we looked after them. We take care of it as well as our land.  Let's go back to what has been successful and worked for 30,000 years, and that's our culture and our spirituality and our spirit of who we are and how we can connect with one another and our land. The more we love ourselves, the more we love everything else, and that includes our land, our water – where, essentially, our teachings come from. Healing is a holistic approach.   Me: And so having interconnected, holistic services based in local knowledges is really important. From the ground up. (Ross, 2014; Waldram, 2008)     231  Decolonize: We need decolonized spaces, so for example cedar buildings, not square buildings made out of unhealthy attitudes and misguided assumptions and unhealthy materials. Spaces that centre and reflect the local Indigenous peoples who's territories we're living in. So that there are opportunities to create better relationships with local Indigenous peoples and sustain healthy ecologies. So through longitudinal research approaches for example: how are we sustaining and creating intergenerational mentorships for maintaining healthy communities? We begin from the community's perspective and then look at the gaps and then making appropriate space for folks, like having yuwipis in the sacred spaces in hospitals, for example, not to take on that knowledge but to appropriately make space for those professional ceremonial/culturalists as their primary functions as health care professionals who are aware of enhancing the human rights of Indigenous peoples.   Bob: The organization I work for, I really like their vision because they started out as a housing agency, but were quick to realize if you don't have the social safety nets to catch people, there's a lot of cracks for them to fall through. So we have a medical clinic, a dental clinic, coffee shop, life skills centre, drug users' resource centre, managed alcohol program,      232 InSite, OnSite, a bank, you know, ‘cause some of our folks don't fit well in the banking system, so it just goes on. We have 19 housing projects and it's all intertwined. Anywhere can make a referral to anywhere.   And it's not very formalized. It's mostly a matter of picking up the phone, phoning the other manager, and they'll do what they can. You don't have to send a referral form in triplicate and get the client to do all this paperwork and da da da. That will get taken care of, let's just get ‘em there first.  And on that note, I think if people are looking for help and for change, if they see you working on it immediately, it does something to their self-esteem and self-worth. If you're like, "come back next week," it's like, "obviously I'm not that important." But if you're like, "okay I'll do that right now - where's my phone?" and you can give them some kind of hope, like hope fuels hope.  Me: I love that – so bureaucracy doesn’t get in the way! And those integrated, holistic programs are saving lives every day.   Resurgence: There has to be the space and cooperation of the doctors and people that are working with them, and there also has to be the right cultural person running the program. It has to be long term.  In this dual diagnosis program, they would have a      233 program and run it for six months at a time. Six months helps them stabilize, but they go back out and right back to what they were using. The whole thing got extended to one year, and after it helped them that far, they extended it to two years, and then five years, and then there'd be other places we could send them to. But by two years they should be stable enough that they can go to school or get job training or work somewhere.   Me: So having the infrastructure to support integrated, long-term services is critical if we want to help people in a meaningful, lasting way. Clearly, the corporation mentality toward health does not lend itself to this. In the long term, though, prioritizing profit over people ends up costing more money, and many people pay for it with their lives. (Shaking her head) Bob also talked about how harm reduction programs as part of integrated services have been very successful in helping some of our people who are struggling with substance use.  (Fiske, 2008; Fletcher & Denham, 2008)   Bob:  So another one of the programs we have is the managed alcohol program. I think of the 10 people in it, eight are First Nations. A lot of them have been to detox hundreds of times and are in the hospital all the time because of drinking non-     234 beverage alcohol, and they are in constant brushes with the law. So we started the managed alcohol program where they get a measured dose every hour. And there's checks – like if their gait's staggering or their words are slurring, they might miss a dose or two. It's done miraculous changes for their lives. ‘Cause some people have too much pain, too much trauma, for them to all of a sudden have to face all that sober at once, with severe alcohol dependency. But as a result their hospital admissions have gone way down, their brushes with the law, things like that.   Another successful program is InSite. Same thing, very inclusive. Nobody has to give a name when they come in there. I've gone right in there to injection booths where people have just lost a family relative, so they're doing their fix. I'm sitting there doing the best I can at being therapeutic and supportive while they're doing that, and just listening to them. Which is a bit interesting – different from the usual counselling office. I mean that's where they feel safe, so you give them the best of what they need.  Me: This is another good example of the creativity of contemporary Indigenous knowledges. As others have mentioned, drugs and alcohol are not our way, but that doesn’t mean that we don’t need to be flexible in service provision.      235 And/and! Again, this comes back to meeting people where they’re at and creatively working to meet their needs in a way that will ultimately be most helpful. These programs save lives. iyinisiwak also talked about how we conceptualize and enact therapy more generally from an Indigenous approach – considering therapy as ceremony and multi-modal approaches as important to our work with Indigenous peoples.  Water: Every session is a ceremony in itself – a therapy ceremony. You're in your lodge with your client and you're doing spiritual work because it is a spiritual session. You can't predict the outcome, you can't predict what's going to take place, you can't predict the visitors that will come, the ancestors that will be there. It's something that is a collective, interconnected experience. So in that way it's very ceremonial. It's really about interconnected relationship. So every sitting is a sacred sitting.   mistahaya: And instead of the traditional talk therapy, utilizing things like somatic transformation therapy, which is just excellent for working with Indigenous clients with deep trauma especially. Experiencing, AFOT, art therapy, just investigating different modes. It's a strengths thing. It becomes about self-regulation then instead of clients      236 becoming dependent on us for healing. They come see us when they're feeling bad or things are getting hard, but then they can do it themselves.  Water: (Nodding in agreement) One of the things that's really important in Aboriginal psychotherapy is to teach the people the tools. Because people are movin’ around, and in Aboriginal psychotherapy, we're so few practitioners at this point. It's hard for people to find therapists, and once they've had that kind of therapy they don't want any other kind of therapy – they want that therapy. And it's good for everybody. It's not just for Indigenous peoples, it's for all peoples. So a lot of times people only get a few sessions and they learn some skills to be able to do a lot of it themselves. It is the kind of therapy you can learn to apply on your own.   Me: Which is so empowering, because people are able to look after their own wellness in that way. And empowerment is an important part of therapy with Indigenous people. Very different than certain conventional Western Eurosettler therapies that rely on the ‘expertise’ of the therapist.  So the final aspect of iyiniw kiskêyihtamowin that iyinisiwak emphasized was the importance of acknowledging and honouring diversity in our work in urban environments.  (LaFromboise et al., 1990; Poonwassie & Charter, 2001)  Running Two Bears: In an urban setting, you have dozens of      237 distinct First Nations. For example, we're serving 500 families from 100 distinct Aboriginal communities that represent a few dozen Indigenous cultures and distinct language groups, each with very different notions about what health and emotional and spiritual wellness are.  And then to recognize that we're also seeing increasing diversity within individuals. So having an organization that can deal with a family that itself is Dutch, Haida, African-American and Mic'maq is a totally different thing, right? What does wellness mean when you get to that level of complexity?  With our program, our first objective is honouring diversity. So it was really important that we included non-Aboriginal kids, so some new immigrants to Canada, and then some of the kids who "identify" as Aboriginal, but are diverse. So we used it as a space to talk about cultural diversity, what it means to be Aboriginal and non-Aboriginal, and how those things affect and orient us in our practice. The program itself is supposed to draw on and acknowledge different global teachings and that they can be in conversation with each other, and that all of them are applicable to our holistic wellness – not just mental health – in a variety of ways.  We've brought in Elders from all sorts of different places. From the testimonials that we've heard from the kids     238 and the way that we've seen them grow, we can see that honouring diversity is impacting them in positive ways. And it's not only diversity of cultural perspectives, it's also diversity of where kids are at in terms of home and family life – we have a lot of kids that are in foster care, but then we have some kids that aren't in foster care, and so it starts to bridge the gap between a lot of kids. So we're trying to be holistic in our objective to honour diversity, not only honouring cultural diversity, but also social diversity and economic diversity and things like that.   Rain: In the urban context I remember one of the struggles we had was what kind of drums are we gonna make? Who's gonna teach the teachings of the drum? Can women do it on their moon time? So there were all these protocol issues, and it's a matter of navigating that because in the urban context, you have many different teachings. So just acknowledging the diversity, and that people have different teachings for the same thing. Over time we had different people who brought in different teachings around it.   Decolonize: Making space for folks to come in and give their teachings in a way that they've been taught. To try to push it into a curriculum for somebody else to do it, that's not the way it's done. So you learn different styles of how this knowledge      239 gets transferred. They're not required to make out a curriculum that somebody buys.         miyo pimâtisiwin (Living a Good Life) Me: So honouring diversity in our programming is key. Contemporary Indigenous knowledges and adaptations in urban environments are complex, and that is a wonderful thing! (Smiling) (Holding the sage, cedar, and sweetgrass in her hand) So from the teachings of these medicines, the knowledges that inform our practice, we move to miyo pimâtisiwin in the West. Living a good life. These are the ways that we enact and live iyiniw kiskêyihtamowin. miyo pimâtisiwin is represented by the smudge bowl. In the places I’ve lived, often you see people use an abalone shell, stone, or clay dish for smudging. In this bundle is a large grandfather stone I received as a gift from a dear Elder in Minnesota. The smudge bowl is where we light our sacred medicines, where we bring our knowledges and teachings to life. (Karlee prepares and lights a smudge of sage, cedar, sweetgrass, and bear root. She smudges herself then passes the stone with the smudge around the circle) iyinisiwak spoke of the need for Indigenous ways of living a good life to guide the work we do in urban-based Indigenous health services. This is the application – how we      (Andersen, 2013)                   (I. Downwind, personal communica-tion, 2015)                  240                                                 68 Lakota for sacred pipe bring iyiniw kiskêyihtamowin to life in our clinical work using our cultural and spiritual practices, which are inherently healing. These ways of living well address people’s mental, physical, emotional, and spiritual wellness holistically.    (Hart, 2002; Linklater, 2014; Poonwassie & Charter, 2001)  Bob: Quite simply, I think all the things that colonialism and residential school took away, you just have to replace. It worked for thousands of years. Obviously we can't go exactly back to how we were, but we did a lot better than we're doin’ now… I try to incorporate ceremony and culture as much as possible. For the population we work with, that's sometimes a bit of a struggle because we work with a lot of people who are still in active addiction. But a medicine man told me once, "medicine is for people who are sick," you know, very simple. He says, "maybe they don't touch things like eagle feathers or things that. They can certainly smudge when they're under the influence, and things like that.”    Kink’inap: One of the women I work with was havin’ a hard time, so I said, "why don't you pray? How would you feel if I brought my canupa68 and we smoked the pipe?" She's like, "I've never done that before." But she really wants to connect and she's, you know, "I'd really like that." So I brought my      241 pipe in and me and her and my coworker filled the pipe and smoked it and prayed for her. She was crying and she's like, "that was the most awesome experience I've ever had."  She went home and posted on Facebook and said it was so healing for her. So we were able to have that prayer and help her. Like I can smudge and bring my pipe in and we do sweats for women, and it's just fantastic. So incorporating the spirit and culture and traditions, that kind of healing…There's also different seasons, doing medicine picking and stuff too. We also take youth to Sundance.  pisim iskwew:  Where I've had the most learning about what works for our people is just being part of the Aboriginal community, but also attending ceremonies. The most amazing transformations I've seen in people have been through the Sundance. The people that come to Sundance are, many of them, this is the last ditch effort for them to save their families, their lives, this is it – they've come to the end of their struggle, trying to find a way out of their despair, out of their sickness.  What seems to work in that setting is giving them hope that this might be a way for them. They're working through those issues over three days, and they're supported within a structure that is greater than what they can fathom about how      242 they can help themselves. They're giving it to creation.  The other part is when you take away food and water, all you're left with is your mind and feelings, and you're working through all of that. I don't know how you would replicate that formula outside the ceremonial lodge, but I've also seen interventions through sweat lodge ceremonies. How I've seen people get helped is they surrender – to the lodge, to the group of people that are there.  Some of the problems that our people carry are so huge that they have to release them in spaces like lodges, Sundance ceremonies, or we need to let it go in the forest, we need to let it go in the water, because that's the cleansing of it. And as a therapist, you have to learn how to offer that experience to your client, and then you can focus on how that trauma has played out in who they are.  askîy: When I connect youth to ceremony, Elders, ceremonial people, and the drum, you just start seeing (she sits up very tall and motions an outward circle, like something blossoming from the centre of her chest) this beautiful spirit coming out of them. All of a sudden their eyes are shining – they're looking at you in the eye, their rosy cheeks – they're filling out, they're strong. I'm getting shivers just saying it – it's a beautiful thing.   miskinâhk: “Ceremonies are the means and the method for       243 establishing social networks, connecting with the natural environment, reconnecting personally and anchoring oneself, helping others and being helped by them in return, developing a sense of spiritual connectedness, learning traditional teachings, and storytelling.”  Participation in ceremony, learning traditional teachings, and cultural and spiritual connection are important contributors to Indigenous people’s wellness.       (Poonwassie & Charter, 2001, p. 68)  (Hart, 2002; McCormick, 1996; Poonwassie & Charter, 2001)   Me: (Nodding) Which connects back to the central role of spirit in our healing and wellness, which pervades all the themes. These ways of living nurture one’s spirit. (McCormick, 1996; Ross, 2014)  Karl Lee: Spirit is such a big part of who we are. If you have a close, intimate relationship with your spirit every day, feed your spirit every day, your spirit can carry you through what nothing else can. It doesn't make everything better, there's still gonna be the roller coaster of life, you just don't deal with it with drugs and alcohol anymore, you call out to your spiritual leaders and your spiritual family and healers.  There's kids in our community who don't have any Native blood in them at all, but living the spiritual way with the spiritual people, they're way happier. The spirit knows no colour. It's that we're the ones that carry these medicines: the songs, the dances. It's our responsibility to keep them going      244 for not only our descendants, but everybody else's.  mistahaya: So having Elders to refer to is very helpful. We have Elders on site as well. They're just powerful healers, spiritually, and I've seen them work during the TRC week, and it's just amazing the stuff they do. It's not stuff that I have knowledge of, regardless of my mainstream training, and so having access to that kind of skill set is just incredible.   Me: I can’t even begin to describe the profound impact that ceremony and spiritual practices have had on me. Participation in ceremony and strengthening my own spiritual connection has changed my life in ways I couldn’t have imagined. Not only does this resonate personally, but I also witnessed how powerful ceremony and spiritual practices were for the clients I worked with at IHB. I had the privilege of sitting beside a number of clients in their first sweat lodges and other ceremonies, and hearing how these experiences were deeply transformative for them. (Puts her hand to her chest) I feel emotional just thinking about it…  iyinisiwak also discussed flexibility with protocols that may otherwise act as barriers to people accessing ceremony.   Bob: We try to be as inclusive as possible.  I think that's the key. Some sweats they say you have to have four days clean from alcohol and drugs, but we say one day is enough.       245 Although one day I had an old timer show up and he's like, “I wanna sober up and I wanna detox,” but then he got really shaky after the third round and so I said, “when did you quit drinking actually?” I thought it had been a couple of days, but it was that morning. Could've been a little more thorough on the screening with that one. Oops. Live and learn. (Laughing) But we pulled him out, said, "okay you're done, you just rest now."  He was happy.  And same thing, we just had the Downtown Eastside powwow and there was a guy there, and he's actually a pretty good hoop dancer. But somewhere he's hit a few bumps in the road, he's down there now. But I think one organization helped him get some regalia and hoops and he came and danced. But, you know, he was a little bit half cut, probably ‘cause if he wasn't, he'd go into full withdrawals.   Me: And this kind of flexibility totally connects back to sâkihitowin and absolute non-judgment. (Smiles) âsokanihkêw also raised the point of how it may be helpful to have ceremonies specifically meant to address traumas, as traditional ceremonies aren’t necessarily targeted toward that kind of healing.   âsokanihkêw: I think people are really looking for safe places they can be in ceremony. When we are betrayed, we're always      246 looking for ways to restore our sense of trust, to heal from that betrayal, and we'll keep looking throughout our whole lives. So a lot of people keep going to ceremonies and being hurt.  So I was like, man, we need to be able to develop a ceremony to address the trauma, like all those kinds of traumas, like the trauma of the different betrayals that have happened within our intimate partnerships, our families, our communities. In pre-colonial times, that betrayal wasn't something that ceremonies were necessaril