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Understanding how First Nation People practice and interpret spirituality when having a terminal illness Mussell-Oppenheim, Joanne Lisa 1998

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UNDERSTANDING HOW FIRST NATION PEOPLE PRACTICE AND INTERPRET SPIRITUALITY WHEN HAVING A TERMINAL ILLNESS by JOANNE LISA MUSSELL-OPPENHEIM B.I.S.W, The University of Regina, 1993 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SOCIAL WORK in THE FACULTY OF GRADUATE STUDIES (School of Social Work) We accept this thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA September 1998 © Joanne Lisa Mussell-Oppenheim, 1998 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of ^>cJr\CO\ n 4 ySoojodl UQo/t -The University of British Columbia Vancouver, Canada Date ^ p f f - rSQ t DE-6 (2/88) 11 ABSTRACT This qualitative study of eight First Nation participants and five First Nation Elders is to help understand how First Nation people view spirituality and how it is practiced when one has a terminal illness. Spirituality is often so abstract and practiced in various ways that it requires clarity and understanding from the people around them. Health care professionals could improve health care by understanding some of the spiritual aspects practiced when people are within their health care system. The First Nation people's perspectives aim to banish some of the mystery or unawareness that looms around spirituality in order to improve health services. Social workers have little or no information about First Nation beliefs and practices around spirituality when they have a terminal illness. The study is to help health care professionals and people with a terminal illness understand spiritual practices through specific beliefs and examples of how spirituality is practiced. I l l TABLE OF CONTENTS Abstract ii Table of Contents »i Acknowledgements v CHAPTER ONE Introduction 1 Terminology 2 Literature Review: Definitions of Spirituality 3 Researcher's Point of View 4 Personal Story 5 Purpose 8 CHAPTER TWO Literature Review 9 Definition of Spirituality 9 Holistic Perspective 11 First Nation Spiritual Relationships. 14 First Nation Beliefs 17 First Nation Practices 20 Conclusion 24 CHAPTER THREE Methodology 28 Description of Design 28 Interviews with Terminally HI Respondents 30 Recruitment of Participants 30 Exploratory Stage 31 Sample 32 Personal Interviews 33 Location of Interviews 34 Participants' Homes 34 Vancouver Native Health Society 35 Provincial Corrections Facility 35 Duration of Interviews 36 Interview Guide 36 Data Analysis 37 Vignette Number One 37 Vignette Number Two 38 Vignette Number Three 39 Vignette Number Four 39 Vignette Number Five 40 Vignette Number Six 40 Vignette Number Seven 41 Vignette Number Eight 42 iv Narrative Style 42 Coding 43 Narrative and Categorizing Analysis 43 Validity/Credibility Issues 44 Summary 47 CHAPTER FOUR Findings 48 Elders' Perspective 48 Danny Charlie: St6:16 Nation 55 Janet Charters: N'lakapamux Nation ...60 Ida John: St6:l6 Nation and N'lakapamux Nation 63 Paul Oppenheim Sr.: N'lakapamux Nation 67 Bev Julian: St6:l6 Nation 69 Barriers of Practising Traditional and Cultural Techniques 72 Summary of First Nation Elders' Perspectives 75 Participants' Findings 77 Practice 77 Meaning to Their Lives 78 Specific Purpose in Life 80 Action 81 Searching 83 Acknowledging the SpiritWorld 86 Death 88 Prayers -90 Diagnosis 92 Spiritual Experience 94 Barriers 95 Goals 98 CHAPTER FIVE Discussion and Recommendations 100 Discussion 100 Recommendations 101 Social Work Role 102 Issues 103 Researcher's Final Perspective 104 Bibliography 105 Appendix A 109 Appendix B I l l Appendix C U3 V ACKNOWLEDGEMENTS Thank you to the Creator and to all the Creator's Helpers: Thank you all: my family, friends, Elders, participants and spiritual teachers for their support, teachings, gentle spirits and understanding when needed. A special thank you to my eight participants in this study - without your support this would not have happened. Thank you all for your openness and knowledge. Also to the Elders in this study: Janet Charters, Paul Oppenheim Sr., Bev Julian, Ida John and Danny Charlie; thank you all for your insight and wisdom. Special mention to family/friends: Eanette, David Sr, David Jr, Shayne, Daniel, Opie -Oppenheim, Jean Charters, Anabel Stewart, Karen Kew (Little Bear), Patricia Soop, Trina Carpenter and Peter John for believing in me, giving me room to grow personally and for receiving their support throughout my academic endeavours and crucial times in my life. My family in the spirit world: Sophie & Stanley Mussell and Karen Oppenheim. Prof. Richard Vedan; my thesis advisor for his guidance, patience and expertise. My thesis readers: Dr. Deborah O'Connor and Dr. Rod McCormick for their knowledge, time and devotion towards my thesis. My financial supports: Coldwater Band Education Department and the First Nations Health Careers Bursary of U.B.C. for their financial support and encouragement. And many thanks to Vancouver Native Health Society staff for their active support throughout my academic endeavour. All my relations. 1 CHAPTER ONE INTRODUCTION For three years now I have worked as a Native Acquired Immune Deficiency Syndrome (AIDS) Coordinator at St. Paul's Hospital and Vancouver Native Health Society. During that time I have talked with and tried to assist some of my First Nations clients with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS). I have also had the opportunity in non-employment situations to become acquainted with other First Nation persons who are experiencing a terminal illness. During this time I have been struck by a difference in the way First Nations people understand their illness and the way that non-Native health care providers from the "traditional Western medical model" of service understand the same illness. It is apparent to me that this difference in understanding has a definite effect on how each person tries to cope with the illness, whether as the "patient" or the "healer". One of the important "tools" that the First Nation clients use to understand their illness and to develop a way of dealing with it, is what is generally referred to among First Nation peoples as their spirituality. Spirituality is defined by Hultkrantz (1990) as the consciousness of another world, the world of spirits, god, and wonders. There are many ways that spirituality can be defined, but for now, I will say that it is a concept, a belief system, that is often referred to and used by the First Nation's person. At the same time, it appears to me that social workers in the hospital setting often are not aware of this belief system, and if they are aware of it, their understanding is fairly 2 limited. They may have their own sense of spirituality, their own belief system, but it appears to be rather different and it may or may not seem to be used in this context. I think that the different beliefs and different approaches do indeed exist and is not helpful either to First Nation's people or to social workers unless there is recognition and respect for the diversity. The client may be unnecessarily anxious or at a loss as to what is going on, or what to do in the hospital context to help themselves. The social worker may be puzzled, frustrated, or even annoyed at evidence of the First Nation belief system that they don't understand and may fail to see how it applies in the medical setting. Given these observations and impressions that I have formed over these three years of intensive work, it seemed that MSW thesis research would be an excellent way to look more carefully and systematically at the role of spirituality for First Nation's persons with a terminal illness. It may be that by increasing an understanding of the !, role of spirituality, both social workers and First Nation's people's themselves will be able to find a common ground that will allow both to handle the challenges of a terminal illness in a way that works better for all concerned. Therefore, my thesis topic can be stated as: An exploration of the ways that traditional First Nation concepts of spirituality are used by persons experiencing a terminal illness. That is my topic, but my overall goal for the thesis is: To contribute to improved social work practice in the hospital setting for First Nation's persons with terminal illnesses. Terminology Within the literature, "Native" has been the term most commonly used to denote status, non-status, and Metis First Nation people. This study used the terms "Native", 3 "First Nations", "Aboriginal" and "Indian" interchangeably when referring to status, non-status and Metis First Nation people. Any use of these terms as used by the Elders and participants throughout the study refers to First Nation people. I prefer the description First Nation people because it implies the First peoples of the land, opposed to the second, third or fourth peoples arriving to the land. In addition, the term "non-Native" has been commonly used to denote people who are not of Aboriginal ancestry. Elders and participants used in addition and interchangeably, the terms "white", "non-Aboriginal", and "non-Native" to refer to people who are not First Nations. When the terms "traditions" and "traditional" are used they are referred to both historical and contemporary beliefs, customs and practices of First Nations peoples. Literature Review: Definitions of Spirituality I am only aware of three studies that address the issues of spirituality of First Nations' people who have a terminal illness. One is a book by Thomas E. Mails called Wisdom and Power. This is a dialogue with the great Sioux Holy Man, Fools Crow. Another book is written by Erodoes and Fire called, Lame Deer Seeker of Visions. This is a novel format of the life and teachings of John Lame Deer. And the last book is by Medicine Grizzlybear Lake called Native Healer. This is written by a traditional First Nation healer that reveals his teachings. These studies involve non-First Nation people observing and interviewing respected First Nation spiritual men in their communities over a period of several years. The researchers' methods consist of a study through the means of participating or 4 observing. The focus was on traditional teachings of spirituality and some aspects around terminal illness. The literature review made me aware of how little information there is on spiritual practices of First Nation people who are terminally ill. This lead me to research information on general practices of spirituality when First Nation people are terminally ill. I then looked at other social work related theories to help accomplish a working definition of spirituality. It is through the First Nation's holistic theory and a sub-section of First Nation systems theory that I am able to get closer to an understanding of what the practices and beliefs are around spirituality of terminally ill First Nation people. Further clarification of this information will be described in detail within the literature review chapter contained in this thesis. Researchers Point of View I am a First Nation person from the N'lakapamux and St6:l6 Nation in British Columbia. My spiritual practices and teachings are an integral part of my existence because it brings me the direction, peace, purpose and meaning in my life that I strive for daily. It is through my upbringing, education and experience that I have a strong First Nation cultural belief system and strong cultural practice ethics. As a St6:l6/ N'lakapamux First Nation woman and professional social worker I am sensitive to experiences and beliefs around spirituality and those people who are terminally ill. My own cultural/spiritual practices and my professional education in the social work field has given me this sensitivity and understanding. Since May 1995, I have been working at St. Paul's Hospital and Vancouver Native Health Society as a Native AIDS Coordinator to work exclusively with First 5 Nation people who are HIV positive or have AIDS. In addition, I am also aware of various First Nation cultural/spiritual practices because of personal beliefs and practices and because of my academic pursuits to gain more knowledge in this area of study. In the hospital setting and within a community outreach program, the job entails counselling, community networking, educating, and supporting those who are HIV positive and their family members. I especially enjoy incorporating spirituality into my professional practices because it gives my clients a complete treatment that can allow them to heal in a holistic traditional manner. It is through my culture and education that I am realizing and implementing the strength of the spiritual practices of First Nation people. This practice has prompted me to do this research. Within this chapter my goal is to share my experiences of how my "journey" of writing this thesis has enhanced the depth of this paper by its cultural relevance to spirituality and terminal illness as a whole. Personal Story After an interview with an Elder within the Sto.16 nation I was very moved because I had received some practical advice that had to be tried. When he was younger an Elder told him that if he had any problems he could go and stand under a cedar tree and ask the tree for help. This is performed by talking to the tree and stating what the problem is and requesting help for that specific situation. The Elder practised this and eventually received the help that he was seeking. So he taught me that if there are any problems or troubles in my life I can go to the cedar tree and ask for help. He said that in our lives we do not have to do things alone because there are a lot of spirits that are willing to help people, we just have to ask. 6 So I took his advice and went to a nearby park and stood under a cedar tree and asked for help in understanding what the spirits want me to write for my thesis in order to relay the teachings in an effective and culturally sensitive way. I asked the spirit of the tree to give me the strength and the insight to write a thesis that will give the cultural teachings the justice they deserve. The teachings I acquired from the Elder, Ida John is that anyone can ask the grandmother and grandfather spirits in the spirit world for help. She teaches that the spirits are happy to be asked for help and would like to be of help. She had recommended that I ask for help in my academic course work. I followed her suggestion because during the first term it was very challenging to complete the academic work and also to deal with the current deaths and losses in my family. I prayed to the spirits for academic help and spiritual guidance to assist me through the course work and the grieving period I had experienced. This belief and process calmed me emotionally, gave me spiritual hope and allowed me to concentrate mentally on the academic tasks on hand. Janet Charters an Elder from N'lakapamux, recommends that people do Indian swims (to swim in a lake, river, or creek and say prayers) and fast to help gain strength and to become spiritually grounded in their lives. I swam twice daily for two days in the early morning and in the afternoon. I also fasted for three days. This was to help my spiritual state and to strengthen my mental state because I felt the pressures of completing papers for my courses. Some of the pain I felt from the deaths in my family, at that time, was also alleviated. When I followed Janet Charter's teaching this was a powerful time for my prayers because I had to suffer a little bit by not having any food and because I would 7 swim in the icy water during the winter to ask the water spirit and Creator to help me. I believe in the process and know that this was effective in helping me to cope with my academic responsibilities and grieving process. The academic responsibilities were effectively completed and the grieving process assisted my acceptance of family deaths because of the swims and the fast. It is within my understanding of the First Nation culture that seeing an eagle is a positive experience because an eagle is very powerful and respected animal in our spiritual teachings. The eagle can represent one that has excellent vision and can reach high elevations that no other birds can attain. I interpret seeing the eagle as a point in my life to look further into the future or vision to get a sense of the bigger picture that I may be missing. I consider the eagle to be very powerful because I usually see them at spiritual gatherings: funerals, cultural burnings, sweat lodges ceremonies, and feel that they are messengers from the spirit world. On the occasions that I do see eagles I feel blessed because there is a spiritual message there for me to search and to experience. On one occasion, when I had stopped by Vancouver Native Health Society (VNHS) to see how my clients and participants were doing, my co-worker informed me that two of my clients had died recently on the same day. Understandably this made me very sad, one of the clients was a participant in this study and both were well known to me. I left VNHS feeling sad and was driving on Hastings street towards Main street and had to stop for the traffic light. I then looked up in the sky because something caught my eye, I noticed a bald eagle flying high above "Skid Row". This made my heart feel better because I understood this as a spiritual sign that this area is not so bad after all, since there was an eagle flying high above it. I also thought that the eagle may have been relaying a message from my clients' spirits; that they are doing well and are 8 in a good place. Congruent with cultural beliefs I hold; this sign allowed me to accept their death a little quicker. Purpose I tell these stories to illustrate how my spirituality is a part of my understanding of the world, and an integral part bf who I am. Through my spiritual practices and beliefs I find comfort and guidance. Recognizing the importance of my spirituality for myself, I wanted to explore how other First Nation persons experienced their spirituality within the context of a chronic illness. The process and the description of the study will be presented, starting with a literature review which will review the meaning of spirituality. Then the spirituality perspectives as expressed by five First Nation Elders or traditional healers will follow. Finally the field work study findings and conclusions will address what has been learned about the role of spirituality in dealing with First Nation people who have a terminal illness. Recommendations for improving service are based on the complete findings of the study. 9 CHAPTER TWO LITERATURE REVIEW Within this chapter I will present what the literature has to offer in the following areas; definition of spirituality, holistic perspectives, First Nation spiritual relationships, First Nation beliefs and First Nation practices around spirituality and terminal illness. Each of these areas will be described fully along with its relevance to each other in order to explain the purpose of this review. This review will lay a foundation of how spirituality is currently understood. Definition of Spirituality There are many First Nation's people who seek to study and practice spiritual healing beliefs, while other people are still skeptical and find spiritual issues unrealistic unattainable or problematic. Many First Nation people however are practising a traditional spiritual way of life and are being very effective. Spirituality a basic tenet to my thesis, is a difficult concept to describe because it is so abstract and personal. I agree with Diaz (1993) who writes: spirituality has no universally accepted definitions but this should be seen as part of the normal evolution of any new and emerging area of study, and not a fatal deficiency. I am referring to the emergence of a spiritual realm in Western medicine. Spirituality is described in the following manner: "Spirit refers to that non corporeal and non mental dimension of the person that is the source of unity and meaning, and 'spirituality' refers to the concepts, attitudes, and behaviours that derive from one's experience of that dimension" (Aldridge, 1995, quotes Hiatt1986, p. 104). 10 Sometimes spirituality is used synonymously with religion, Diaz (1993) however suggest that it neither excluding nor exclusive to the religious. There is a difference between spirituality and religion. Spirituality is the whole life of a person lived in relationship with the Transcendent (a level of reality that exceeds the limits of human existence, that there is more to us and to life than we first perceive). A person's individual spirituality may or may not incorporate the rituals, practices, and beliefs of a particular religious group (The Catholic Health Association of Canada, 1996, pp. 11-12). Specifically, some religious practices are described exclusively in the following manner: "Reed (1991) defines religious practices as church attendance, praying, singing, and scripture reading" (Hall, p. 144, 1998). This definition can assist in clarifying the difference between practices of religion and spirituality. First Nation's perspectives on spirituality do not have concepts that are exclusively religious. Spirituality can be described as giving people a purpose or a way of living. One definition of spirituality is: "Spirituality includes sacredness, faith, having a global sense of interconnectedness, respect, religion, higher power, prayer, forgiveness, practicing traditions, and participating in ceremonies" (van Uchelen, 1996, p. 17). When spirituality is practised within one's life Tart (1989) found that some people felt they could temporarily open their minds to "channel" higher "forces" or "beings" who want to help us and teach us. Part of our approach to choosing spiritual paths, should be based on a continual effort to understand and mature our emotional and instinctual nature. First Nation people have specific spiritual beliefs of what the purpose of practising spirituality can offer. First Nation spirituality can be further explained by looking at relationships. Relationships are difficult to explain and to describe because they include everything that is created by the Great Sprit and how this is taught and implemented in the 11 spiritual realm. One way to relay this concept is to relate a First Nation teaching that shows the importance of understanding how each one of us is related to everything within creation. Tiedman (1994) writes that spiritual power (enhancing one's spiritual awareness), derived from natural resources (using natural elements of the earth), can alleviate suffering. Suffering can be described by the individuals themselves and can include those who have a terminal illness. First Nation subjects can move toward spiritual transformation. A spiritual transformation can be described as one recognizing one's spiritual beliefs and thus practicing one's spirituality according to their beliefs. The First Nation subjects move toward spiritual transformation by entering a metaphysical space in which the land is sacred and elemental to survival. Holistic Perspective Spirituality is one of the four main areas of holistic medicine. The other three areas within holistic medicine include mental, emotional and physical, parts of the human being. Chirban (1991) argues for the return to approaching human health holistically, while maintaining strengths of independent dimensions of inquiry. Healing is restoring, curing and making whole. Further clarification of this concept is described in detail; Holistic medicine considers the close connection between a person's sense of well-being, or lack of it, and health and disease. An individual's biological make-up and his or her personality and spiritual orientation are deemed critical to his or her illness, healing and growth. Healing is considered a valued goal because it consists of lightness, wholeness, and soundness of body, mind and soul (Chirban, 1991, p. 8). Each of these parts of the human body need to be healthy and worked on. An 12 individual person can look at his or her life holistically; exploring mental, emotional, physical and spiritual aspects of their self to determine if each area is being addressed and worked upon. A holistic perspective of balance can extend beyond the individual. Morrissette, McKenzie & Morrissette (1993) write that the notion of balance is important to First Nation people because it is originating with the requirement of balancing survival needs with the needs of the family, community, and nation. The concept of the circle illustrates the idea of balance, as captured in Bopp, Bopp, Brown, & Lane (1984) models such as the Medicine Wheel (See Appendix A). George (1991) teaches that the medicine wheel is a symbolic circle of the universe which holds together the relationship to one another. Everything is seen as having a purpose and a balance to offset the other. It is similar to the world itself, being balanced by the four cardinal directions, the four races, and the four human characteristics. All areas of the medicine wheel are related and in balance with each other and are respectful to one another. Individually we start with balance in our own physical, mental, spiritual, and emotional being in order to be balanced and respectful to each other. First Nation traditions are found in the experience of time and process. The traditions are in terms of the circle - that is cyclical and reciprocal (Brown, 1982). First Nation people believe in and practice a holistic way of living, one that aims at balancing emotional, spiritual, physical, and mental aspects of a person for health, as symbolized in the medicine wheel. Further teaching reveals the importance of circles; Nature wants things to be round. With us the circle stands for the togetherness of people who sit with one another. The nation was only part of the universe, in itself circular and made of the earth, which is round, of 13 the sun, which is round, of the stars, which are round. Circles within circles, with no beginning and no end (Lame Deer & Erodes, 1972, p. 100). The main reason for living in balance or living holistically is described by George (1991) as the holy people stressed that it was important to keep all things in balance in order to become the best possible human being in our lifetime so that we can enter into our eternal life with the Great Spirit. A Catholic religious view of living in balance is described as: If one of our inner resources (biological, psychological and spiritual factors) is deficient or becomes the object of continual attack of some kind, and our other energies are unable to maintain our 'balance', then we fall prey to some sickness or another (Catholic Health Association of Canada, 1996, p. 19). When we consider the concepts of spirituality and healing, we can also look at self actualization. The concept of self actualization can be examined upon by looking through a different lens of spiritual healing. Goldsmith (1959) writes that spiritual healing is much more than a purely physical experience or even a mental experience; healing is finding an inner communion with something greater, far greater, than anything in the world. It is finding ourselves with God, finding our selves in a spiritual peace, an inner peace, an inner glow, all of which comes to us with the realization of God with us, the presence and power of God felt. Another form of self actualization can be what Jones and Crandall (1991) state, that Maslow's meaning for transcendence involved going beyond some divided state with boundary conditions to a greater underlying wholeness or unity. The transcendence can involve an individual experiencing a phenomenon that is beyond the physical state. When 14 one goes beyond the physical state of being one can move towards a holistic perspective of wholeness or unity. Wholeness or unity can be aided by traditional First Nation healers. Grizzlybear Lake is a well respected spiritual person who is a pipe carrier who teaches many traditional First Nation teachings. Grizzlybear Lake (1991) teaches that to make a person well, the healer has to take an holistic approach and doctor all parts of the human constitution. The Creator's laws in the Native ways are handed down orally through sacred teachings such as myths or ceremony. It is within the sacred teachings that, In the traditional Indian way we are taught to see the whole of each thing and attempt to understand its relationship to each part that make the whole; how each part relates to other parts in Creation; how all parts serve to make the whole Creation (Grizzlybear Lake, 1991, pp. 146-147). The holistic approach taken by First Nation doctors goes beyond the call of duty in the treatment of patients. They will work on the physical injury, but in addition doctor the patient's mind, emotions, and soul (Grizzlybear Lake, 1991). First Nation Spiritual Relationships First Nation relationships are difficult to explain and to describe because they include everything that is created by the Great Spirit and how this is taught and implemented in the spiritual realm. One way to relay this concept is to relate a First Nation teaching that shows the importance of understanding how each one of us is related to everything within creation. In the Beginning, when the Great Creator first made the world, He called together all the different spirits and asked them what they would like to be. Some wanted to be the Four Powers of the Universe, some wanted to be Lightning and Thunder, Wind, Rain, Snow, Earthquake. Some of the spirits 15 said they would be oceans, mountains, rivers, and streams. The other spirits said they wanted to the Plant people, Tree people, Animal people, Bird people, Fish people, Snake people, Bug people, Rock people, and Human people. In this way they would represent all those who walk, crawl, fly, and swim, seen and unseen. Together they all made Creation (Grizzlybear Lake, 1991, p. 145). This example teaches us that all things have two sides, physical and spiritual, which serve to make the whole of any living thing. It also teaches that such things in creation are all interrelated and dependent upon each other for functioning and survival (Grizzlybear Lake, 1991). The storytelling format is described by Gill (1993) as imaginative and creative in nature. It is a way for man to realize his capacity for wonder, meaning and delight. It is also a time for man to invest and preserve himself in the context of ideas. Man tells stories so he can understand his experience and storytelling is a way to understand human experience. "Native Americans oral traditions are not meaningless stories of fanciful characters and places, but they engage history and human culture in a vital manner" (Gill, 1993, p. 43). The teachings reveal various ways to live life. Stories are medicine, they have such power: they do not require that we do, be, act anything, we need only listen. The remedies for repair or reclamation of any lost psychic drive are contained in stories...stories are embedded with instructions which guide us about the complexities of life (Estes, 1992, p. 14). First Nation families also have needs that are met through spirituality. Red Horse (1980), writes that First Nation families tend to family needs through cultural and spiritual maintenance as well as through physical and emotional needs satisfaction. Family members learn how to tend to the family needs through comprehensive family strengthening roles identified throughout the family members life span. This aspect can be very beneficial to the 16 family and the family member that has someone who is diagnosed with a terminal illness because the strong family relationship keeps the cultural and spiritual identity strong also. The strengthening of the family also entails the following teaching: When Indians say that we are related to all things, we mean that all races have the same Mother, Mother Earth, and we are all brothers and sisters. Humankind and all earth-dwellers are one tiyospaye (extended family) -humans, the winged ones, and the four-legged, finned, and planted ones. We are all one family (McGaa, 1990, p.28). Not only are we one family, but we are also supposed to: Think of your fellow men and women as holy people who were put here by the Great Spirit. Think of being related to all things! Our search for spirituality, and our quest for peace, we will be far more successful when we truly understand the Indians' respect for Mother Earth (McGaa, 1990, p.208-209). The attitude towards the sense of unity and brotherhood of all creation brings awareness to the understanding that each part of creation becomes a living "brother" or "sister" (Mails, 1991). Mails (1991) continues to state that the concept of inter-connectedness reaches out to embrace environment and ecology, and it is the core ingredient of harmony in the world. Fools Crow's (a great Sioux Holy Man) attitude towards interconnectedness is another way he is given a deep sense of belonging, contentment, and peace. The latter, Fools Crow defined as, "freedom from fear." Spiritual relationships show how many relationships are involved when looking at all of creation and the importance of recognizing this relationship. This belief will help one to further understand how First Nation people practice spirituality and why they practice spirituality the way they do. 17 First Nation Beliefs First Nation spiritual beliefs reveal what is important to First Nation people, how they practice their spiritual beliefs and why they practice spirituality in certain cultural ways. Focus will be upon beliefs related to spirituality and terminal illness. The beliefs presented are basic and generally taught throughout all First Nations. "Faith gives a sense of purpose and direction to the totality of one's life, both daily and throughout one's life" (Driedger, 1997, p. 14). Within a spiritual realm, aspects of faith contain a belief that deserves recognition and understanding from a First Nation perspective. Mails (1991) writes that faith is the first thing that brings the spiritual power in. Of course, the rituals and the tools play a part in this, but without faith there is no power and there is no movement. If people want to stay healthy and live a long life, there is a realistic way to do it. It is essential that they give themselves to Wakan-Tanka (Creator or Great Spirit) and live a spiritual life. Fools Crow is aware that we all respond differently to the Creator, and do what we do the way each of us hears and feels His guidance. He continues to add that it is absolutely fundamental that we must "believe in order to see," rather than to follow the scientific way of "seeing in order to believe" (Mails, 1991). This teaching tells people that they are to have faith in the process of what the Creator has for them. Another one of the most basic teachings is that for First Nation people the world of nature itself is their temple, and within this sanctuary they show great respect to every form, function and power (Brown, 1982). The Indian belief is that most of the sins related to sickness, as one understands it, occur because of individuals violating laws against 18 nature (Grizzlybear Lake, 1991). This also has a connection with what Mails (1991) writes that if you believe something has life, it has life. The Creator taught us to think that all things have life within them and this needs to be apparent to us, and we treat them accordingly. We do not abuse or misuse them. When everything of creation is respected it can help First Nation people in their ceremonies. Grizzlybear Lake (1991) informs us that our tribal medicines, our power centres upon this earth, our ancient ceremonies, and our spiritual forms of knowledge cry out to be used; and we need to use these things with sincerity and respect. McGaa (1990) expresses about the respect and thankfulness of the Sioux' is the key ingredient of inner peace was to be thankful to the higher powers, the created forces, and of course, Wakan-Tanka (Creator). The human connection with all of creation and with the Creator have strong influences in the spiritual aspects of First Nation spirituality. Human beings, according to Fools Crow only have the power to imbalance the earth and when they unbalance the earth they unbalance themselves. He continues to state that the environmental threat may prove to be worse than a nuclear war because of its global dimensions. People's connection with nature is further explained by Pete Catches referring to Lame Deer's teachings that all of nature is in us, all of us is in nature. That is the way that it should be (Lame Deer & Erdoes, 1978). The natural ingredients amongst people are also of significance to First Nation people. Mails (1991) states that Fools Crow says the sun, fire and crystals are the Creator's way of coming closer and closer to us, and even touching us. He says to remember to think about the closeness of the Creator. If they live in this 19 wisdom it will give them endless strength and hope. When freedom from fear has come to a dying person, they sometimes live much longer than expected (Mails, 1991). When people understand the closeness of the Creator and understand the natural laws people can also begin to understand the healing process. A spiritual person or a medicine man explains his understanding of why sicknesses occur: I have handled cases where people's sicknesses were due to all kinds of violations such as killing rattlesnakes without just cause, digging up burying grounds, gathering herbs and roots without a proper prayer and agreement, making bad prayers and wishes against others, abusing spiritual knowledge and powers, stealing,...playing with power or witchcraft; the list can go on. It may be hard for you to accept this, but it is the basis of Native healing. Sometimes people are in pain because they are being tormented by ghosts, spirits, and forces out of ignorance; they simply entered the abode of a bad spirit while camping, hiking, or partying (Grizzlybear Lake, 1991, p. 118). Spiritual healers initially need to know what is causing the sickness. Mails (1991) writes that Fools Crow needs to know what the cause of the sickness is, because he has to cure both the illness and the cause at the same time. If Fools Crow just cures the illness without curing the cause, the illness may come back. In addition, traditional healers have certain beliefs that they live by and relay onto other people; Fools Crow knew that when power was abused, misused, or allowed to lay dormant, the holy or medicine person could lose it, or better said, that Wakan - Tanka and the Helpers would withdraw it (Mails, 1991). Traditional healers and First Nation people know the magnitude and importance of spiritual healing being implemented. "Spiritual healing is the touch of the Spirit of God in man's Soul: and when that touches him, it awakens him to a new dimension of life, a 20 spiritual dimension where he has experiences totally unknown on human life level" (Goldsmith, 1959, p. 13). The First Nation beliefs presented in this chapter originate from various teachings and teachers. Some teachings in this chapter come from First Nation traditional healers, medicine people, and elders who have acquired spiritual knowledge through personal experience and who are willing to share these teachings within literature. The First Nation beliefs presented were taught to each generation of First Nation people since the beginning of time. The spiritual and cultural teachings have always been passed down orally from generation to generation. In addition, some First Nation people receive teachings about religion and Christianity from their brothers and sisters of the church. Therefore, some of the spiritual teachings are adopted or incorporated from religious or Christian teachings. The language and terminology of Christianity may be used by First Nation people when addressing their spiritual beliefs. First Nation Practices First Nation practices involve the interaction with various spirits. Grizzlybear Lake (1991) teaches that smoking and praying with tobacco is the main source for almost all First Nation ceremonies; it is probably the most ancient ritual and it is still being used today. The tobacco is offered to the spirits as a payment in exchange for their assistance. Smoke from tobacco offered to the Great Spirit of the universe, our Creator, carries our prayers to him from the physical world to the spiritual world. Hultkrantz (1990) writes that tobacco has been intimately related to American Indian religious practice. 21 First Nation culture teaches that there are plants that can assist in communicating with the spirits. Specific plants include tobacco, cedar, sage, sweet grass, juniper, rose bush. When these plants are burned in a spiritual ceremony the spirits receive the payment or gift that is offered by the person requesting help of the spirits. Tobacco is the most sacred plant used in many ceremonies. A First Nation person that is requesting help from a First Nation traditional healer can offer the healer tobacco in the assistance of requesting help from the spirit world. One specific spiritual practice involves a vision quest. It is noted by McGaa (1990) that the vastness of life around us helps eliminate self-centredness. We are not doing the vision quest to make ourselves feel important but to realize the vastness of the universe and our oneness with it. Another important practice is clarified by Tart (1989) that when he encounters a spiritual system or teacher, he tries to "listen" and evaluate with his mind, his heart, and his instincts, drawing on what he thinks he knows, and remembering that he's made mistakes before and will probably make more in the nature. We are fortunate to have traditional healers to listen to and follow because they can offer so much to people when the circumstances are right. Most of the traditional Indian healers, are no longer afraid to use their skills openly on the reserves. White doctors and nurses are now admitting: medicine men can be as effective as non-native physicians A growing number of medicine men and native healers are being hired by hospitals and health centres to work with native patients. And a federal report concluded that some of the practices of the traditional healers are "superior" to those of modern medicine (York, 1990, p.263). Albert (1997) writes that spirituality and symbolic healing may be iii the form of attending ceremonies which may reconnect an individual to cultural identity. Specifically, 22 Mails (1991) writes how Fools Crow goes about his spiritual practices when helping a person in the traditional cultural way. Step one: The person must bring an offering of tobacco to Fools Crow. "Why tobacco?" Because the Creator has put pure sacramental power into it. Step two: Fools Crow has to know whether or not he should smoke the tobacco. He would determine this by measuring the faith of the person by placing his hand on the person's shoulder to see whether is would grow hot or cold. (The book did not clarify which treatment was done if his hand grew hot or cold). Step three: Once the tobacco is smoked, Fools Crow talks with the person for a long time about the way curing is performed. They talked about the cause of the illness, what had happened since it started, who the person had already gone to for help, and what had been done. Fools Crow then explains that treatment is done at four equal intervals a day, for four days. Step four: Fools Crow then wraps up or uses a stone and blanket, or he goes to the purification lodge to determine all he can about the illness. He added what he learned from what the person had already informed him of. he learned both the specifics and the full range of the illness. He also learned what medicines he should use, and how he should apply them. He let the Higher Powers have both a continuing and a final say in which way to go in the treatment. Step five: Fools Crow opens himself fully to the Creator and the Helpers to call in curing power. The person has to know everything Fools Crow is doing and know that he is sending them a basket of love. And when the person touches Fools Crow with their love, he knows that their love is as big as his. 23 Step six: To deepen Fools Crow communication of love, he applies medicines gently, and sometimes sings songs as he works. Fools Crow realized through experience of treating people that the greater the faith of the people involved (holy man and person together), the greater the result. Step seven: When treatment has ended, thanks must be offered to the Creator and the Helpers, and the promises must be claimed. The person should purify themselves regularly by smudging with sweet grass or sage, attending a sweat lodge ceremony. Waldram (1993), informs us thai the sweat lodge involves cultural and spiritual education. It is also a religious undertaking involving prayer, an education undertaking involving, among other things, confession and peer support, going for a spiritual swim in a river, lake or creek, bathing in cedar water, or any other spiritual ceremonies. Fools Crow continues to state that a person is to learn to think of themselves as hollow bones. "All medicine persons are hollow bones that Wakan-Tanka, Timkashila, and the Helpers work through. In and through. The power comes to us first to make us what we should be, and then flows through us and out to others" (Mails, 1991, pp.30-31). The people requesting help should also not talk overly about what had happened to them, and certainly must not brag about it. The process used by Fools Crow is to help people with their illness. He patiently explained that what he would do had its roots in ancient history The way that Wakan-Tanka would use was old and proven. Fools Crow himself had used all of his methods many times with great success. The person was going to see this happen in his own life now. It would be exciting, and the community would see the person healthy again and know that Wakan-Tanka was watching over the people (Mails, 1991, p. 154). The techniques or steps mentioned are those that were used by Fools Crow, other traditional healers may vary in some degree or another. So it is important to ask the 24 traditional healer when seeking help what their teachings are around the healing process. Healing has spiritual connections that are expressed in the following way; Healing must be learned; first, that God is; and second, that the nature of God is good - the nature of God is love, the nature of God is wisdom, and the function of God is not only to create an image after His own likeness, but to maintain and sustain that image, including all mankind, in a divine embrace of harmony, wholeness, completeness, and perfection (Goldsmith, 1959, p.19) "Healing occurs when people find culturally appropriate resources that are in harmony with their own beliefs and values" (van Uchelen,1996,p.4). First Nation traditional healing practices and spiritual concepts have their specific goals to attain. One of the social implications of these techniques reveal: "What is required is an emphasis on the intersubjective experiences of Aboriginal people and methods that can both trace these experiences and interpret them within the context of the social reality of Aboriginal people" (Morrissette, McKenzie, Morrissette, 1993, p. 106). In addition, Mails (1991) writes that healing is purely spiritual and has to do with helping a person to be right with the Creator. Healing is a priceless gift that can be given to anyone who will accept it. Healing can reach many people and Mails (1991) questioned Fools Crow, "Is it possible to heal the world?" Fools crow replies, "With the Creator everything is possible. Without him it is not." People must let the Creator and the Helpers heal them first so they will know how healing works. The Creator can use us for curing, healing, and helping one another. Conclusion There are some important First Nation spiritual aspects within the literature that require mentioning. The teaching techniques of spiritual concepts and terminal illness will 25 need further exposure in order to educate more people and to bring about a clearer understanding. The future of spirituality is dependent on all of the people, just as it was in the beginning: we all must take the individual responsibility to go back and restore our spiritual values (George, 1991) In addition, The most important step, however, requires a commitment to change, which begins with dialogue based upon mutual respect and appreciation of diversity. Aboriginal people are aware of the dichotomy that exists between Aboriginal and non-Aboriginal world views; they interact with this on a daily basis. The challenge for non-Aboriginal people is to become equally aware of this dichotomy and to respond by promoting needed changes in institutional forms and practices (Morrissette et al, 1993, p. 106). First Nation people are aware that there needs to be mutual respect and appreciation of diversity of points of views of all people. First Nation people look at life in a holistic perspective and are aware that their views are not always the same as other nation's views. First Nation people are very aware of the non-Aboriginal lack of understanding of the First Nation world view and would like their views to be understood and addressed by other nations. Currently it is difficult to ignore First Nation peoples' strong belief system relating to aspects of spirituality and spiritual healing. In the past First Nation spirituality was socially and politically suppressed because of misunderstandings and European intolerance of First Nation cultural beliefs and practices. It is now interesting to read current perspectives because of the change in social and political perspectives. Jensen (1991), states that the implication is that the so called primitives and savages (First Nation people) were not primitive and savages, but victims of theoretical error. This is important to note because First Nation people can offer a great deal to all nations in regards to spiritual teaching in relations to healthy living. First Nation spirituality is now 26 recognized as: "American Indian spirituality calls all Americans to a truer and purer understanding of God, to an ethic of peace and justice, and to an aesthetic of natural simplicity" (Porterfield, 1989, p. 162). Literature written twenty years ago did not contain the sensitivity to First Nation views on spirituality and terminal illness that it is now starting to receive. Tooker (1979) writes about the editing process of their writing. For example, Indian words have generally been eliminated because it was felt that although familiarity with such words is essential for a more complete understanding, they are more distracting than illuminating to the general reader. Some specific goals First Nation people address are as follows: 1) The lifestyle that is wanted by First Nation people; values of family, Mother Earth, natural resources, holistic health, co-operation, and sharing (MusseU.,1993). 2) The First Nation people with disabilities want hospitals to allow our medicine men and women to look after our people when they are in hospital (Sinclair, 1993). 3) Part of the solution for health and social problems is to recognize the traditional culture and approaches to healing and to have a holistic approach to critical problems in First Nation communities (Royal Commission on Aboriginal Peoples, 1993). 4) "Dr. Connors said he felt that although traditional knowledge has suffered and has gone underground, it is now surfacing again. But it will only flourish when people of the western society begin to show their respect for it" (Royal Commission on Aboriginal Peoples, 1993, p.298). 5) "We need peace and understanding and unity of young and old, Indians and non-Indians alike. We must all stand together for the reason of peace and tranquillity of life for all. 27 You must first better understand yourself before you can express yourself to others" (Mails, 1991, p. 199). The literature chapter addressed definitions of spirituality, a holistic perspective, First Nation spiritual relationships, First Nation beliefs, First Nation practices, and revealed what some First Nations goals are in relation to spiritual concepts and terminal illness to further educate people. Another way to educate people is to address how this study was conducted and this will be further explained within the methodology chapter. 28 CHAPTER THREE Methodology In general, this study was exploratory in nature, and employed a qualitative approach. Specifically, I chose to implement an individual interview format with an interview guide being semi structured. The analysis was based on a phenomenological approach. The aim was to contribute to understanding by exploring and clarifying how First Nation person's with a terminal illness interpret and practice spirituality when terminally ill. This research goal is improve social workers practice in providing services in the hospital and other health settings. The qualitative methods employed in this study were approved by the Ethical Review committee at the University of British Columbia. Description of Design The research process contains four main areas of study to identify: to develop a working definition of "spirituality"; to collect data from First Nation persons who are experiencing the trials of a terminal illness; to collect information from First Nation elders and/or traditional healers on spirituality in relation to a terminal illness; and to identify theories that offer the most information on the practice, concepts, and applications of First Nation spirituality. Qualitative methods are described by Maxwell (1996) as having five research purposes: to understand the meaning of the participants studied to include cognition, affect, intentions and the "participants' perspective"; to understand the context in which the participants act, and the effect that this context has on their behavior or actions; "to 29 identify unanticipated phenomena and influences, and generate new grounded theories about the latter."; to understand the way in which events and actions occur - qualitative research emphasizes the process of the area studied rather than the outcome and; to develop causal explanations (Maxwell, 1996, p. 19). This qualitative explanation reveals the events of the process and connection of understanding the participants' story, environment, and context of behaviors to effect how they act. When this has been implemented it can help develop new theories and causes of the situation. An effective qualitative approach is: A phenomenological approach in general nonphilosophical sense has been prevalent in qualitative research. Phenomenology is the sense of understanding social phenomena from the actors' own perspectives, describing the world as experienced by the subjects, and with the assumption that the important reality is what people perceive it to be (Kvale, 1996, p.52). Since this research involved looking at an ethnic/racial minority group a qualitative approach is the best method of study because it allows the researcher to tease out the inherent complexity associated with culture (Ponterotto & Casas, 1991). The complexity of the culture can be expressed in a qualitative approach that recognizes the participant as an expert on his/her culture and provides the space for him or her to talk about what is important to him or her in regards to spirituality and terminal illness. This research will reveal what is important to the eight First Nation participants and five First Nation Elders/traditional healers focused within this study. It is important to understand that qualitative methods do not have, "discrete measurable outcomes and generalizations are not the goal of the qualitative paradigm" (Leininger, 1994, p.95). But overall the they are best because they do have the benefits of 30 acquiring the knowledge of understanding the social phenomena of First Nation people's perspective, actions or behaviors on spirituality when they are terminally ill. This method of approach is to "acquire in-depth knowledge used to guide further study" (Reid & Smith, 1981, p.88). Qualitative research methods are designed to understand the person's meaning, context, new theories, reasons for events occurrence and to develop causal explanations (Denzin, 1994; Maxwell, 1996; Miller & Crabtree, 1992). I chose this method because I believe that it provides the best opportunity to capture a full understanding of the First Nation individuals perceptions of their spirituality when terminally ill as there is very little knowledge available on the definition of spirituality and how First Nation people practice it. Interviews with Terminally DI Participants Recruitment of Participants This study has two distinct phases that involve interviews with the Elders and then interviews with the participants. The process of acquiring information from the participants started with the method of accessing respondents through a flyer that was distributed in health care centers in the Vancouver area and within various First Nation organizations. In addition, I told many health care professionals, friends, family workers and previous co-workers about my study and asked them if they knew of anyone that may be interested in the study. The participants were informed by word of mouth about this study through my friends and co-workers. My friends and co-workers gave each of the individuals the background of the study which includes; the research topic, eligibility criteria, a copy of the research flyer and any further information the individual required to know about the study. My friends and co-workers asked if the individual was interested in 31 participating and when an individual was interested, I received a phone call about a possible participant. I then went to Vancouver Native Health Society (VNHS) to meet with the individual to clarify their interest and then scheduled a time for an interview. If I did not meet them at VNHS I would phone the individual at home to confirm their interest in this study and then arranged for an interview by agreeing on a time and place to meet. Essentially I used the "snow ball" approach where individuals were informed and it grew as it reached more people through the process or recruitment. The criteria set for interested respondents involved that each were required to give consent when they were not under the influence of drugs; and this included not interviewing people who showed up for the interview in that altered state. Each participant had to be alert and oriented mentally x 3 to person, time, and place. Each fit the criteria of being of First Nation descent, with a diagnosis of a terminal illness from a medical practitioner, and who was willing to share his or her views on spirituality and terminal illness as it related personally to him or her. Exploratory Stage My initial exploration of this study started with an interview with three participants that aided me in the process of gathering information. The exploration stage gave me an opportunity to ensure my electrical taping equipment was in good working order. I noticed it was necessary for me to use a tape recorder that captured a clear recording of the participant because my first recording contained too much static and outside noise that I could not hear all of the participant's dialogue. With this knowledge, I then purchased a mini lapel microphone and borrowed a newer model tape recorder, in order to receive a clear recording of the interviews. This stage also gave me time to get comfortable in 32 asking the questions and to become familiar with the interview process of gathering qualitative data in this way. With the experience and information of the three preliminary interviews I incorporated these new techniques for my eight participant interviews used in this study. I believe that this process enhanced the depth and quality of the research sought. The goal of the interview researcher is to return from the stages of his or her qualitative inquiry with a tale that does justice to the subjects' stories of their lived world and that conveys new and valid knowledge and insights to the listeners to and the readers of the tale (Kvale, 1996, p. 80). Sample I was very fortunate that it was not a difficult task to find eight participants for my study. In approximately five weeks I had eight participant interviews scheduled and there were still other people inquiring about my study. I had to inform them that I had enough participants scheduled and that I was very grateful to them for their interest. I further explained that I only requested six to eight participants with the U.B.C Ethical Review Committee and felt that I ought to follow my proposed number of participants I submitted. I chose the first eight participants by ensuring that each fit the set criteria I set out. Each of the participants were referred by my co-workers and family members. I chose the eight participants because each was willing to be interviewed and each showed up for the scheduled interviews. "An aesthetic thrust of sampling in qualitative research is that small is beautiful" (Sandelowski, p. 179, 1995). This information gave me the information and insight to recognize that eight participants was adequate number to conduct this study because a small number works well when doing qualitative research. 33 Personal Interviews The rationale for this method of doing personal interviews is because it is a very personal topic for people and the time spent together was respected. I viewed, "the qualitative research interview as a construction site for knowledge, which views the interview process as literally an inter view, an inter-change of views between two persons conversing about a theme of mutual interest" (Kvale, 1996, p. 14). In addition, I chose the interview method because the population that I was aiming to interview have unpredictable lives because of their health and possible medical appointments. Specifically I chose interviews because: The topic of qualitative research interview is: the lived world of the subjects and their relation to it, seeks to describe and understand the meaning of central themes in the life world of the subjects, aims at obtaining nuanced descriptions from the different qualitative aspects of the interviewee's life world, aims at obtaining uninterpreted descriptions, seeks to describe specific situations and action sequences for the subject's world, and attempts to gather descriptions of the relevant themes of the interviewee's life world that are as rich and presuppositionless as possible (Kvale, 1996, pp. 29-33). Qualitative methods involve face to face interviews that allow the participants to give their story of their circumstance by asking them semi-structured, open ended questions. At the beginning of each interview I informed the participant that the interview was voluntary and that they could withdraw from the interview at any time. Each had agreed to the study and signed a consent form that outlined the guidelines and expectations of participating in the study. The interviews gave me a current snap shot of their beliefs regarding spirituality. According to Rorty, "We may see conversation as the ultimate context within which knowledge is understood" (as cited in Kvale, 1996, p.37). Individual interviews are also 34 private, quiet, and safe and encourage open discussion with little distraction from other people. I agree with Kvale (1996), writes that a qualitative research interview aims to understand themes of the lived daily world from the participants own perspective, thus is beneficial to use because it allowed me to observe the participant throughout the interview and to attain a better understanding of their current life situation. The setting was also comfortable for a First Nation participant because it allowed him or her to speak out and share their story in the oral tradition that he or she is accustomed to. Throughout the eight interviews I continued to observe the participants behaviours and actions in order to continue to gather valuable information. It was also necessary for me to keep extensive notes of the how the situation was unfolding so that this could be referenced at a later time if required. Location of Interviews Participants' Homes Four of the interviews took place in the individual's home because this is where the individual wanted to meet and felt comfortable This location allowed me to gain a better understanding of the participant because I was allowed into their personal home environment which allowed me more insight about the participant than those not in their home environment. I noticed that each one who invited me to their home were in a stable relationship with their partner. Another reason for three of the interviews occurring in their home is that each were not feeling well; each did not want to travel and each did not have the physical energy to leave their home environment Despite their low energy level and health situation each were very willing to continue with the interview. 35 Vancouver Native Health Society Three interviews were conducted in a secluded room at the Vancouver Native Health Society because this is where the participants frequented and suggested to meet. This setting was different than the interviews done in homes because it did not contain the personal atmosphere as the home environment did. In addition, it was necessary to adjust to Vancouver Native Health Society's environmental situations of the phone ringing, main outside door buzzer going off each time a client entered or left the facility and (for myself only) seeing clients walk past the office window during the interviews. Despite the distractions the participants managed to convey their story. I feel that it was an interesting atmosphere to be in because people commented or questioned what the participant and I were doing. The participant and I appeared to have sparked an interest in other people and thus made me feel that what we were doing was important and official. Provincial Corrections Facility The last interview occurred in a cultural room within a provincial corrections facility. I had to have a criminal records search done before they would even consider me for the opportunity to conduct this interview. I walked through the highly secured gates of the corrections facility and was lead by a security guard to where my participant sat. The cultural room is a round shaped building that is quite spacious with chairs situated in a circle within. The door was left open throughout the interview and some of the inmates walked past or peered in to see what was occurring inside. I feel that this interview was especially respected by both myself and the participant because so much effort was put into organizing it. The participant stated that he felt really important and honored that I drove a fair distance and "cut through the necessary red tape" to hear his story. 36 Duration of Interviews I interviewed eight individual participants in sessions that lasted approximately forty five minutes to one and a half hours each. Each participant was given a copy of the interview guide at the beginning of the interview. The interview guide followed the semi structured interview format to ensure that each had input into the study and by asking open ended questions to address any issues. The interview guide was used in each interview in order to access the same information throughout my study. I would allow the participants to speak freely on the topic by asking them an open ended question. I would then refer back to the interview guide several times in order to move the interview along when I thought a topic had been adequately discussed. Interview Guide The interview guide contained the following questions: 1) How do you explain spirituality? 2) In what ways do you practice spirituality? 3) Who taught you the principles of spirituality? 4) How were these principles taught to you? 5) How has the practice and belief of spirituality changed if it had, since you have been diagnosed with a terminal illness? 6) Are there any barriers that you can identify in the medical field that may prohibit any of your spiritual practice? If so please explain. 7) Is there anything else important that you would like to say, that we may not have covered so far? 37 "Listening to participants meanings, letting them define their own perspective through open ended questions" (Maxwell, 1996, p. 90) was the goal of conducting this research. Data Analysis Data analysis is defined in literature as... What all of these strategies have in common is that they do not focus primarily on relationships of similarity that can be used to sort data into categories independently of context but instead look for relationships that connect statements and events within a context into a coherent whole (Maxwell, 1996, p.79). The process of conducting the analysis had many stages and is discussed in full within this section. Data was also obtained through observations of the participant throughout the interview. This included body language, atmosphere, eye contact and voice tone. The interpretation of the data is the perspective of the participant studied and this is attained by revealing the meanings they attach to their words and to their actions. Through the data analysis process I thought that it would be important to recognize the participants in a respected cultural manner. This will be achieved by giving each a St6:l6 name in the Halq'emeylem language from where my matrilineal lineage originates. To give the reader a frame of reference and to understand the nature and personalities of the participants, I present eight vignettes. These vignettes will give readers a brief synopsis to introduce the lives of participants diagnosed with a terminal illness and their views on spirituality. Vignette Number One 6:ywoses, "On Both Sides" is a single man in his mid forties from eastern Canada who is tall and very slim. He looks very serious but at some moments I could see a sparkle 38 in his eyes and a slight smile on his face. 0:ywoses is a person who was diagnosed HIV positive three years ago and lives in the downtown east side of Vancouver in a small one bedroom hotel room. He is an active intra veinous drug user of heroin, likes drinking rice wine ( 37% alcohol content and high salt content) and one who has some university education. 0:ywoses has also been in prison and in foster care prior to moving to Vancouver. He has also done some traveling around North America; particularly the United States. He is of the Catholic faith and has some beliefs from the Navajo faith. 0:ywoses is very popular at VNHS because of his good sense of humor and gentle manner. I gave him the name "On Both Sides" because he has seen both sides of situations in his life, for example being in foster care/living at home, studying religion/cultural perspectives, and traveling/living in the city. About six months after conducting the interview 0:ywoses died alone in his hotel room due to a heroin overdose. Vignette Number Two Mathkwi, "Easy Traveling" is a man in his thirties who is tall and has long beautiful straight black hair. Mathkwi has been diagnosed HTV positive for a year and a half and has contracted the virus through intra veinous drug use of cocaine. He did not indicate that he was an active intravenous drug user or not. He is a man who has a gentle personality, a big "heart" and a deep laugh that originates from his stomach area. He currently lives in the city of Vancouver but is originally from Saskatchewan. He is in a relationship with a woman and stresses the importance that it be known that he is not gay. Mathkwi has been taught First Nation traditional beliefs and practices but does not practice them today. He had a dream about ten years ago which he interprets as a sign for 39 him to return to the traditional ways of living. I gave him the name "Easy Traveling" because he travels easily in his dreams. Vignette Number Three Slakeyanc, "Young Sockeye" is the youngest participant in this study. Slakeyanc is one who has many traditional teachings from his grandparents and continues to practice many of those teachings today. He is one who speaks his traditional language fluently. Slakeyanc has been HIV positive for twelve years and has had AIDS for the past three years. He has been in and out of hospital for the past year. He is a two spirited (homosexual) man who has a supportive partner. Slakeyanc has limited physical energy but a strong spiritual belief system. He also accepts his health condition and is able to talk about his death along with his beliefs of afterlife. I gave him the name "Young Sockeye" because he is the youngest in the study and because in my culture sockeye salmon is an important part of our life and diet, as he is an important part of this study with his wealth of cultural information. Approximately four months after this interview he died in hospital of ADDS that was at the end stage of its course. He had his partner and his "street friends" (who became his family) to support him until his death. Vignette Number Four Qemlolhp, "Maple Tree" is a single man in his thirties who has been HIV positive for three years. He did not indicate how he had contracted the HIV virus. He lives in Burhaby but often frequents Vancouver Native Health Society. Qemlolhp is an easy going man who likes to help people through volunteer work for HIV related First Nation organizations. Qemlolhp also likes to go out and have his occasional beer. He is usually cleanly dressed and well groomed. He is very healthy and has had no medical problems 40 because of the HIV virus. He states that he does not follow any particular form of spirituality, such as Christianity or First Nation spirituality. I gave him the name "Maple Tree" because he has a quiet strength about him that is unassuming. He is a maple tree that has potential to grow in many directions with the proper environment and nourishment. Vignette Number Five Sqam, "Calm Water" is a small, very nurturing female Elder. She has been diagnosed with cancer over two years ago and was told that she has cancer throughout her body, now she has many physical limitations. She lives in the St6:l6 Nation within the Fraser Valley with her husband and cannot go out to too many social functions for the fear of acquiring germs that could be harmful to her health. Sqam is a leader in her large extended family and many family members seek guidance from her. She has strong First Nation cultural beliefs which she receives from the longhouse teachings. She identifies her job or purpose in her life is to help and teach young people. She teaches young people within her home by talking to each person on a one to one basis, and she accepts this responsibility graciously. I gave her the name "Calm Water" because water is a natural cleansing source that is valued to people. She is a person who helps people and is also appreciated by many for her assistance. Vignette Number Six Ta'telew', "Little Creek" is a very kind, soft spoken man in his early thirties who has been HIV positive for seven years and has been living in the Vancouver east side. He is a two spirited man, and an intra veinous drug user with a stable, supportive partner. Ta'telew* incorporates religion and First Nation spirituality into his life because his mother 41 is French and he was brought up in a French Monastery. His father is Ojibway and is a traditional First Nation medicine man. His health is good, so he enjoys an active volunteer life with various nonprofit agencies in Vancouver. His main goal in life is to help and teach young people with HIV education and to offer support to them. I gave him the name "Little Creek" because he has a pure quality to him (as creek water) which was taught to him when he was young. I have been taught that water is the most powerful element on earth and also the most humble; I see him as humble and having the potential to do some good work for people. Vignette Number Seven Iyem, "Strong" is a very well respected sixty-seven year old elder from the St6:l5 Nation in the Fraser Valley. Iyem has been a winter spirit dancer for twenty-six years in the longhouse. He was first diagnosed with cancer eight months prior to this interview. For the last five months he has been at home very sick with a cancer that has spread throughout his body. A few months ago he was in hospital with pneumonia that would only give him initially only a few days to live because bis immune system was next to nil. Iyem is married and is the father of five grown sons. He has a very strong First Nation cultural belief system and specific practices to speak of. Iyem is a person who has accepted his diagnosis of cancer and is ready for his death. He can also speak of afterlife with no fear and in the meantime teaches many people the traditional teachings that have been taught to him in his life time. Iyem's words are wise yet his manner is very humble and welcoming during his time of sickness. I gave him the name "Strong" because his spiritual teachings and practices are strong. His strength was also earned through life experience. Three months after the interview Iyem died in hospital because of his illness. 42 Many family members, friends and community members were there for his family during and after his passing. Vignette Number Eight Sqwa, "To Go Through" is a single man in his mid thirties who is interviewed in the Provincial Corrections Facility. I am unaware of what his crimes are. Sqwa is HIV positive through intra veinous drug use and one who likes to drink rice wine when he is living in the downtown east side of Vancouver. Despite the "rough" environments he has been living in, he has a good sense of humor. Sqwa is searching in many ways in his life. He is learning about First Nation spirituality through sweat lodge ceremonies and smudge ceremonies that are allowed to be performed in the facility. He also seeks guidance from the priest and thus is able to receive help from both sources. I gave him the name "To Go Through" because he has gone through various situations in his life: the corrections system; HTV; and search for spiritual meaning. One year after conducting this interview he died in the Intensive Care Unit at the hospital. His family was their to support him while in hospital. It is also important to note that he died a few hours after his birthday. Narrative Style The analysis conducted in this study employs a combination of narrative and coding methods. In reading on narrative style I found that there are some categorizations of styles which I found helpful. Mishler (1995), divides narrative analysis into three groups: reference - which emphasizes the representation of events in a particular order; structure -which investigates the story text and language used, and function - which studies the purpose of the stories. Narrative research is also personalized and specific to the 43 individual in the study because they are the primary focus. "Narratives are useful for what they reveal about social life - culture 'speaks itself through an individual's story" (Riessman, 1993, p.5). With this narrative approach it is my goal that the participants social condition, cultural beliefs and practices are revealed through their reference of their stories, structure of their stories and their function of their stories conveyed in this study. Coding Coding as an analytic strategy undertakes three kinds of operations: "a) noticing relevant phenomena, b) collecting examples of those phenomena, and c) analyzing those phenomena in order to find commonalties, differences, patterns, and structures" (Coffey & Atkinson, 1996, p.29). Coffey & Atkinson (1996), continue to state that coding does not need to be seen as merely reducing data to some general, common denominators but can be used to expand, transform, and reconceptualize data to reveal more diverse analytical possibilities. This is especially helpful when looking at First Nation spiritual beliefs and practices. Coffey & Atkinson (1996) state that the process of coding involves the following procedures: the recontexualized data needs to be shown in a way that can be read easily and; involves playing with and exploring the codes and categories that were created by retrieving, splitting, splicing, and linking them together. Narrative and Categorizing Analysis I started with a narrative style of analysis by presenting the participants' interviews in a story like format. This method gave me many stories but I needed to present them in a order that contained the broad spectrum of their ideas. I thought it best to use the 44 narrative style approach because First Nation people have been known to teach others through stories. The participants often used stories to illustrate the development of their beliefs and practices. I then used the coding process to further clarify their words by having the data put into categories of common interest or contrasting ideas. In addition, I also implemented the use of codes because the interviews had such diverse and rich information that it was necessary to capture the participants meanings through the coding process. The stories were broken down into categories which identify patterns, comparison, and differences of the participants points of view. I then began to pull out direct quotes to maintain their themes and ideas which Coffey & Atkinson (1996), report that: "When codes are attached, it reflects a series of readings and re-readings of the data, in which the details of the interview and our own emergent concerns interact" (p.44), which is largely what I have tried to do with my research. The physical disaggregations of the data was accomplished by physically cutting up different color copies in order to conceptualize the data. This choice of analytic methods also reflects my desire to have their teachings and experience be recognized and acknowledged in their context and reference. Validity/Credibility Issues "Validity is the correctness or credibility of a description, conclusion, explanation, interpretation, or other sort of account" (Maxwell, 1996, p. 87). Maxwell also explains that there are three ways of understanding research and that each is open to particular problems or threats which place results in question: description, interpretation and theory. Inadequate recording of the data collection process can threaten the validity of the data's 45 description. The inadequate recording brings suspect to the conclusions drawn from the data. The interpretation of the data can be threatened by the influence of the researcher's own beliefs over those of the participants. And the theoretical validity can be challenged by the researcher's own avoidance of conflicting data or alternative theories. The implementation of my research study took into consideration validity threats. I practiced a number of techniques (as discussed in Maxwell, 1996) to validate the credibility of my results. In addition to audio taping the interviews, I made extensive notes during and after the interviews. Also during the interview I observed the participant closely and was able to write up a summary of the interview because of these notes and observations. The audio tapes from the interviews were transcribed verbatim before they were analyzed. All of the interviews followed the regular procedures of: obtaining written consent (See Appendix B), tape recording, note taking, observing nonverbal v actions and implementing the semi-structured interview. One particular interview had problems due to mechanical breakdown of the recording system creating indistinguishable words on the recording. It was then necessary for me to meet with the participant once again because I wanted to capture his words and experience that was shared earlier. He read my summary write up of the interview and had the option to add, delete, or change any pertinent information. He did clarify some areas and also added some information that made his "story" complete. It was with this process of clarification that I received a completed transcript that was sanctioned and reviewed by the participant. "Soliciting feedback from others is extremely useful strategy for identifying validity threats, your own biases and assumptions, and flaws in your own logic or methods" 46 (Maxwell, 1996, p. 94). I also went back to each of the participants to review their own transcripts to verify their ideas. Each stated that their written transcript was translated properly from the audio recording. I then presented the four participants that are alive the preliminary findings and asked them to critique the analysis so as to make sure it was congruent with their spiritual beliefs and practices. In addition, I had friends, family, and other academic persons read parts of my thesis while it was in progress and asked for any feedback that they may have and give explanations for their points of view. For my research, the most troublesome area involved the interpretation of the data. My study is highly interpretive in style and I have been concerned that my own beliefs and practices of spirituality influencing the data gathering process. During the data gathering process I took special notice and addressed areas that "surprised" me and areas that challenged.my current understanding of spirituality and terminal illness. It is through this analysis process that I aimed to remain open to "hearing" other perspectives that were revealed in this study. Yet, despite my fear, I believe my interpretations are valid and that the quotes I selected provide clear illustrations of how the participants interpret and practice spirituality when terminally ill. I believe that I can make a claim for credibility for my study in terms of researcher involvement in the area being studied. "Stake (1994) provides this definition: 'Qualitative case study research is characterized by the main researcher spending substantial time, on site, personally in contact with activities and operations of the case, reflecting, revising meanings of what is going on (p.242).'" (Kvale, 1995, p.232). "Naturalistic generalization rests on personal experience: It develops for the person as a function of experience; it derives from tacit knowledge of how things are and leads to expectations rather than formal predictions; it 47 may become verbalized, thus passing from tacit knowledge to explicit prepositional knowledge" (Kvale, 1995, p.232). I am the main researcher in this study, and I am a First Nation social worker who has the experience of working with people with a terminal illness for over three years in the hospital and community setting. I also understand various spiritual teachings from my own traditional, cultural teachings, along with my Christian teachings too. I realize that this does not give me a right to claim insight or special knowledge about spirituality of those who are terminally ill, but I feel that my work and commitment to understanding this area does give me the ability to listen and start to understand their spiritual beliefs and practices when terminally ill. Summary The research methodology used for this thesis is designed to examine uses of spirituality by First Nation people when they are terminally ill. The method study addressed: developing a working definition of spirituality; collecting data from First Nation persons who are experiencing the trials of terminal illness; and collecting data from First Nation Elders and/or traditional/cultural healers. Overall, the methods used for this study included personal interviews which were analyzed with a narrative and coding style approach to reveal the participants' spiritual beliefs and understanding when terminally ill. And finally I addressed the validity and credibility issues concerning this study. The next chapter will address the final findings of the five Elders and complete the section with the final findings of the eight participants of this study. 48 CHAPTER FOUR FINDINGS This chapter will show the results of the data collected from the First Nation Elders' perspectives and the eight participants who are diagnosed with a terminal illness. The findings will begin with the Elders' perspectives and then end with the eight participants perspectives. Elders' Perspectives A section which focuses upon the Elders' perspectives is necessary because it enhances one's understanding of the concepts of spirituality, health and terminal illness. I feel that this perspective is imperative because current literature does not yet have this area documented. One reason for this situation is because as Grizzlybear Lake (1991) informs, First Nation people have traditionally been teaching in the oral tradition through sacred teachings such as myths and ceremony. First Nation oral traditions require a social environment that is supportive of knowledge transmission and protection from generation to generation (0'Neil,1993). "The oral tradition is that process which the myths, legends, talks, and lore a people are formulated, communicated, and preserved in language by word of mouth, as opposed to writing. Or, it is a collection of such things" (Gill, 1993, p. 48). Many of the traditional teachings, especially on aspects of spirituality have not reached the printing press because the First Nation culture is primarily taught in the oral form. For example by Carlson, Carlson, Thorn, & McHalsie (1996) suggest St6:l6 culture and traditions are expressed primarily through elaborate oral narratives. Therefore, it is 49 necessary for me to extrapolate spiritual/cultural teachings by talking to Elders and/or traditional healers on this subject of analysis. Elders are described as people who have experienced life extensively enough to teach other people despite what their age may be. An Elder is used to describe someone who has knowledge and understanding of the traditional ways of his or her own people and their spiritual tradition. Traditional healers are those people who have a sacred gift of helping people with their hands or their teachings. The traditional healer is one who is often born with a natural gift for healing, but they must also study under the guidance of Elders, as well as pursue his or her learning through experience and spiritual development. As written, "You (traditional healers) are born with a special kind bf power, gift, talent, and knowledge. It is not your power; it belongs to the Great Creator and the people" (McGaa, 1990, p.7). Currently First Nation people are legally able to practice their traditional ways and many of the traditions are being revived or practised openly so spiritual people are now willing and able to share some teachings with those who are interested. This was not always the case - Carlson (1996) writes that in the 1884 Indian Act many of the traditional ceremonies were prohibited to be practised by Aboriginal people. Another government document that aimed to affect traditional practices is: "The 1969 White Paper Policy from the Liberal Government of Pierre Trudeau was strongly opposed by Native leaders across Canada because it sought to remove the distinct status that Native people held" (Atlantic First Nations AIDS Task Force, 1995, p.xiii). 50 Despite many of the political obstacles that the First Nation people had to over come in the past, I will share some of the teachings from the communities I come from; St6:l6 and N'lakapamux. The five people interviewed are either traditional healers, medicine people or Elders who have cultural wisdom. All five people agreed to be identified by their given Christian names: Danny Charlie, Janet Charters, Ida John, Paul Oppenheim Sr., and Bev Julian. The goal of this section is to relay some of the First Nation oral teachings from five people from the St6:l5 and N'lakapamux Nations about spirituality and its relationship to those who are terminally ill. The results of these interviews aim to enhance the concepts of spirituality, to educate people, and sensitize people about the practices and beliefs of the First Nation people who are terminally ill. Grizzlybear Lake (1991) writes that Native traditional healers are "natural practitioners" because they use natural knowledge, natural methods, and Nature in order to doctor a person. "A medicine man is a visionary who has succeeded in receiving power to cure people" (Hultkrantz, 1990, p.7). This understanding will help one to understand the following teachings of the traditional healers/Elders of the St6:16 and N'lakapamux Nations of British Columbia. I chose five respected Elders and/or traditional healers in the communities of St6:lo and N'lakapamux because I am familiar with them and have strong cultural ties to my nations and have a better understanding of my own communities rather than any others. I interviewed two Elders/traditional healers from St6:l6 Nation, two Elders/traditional healers from N'lakapamux Nation and one Elder/traditional healer from both of the above stated nations for recruitment balance of my matrilineal and patrilineal family ties. Each of the Elders are well known to me because of their work in the 51 community and because of my contact with them during my up bringing. Since I knew each of them personally, I either went directly to their homes to recruit them for the study or I telephoned them. At this time I informed each that I was doing research on "Understanding how First Nation people practice and interpret spirituality when having a terminal illness" and that it is necessary for me to gather more spiritual and cultural knowledge because current literature only addresses a limited perspective of these issues. So therefore, I explained that Irequired an Elder's perspective for these teachings and felt that an interview would be the best method to acquire this information. I then informed each that the participation in the study was completely voluntary and that each did not have to participate if he or she did not want to. The five Elders I approached agreed to provide the information and be part of this study. These are people who are well known for helping others spiritually, mentally, physically and/or emotionally when they are asked to do so. I interviewed respected people from the communities of my heritage because they can provide me with valuable information about spirituality. I know that each person is respected in the community for what they do and what they know because I have seen them work, heard good things about each of them and will document their contributions through the oral tradition. It is necessary for me to interview these Elders and/or traditional healers because I do not claim to know a great deal about this topic and need their interpretations to incorporate it in an Elder's voice that is respected and accurate. As stated earlier there is not very much literature available on this topic so it was necessary to conduct research by interviewing people who understand the topic. 52 I respected the people that I interview by adhering to the traditional protocol of offering tobacco to the Elder. I was taught that the offering tobacco to the Elder or healer and the Elder's or healer's acceptance of it reveals that each is agreeing to tell me their stories for the purpose of this thesis. When an Elder accepts the tobacco it is equivalent to formal informed consent of the issue addressed. It is my understanding of this First Nations cultural practice that if one wants something significant or some assistance from someone, then one gives the person they are asking some tobacco in exchange for help. When a person is giving tobacco, they are requesting that the wealth of the person sought teaches them their knowledge on the information requested. It is to be noted as Herbert (1994) writes that the use of the tobacco is not at all related to the use of tobacco as a recreational drug. The data was gathered through the means of individual interviews with Elders of First Nation descent. Three of the interviews were conducted in the comfort of their homes, one in a secluded booth of a restaurant and one was conducted over the phone. After giving the tobacco, I explained to them that this study is for a thesis that examines spirituality and its interpretation and beliefs of First Nation people that are terminally ill. I then explained that the purpose of the meeting is to learn more about their teachings in regards to their beliefs and practices with spirituality. Each of the Elders was very humble in his or her manner and indicated he or she felt honoured to be consulted on their teachings or opinions for this study. Although each had generally indicated to me that they really do not have that much to offer on the subject, once the questions were asked they were quietly on their way giving me a wealth of valuable information. 53 The interviews ranged from half an hour to an hour and a half long. During the interviews I took extensive notes on the information shared by the Elder and/or traditional healer. I chose this method for two reasons: to gather information from them in a traditional sense by listening to the teachings they had shared with people in this manner all their lives and; to capture their words the best I could by writing the descriptive notes during the interview. During each interview I also had a tape recorder ready to be used if it were permitted. I gave each Elder the option to have the interview conducted with or without the tape recorder and each of them preferred without, so I took elaborate notes while they spoke. The interview guide used is as follows: 1) What sort of spiritual advice would you give people who have a terminal illness? 2) What sort of spiritual advice would you give to professional social workers who work in health field? 3) Can you tell me of any barriers within the health field that may effect your spiritual beliefs or practices? 4) Is there anything else that you would like to discuss that we may not have covered so far? When each of the informants indicated that they did not have anything more to say on the subject I would thank them for their time and give them a gift. "Indian people by nature are extremely generous sometimes to a fault...selfishness is shamed. Indians do not like to ask for money even when they have performed services for others" (McGaa, 1990, p. 122). I would give them a blanket or a set of towels for their teachings and because it is 54 traditional in Sto:lo and N'lakapamux territory to show our gratitude to our Elders for their teachings. It is also important to understand the process of how information was acquired from the terminally ill patients. It is my belief, understanding and teaching that First Nation people consider their spirituality to be very sacred, very strong and essential. Some basic concepts known to First Nation people are holistic living, connectedness, unity, respect, strong belief system, and an understanding that anything can be accomplished through the Creator if it was meant to be. Mails (1993) informs us that healing is purely spiritual and has to do with helping a person to be right with Wakan-Tanka (Great Spirit or Creator) and healing is a priceless gift that can be given to anyone who will accept it. In addition Mails (1991) writes that medicine people first receive the power from the Wakan-Tanka to make us what the medicine person should be, and then the powers flow through the medicine person and out to others. It is necessary that I state the reasons for presenting the Elders' perspectives within their own distinct dialogue of teachings. I will present perspectives which allow the Elders' words to be recognized on their own merit. The teachings are their words and I am merely a messenger or voice. The Elders teach that if there are specific teachings an individual does not understand it is because the individual may not be ready for the teaching presented. In the future the individual may understand the teaching when the individual's life is more relevant to the situation. In this situation, I would like to think that a spiritual seed is planted within the individual which has potential to grow if it is further nurtured by seeking further explanation from Elders. In addition, I will not restrict the teachings of the Elders by implementing a contrast/comparison analysis because my 55 perspective will limit the depth of teaching it can attain. When the Elders' words are spoken they can teach the individual according to their life situation, thus have a personal perspective that can vary from one individual to another. Danny Charlie: St6:lo Nation The following teachings are from Danny Charlie, a St6:16 man who is called many times throughout the year to help people in their lives. It has been his experience in the twenty-seven years of active spiritual practice that he has been greeted openly by various organizations, people, and individuals. Danny is a winter spirit dancer in the long house. The spirit dancer custom originates from the Pacific Northwest First Nation people. The spirit dancer will enter the longhouse every winter to dance his or her own special spiritual dance while it is sung by fellow winter spirit dancers. During each winter season many of the winter spirit dancers gather to share their songs and their traditional teachings. When Danny was a young spirit dancer an Elder had pulled Danny aside to tell him that he is a person who has been designated to perform cultural burnings for the spirit world. Danny also takes on the responsibility to be a cultural healer who works with his hands to help people spiritually, physically, mentally and emotionally. Danny agrees with the following belief on the spirit and the body connection. Spirituality is bringing together of those things that are essential to our becoming human beings. The human part is our body, and the being part is the spirit. Our purpose in life is to bring these together in the best possible way, as the Creator intended (George, 1991, p. 160). Before Danny performs any traditional spiritual work, he fasts (refrains from food 56 and water for days/hours), and prays that he understands his destination and the purpose. In regards to his prayers Danny states, "One must believe in the prayer and have no doubt about the healing process. When a person is receiving help, faith is the first thing that brings the spiritual power in." Danny agrees that the rituals and the tools play a part in this but without faith there is no power and there is no movement (Mails,1991). In regards to sickness: Danny states, There are the Seven Great Laws to live by; honour, love, kindness, respect, i sharing, caring and happiness. I have received the Seven Great Laws teachings from the Alberta Elders. The Seven Great Laws are to be directed at all times towards the family, community, Great Spirit, universe with all that it provides and Mother Earth. Danny also recognizes the importance of Mother Earth and understands the following quote: The concept for mother earth has become a hallmark of American Indian spirituality. It is the movement's primary symbol of respect for nature, and it figures predominantly in claims that native attitudes toward life are antidotes to the abuses of nature that epitomize the corruption of Western society (Porterfield, 1989,p.l58). Danny continues his teachings: I have been taught that when a person breaks these laws they will suffer. The person is advised to acknowledge the hurt and pain that one is going through. It is my understanding that usually behind pain is anger. When a person is angry, one can reach a point in their life where he/she does not care about himself/herself. When the Laws are broken there is a punishment of the spirit. The person may externalize feelings of shame, guilt, hurt and may go to the body in some form of sickness, ie. cancer, arthritis, heart attack etc. Danny reminds us of the concept of mind over matter. He teaches the following beliefs and practices: The person needs to believe in what the doctor is doing for the treatment to be successful. If the person does not believe the treatment is going to be 57 effective, chances are that it will not be. It is also good to acknowledge this teaching when a person is advised to believe in prayers and that these prayers come from the heart. A traditional healer can assist in the healing process but it is the healer's and individual's responsibility to have a successful outcome by having faith. A traditional healer is a person who is only a servant to the Creator and the person requesting help must have a trusting relationship with the Creator for success. The traditional healer is only used as a tool to accessing the Creator's healing powers. There are various ways for First Nation people to restore their faith. Danny identifies the following procedures: smudging, cedar brushing, and praying will start the healing process. Smudging is a ceremony that allows people to purify themselves. This ritual uses the dried form of sage or sweet grass and is burnt to form smoke that anoints the person's body. Personal prayers are said in order to be connected to the Creator. Cedar brushing is practised by gathering a few cedar boughs and having the boughs lightly brushing over the person's body. This brushing also cleanses the body in the spiritual realm. The cedar tree is looked upon by many First Nation people to have the strength to help people. Danny also continues, People can clean their blood by eating more grapes and raisons. It is also good to ask traditional healers or herbalists to prepare medicine for them. Each person needs to keep an open mind to the various teachings and practices that are experienced throughout life. It is also important to practice; leam to listen and then listen to learn. Another teaching I want to relay onto you is; learn to talk the walk, then walk the talk. I have some additional teachings for terminally ill individuals: talk to a priest or counsellor for emotional guidance; request prayers of a priest or spiritual person to be said on behalf of the terminally ill individuals and for the individuals to love and accept one self for who they are. 58 Danny agrees with the concept George (1991), writes that we must love ourselves, then we can love each other; respect ourselves so we can respect each other. Danny states, Today a lot of First Nation people are following in the foot steps of the non-native society. I notice that some people have the belief that their God or spirituality is better than others' spirituality. This belief embraces the concept of having no other way to practice spirituality except the concept that the person or individual already holds. I recognize that the belief of only recognizing and acknowledging one's own spiritual practice and belief is occurring amongst our own (First Nation) people. I would like to teach that each individual has his or her own way of practicing spirituality and if another person practices it differently than yourself it does not necessarily mean that it is the wrong way. I have seen some elders sit back and think that an individual is making a mistake and say they, 'This is not our way'. I have been taught what when a person is truly understanding the Great Spirit, they realize that all four races of the world have been given a distinct language, traditional customs of practicing their beliefs; (for example) in the Catholic church the people cleanse with holy water before they address the people (or when entering the church). Our Native brothers and sisters of the eastern and southern prairies use smudging to cleanse. The St6:l5 people use cold water to bathe in and cedar boughs to cleanse with. In understanding the beliefs of the Great Spirit we need to know that all of these traditional ways of practicing tradition accomplish the same thing. People don't understand the different practices and it becomes the fear of the unknown. The fear then perpetuates the practice and belief that one way is better than another. In regards to understanding the Great Spirit, Danny teaches, There is only one Great Spirit and we need to understand that our belief system and practice is one that works for us. So (therefore), we are to respect each other's traditional belief system and traditional way of doing things. It is important that we do not condemn each other's ways because this is our connection, our belief for our healing. For example, a person does not go into your house and move the couch, the television and pictures to their liking. The person is to respect how everything is placed because that is the house owner's style. Similarly the person is to respect another person's life style and their traditional beliefs and practices. 59 It is just as important to understand and acknowledge the practices of how to the traditional healers and elders when requesting spiritual help. Compensation for traditional healers is a topic of considerable ambiguity and some controversy. Danny continues to teach, Payment (compensation) can be received in many forms: money, cup of coffee, a meal, a gift such as a blanket or towels, kind words, or a handshake Oust to name a few). A traditional healer will receive whatever the family or individual can afford to offer. A traditional healer acknowledges that a true spiritual gift from the Great Spirit is enough payment in its self. A traditional healer or helper will accept whatever the person requesting help puts into their hand after the spiritual work is done. I have been taught that 99% of the elders taught me that it is important to have a high respect towards the Great Spirit because this is where people can receive help. Not only are we to respect the Great Spirit but we are also to respect all things that the Great Spirit has created. This includes the sun, moon, stars, human beings, and everything that has been created. Native people are taught that each of the Great Spirit's creation has a spirit within it. This living spirit is within each of the things created and we are to respect everything around us. Respect, honour, faith, and trust are beliefs that enhance a connection with the Great Spirit and all that is created. It it with this understanding and practice that we can have the total connection to spirituality. A person working as a healing person has a spiritual belief system that allows them to put all the faith and trust into the process of the healing that is taking place. This is not just physically but mentally, emotionally and spiritually too. The gift of life is something that has been suppressed to a point today where we don't understand that everyone of us as Native people are born with a sacred gift in life. The references to the gift of life are: home builders, hunters, fishermen, messengers that would run messages to other . villages, dancers, basket makers, gatherers of medicine, midwives, sweater makers, male and female Indian doctors, healers of the hand, seers, speakers, cultural burners. I understand that there are various ways in which a person could find out what their gift or purpose in life by having a Vision Quest, going to the mountains, fasting and praying, and through elders/spiritual leaders recognizing their gift and teaching how to develop their gift. These ways will show the person what their gift is, how to practice it and other 60 teachings that are relevant to using their gift. When a person has received teachings by the above mentioned ways the person has the right to practice their gift and are totally connected to the spirit. I know that these ways are the traditional customs and beliefs of the past. Today there are a lot of changes. I notice that today people want to be healers, herbal medicine people but they do not totally have the gift. These people are not practicing the sacred gift of the life with which they were born. (He warns) We have to be careful of these people because it has not been their 'calling' and they have not been taught the proper traditional training. It would be wise to ask the person you are seeking help from why and how they started the traditional practices. When you do this it is done to protect yourself. Danny agrees with Grizzlybear Lake (1991) who writes that a Native healer is born with a special kind of power, gift, talent, and knowledge. This gift or power must be handled in the right way or someone could get hurt. Danny teaches, It is also important to know that not all medicine people are good. Some of them try to steal one's power or are jealous of a person's life and can try to take away a person's power while they are doctoring the person. One of the most important beliefs I hold is that when I complete my traditional/cultural work, I do not look back and question if the Great Spirit has helped this person. I just have faith. Janet Charters: N'lakapamux Nation Janet is a sweet, kind Elder, who has many teaching to offer. Janet states, "I feel that I have been put on this earth to pray for people and to help people." She is well known in the Nicola Valley and receives requests to help in various capacities including those with a terminal illness. Janet states, My personal experience with spiritual work the time when two years ago I experienced a mild heart attack or stroke that does not bother my physical health today. My heart condition was officially diagnosed by my doctor. I went to my doctor's office to get an update on my heart condition and when the doctor was examining me he was very surprised that my heart was only labouring a little bit. He was surprised because he was aware that I had not had any medical attention by any medical staff. 61 There are three main reasons for my recovery. It is all because of the following reasons: 1) for the many people praying on my behalf to get better, 2) by seeing a traditional healer in Kamloops who spiritually seen and removed two dry fish bones that were sticking into my heart and 3) by taking traditional herbal medicines that were suggested by the female medicine doctor. With sparkles in her eyes and a smile on her face and she told me, "There is nothing wrong with my heart now." Janet has a strong faith in the church and traditional/spiritual techniques. Janet has incorporated many Christian values into her own spiritual belief system: When I am called to help someone I will pray to Jesus and ask that I arrive there safely and that the person is helped physically and spiritually. A person must have absolute faith in Jesus and the healing. With Jesus anything is possible. I can also see the spiritual images or objects on or within the person. People who have not been trained in this area of healing will not see these spiritual images or objects when they are present. Janet's healing is similar to, Wakan-Tanka (Creator or Great Spirit) and the Helpers cast spiritual light onto things so that I can see them for what they really are. You will notice how the sun does this to the earth during the day, and how things look different in different light. That is what the Higher Powers do for me in spiritual matters. This light also pushes the darkness away and shows me what is there (Mails, 1991, p. 77). Janet teaches that, The spiritual images or objects seen make the person sick and with the help of Jesus I can take them off. I want to ensure that people understand that prayers can be very powerful and do work. Never underestimate the power of prayer and healing. The person is to have faith in the process and know that I am only a Helper. Jesus is the one who is the healer, I am only a tool in the healing process. A person can keep themselves balanced by going to the water and having a traditional/cultural swim. The person goes to a body of water; a lake, river 62 or creek and praying to be cleansed (spiritually, emotionally, physically and mentally). You can have swimming shorts, a bathing suit or your birthday suit when going into the water. You can then put mud or sand all over your body and dip into the water four times to wash away the mud. When you come out of the water you will be nice and clean. The swims could be done in four (consecutive) swims or ten consecutive swims with two swims occurring each day. A swim is done once in the morning and once in the afternoon. The swims can be done over two days or five days to complete the cleansing. Ten swims are better than the four swims but if you can just do the four, that is fine too. Janet teaches, Some people are forgetting to offer tobacco when they ask for help or need questions answered. It is important to offer tobacco because I had a dream about the importance of giving tobacco to people when they are asking for help from any spiritual and/or cultural people. I notice that people are neglecting to give tobacco and I feel that it is important for me to teach people or remind people of this traditional practice. Any amount of tobacco given is good enough as long as it is given at the time you are asking for cultural or spiritual help. When someone is really sick Janet recommends that a loved one go to the mountains for a Vision Quest (See Appendix C). This is similar to Grizzlybear Lake who describes a Vision Quest: In order to have a vision we must turn to the Great Creator, Mother Earth, and our relations in Nature. We must enter the dream world and the deeper levels of our own mind, to the ancient archetypal images in our unconscious, to our very soul. A vision can guide us through life and give meaning to our life, to give us strength and protection, and to find answers to those mysterious questions and experiences that plague our life with pain and suffering (Grizzlybear Lake, 1991 p. 43). Janet teaches, A Vision Quest can be accomplished by the person going and camping in the mountains to wait for a vision. In this vision, the person is asking the Creator how he/she can help the person in need by having a dream where one can see which medicine would be best to give to the person in need. The person on the Vision Quest will stay in the mountains until the answer is revealed to him/her in a dream. In this dream he/she will be shown what 63 the plant looks like, how to prepare the plant, and how much to give the ill person. I am also aware of different medicines that will help people with liver or kidney problems. There are five herbal medicines that can be taken to heal these two conditions. The five medicines are: 1) alum 2) kinnikick 3) wild strawberries 4) purple flowers (specific ones) 5) "pasactitch" (only knows the Indian name and not the English name). I can show you each of these medicines while outside and when you have these five medicines mixed together in a tea mixture it will help the person with a liver or a kidney problem. Janet also has some suggestions to the people who are seeking help: Have absolute faith in the healing process, refrain from taking drugs and/or alcohol during the helping process, do not have a temper that is active. If these suggestions are followed, the healing will take place. Ida John: St6:ld Nation and N'lakapamux Nation Ida is a woman who is respected in the territories and works to teach First Nation people how to enhance their traditions and their spirituality. Ida is a pipe carrier, sun dancer and dietician. She is an Elder who works extensively to enhance First Nation health through education around herbs, nutrients, specializing in assessing the diets of First Nation people and taking care of them spiritually also. Ida has experienced an amazing recovery in her life because of her beliefs and First Nation traditions. Just a few years ago, she and a friend were travelling in a car while in South Dakota and during her journey she could see warning signs in the form of four animal sightings. First she saw an owl and almost hit it as it flew right in front of the vehicle. Second she saw a white mouse run across the road. The third animal was a porcupine that she almost ran over. Ida did stop the vehicle and back up but she did not 64 get out of the car because she had seen drunk drivers in the area and felt that it was unsafe for her to do so. The last animal she saw was the owl again. It is within her beliefs and teaching that an animal is a messenger and is sent to tell her something. Mails (1993) writes that animals can appear in their earthly forms or they come in their spiritual forms. When she sees an animal, Ida has been taught to stop on the side of the road and offer tobacco and pray to understand the message being sent. However, on this trip instead of stopping on the side of the road and acknowledging the message, Ida and her friend kept driving because they needed to arrive at their destination at a specific time. Ida now recognized the importance of the signs because she was in a serious car accident within one hour of sighting the animals. She knows that the animals were there to warn her and to slow her down. She knows that each of the animals were willing to sacrifice their own lives to protect her for a little difference in the time and therefore the location of where the accident took place. The driver of the other vehicle was impaired. If they had stopped and acknowledged the animals they may have been able to avoid the accident. Ida recalls that she was conscious and able to move in a limited capacity, while her friend lay unconscious. Ida does not know how long she was in the vehicle because she was slipping in and out of consciousness. But she remembers that the man who caused the accident did return and pull her out of the vehicle. He set her down just outside of the car door that was hanging loosely on the car frame. It was at this time that Ida saw an owl near her and this sharpened her senses to what was happening around her. She knew that the owl had a message and it was then she 65 remembered that during the accident her spirit may have left her. She knew that without her spirit she would not have the will to live much longer. Ida did want to live and she was taught that she could call her spirit back if she had tobacco. She remembered that on the rear view mirror in the car there was a tobacco tie there. So she struggled to get to it and put some tobacco in her hand and prayed that her spirit return. Ida was also concerned about her friend who lay unconscious nearby. She placed some of the tobacco in her friend's hand. As she did so she told her friend that the Creator will take care of her and that the tobacco will help her. Ida told her friend that it is also important for her friend to call her spirit back. Much later the ambulance and police came and they took each of the women to different hospitals. Ida is of First Nation ancestry and she was brought to the local hospital and her friend, who was white, was brought to a larger hospital further away. Today Ida feels that the medical attendants discriminated in where they brought the woman for medical treatment. The car accident had injured her to a point where she now can barely walk and is in severe pain. When discharged from the hospital Ida was walking through the hospital doors and she noticed a car pull up in front of the hospital. She saw her friend who was in the accident with her step out of the car and greet her. Ida noticed that in her friend's hand she was still clutching onto the tobacco that she had put there during the accident. Meanwhile, a traditional/spiritual man arrived at the hospital and was looking for the two women from Canada who were in the hospital. He explained that he was sent here by the Creator to see them. 66 The man brought Ida and her friend to a nearby sweat lodge and they both participated in the sweat even though each was in extreme pain. Ida believes that the sweat lodge ceremony helped her immensely both physically and spiritually. It took her many months to recover from the accident but she continued practicing the spiritual practices of the sweat lodge, sun dances, prayers. She also began teaching people about these practices. Ida is very anxious to share teachings that she has received from an Elder that she really respects. Ida was taught by the female Elder that prayers are very powerful and important to practice. Prayers are important because there was a time when the Elder was on her "death bed" in the hospital and she had an out of body experience. The Elder left her physical body by travelling in the spirit form and walked down a path way. As she journeyed down this path a large flame crossed right in front of her. This flame would not allow her to continue the journey because she could not get around it so she realized she had to turn around and go back. The next thing she realized she was back in the hospital. In the hospital bed she found her son sitting beside her. The Elder later learned that her son was praying to the Creator not to take his mother away because he still needed her. In his prayer he explained that he still needed to learn more from his mother and would like the opportunity to spend more time with her. The Elder teaches that if there is only one reason why she was brought to this earth, it is to teach people the strength of prayers. Ida, also has been taught to live by the Seven Great Laws (that were earlier mentioned by Danny): honesty, health, harmony, happiness, gratitude, respect, and generosity. She received this teaching when she was at a pipe ceremony and she believes 67 that it is a general teaching that is passed to the First Nation people. If a person can live in this manner he/she can have a fulfUling life. Ida is also known to help people spiritually and physically by smudging, singing, using the sacred cedar, dramming, giving people some traditional food while they are in the hospital and praying for them. Ida also believes in the sacred number four, for example there are four races: white; Caucasian people, red; First Nation people, yellow; Asian people and black; black people. The four directions: north, east, south and west. Similarly there are four elements: fire, rock, air and water and there are four parts of our body: mental, spiritual, emotional and physical. She believes that we are all connected to everything around us and thus need each other. She recognizes everything around us is a brother or a sister. She makes reference to the people, animals, plants, and rocks We are to respect each because it is there to help us throughout our life time. The plants or herbs can heal us, the rocks can heal us also, the water and fire can cleanse us. She knows that each of these elements are more than willing to help us, we just have to ask and respect what it can to for us if it is not abused in any way. Ida teaches that there are so many spirits: spirits within plants, animals, people, rocks, water, and fire. Spirits that have passed onto the spirit world are more that willing to help a person. A person does not need to do things alone but can ask for help from many of the resources available to them. Paul Oppenheim Sr.: N'lakapamux Nation Paul Sr. is healthy Elder who resides in the N'lakapamux Nation near Merritt, B.C. He is in his seventies and has nine grown children, many grand children and even some 68 great grand children. He is a very hard working Elder who has gone through many trials and tribulations throughout his life. Paul has been working hard on his land, doing irrigation, fence mending and when younger tended to his team of horses. During one cold winter he was caught in the cold weather of the central interior and his feet became frost bitten. As a result the doctors had to amputate his toes and part of his feet. Despite this condition he manages to do his work effectively. Paul Sr. lost his partner of fifty plus years three years ago to a form of stomach cancer. He currently lives alone in the house he shared with his partner. I talked to him in his kitchen while we had a cup of coffee together I asked him if he had any suggestions to people who have a terminal illness and he states, You can help a person's sickness by going into the mountains and looking for the balsam tree. It is important to give thanks to the Creator for the medicine balsam bark and give thanks to the tree for the medicine. You then gather the bark and then boil the bark into a tea to take daily. My Mrs. (Lily) did this and it helped during her sickness. I was taught by my dad to go to the sweat house to pray. I was quite young when we started doing this. We used to go to the sweat house every week. Dad would send us (children) in there when we were sick and this would help. I still like to go to the sweat house, I have been doing this for many years. The sweat house is a way to cleanse ourselves spiritually and physically. It is our way of going to church and praying. Paul is leading an active life with the Elder's group in Merritt, in addition when there are funerals on the Coldwater reserve he is one of the official persons who rings the church bell. He seems to enjoy teaching people because when he talks there is so much life in him - I see his eyes sparkling while he talks and his hands moving in much expression. 69 Bev Julian: Std:lo Nation Bev Julian is a very strong traditional healer/medicine woman and a winter dancer in the long house. She is held in high regard, she is called throughout B C to work with people on a spiritual and cultural basis. Bev was taught that she cannot refuse when she is asked to help someone. Usually people hear about her work by word of mouth. Bev Julian is a gifted woman who can see and feel a sickness a person when he or she is not well physically, spiritually, emotionally or mentally. She is able to help people by removing spiritual objects from people. When Bev removes spiritual objects from a person she does so by feeling and seeing the object. The foreign (not regularly known to the body) spiritual object(s) is revealed to her by the Creator. She is able to do this because she has gone through the training to become a traditional healer who heals through her hands. Bev's hands can remove the object by placing her hands on the object and then lifting it away from the individual's body. She then releases the foreign spiritual object up towards the sky for the Creator to deal with accordingly. Bev also uses her hands to do acupuncture. Grizzlybear Lake (1991) writes that a hand-healer usually uses innate powers of healing, that of the Great Creator, and certain powers in Nature to doctor the person. Bev was sent to China to master the skill of acupuncture in order for her to heal people with her hands. In addition, Bev teaching someone how to spiritually to clear one's mind so that the individual requesting help will think only of the procedure taking place. In this way they are on the same mental and spiritual level for the work to have an effective output. This focusing helps to understand the teachings and also helps the individual calm down. 7 0 Initially, Bev Julian will share her story with the person requesting help. Her story goes like this: About seven years ago I was diagnosed with Addison's Disease, that is a shortage of cortisone. Some of the symptoms for this disease include; discoloration or darkening of the skin, decreased body weight, fatigue, fainting, dizziness and being cold. Prior to diagnosis I was laid up for two months on my chesterfield and I was getting sicker. My relations thought that I was getting Indian sick so they put me into the Long house to become a spiritual winter dancer. My understanding of Indian sickness involves the power of the winter dance spirit hitting people in the fall time as it comes down from the mountains. The person hit wakes up by going to the Long house and starts singing their spiritual song. This Long house season lasts from fall until the spring. In the spring the winter dance spirit returns to the mountains and the Long house season is then over. But while I was in the Long house my health continued to get worse and I couldn't eat. Usually, in the Long house one is not supposed to drink water but I would sneak some and also have some wild meat soup broth. Finally, the people of the Long house sent me home and every two hours I would have something to drink. For the next three to four months my sister would go to the woods and pray for me. This would feed my Indian spirit. Then the Long house people finally let me see my doctor. My doctor knew that I was sick but referred me to a specialist who knew what was wrong with me right away. They put me on an IV because of the dehydration and to receive more cortisone. When I was in the hospital I "went to the other side". My mom came and got me the first night at the hospital and we floated to "heaven". She took me to a place that was like the inside of a cave with a counter. Near the counter there were two boys standing there and both were looking at me and smiling. I then realized that these are my brothers who had died years ago. Then mom and I had jumped on some clouds. I asked my mom, "How come you have such an awful outfit on? It is such an awful colour." We continued to sit on the cloud and she answered, "These are borrowed clothes, I have my own clothes." I then asked, "Is this done to discourage me from this place?" 71 Meanwhile in the background I could hear kids in the back. I then asked mom, "Are there any adults here?" Mom says, "No, I have to look after all of these kids. And right now you have a choice to stay here or to go back." I thought about this and reply, "Mom, you know I do not like the cool, dark and damp but I do love the children. I think that I would like to go back." Mom says, "You can't think - you have to know." I then say, "I know that I would like to go back." Mom then said, "You have to keep three promises: 1. Apologize to your workers. (The Long house people) 2. Apologize to the water because you wouldn't get into it. 3. Continue doing your work. I agreed to do all this and next I felt a cold hand holding my wrist and I opened my eyes and said, "Hi, Dr. Chan." He just about jumped out of his skin. I told him, "I went to the other side." He responds, "I know, we thought we lost you a few times there and don't tell me about the other side, I don't want to know." Grizzlybear Lake (1991) teaches that a traditional healer can receive the calling in the form of a dream, accident, sickness, injury, disease, near-death experience, or even actual death. When Bev works with people who are terminally ill, she tell them the facts. She works on them and they are to believe in what is happening to them. After she tells her story, she informs them that nothing is really that bad, for example the sickness or going through to the other side because she has been there. Bev also works on people through a term that she uses as mind talking. Mails (1993) teaches that a traditional healer can close their eyes and concentrate upon the 72 thoughts one wants to send to the receiver. When the sender believes and the receiver believes in the process it can be done by calling in the power. This is where Bev tells the receiver the facts by relaying the message through mind transmission. An example that she gave was about a man who was in the hospital in Campbell River. The family did not want to tell him that he only had two weeks to live because this information might upset him too much. Before she went to visit him in the hospital she went and slept over night at his house. During this time she saw him in a dream; he was all dressed up standing in front of his hospital bed. He was standing near his wife who was sitting with her head down and with his hand on her shoulder. At the visit in the hospital Bev went to the man and he kissed her hand. Bev told him that if he understands what is being said he is to nod his head and then told him to close his eyes because she is going to do some work. Bev told him, "You have to prepare your wife, the Creator is taking you, we can't keep you here any longer. I'm going home now, I'll pray for you. Do you remember the dream you had last night with me in there?" He nodded and reached for her hand and then Bev returned home. Two weeks later Bev received a phone call from his wife and was told that he died but that he taught his wife to accept his death because he had learned to do so. This is only one of the many spiritual experiences that Bev has gone through and was willing to share at this time. Barriers of Practising Traditional and Cultural Techniques It is necessary to look at the barriers of practicing traditional and cultural techniques because it widens our perspective of those people who practice spirituality. The same Elders and traditional healers taught the following teachings. 73 Danny Charlie states that generally the pathway to do spiritual work has always been clear Some barriers may be that he cannot smudge in a hospital, and is not allowed to bring out drums and sing songs. The last barrier he experienced was when there was opposition from a family member of the person requesting help. The family member would not let Danny in the hospital to see the person requesting help. Janet Charters explains that she has not had too many barriers to talk about. She recalls that there are situations where she has to lie to the nurses. For example when a good friend is in the hospital she tells them that she is family so that she can visit her friend. This is true in the traditional sense she is family. Janet believes that the Creator clears the path for her and so that she can be at that specific place to help. Before Janet starts on her journey to help people she prays that she arrives safely and that the work that she needs to get done; gets done. Ida John had experienced the following barriers while attempting to help a person traditionally and culturally in their health. Family members were limited in number of people who were allowed to visit at a given time. She could not smudge in the hospital because of the fire alarms. Singing of traditional songs was prohibited because it is too loud in the hospital. She noted that a song that is heartfully sung needs to be sung with your voice that reaches from your diaphragm and with meaning in your voice that contain no volume restriction. Ida teaches that sacred tools like the drum and the eagle feather are not to be touched by just anyone. Especially women who may be on their moon time (menstrual period) because they have so much spiritual power at the time should not touch such sacred items. They do not need the additional powers derived and could harm other 74 people that are in contact with the sacred item when used spiritually. Ida was mainly concerned for the family members and hospital employees lack of unawareness regarding unnecessarily touching the sacred items when on their moon time. She also noted that the hospital staff often act like the traditional ways were an inconvenience. They appeared to be patronizing in these situations, and would allow procedures to occur but there was no understanding. Ida recommends that the deceased family member be kept in the hospital room so that family members can see him/her and the traditional medicine people. Bev Julian uses the following story to illustrate the barriers she has encountered. She had a sister-in-law who was having severe headaches and was brought to the hospital after collapsing at work. The hospital staff had run some tests and could not find anything wrong with the sister-in-law; they told her, "There is nothing wrong with you" and sent her home. Bev was called to look at her and she worked on her spiritually and she could "feel" a crown, spiritual traditional regalia for winter dancing on her head, but could not see it. She was still having severe headaches and went to the hospital again and the family was demanding a head scan. But the doctor kept on saying, "No, it is just in your head." A few weeks went by and she had gone to the doctor again and soon found out that she had an aneurysm and that it was too late to treat it and soon after the sister-in-law died. Bev suggests that the health care professionals listen to the families and consider their suggestions. She reminds us that individuals are the only ones who know their body best. In the beginning and at her previous job, Bev would have to sneak around to do her spiritual and cultural work. She reasons that it is because of the power struggles with the nurses that she worked with and that they were envious. They had prohibited her from 75 any of these practices. She tried to explain to them that she cannot refuse anyone her service but they did not understand. In summary, the elders and traditional healers would like to educate people around the importance of the extended family members visiting and the importance of practicing spiritual ceremonies while in the hospital. The practices include smudging, singing traditional songs, and having ceremonial tools being used properly. In addition, they would like their spiritual ways respected and have their requests be listened to also. Summary of First Nation Elders'Perspectives There are many First Nation' people who seek to study and practice spiritual healing beliefs, while other people are still skeptical and find spiritual issues unrealistic, unattainable or problematic. Yet many First Nation people are practicing the traditional techniques and finding them very effective. It is difficult to ignore the strong belief system of the First Nation people around the aspects of spirituality and the belief in spiritual healing. Spiritually, people heal on a personal level by balancing the physical, spiritual, emotional and mental. Nature has many ways of Creating balance and harmony. All things have their place in life, and all living things have their functions. First Nation people respect nature and live close to nature because it offers so many techniques of aiming for balance in all aspects of peoples lives. They respect "Mother earth" and all that live on the earth because everything is connected and has a purpose. First Nation people are people who can live within their distinct social system by implementing and sharing their culture in practical ways to enhance a logical way of living 76 with all other systems around it. In addition, First Nation people can enhance their spiritual connection with the Creator to work towards understanding self. The more one understands self, the more one understands the Creator because the Creator is everywhere; the Creator is within us. When the belief is there and not doubted many gifts can be offered to people, especially those with a terminal illness. First Nation people have a culture that is not always understood by the dominant culture but this Elders' perspective is written to help alleviate this situation. It is also effective to ask their Elders or traditional healers in your territory for clarity. One can also approach the Elders that were interviewed in this chapter to clarify any perspectives that are unclear to you. The next stage in the research process entails the final research findings of the eight participants who will explain their views on spirituality and terminal illness. 77 Participants' Findings The research question is, "How do First Nation people interpret and practice spirituality when diagnosed with a terminal illness?" It is also necessary that I state that in this section I will be following the same protocol by respecting the participants as I have with the Elders in this study: I will not restrict the teachings of the participants by implementing a contrast/ comparison analysis, brief synopsis or summary story about how traditional First Nations spirituality is applied by persons experiencing a terminal illness because my perspective will limit the depth of the teaching it can attain. I do not think that I can provide a "cook book recipe" on this topic because it would lose much of the essence needed from the participants words. I will provide the qualitative phenomenological approach of capturing their stories, their lived experience of their world in their words. I believe that the participant's stories will explain how each participant interprets and practices spirituality when diagnosed with a terminal illness. The stories are categorized into sections that address how they practice spirituality, how spirituality brings meaning to their lives, how spirituality reveals a specific purpose in life, how they put spirituality into action, how they are searching spiritually, how they acknowledge the spirit world, how they view death, how they pray, how they practice spirituality after being diagnosed with a terminal illness, how to look at spiritual experiences, what barriers they encounter and what goals they have for themselves and other people diagnosed with a terminal illness. Practice It will be important to begin with how they describe spirituality. I noticed that there were only two participants who identified what spirituality means to them in one 78 sentence or short statement. The other participants did not have a simple explanation for their beliefs and practices around spirituality. Here is the first explanation from Mathkwi. "For me spirituality means . at peace with one's self and environment." Mathkwi explains that spirituality is a personal state of having peace with their physical environment. He considers that there are only two factors to consider when addressing spirituality: self and environment. Ta'telew; will address spirituality in the following way; "Spirituality is the basis of one's whole life. I define it as a being, a greater power and inner power in which all your outer being evolves around." Spirituality is the foundation for his life. It involves three factors; a being, a greater power and the inner person. I only address these in there simple forms of breaking them down into what factors they consider when looking at spirituality. The next area will look at how the participants beliefs that spirituality gives meaning to their lives. Meaning to Their Lives It is important to continue to describe how they describe spirituality. I have found this to be a difficult task to complete because it is such a broad and abstract perspective to describe. I will continue with how the participants describe spirituality through their words which give meaning or purpose in one's life. Most of the participants have a wide range of views of spirituality and prior to the interview had not developed a clear explanation of their beliefs and practices around this subject matter. As the interviews progressed the participants were able to describe what spirituality meant to them. One effective way to explain their phenomenon is to reflect back upon one's life and see what significance an event has to them now. In the following quote, 79 Qemlolhp will describe a typical day, then shows how this progresses into an explanation or insight of what spirituality means to him. Joanne: "What keeps you going then?" Qemlolhp: "I don't know, I just get up and go. Yeah, every morning I sit around at home and think that I'm gong to stay home but I take off and go." Joanne: "Do you think that you are in touch with your spirit?" Qemlolhp: "Yeah, I don't know, I guess that there was a lot of things that should have happened before, I guess that the spirit just protected me. Joanne: "You mean like your overdoses?" Qemlolhp: "Yeah, things like that, yeah. Like, ah so I'm here for a reason." When Qemlolhp looks into his past he able to interpret that he is living for a reason. He does not give his specific reason at this particular time but at least he is giving his life definition and purpose through the process of reflection on his life. Through self reflection he can start to better understand himself if he looks at the teachings it may bring. Another participant, Sqam reflects on her life and refers to a specific spiritual gathering that brought meaning to her life. Her teaching is very specific and involves some advice from some spiritual leaders who have died and gone to the spirit world. The words and the advice they gave Sqam made her feel better about her life and her health condition. Sqam teaches, When I first got sick I had a burning out here in the fall time and old man Pateo's and Kenny Moses (spiritual leaders) were there and they have been deceased for a year or two before. And they came to the fire and they wanted to eat so I came into the house to get plates. The fire burners I had here had to work over me, to give me the strength and 80 they (Pateo and Kenny) told me that my time wasn't up yet, that I had a lot of work ahead of me and they want me to look after the young people here. I haven't finished doing that and I must finish the work before it will be time for me to go (die). At first it was hard for me to believe because they were gone for some years but they had an awful lot of respect for me to believe that I had to go through all this. To get myself better in order to help young people because it has been a long road for me to go. I always think of my spiritual leaders when I am really, really sick. So, I believe that it's true, I believe that my work isn't done. 'Cause if it wasn't they (people) wouldn't be praying for me yet. This experience and the belief of this spiritual experience has given her direction which brings her a sense of satisfaction and understanding to her. Sqam makes sense of her illness by believing in the spirit world which gave her a message to help the young people. This belief and practice has given her life direction and meaning. Qemlolhp and Sqam both reveal how each reflects upon their life in order to see what sort of meaning it can represent to them in a practical sense. I noticed another way in which the participants view their spirituality is to discuss their interpretations of what they interpret as their purpose in life is. This belief looks at an individual's life and one sees that initially one is brought on this earth to perform a specific task or use one's gift that the Elders talk about. Specific Purpose In Life One important aspect of spirituality is that the participants need to identify what their specific purpose in life is. This does not necessarily mean that they are reflecting back to a certain time in their life but just to reflect upon some teachings that they have acquired along the way. This insight may come from personal experience or from teachings they have been taught. Iyem and Qemlolhp will discuss their perspectives of what they interpret as their purpose of living on this earth at this time. 81 I've been on this earth for 67 years and it's a lot more than a lot of young people that are gone (dead). A lot of young people don't realize how much the gift of life is, what it meant to some people. Um, you are playing with your lives and always trying to have a good time (drinking or doing drugs). And that is not what life is about, they (longhouse elders) always told us that, "We are put on this earth to do a job and this is to help other people. Iyem I'm here for a reason. Maybe I was here (Vancouver Native Health) to cook every Monday, I don't know. I applied for a job as HOS, Healing Our Spirit to go talk on the speakers bureau. So that's what I'm here for, to talk to people and warn people about the dangers of doing drugs. Qemlolhp Participants seemed to rely upon the perception that there was purpose in life to give them direction. When the participants help people they are able to relate their personal story through their experience or teachings they have received. I will also address how the participants anticipate putting their spiritual teachings to practice. Action There is a distinction between the beliefs and practices of spiritual concepts. The beliefs are the concepts of the spiritual aspects and the practices are the implementation of the beliefs it follows. 6:ywoses understands what his beliefs are concerning the practice of spirituality but his practice of his beliefs are not apparent at this time. He is saying that he can do the work if he wants to but right now he is more concerned about himself than to help other people. Joanne: "What do you believe you are?" 6:ywoses: "A mercenary, it means I can deliver if I want to, I will." Joanne: "And where do you find yourself in that? Are you delivering or are you wanting to?" 6:ywoses: "No, I'm selfish. (Chuckle) No, I am." 82 I believe that this is how he wants to live his life at this time as he understands his position and is comfortable with this. The following quotes will describe how the participants are planning on helping people or how they are specifically helping people today. I thought that it would be useful to show that many of the participants would like to assist other people as it appears to be an important aspect of their spirituality. The participants address where they learned the principle of helping people: longhouse teachings, elders, and personal experience. "I would like to buy a car this summer and go travelling to the pow wows and stuff. I would like to be a guest speaker to volunteer to talk about AIDS and stuff." Slakeyanc Goal: Educating people about AIDS. "I try to be good to people. I do volunteer work and I give things away to people to help them out. I feed them when they are hungry. Things like that you know " Qemlolhp Goal: Assist people with the basic needs in life. I have lots of work to do and I have to get myself together and finish the work. Even if I don't belong to this smoke house I still have work to do. So if I think if anybody sort of follows their traditional ways they'll find that there is something there for them. They'll find out that what they haven't finished yet or what they have to do." Sqam Goal: Work gives purpose to her life. I want to become a teacher to help younger kids, teenagers and even adults because there is so much messed up people out there. For instance, when kids are going to school and graduate from grade twelve, the first thing they want to do is to hit the big city lights and find out who they are. Their curriculum should at least teach them who they are inside. Ta'telew Goal: Teach young people about their identity. 83 I would like to see the old teachings come back to the people that make up their own rules and make up their own teachings. 'Cause this is how we grow weak when we let them change everything. If we bring back the teachings to the young people we will be doing something. Iyem Goal: Bring traditional teachings back to the people. I seem to just like to help the younger people eh. I see them when they are working on my crew, young kids and I tell them how many times I've been here in here (prison) and what I've been through. "There is a life out there and if you want a life, stay out of here." I just talk to them really hard eh. There's this one kid that was in my dorm that stayed out of here and he made it through EMP (Electric Monitoring Program) at the recovery house. I like doing that (helping people). Sqwa Goal: Educate young people about prison life. Each of them stated the enjoyment of helping people because overall it would give themselves and other people purpose, identity and traditional understanding. Each sees the importance of doing this. Another area of spirituality to involves the participants searching for spiritual meaning. This does not mean that they do not have a spiritual base it just means that they are expanding their spiritual knowledge through their personal search. Searching Participants stories suggest that searching for spiritual meaning in one's life is a very natural process to go through. Some participants have reached a point in their lives where they need to consider what their spiritual beliefs are. The participants will show that they do not quite know the answers they seek but they are stating various ideas. "I just know that there is a spirit there, I don't know. I think that when we die, we die and we don't go no where. Just blank." Qemlolhp Qemlolhp is pondering the thoughts of after life. He does not have a definite 84 answer because he is still searching for his own personal meaning. 6:ywoses will discuss how he is still trying to understand his spirituality and he admits that it is confusing. Well, I read the Bible every morning, I don't know, yeah it's kind of confusing. I know where I am supposed to go. I don't know, mainly it's something within myself that I am supposed to do but I am still in a state of confusion. 6:ywoses Joanne: "Earlier you said that you were confused. You were confused about spirituality or your life?" 6:ywoses: "Aahh, my whole life." Joanne: "Was there a time when you were not confused?" 6:ywoses: "Oh yeah, when I was hatched and that was when my mom used to hug me all the time." Joanne: "And you weren't confused?" 6:ywoses: "No, that was security, so after that..." Joanne: "So when did she stop hugging you?" 6:ywoses: "I'm not exactly sure to tell you the truth 'cause I was apprehended by the Caucasian people." Joanne: "When did confusion start in you life?" 6:ywoses: "Ahh, ever since when I was getting molested by this woman. My foster mom or whatever. I didn't know if it was love or what the hell was going on." Joanne: "Have you been confused since that time, did you ever find security in your life again after that?" 6:ywoses: "Ahh yeah, when I was shooting up all the time." Joanne: "And that gives you security?" 85 6:ywoses: "Just makes everything blackout." 6:ywoses understands his state of contusion regarding his beliefs around spirituality and gives reasons explaining his confusion. He states that he was fostered out to some Caucasian people, sexually abused by his foster mother, currently using intravenous veinous drugs and not having security in his life. With these many life factors to consider one is able to see his confusion around spirituality and his lack of practice because of previous life experiences and his current life style of using drugs. The extent of his spiritual searching involves his reflection on his life. Ta'telew' is grateful for his body and would not ask the Creator for anything else. He states how he's acquired a masochistic trait from his mother. He had to search through his past to understand his current behaviours. He does not say that he is going to change this behaviour, he is starting to process the information for himself. From the great spirit, I would never ask for good health. I already have my body and I appreciate it. I would rather inflict pain on myself. Like maybe I would fast a bit too long and hurt my body or I would let someone that I care for dearly hurt me emotionally, mentally. And in that sense I would still be giving praise and I would be hurt and be kind of masochistic in the sense of liking pain being inflicted upon me and feeling OK about it. I seen a lot of pain being inflicted on my mother, so I sort of acquired wanting to take some of the pain away. And so I think that I have acquired a lot of the masochistic trait from her and that is how far I got in that. Ta'telew' Mathkwi will share his dream and it reveals how he is still searching for spiritual meaning in his life. He acknowledges the dream but has not put the teachings he has learned into practice. His search will continue and he will have the option to put his spiritual teachings into practice. 86 I had a dream and I will always remember this dream. I think that when I remember a dream for a long period of time it must be important and mean something. In my dream there were four elders that came to me and two were on each side of me and lifted me up. Then took me away and we were flying though the sky and going out to the country. We were in the air and they brought me to a house that was fenced in and they left me there. I wanted them to take me with them but they did not. I think the dream means that I am living the white man's ways and I have to find a way to get on the other side of the fence and use some of the traditional ways again. I don't practice the old ways right now but I feel that I need to go back to them because of my dream. Mathkwi He is not putting the teaching of the dream into practice but he is at least contemplating his life situation. Iyem explains that when you need an answer the sprits can help through the median of dreams. A lot of time if you are troubled you ask the great spirit to solve whatever the problem is and the only way they (spirits) can contact you is through a dream. You may think you are sleeping but sometimes you are awake and dozed off or something, but those things happen. Iyem Sqam is searching for meaning in her life and answers from those around her. I don't believe in the church. I think it's only my Native people that help me 'cause they tell me that they can't feel sorry for me because I have to learn to be strong. And I am learning to be strong but it is difficult. I think if I didn't know the smoke house people and know the ways of the smoke house I don't think I would have the strength that I have now. They have taught me an awful lot and this is a hard struggle to go through. Sqam Sqam is sorting through the lesson that addresses her emotional state that teaches that people cannot feel sorry for her and that she needs to be strong. Acknowledging the Spirit World The participants also stated their beliefs and some experiences of the spirit world or spiritual dimensions. They talk about spirits being all around and protecting people. Theme: Spirits as a Protector 87 Slakeyanc talks about his belief that he is protected by many spirits, no matter what location he is at. When I was 13 or 14,1 became rebellious to my spiritual grandparents you know and the physical and spiritual grandparents. I became a street kid and then as long as I was still being where I am...I was still mad at them (grandparents) because I was still in a spiritual land and you're protected by all those spirits, you know. There is too many spirits that I could name but I know I am protected. Slakeyanc Theme: Accessing Spirits Spirits also play an important role in Iyem's life. Iyem also teaches the importance of giving the spirits thanks for what they have given you that day. We have to believe in all the spirits walking on this earth. That is one way, but different places have their own way of bringing out the spirits. Like Okanagan, Shuswap, up north, they all have their own way of doing this. We never, we're always told that it is their way of doing things, and don't try to go and copy them, you have your own way. So that's what we were told when we were new dancers. We were told to never make fun of anybody, never to call anybody down because they are doing it a different way, it is their way. Iyem Theme: Showing Appreciation People face the east and thank their great spirit for giving them light, giving them the sun. The sun makes everything grow. So they respect all of those things; the water, the rain, they don't say, "It's raining, damn it's raining." They never say that because they realize that without the rain there be nothing living on this earth. So they thank the rain for washing the face of the mother earth and they respect everything that we are given that day. Like ah, thank them for yesterday's food that was brought to us, all the ...thank him for looking after us though the night, to give us another day on mother earth. We... I guess we kind of pray by ourselves, I would see the old timers pick hops and stand beside their baskets and see the sun come up. I used to wonder what they were doing when I was about eight or nine. Then I got close to this woman and she was praying in Indian and then I understood what she was doing. And I asked her, and ah you know they were great teachers, they never said, "Mind you own business." Never said anything like that and she just told me, "Thank the sun for giving us the nice day, thank the 88 great spirits for what they gave me yesterday and all of those little things." Iyem Both participants reveal the teachings of acknowledging the spirits for the protection and teachings they offer. Iyem knows the importance of thanking the spirits for the gifts they offer and teaches where he acquired these teachings. When the participants acknowledge the spirits around them it can keep them in harmony with their environment and keep them from harm, as written in the literature chapter of this study. Death When a person has been diagnosed with a terminal illness it is very important to know their beliefs and feelings about death and particularly how he or she views his or her own death. Qemlolhp looks at his death by describing where he wants to buried. I think that we are all part of nature, so I guess that it would be part of nature hey. We came from nature, I don't know how we got here, but look how big we are, and each of us came from some where from each part of the planet. So when I die, I hope that they bury me so that I can grow back into mother earth. I like this one west coast idea, I read about they used to bury the dead in the trees. They would find an old tree and bury them in the tree and the tree would grow and they would grow with the tree. Qemlolhp Qemlolhp identifies that he is part of nature and there is a connection, so he explains why he want to be buried in a tree. He addresses his physical being but does not address beliefs about where his spiritual being goes. Sqam talks about her experience of how she started to contemplate her eventual death. Um, last summer was two years. Last March end or March 13th, I went to my first operation and then I found out I had cancer. I came off for six months then I was...my visits were good, good every month and then good for three months. Then all of sudden she (doctor) said, "Can't do nothing more for you, you got to do what you can and we can't do any more for you." 89 And I said, "Oh." I didn't understand that word for the longest time, I um and neither did my husband. "Can't do anything more for you," but it stayed in my mind - those very words. And I asked my doctor about it and he said, "For a time, for a time." And um and it took about a month or so before I got those words together and that nothing more could be done for me. Then I realized I was going to die, that's it. Sqam Sqam had to sort through her medical doctor's words very carefully to understand that death was upon her. Another participant does not see his death occurring for 25 years from now. "I'm not going to be deceased for another 25 years, unless I run around and blow it away with over amping (drug overdose). I just know that I will live a lot longer because I am very positive." 6:ywoses 6:ywoses just states that he will live longer because he is positive in his attitude. He does not give any further clarification to his belief of living so long. Sqam will discuss how her concern about preparing things and concern towards her family to with her death. It was about a month ago and I was running around trying to get everything ready that I wanted to get done but I wanted to make sure that I got my family in order. My family is my biggest worry at this time and I know that I don't like coming from a big family because one person like me can hurt so many people. Sqam Slakeyanc accepts his death and believes that the Creator knows when he is going to die and bring him to the spirit world. "Most recently people have started knowing that I am spiritual. I have been sick again and I have lost weight. I told them, 'Oh, if the great spirit wants to take me home, let Him take me home.' It's his (great spirit) business and not anyone else's you know." Slakeyanc 90 In addition, Slakeyanc teaches us what his views are on not taking medications and his reasons for doing so. I believe that his system works for him because he has been living with HIV for twelve years. People tell me not to cut down on medications because the doctor gave you the medications. I say, "You can't always take everything the doctor gives you because some of them don't know what they are giving you." You can tell by looking at the label of the medicine that they are trying to put you away earlier. Then they try to make you live longer. I've heard of people who are HTV positive who have taken medication and they've died. Slakeyanc Iyem addresses his death by explaining that he went through a process of "bargaining" with the Creator for more time on earth to complete some tasks. Now that he has completed those tasks he says that he is just waiting (to die). But I had a close call here in January or February, I got pneumonia and they told, "If you ever get pneumonia you are only going to last a couple of days because your immune system is nil." So they put me in a hospital any ways and they gave me triple dose of antibiotics and in eighteen hours I pulled out of it. So I was lucky. I didn't have things ready; like a will. A lot of the things I did not tell the wife that I wanted done. So I talked to my great spirit asked him to give me more time to get things straightened out. For two nights I did not want to sleep because I was scared to sleep. But then I pulled out of it and I knew that the spirits were still there, so right away I called my friend and got my will made up and got everything, got Kathy (wife) in here and told her how everything was going to be divided. I guess, I don't know, I guess I'm just waiting now I guess. Iyem Iyem addresses his spiritual concepts around death by believing that the Creator can give him more time on earth to complete the tasks that he finds necessary to do before he dies. Prayers When I asked the participants how they practice their spirituality they talked about the importance of prayers. The prayers are practices in various settings with 91 various traditional herbs. The participants explain where they pray, the reasons they pray, who they pray for and what "materials' they pray with. Sqwa shares his experience of praying within the sweat lodge ceremony where he prays for mother earth, Creator and all of his loved ones. He also prays for his own needs and continues to pray before going to sleep, all because he believes in the Creator. I made it to about seven sweats here (prison). We do three rounds at least eh. The first round is to thank the mother earth, Creator and the second round is to pray for our loved ones. That is to pray for pur ladies and for the children. The third round is for what we need and we pray to the Creator for what we need. We also pray for the brothers that are getting released. We also pay for the brothers and sisters that are in other institutions and the ones on the streets that are doing drugs and alcohol...Well, for me I just do prayers every night and I send out prayers for my family. I also pray for myself to be better in ways that I am not. In certain ways I feel that I need some things that I have to do for myself and to better myself. I'm sort of struggling and I pray for my family: my kids, and brothers and sisters, nieces and nephews. I believe in it, I believe in the Creator hey and that is why I do it every night before I hit the sack. Sqwa Ta'telew' explains where he can pray and shows his complete towards the Creator for all that is given to him in his life. He is very grateful to the Creator and also prays for his loved ones. Ta'telew' prays by smudging with cedar, tobacco or sweet grass. I always maintain that I can pray any where. A church is not the only place where I go and pray. When I do so I become calm and I don't ask for anything. I thank the great spirit for my loved ones or people in my life that I love very much. I thank him for myself and I thank him for coming into my life and giving me all the chances and sometimes I spend time emotionally, which is all to him Thanking his so much, yeah. With the cedar, tobacco, or sweet grass, if I have any, I would start a smudge and I would anoint my body. I would be thanking for my eyes, my ears, my nose and I would cleanse my hair and my whole body parts with the smudge. Before I start the smudge I would pray. When I do this I would abstain from drugs and alcohol and I would then use those special things. 92 Both participants believe in the Creator and see the importance of praying for protection of loved ones and the gratitude each has in their life. I will complete this area of the words from Iyem who teaches that people have different ways of praying. "All people have their own way of praying, some would go to the water, the creek and go into the creek. They would jump in and pray to the spirit that they have a good day ahead of them." Iyem Diagnosis Once I found out how the participants have been practicing their spirituality, I needed to find out if their beliefs and practices have changed since being diagnosed with a terminal illness. Mathkwi admits that he is having a difficult time with the HIV diagnosis and does not accept his diagnosis. "So far I haven't really accepted the fact about being HTV positive. It been about a year and a half and I'm still having a hell of a time with it." Joanne: "Have your practices and beliefs around spirituality changed since you have been diagnosed with a terminal illness?" Oh, not really. I don't know sometimes I think about it you know and I'm still involved with the brotherhood and that ...praying and everything. I try to forget about it eh. I don't even think about it hardly. It doesn't bother me. When I first got told about it, I don't really know too much about it though and it doesn't bother me eh. And I just wish that it just wasn't true. You know, but it was my fault but I'm not going to give up. I'm not even worried about at the meds (medications) eh, I just have to straighten out myself and say some serious praying once in awhile .1 seemed like I didn't care but I just didn't think of it eh. Like I don't think of it too much yet either. I don't know if it's healthy or not. Yeah" Sqwa. 93 Sqwa heard about his diagnosis but his way of dealing with it involves avoidance by "not thinking about it." And it is interesting to note that he is not unsure if this practice is healthy or not, as he is starting to address his feelings on this matter. Joanne: "So have your practices and beliefs around spirituality changed since you have been diagnosed HIV positive?" Yes, very much so, I learned greater appreciation about life. Now when I am walking I can appreciate the trees more. Before I was...and before I had the virus I didn't and I always wanted to respect my being and I knew that I should respect myself and my surroundings. As the people who look up to, like my mother and my father and certain role models in my life. And I always wanted that special bond and ever since I've been diagnosed with the disease I realize that life is so limited and it shocked me and now I pray to appreciate the little things in life more. And that I gained, I gained to appreciate my life and my surroundings. Ta'telew' Ta'telew' on the other hand accepts his diagnosis and appreciates many aspects of his life: nature, family, and the "little things". He appears to want to live his life positively in the best possible way he can. These two participants reveal that each are at different stages of understanding and implementing their spirituality. Joanne: "Did your outlook on your life change when you were first diagnosed?" Qemlolhp: "Oh yeah, I was fighting everybody, getting loaded. Ah who cares, I'm going to die anyway. So I'd just go out and get loaded you know." Qemlolhp dealt with his knowledge of his diagnosis by having a self destructive behaviour. For him to cope he decided not to take care of his health because he understood it as; death is upon him. Qemlolhp appears to look at his diagnosis in the context of a death sentence. 94 The other four participants explained that their spiritual beliefs and practices have not been affected in any way. Each stated a simple, "No" when asked this question and did not elaborate on this situation. Spiritual Experience One area of my study gave me difficulty because the participant produced information which was different that the others. It made me question if his experiences were of a spiritual nature or not. 0:ywoses will share his experiences when on peyote and reveal his spiritual beliefs of the life journey he plans on experiencing. When I was in Mexico I went and did peyote. I sat in a cave and seen all this weird shit going on. I seen the tortoise, the turtle and I seen, I seen a wolf head. I seen them during peyote and it is what you call a hallucinogenic drug and I seen them all. Then a great white figure comes down and touches me, Whatever the hell that supposed to mean I don't know. 0:ywoses 6:ywoses' confusion about his experience brought confusion to my study. I eventually realized that I cannot interpret his experience as a hallucinogenic reaction or a spiritual experience because O.ywoses cannot identify it from one or the other. I just know that the experience frightened him. It is my understanding that a person is to have faith in the spiritual process and in his situation I need to consider that he was in a foreign territory with foreign practices and he did not find out any of the meanings behind what he experienced. Well, I'm living on a different plane my whole life cause I believe that there's five plane of life. It's hard to explain but you see earth is the mother and that is one plane. The second plane is an octane higher that is very spiritual and then the third plane is when you are starting to decease. And the fourth is when you start to obtain the power and the fifth plane - you are in the void. I'm knocking on the deuce (second) and I'm starting to deteriorate and it doesn't really matter to me one way or the other because I know I'm going to make it to the void. 95 In addition, his beliefs around the five levels of life is a theory I have never heard of before in my education, personal experience or other research contained within my study. I will accept his belief of the five levels and recognize the fact that there are many other spiritual theories which I am unaware of. Barriers One area of special interest of mine involved the possibility of barriers within the health care system or personal barriers which some how may prohibit their beliefs and/or practices of spirituality. Theme: Discounting Beliefs Slakeyanc discusses a time when he had an experience in hospital which involved a conflict of beliefs between Slakeyanc and his nurse. He attempted to explain his nurse that on a spiritual level he felt that someone was trying to harm him. As a result, the nurse only looked at the situation on a physical level and did not see a person in the room who had an opportunity to harm him, so her explanation determined that he was "crazy". The nurse was either ignorant to the possibility of spiritual harm or does not believe in this phenomena occurring. Either explanation did not consider his beliefs around spirituality and therefore his danger. Because I know, cause a lot of times like ah, people will try and use food and medicine on me. Like um...one instance like this Haida Indians tried to use medicine on me and it back fired on that lady and she died. She was trying to kill me at the time because of jealousy, because ah of Jeffs former lover was Haida. When I was in the hospital she came into my room and she had this big black feather and she was going around the bed singing a Haida song. 96 Then all of a sudden I woke up and said, "You are not going to beat me and interfere with my life you know." I then told her to get out and kicked her out of my room. This was all happening in the spiritual round (realm). I was in the hospital and I could see spiritual things that the white people who were around could not see. I told the nurse, "Someone is here that is trying to do something to me." She said, "There is nobody here'" Then I said, "You don't understand Native people believe in bad medicine that can harm people in the spiritual sense." The nurse did not believe me and gave me a needle because she thought that I was crazy. Slakeyanc Theme: Importance of physically able to practice Spirituality Sqam shares her passion for fishing and remembers the first time her body could not sustain the physical endurance required for fishing. Fishing is so important to her that if she could not fish she wanted the Creator to take her from this world. She identifies her barrier as being one of a physical limitation. When I first got sick I went out with the boys and I went up to Yale fishing and the next day I could not move my body. My body was so sore from the boat ride and the truck ride. I could not move and was in bed for three days and I thought I damn near had a nervous breakdown because of it. I thought that was the end of my fishing life for me. But I managed through that one 'cause I walked up the bluff here, I think that was the next year I walked up the bluff and put the net out. But I think that if there was a God then I would have said, "No, take me now." Sqam Sqam states another barrier which she encounters because of her physical limitations. She identifies the restriction of certain foods, objects and gatherings of people because of her diet and to reduce the exposure to germs that may be harmful to her. 97 So I'm torn between not going to the smoke house too much now because of having the ailment. I just can't eat ordinary food I have to have special food. With the ailment I can't be touching any old thing and I also can't be around people too much because of different diseases that somebody might have colds or whatever. So I have to stay home most of the time So people have to come here and talk to me. Sqam Theme: Spirituality is what fills you up. Without it, you are empty. 6:ywoses will discuss how his spiritual barrier includes the use of drugs and alcohol. His use of these substances cause him to lose his connection with spiritual aspects of his life. Joanne: "Are you still inspired?" 6:ywoses: "No, I kinda slowed down." Joanne: "By choice?" 6:ywoses: "No." Joanne: "What made you slow down then?" 6:ywoses: "What made me slow down is because I'm losing my spiritual touch." Joanne: "How did that happen?" 6:ywoses: "Drugs and alcohol." Joanne: "So what's it like to lose your spiritual touch?" 6:ywoses: "You're empty." Mathkwi identifies his spiritual barrier as having no knowledge of Elders or traditional people to turn to. "I don't know any Elders or traditional people around here." Mathkwi 98 Goals I will complete this section with what goals the participants have in mind for themselves, the medical health field practitioners and First Nation organizations. Ta'telew' starts his suggestion of having a medicine person teaching people traditional and cultural ways of the First Nation peoples. People could be shown and they could go to a support group and you have a medicine man come in he'll have a feather and he'll explain the feather. And just by observing, watching or with the sweet grass a lot of the different people that come in contact with smudging will sort of stop them and make them look. And they realize there is something here, maybe it doesn't click in right away but at least they are observing. Ta'telew' Ta'telew' also addresses his concerns of not having the traditional herbs easily accessible to him because there is a low supply in the city and because they are not funded by the medical coverage. His goal is to have the traditional medicines available to him because he feels that this is what is important to him in a holistic perspective. Someone will have sweet grass and like in my culture you don't pay for sweet grass. But in a bigger city like this it is so hard to come by that you could buy it in certain places or just give a gift exchange. Cedar, sweet grass, mushrooms or tobacco are not funded for and like that is what's saving my whole life socially, mentally, physically and emotionally. That is the most important thing rather than Tylenol 3's to help a headache or prohibitors. A lot of the stuff that I learned about like pain killers are from plants, barks and roots that are condensed into a pill. But I think that in the raw form they are better for you. My grandfather would help people in these ways." Ta'telew* Sqwa explains that his goal is to have a drop in centre or friendship centre available to First Nation people to assist or to teach them about spirituality. I don't know now a days it is just so hard to get through to them (First Nation people) spiritually. And I think that it would help to get close to them right away before they are too far gone and you have to grab them 99 before they get too far in it (addictions). The best place to do it is at a drop in centre or a friendship centre for Natives especially. Sqwa Qemlolhp's goal or preference is not to have people who have their own agenda of reforming or saving people spiritually. "Some people start bothering people with spirituality and they get right into it and they won't leave you alone. And I hate being bugged about things like that because some people are very extreme in that way." Qemlolhp I will complete this section with one last goal from 0:ywoses. Joanne: "I'll ask you this one time not to be selfish and ask you if you offer any or spiritual teachings to other people who are diagnosed with a terminal illness or to teach the health care professionals?" 0:ywoses: "Well, don't pity the suckers. If you pity them they would go around and do it even more." Joanne: "Do more what?" O.ywoses. "Do whatever they are doing." 6:ywoses does not want the health care professionals to pity the clients in any way because it can cause them to keep practicing the "pitiful" behaviour. A discussion on the eight participants understanding of how they interpret and practice spirituality when diagnosed with a terminal illness will be addressed in the next chapter. 100 Chapter Five Discussion and Recommendations Discussion The eight participants in this study and the five Elders were quite open about the fact that they have various spiritual beliefs and practices to share. The participants were all willing to discuss their beliefs that could include all or many; traditional, cultural, or religious perspectives. I believe that I interviewed four of the participants at the opportune time because it was prior to their death and each had important narrative stories to share with me. The goal of the study is to understand how First Nation people interpret and practice spirituality when terminally ill. The results from the participant's data revealed - that spirituality brought meaning or purpose to their lives; how some are still searching; how they address issues of death; how they dealt with their diagnosis; how and what barriers they see in the health field; what goals they would like to see attained and my own questions of data containing spirituality. The research conducted in this paper reveal the many diverse ways in which First Nation people interpret and practice spirituality when having a terminal illness. One has to conclude that the definition of spirituality is one topic that is not easy to define because of its broad perspectives. It was my intention to have more insight into how First Nation people view and practice spirituality when having been diagnosed with a terminal illness. When looking at the Elders and participants in the study one realizes that each are at a different level of practising spirituality. As some participants have a strong belief system and numerous practices, while some are confused, lost and questioning 101 their beliefs and practices around spirituality. Specifically I learned that spirituality can include religious practices; going to church, having faith in Jesus, reading the Bible. The religious practices were mentioned by both Elders and participants in this study. The Elders and participants also stressed the importance of acknowledging the spirit world. This includes the belief that spirits can be there to help a person in need or that spirits can be there to harm a person. Some spiritual practices include; praying when the sun rises, praying in bed before going to sleep, entering a sweat lodge ceremony, smudging with traditional herbal medicine, going for a spiritual swim in a body of water, going for a walk, and singing (just to name a few). This information is aimed to educate people around the various practices used by First Nation people who are diagnosed with a terminal illness and ultimately to have these practices respected and understood by all people. It is also important to note that Kubler-Ross (1969), realized the importance of intervention to take place any time between the making of the diagnosis until just before death. Kubler-Ross explains that it is important to work with the person who has the diagnosis of a terminal illness because the person's points of views on death and dying can be further understood. When there is a better understanding of the person's points of views a plan of intervention can be determined by these findings. Recommendations The particular issues raised were varied and have clear implications for those who make policy and provide service. The role for social work as a profession also 102 requires a specific examination. This area of research is very new and it would be very important to have more studies address First Nation spirituality and terminal illness because we could learn more with further research. Social Work Role The implications of this study are broad for social work. The participants had direct concerns with other health care professionals but it can be easily applied in this profession too. Education around spirituality and terminal illness of First Nation people can be introduced to social work education. Social work training in this area would be of benefit to everyone involved. As practitioners, social workers need to develop an understanding of spirituality and terminal illness of First Nation people and the issues facing the people in this situation. Within the schools of social work I believe that Elders can be brought in to teach part of the curriculum around First Nation spirituality in relation to the holistic perspective of the mental, emotional, physical and spiritual aspects of a person. Within health care facilities such as hospital, community health clinics or hospices, I would like the staff to be educated to the beliefs and practices of First Nation spirituality through the median of having literature available to them, guest speakers be scheduled for staff members, and have workshops be available on this topic. Social workers need to be aware of this issue and to ensure that people receive services that are appropriate to their needs, as well as advocating for the development and funding of such services when they do not exist. Specifically, policy in the health care facilities need to include a section that addresses the need to have spiritual practices of First Nation people be implemented, and therefore have the staff educated with this perspective. As a profession, social work must move away from the medical model of 103 health care settings and begin to understand it from a social and holistic perspective. The implementation of the proposed changes are aimed to enhance the services provided to the First Nation clients by recognizing their culture and providing culturally sensitive services based on their beliefs and practices. Issues It has been noted within the findings and the interviews that there have been a few areas of concern that need to be dealt with. Initially the participants state that there are a few gaps in the health care system and or understanding of individual belief systems in regards to First Nation spirituality and terminal illness. Some of the participants expressed ways in which they would like to alleviate some of the issues. 1. Slakeyanc expressed his concern about receiving spiritual harm and the health professional not "listening" to him. It would be of great benefit for social workers to listen to the client's beliefs around spirituality because it can be of great importance to the person who has the terminal illness. I have found in the hospital setting where social workers have only thought of spiritual aspects to be addressed through pastoral care and I believe that social workers can address spirituality too. The profession of social work can work in a holistic perspective which considers one's mental, emotional, physical and spiritual aspects of a person. 2. It would be helpful if the clients who are seeking spiritual guidance from Elders or traditional people have Elders or traditional people be acknowledged and used accordingly to their personal spiritual needs. 3. First Nation people need to have traditional medicines ( sage, sweet grass, cedar, other medicines in the natural form) more readily available to them. Since this is a culturally sensitive issue I would recommend that the First Nation leaders and people 104 as a whole start to work together to address this issue so it can be alleviated. It can be a community effort. 4. Another participant recommends that spiritual teachings be available in the community through a local organization. He initially suggested a drop in centre or friendship centre for Natives to teach the people about spirituality. 5. It is important to have spiritual aspects taught to people but it is also important to remember that people will seek help when they want help. In the social work profession, we recognize and respect the fact that many times people are at various stages of their development and with spirituality we will help people that are at various stages and to work with them accordingly. 6. It is important to listen to what people are saying and respect their ideas and opinions because we just might learn something that we didn't know before. Researcher's Final Perspective I just wanted to state that the research process that I have under taken in this study has taught me in ways that I never thought possible. This study helped me address my own spiritual beliefs and practices while enduring this academic endeavour. I am very grateful to all the teachers who have taught me different perspectives and practices of spirituality. I will carry these teachings from my Elders and participants for many days and pray that their words of wisdom will help other people in their lives. My final note to make; since this study began four of my participants have since died. I just aim to give each of my Elders and participants teachings justice that it deserves. 105 Bibliography Albert, R.H. (1997). Social work practice with first nations men facing addictions, human immodeficiency, (HIV), and acquired immunodeficiency syndrome (AIDS). Unpublished master's major paper, University of British Columbia, School of Social Work, Vancouver, B.C., Canada. Aldridge, D. (1995). Spirituality, hope and music therapy in palliative care. In Arts in Psychotherapy. Vol 22 (2), 103-109. Bopp, J., Bopp, M., Brown, L., & Lane, R. (1984). The sacred tree. Four Worlds Development Press, Lethbridge, Alberta. Brown, J.E. (1982). The spiritual legacy of the American Indian. New York, New York: Cross Road Publishers. Catholic Health Association of Canada. (1996). Spirituality and health: What's good for the soul should can be good for the body too. The Catholic Health Association of Canada, Ottawa: Ontario. Carlson, M.T., Carlson, K.T., Thorn, B., & McHalsie, A. (1996). St6:l5 oral narratives. In K.T. Carlson (Eds.), You Are Asked To Witness: The Sto: 15 in Canada's Pacific Coast History (pp. 181-196). Chilliwack, British Columbia: St6:l6 Heritage Trust. Chirban, J. (1991). Health and faith: Medical, psychological and religious dimensions. Lanham, Maryland: University Press of America Inc. Coffey, A & Atkinson, P. (1996). Making sense of qualitative data. Thousand Oaks, CA: Sage Publications. Crabtree, B.F., & Miller, W.L. (1992). Doing qualitative research. Thousand Oaks, CA: Sage Publications. Denzin, N.K, & Lincoln, U.S. (Eds). (1994). Handbook of qualitative research. Thousand Oaks, CA: Sage Publications. Diaz, DP. (1993). Foundations for spirituality: Establishing the viability for within the health disciplines. Journal of Health Education. Nov/Dec, Vol. 24, No. 6, 324-326. 106 Driedger, S.M. (1997). Relationships among faith development, ego development, and religious orientation in HIV+ individuals: A construct validation study. Unpublished doctoral thesis, Simon Fraser University, Department of Psychology, Burnaby, B.C., Canada. Estes, CP. (1992). Women who run with the wolves. Toronto, Canada: Random House of Canada Limited. George, L. (1991). Native spirituality, past, present and future. In D. Jensen, & C. Brooks (Eds), In celebration of our survival (160-168). Vancouver, British Columbia: University of British Columbia Press. Gill, S.D. (1983). Native American traditions. Belmont, California: Wadsworth Publisher. Goldsmith, J. (1959). The art of spiritual healing. New York: Harper and Row Publishers, Incorporated. Grizzlybear Lake, M. (1991). Native healer. Wheaton, Illinois: Theosophical Publishing House. Hall, B. A. (1998). Patterns of spirituality in persons with advanced HIV disease. Research in Nursing and Health. 21, 143-153. Herbert, E. I. (1994). Talking back : Six first nation women's recovering stories from childhood sexual abuse and addictions. Unpublished master's thesis, University of British Columbia, School of Social Work, Vancouver, British Columbia, Canada. Hultkrantz, A. (1990). The religious life of native north American. In C. Vecsey, (Eds), Religion in native north america (pp. 3-12). Moscow, Idaho: University Press of Idaho. Jones, A., & Crandall, R. (1991). Handbook of self actualization. Corte Madera, CA: Select Press. Kubler-Ross, E. (1969). On death and dying. Toronto, Ont: Maxwell Macmillan Canada, Incorporated. Kvale, S. (1996). Interviews: An introduction to qualitative research. Thousand Oaks, CA. Sage. Lame Deer, J. (Fire), & Erodes, R. (1972). Lame Deer seeker of visions. New York: Washington Square. 107 Leininger, M. (1994). Evaluation criteria and critique of qualitative research studies. In J. M. (Ed.), Critical issues in qualitative research methods, (pp. 95-115). McGaa, E. (1990). Mother earth spirituality. New York, New York: Harper Collins Publishers. McGaa, E. (1992). Rainbow tribe: Ordinary people journeying the red road. New York, New York: Harper Collins Publishers. Mails, T.E. (1991). Fools Crow wisdom and power. Tulsa, Oklahoma: Council Oak Books. Maxwell, J.A. (1996). Qualitative research design. Thousand Oaks, CA. Sage Publications. Mishler, E. (1995). Models of narrative analysis: A typology. Journal of Narrative and Life History. 5, (2), 870123. Morrissette, B., McKenzie, B , & Morrissette, L. (1993). Towards an aboriginal model of social work practice. Canadian Social Work Review. Vol. 10, Number 1, 99-108. Mussell, W.J. (1993). Deficits, foundation, and aspirations signal need for restructuring. In Royal Commission on Aboriginal Peoples (Eds.), The path to healing.: Report of the National Roundtable on Aboriginal Health and Social Issues (pp. 108-119). Ottawa, Canada: Canada Communication Group Publishing. O'Neil, J.D. (1993). Aboriginal health policy for the next century. In Royal Commission on Aboriginal Peoples. The path to healing. Ottawa, Canada: Canada Communication Group, 27-48. Ponterotto, J., & Casas, J. (1991). Handbook of racial/ethic minority counselling research. Springfield, Illinois: Charles C. Thomas. Porterfield, A. (1989). American Indian spirituality as a countercultural movement. In L. E. Sullivan (Eds.), Native American religions (pp. 154-164). New York, New York: Macmillan Publishing Co. Red Horse, J.G. (1980) Family structure and value orientation in american indians. Social Casework: The Journal of Contemporary Social Work. 462-467. Reid, B., & Smith, A. (1981). Dimensions of research design. In Research and social work (pp. 65-93). New York: Columbia Press. Reissman, C. (1993). Narrative Analysis. Newbury Park, CA: Sage Publications. 108 Royal Commission on Aboriginal Peoples. The path to healing. Ottawa, Canada: Canada Communication Group. Sandelowski, M. (1995). Sample size in qualitative research. Research in Nursing Health. 18, 179-183. Sinclair, B.J. (1993). Health and social issues of aboriginal people with disabilities: An Alberta perspective. In Royal Commission on Aboriginal Peoples. The path to healing. Ottawa, Canada: Canada Communication Group, 139-157. Tart, T. (1989). Open mind, discriminating mind. New York, New York: Harper and Row Publishers Incorporated. Tiedmann, R. (1994). Recentring the Sacred: Native Spirituality as a Site of Resistance and Renewal in Selected Works by Armstrong and Silko. Unpublished master's thesis, Carleton University, Ottawa, Ontario, Canada. Tooker, E. (1979). Native North American spirituality of eastern woodlands. New York, New York: Paulist Press. van Uchelen, C. (1996). The Native strengths project. ( Vancouver Native Health Society and Cross-Cultural Psychiatry Program Final Report). Vancouver, British Columbia: University of British Columbia, Cross-Cultural Psychiatry Program. Waldram, J.B. (1993). Aboriginal spirituality: Symbolic healing in Canadian prisons. In Culture. Medicine and Psychiatry. Sept. Vol. 17 (3), 345-362. Weatherford, J. (1988). Indian givers. New York, New York: Crown Publishers Incorporated. York, G. (1990). The dispossessed. London, Ont: Gagne Ltee for Vintage U.K. 109 The Medicine Wheel This is an ancient symbol used by almost all the Native people of North and South America. There are many dif-ferent ways that this basic con-cept is expressed: the four grandfathers, the four winds, the four cardinal directions, and many other relationships that can be expressed in sets of four. Just like a mirror can be used to see things not normally visible (e.g. behind us or around a corner), the medicine wheel can be used to help us see or understand things we can't quite see or understand be-cause they are ideas and not physical objects. Mental Physical 110 Emotional The Medicine Wheel . Fire The medic ine wheel teaches us that we have four aspects to our nature: the physical, the menta l , t heemot iona ! ,and the spir i tual . Each of these aspects must be equal ly deve loped in a healthy, wel l -balanced ind i -vidual th rough the develop-ment and use of vo l i t ion (i.e. wi l l ) . Earth Black White Red The Medicine Wheel The medicine wheel teaches us that the four elements, each so dist inct ive and power -fu l , are all part of the physical wor ld . A l l must be respected equally for their gift of l i fe. Yellow The Medicine Wheel The medicine wheel teaches us that . the four symbol ic races are all part of the same human family. Al l are brothers and sisters l iv ing on the same M o t h e r Earth. I l l Appendix B On U B C . letter head Spirituality Practices and Interpretations of First Nation's People Who Have a Terminal Illness Principal Investigator: Richard Vedan, UBC Social Work Department: 822-3520 Co-investigator: Joanne Mussell-Oppenheim, UBC Graduate Social Work Student: 245-9937. The research is to complete a thesis for attaining a Master of Social Work degree. Purpose: The participant understands that the purpose of this project is to gain an understanding of how First Nation people practice and interpret spirituality when they have a terminal illness, in order to help other First Nation people, and family members identify with this situation. This can also inform health professionals about some spiritual practices and beliefs that are identified in this population. Study Procedures: The participant understands that if he/she is involved with the study, the co-investigator would interview the participant in a private room at Vancouver Native Health Society or somewhere else that is just as appropriate. The interview would be tape recorded and some notes taken during the session. The interview would entail a semi-structured form with six general questions to answer. The total amount of time that will be required of the subject will entail three to five hours in total. There will be at least one interview and possibly two. Each interview is estimated to be at least one hour to an hour and a half long. The co-investigator will offer to answer any inquiries concerning the procedures to ensure that they are fully understood by the subject and to provide debriefing, if appropriate. Confidentiality: The participant understands that any information resulting from this research study will be kept in a locked filing cabinet. Participants will not be identified by name in any of the reports of the completed study. If the data records are kept on computer hard disk, it will be kept under password. Renumeration/Compensation: There will be no money given to the participants involved in the study. 112 Contact: If I have any questions or desire further information with respect to this study, I may contact Richard Vedan or one of his associates at 822-3520. If I have any concerns about my treatment or rights as a research participant I may contact the Director of Research Services at the University of British Columbia, Dr. Richard Spratley at 822-8598. Consent: I understand that my participation is completely voluntary and that I may refuse to participate or withdraw from the study at any time without jeopardy to subject to further services from the community centre. I have received a copy of this consent form for my own records. I consent to participate in this study. Subject Signature Date Signature of Witness Date 113 Appendix C Vision Quest A vision quest is a spiritual journey where one individual partakes alone. It starts with the individual going to a secluded country setting. It is important not to have domestic noises around or the possibility of coming in contact with other people. When the individual is out doors he/she may refrain from water and food. It is a time to pray to the Great spirit for guidance and understanding for the individual's life. This journey is more than a camping trip because one has to receive guidance from the Creator through some suffering. The suffering is in the form of being outside in the natural elements, having little or no food and/or water. 

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