Professor Daya Somasundaram
Addressing Collective Trauma
in Indigenous Communities

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Live Encounters Magazine April 2023

Addressing Collective Trauma in Indigenous Communities
by Professor Daya Somasundaram

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Abstract

Indigenous communities in Australia have undergone considerable trauma and manifest a variety of dysfunctional symptoms at the collective level.

The consequences of collective trauma include loss of self-esteem, dignity, purpose, meaning, sense of belonging, communality, connectedness, ethical mores and norms, spiritual beliefs and an induced state of learned helplessness, dependency and passivity. The epidemic alcohol and drug abuse, violence and child sexual abuse needs to be understood in the context of the experiences of colonization that set-in motion a cycle of massive trauma and loss that was passed on from generation to generation.

Colonization and subsequent interventions by government, missions and others have undermined the family and social systems, the processes that traditionally solved family and community crisis and problems.

The long-term solution would be to break the cycle and rebuild mechanisms of self-regulation within the community and the families themselves.

Interventions need to rebuild healthy family and collective processes, dynamics and functioning, to restore social cohesiveness, confidence, dignity, pride, identity and spirit.

Further research is needed to develop the evidence base for collective trauma, operationalise the psychosocial diagnosis and evaluate family and community level interventions.

The continuing evidence of ill health and disadvantage manifested through a variety of physical, psychological and social parameters in indigenous communities compared to mainstream society in a comparably developed, affluent country needs urgent attention[1]. The large gap in life expectancy; high morbidity, mortality and rates for various mental disorders including Posttraumatic Stress Disorder (PTSD), Depression, Alcohol and Drug abuse, suicide and self-harm; over-representation in prisons; poor educational and employment achievement; high incidence of physical and sexual violence and abuse; and family disharmony all point to a basic dysfunction in the community [2-45, 6] When the family and community are functional many of the social problems do not arise or are sorted out within the community [5].

It is becoming increasingly clear from experiences around the world, that communities which have undergone considerable trauma develop fundamental changes in their social structure and dynamics. Unless community level consequences are taken into account and addressed, well-meaning individual oriented programmes may not be so effective. However, the problem may not fall within western psychiatric medical models or mainstream paradigms. This paper discusses the concept of collective trauma as a useful framework and suggests appropriate interventions.

Collective Trauma

Erikson [7] described Collective Trauma as ‘loss of communality’ following the Buffalo Creek disaster and with colleagues [8], ‘broken cultures’ among the North American Indians as ‘destruction of the entire fabric of their culture’ due to the forced dispossession of traditional lands, displacements into reservations, separations, massacres, loss of their way of life, relationships and spiritual beliefs. Subsequent accounts describe ‘cultural bereavement’ [9] due to the loss of cultural traditions and rituals in Indochinese refugees, and the importance of family [10-12] and socio-cultural consequences [13-18].

Milroy [19] spoke of the tearing of the social fabric in the Australian Indigenous Doctors’ Association (AIDA) submissions. The National Strategic Framework for Aboriginal and Torres Strait Islander Health [20] trace the cause: “The sense of grief and loss experienced by generations of Aboriginal and Torres Strait Islander peoples in relation to dispossession, to the disruption of culture, family and community and to the legislated removal of children has contributed to ongoing problems in emotional, spiritual, cultural and social well-being for Aboriginal and Torres Strait Islander individuals, families and communities.” Lowitja O’Donoghue [21] stated, “The assault on Aboriginal people includes massacres, diseases, dispossession and dispersal from the land… the traumatic consequences of policy and the destruction of Aboriginal and community life that resulted.”

A survey [22] of the aboriginal population of Western Australia, found a high prevalence of Post Traumatic Stress Disorder (55 %), depression (22%), alcohol abuse (73 %), linking it to massive trauma. O’Shane [23] drew attention to the loss of pride, identity, self-respect, language, songs, laughter, spirituality, relationships, traditional knowledge and skills in the communities. The consequences are trans-generational [l5] and result from the breakup of traditional culture, kinship networks, way of life and belief systems [1, 5, 6].

The Australian Guidelines for the Treatment of PTSD [24] links the “the legacy of historical trauma (as) family and community functioning can continue to be compromised in each subsequent generation by social and psychological problems (such as substance use), leading to a vicious cycle of deteriorating conditions, pervasive social disadvantage, and for individuals, increased risk of further victimisation and traumatic exposure, coupled with reduced psychological resilience”. It advocates a “broader approach … using traditional therapies including the use of healers, rituals and ceremonies, Narrative exposure therapy and cultural social processes”.

Sociopathology

‘Collective Trauma’ can be defined as the negative impact at the collective level (that is on the social processes, networks, relationships, institutions, functions, dynamics, practices, capital and resources), to the wounding and injury to the social fabric [18]. The long-lasting impact at the collective level results in social transformation of a sociopathic nature.

The legacy of historic trauma is compounded by what Phillips [25] terms current ‘situational trauma’: police harassment, continuing deaths in custody, and deaths of family members to suicide, self-harm, or other injury. Weatherbum et al [26] point to the destruction of aboriginal culture as the major underlying but distal cause of aboriginal over-representation in prisons and advocate supporting aboriginal women, strengthening aboriginal social norms and increasing investment in boriginal employment schemes. Incidental triggers may precipitate the arrest and detention [6].

The more pernicious consequences of collective trauma include loss of self-esteem, dignity, purpose, meaning, sense of belonging, communality, connectedness, ethical mores and norms, spiritual beliefs and an induced state of learned helplessness, dependency and passivity. The epidemic alcohol and drug abuse, violence and child sexual abuse needs to be understood in the context of the experiences of colonization that set-in motion a cycle of massive trauma and loss that was passed on from generation to generation [27]. The trauma is passed on in child-rearing practice with children growing up in pathological family and community environments of violence, gambling, child sexual abuse, poverty, disinterest in education or work, erosion of respect for elders, cultural values or practices and poor role models. Indigenous youths’ negative experiences with an excluding mainstream society, frustration of expectations and a punitive criminal justice system further compounds and aggravates the situation.

Alcohol and drugs are used to cope with the grief, distress and traumatisation while the suppressed anger and rage manifests as violence towards self and others [5]. Unfortunately, colonization and later interventions by government, missions and others, sometimes well-meaning but more often virulent, actively destroyed the very family and social systems, the processes that traditionally solved family and community crisis and problems [5]. The long-term solution would be to break the cycle and rebuild mechanisms of self-regulation within the community and the families themselves.

Interventions

A fundamental prognostic question is whether the process of systemic destruction and assimilation gone too far, has the loss of traditional ‘high’ culture, beliefs and spirit been irretrievably lost or changed [28-30] ? However, as the burnt bush and forests regenerate with new rains, perhaps if the necessary opportunities and enabling environment are provided, the indigenous culture and community can rise again from the ashes.

Historically, there are examples of successful indigenous initiatives that were stifled but can be learnt from [28]. It is important to recognize and build on their strengths, resilience and what has been achieved in the last few decades to regenerate indigenous communities through appropriate healing and community programmes [5, 6]. Conventional medical treatment of individuals through medication, Cognitive Behavioural Therapy (CBT) or psychotherapy may not be appropriate [4].

The broader problems of collective traumatisation are best approached through strengthening and rebuilding family and community structures, re-establishing the communities’ dignity, self-esteem, collective identity, pride, beliefs and sense of communality.

One way to create pride in the indigenous culture would be to honour traditional beliefs and practices and recognize their value for present day society. For example, strategies for dealing with climate change could learn from indigenous non-exploitive and organic relationships to land and nature. Another important quality are the deep, meaningful human relationships, kinships ties, responsibilities and obligations, resource sharing, co-operation and conflict resolution rituals that evolved over 50,000 years. A potential for increasing pride and self-image, lies in the colonial stereotype label, aborigine, that enshrines negative and denigratory connotations.

The racist ideology of the times gave it a sense of being primitive, inferior, uncivilized, savage and even subhuman that legitamized the colonial domination. Tragically, indigenous people have internalized a negative view of themselves, with shame, self-loathing and a loss of dignity. The term ‘aborigine’ reflects current reality, the power relationship and opressive system that keeps them in place. As this balance changes, more respectful terms such as ‘indigenous’ becomes more acceptable. Other indigenous communities have managed substitute such terms as ‘first nation’.

There are now innovative attempts to repair the torn social fabric among indigenous communities. The Dulwich centre in Adelaide [31] has used narrative practices to ‘reclaim community’. By sharing stories at community gatherings, relationships, connections and links are re-established, traditional values, beliefs, knowledge, skills and hope are re-kindled, giving rise to community solidarity and support. This method has been expanded to other indigenous populations around the world including in New Zealand and North America.

Dadirri is a powerful cultural practice for listening, building relationships, support and healing as are storytelling, family and community story maps, using dreams, art, music, dance and theatre [5]. Similar attempts to rebuild traditional social functioning have been employed by community patrols in the Northern Territory to tackle problems of suicide, violence and alcoholism among the Yolngu people. Pearson [32] recounts how the efforts of Yolngu elders in Yirrkala to prevent the introduction of alcohol into their community were stymied by multi-national commercial interests and the irony of the current government’s legislation aimed to solve the very social problems the Yolngu leaders had frantically tried to avert.

Wilkes [33] of the National Indigenous Drug and Alcohol Committee describes successful systems introduced in the Groote Eylandt and Maningrida communities to reduce alcohol-related problems. In community development work, a sense of agency, participation and ownership is vital[1, 5, 6, 27]. Hunter [2] has advocated for sustained commitment to educational opportunities and resources as a practical way forward.

Although the Breaking the Silence, Creating the Future and ‘Little Children are Sacred’ reports have highlighted the high levels of aboriginal child abuse which have fed popular, stereotyped media images of child sexual assault and led to the Northern Territory emergency response, the Social Justice Report (2007) [6] points out that what is not realized is the alarming levels of child neglect. The report argues that the deprived socioeconomic conditions of indigenous communities with overcrowding, unemployment and lack of services breed neglect.

The failure of the government to provide adequate services and opportunities that could rectify these conditions need consideration as much as focusing on the responsibilities of indigenous families and communities. There are also systemic failures in the child protection system such as underreporting and systemic bias towards western values and strategies that could be interlinked. Indigenous families and communities may not have sufficient trust and faith in a system that responds with forced removals, separations, excessive control and punitive measures rather than address underlying causes and dynamics to report cases or ask for help.

A Royal College of Psychiatrists’ publication recommend for “Culturally Competent Services” the family as the preferred point of intervention [34]. The family is the basic social unit in non-western, traditional ‘collectivistic communities’ [35]. Families tend to think and act as a unit. Mainstream society values a more “individualistic” approach which emphasizes emancipation from the family, individual rights and protection. When there are issues of domestic violence or child abuse, mainstream structures, institution and services move to protect the individual, away from harm’s way and thus subtly promote separation.

Medical treatment also tends to be individual oriented; diseases and solutions are conceptualized in reductionist terms. However family and kinship is central to indigenous culture [1, 5, 27]. In indigenous families, a holistic integral approach, working with available family members, addressing their various needs and relationships as well as the family dynamics, finding and mobilizing support systems maybe more appropriate. In a healthy, supportive family environment, members would recover and may not need individual treatment as such.

It is useful to involve the family from the outset in the initial history and assessment, encouraging their contribution and point of view. At times, difficulties in family dynamics can be observed, assessed and even addressed in these settings. Home visits maybe needed to engage the whole family, including significant extended kin. Initially non-cooperative and difficult males may eventually come around with a non-challenging, supportive and patient approach (Anthea Krieg, personal communication).

Instead of being hampered by excessive concern for individual privacy and confidentiality which are western constructs [36], working within the family circle can be handled with sensitivity and knowledge of cultural dynamics. Prof. Martin from Queensland [37] has shown how much can be done with families even with limited resources but despairs over the devastation and intergenerational legacy that is occurring to children in mainstream families, let alone indigenous families.

The other critical area in regenerating communities is to support, encourage and empower the indigenous community, their emerging leaders and elders to restore social norms, values, beliefs, responsibilities and relationships as well as determine their own programmes.

References

1. Social Health Reference Group for National Aboriginal and Torres Islander Health Coucil and National Metal Health Working Group. National Strategic Framework for Aboriginal and Torres Strait Islander People’s Mental Health and Social and Emotional Well Being 2004-2009. In: Department of Health and Ageing, editor. Canberra: Department of Health and Ageing, 2004.
2. Hunter E. Back to Redfern. Canberra: Australian Institute of Aboriginal and Torres Strait Islander Studies, 2006.
3. Raphael B, Delaney P, Bonner D. Assessment of Trauma for Aboriginal People. In: Wilson JP, Tang CS, editors. Cross-cultural assessment of psychological trauma and PTSD New York Springer; 2007. p. 337-358.
4. Ober C, Peeters L, Archer R, Kelly K. Debriefing in different cultural frameworks: responding to acute trauma in Australian Aboriginal contexts. In: Raphael B, Wilson J, editors. Psychological debriefing. Cambridge: Cambridge University Press; 2000. p. 241-253.
5. Atkinson J. Tauma Trails, Recreating Song lines: the transgenerational effects of trauma in indigenous Australia. Melbourne: Spinifex, 2002.
6. Aboriginal & Torres Strait Islander Social Justice Commissioner. Social Justice Report 2007 Sydney: Human Rights and Equal Opportunity Commission, 2008.
7. Erikson KT. Loss of Communality at Buffalo Creek. Am J Psychiatry1976;135:300-305.
8. Erikson K, Vecsey C. A report to the People of Grassy Narrows. In: Vecsey C, Venables R, editors. American Indian Environments- Ecological Issues in Native American History. New York: Syracuse University Press; 1980. p. 152-61.
9. Eisenbruch M. From Post-Traumatic Stress Disorder to cultural bereavement: Diagnosis of Southeast Asian Refugees. Soc Sci Med1991;33:673-80.
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© Professor Daya Somasundaram

Prof. (Rtd.) Daya Somasundaram, BA (USA), MBBS (India), MD (SL), FRCPsych (UK), FRANZCP (AUS), SLCP (SL),  was a senior professor of psychiatry at the Faculty of Medicine, University of Jaffna, and a consultant psychiatrist working in northern Sri Lanka for over three decades.  He has worked as a consultant psychiatrist at Glenside Hospital; with indigenous mental health services; supporting those coming as refugees and asylum seekers in Australia at Survivors of Torture and Trauma Assistance and Rehabilitation Service (STTARS), and is a clinical associate professor at the University of Adelaide. He retired as a consultant from the Wide Bay Mental Health Services, Hervey Bay, Queensland.

He has also worked in Cambodia for two years in a community mental health programme with the Transcultural Psychosocial Organisation. He has functioned as co-chair of the subcommittee on PTSD formed under the WHO working group on stress-related disorders during the ICD-11 revision process.   Apart from teaching and training a variety of health staff and community-level workers, his research and publications have mainly concentrated on the psychological effects of disasters, both man-made wars and natural tsunami, and the treatment of such effects.   He also functioned in two national bodies, as the co-chair of the Task Force on Psycho-social Support,  Office for National Unity and Reconciliation (ONUR),  and on the UN mandated Consultation Task Force on Reconciliation Mechanisms, Sri Lanka.