I was a caterpillar

I was a caterpillar,
crawling through life;
when I found a beautiful plant
and spun my cocoon.
As I metamorphasisized
and grew my wings,
I thought about
how grateful I was,
for the hibernation.
For I had only experienced life
from one perspective.
When my wings had grown,
The struggle began
as I broke free from the confines
of my cocoon.
I thought of how the fight and the change;
no matter how hard it was,
no matter how much it hurt,
no matter how much pain it caused,
was going to be worth it.
I was no longer
going to see the world
just from the ground.
When the time finally came
and I spread my wings,
I could fly.
Bright, bold and rainbow
I used my wings
to fly high.
I let the wind
blow me around.
I was happy.
I needed to learn,
and then when I
established control,
I could see from above
and
I could fly down below and
I could sit on
a plant like before.
I could see the world
from 2 different
perspectives,
and it allowed me
to be free.
The watcher and
the experiencer.
The best of both worlds.
Once I could fly,
I never once
looked back on
the struggle in the cocoon.
I had a whole new way
to look at everything.

Nature, PTSD and Indigenous Ways of Healing

A Connection to Nature, Indigenous Ways of Healing and PTSD

For:  Professor Dan Longboat

By:  Dawn McIlmoyle

Class:  INDG 2601Y

Introduction

     Canadian veterans are experiencing post-traumatic stress disorder (PTSD) at an alarming rate for a variety of different reasons.  In 2013 Statistics Canada conducted a survey of Canadian Forces Regular Forces members and found that 1 in 6 members reported some form of depression, anxiety disorder, PTSD, or alcohol abuse/dependence (www.statcan.gc.ca, 2014).  This survey also found that between 2002 and 2013 there was an increase in the prevalence of PTSD and panic disorder with 11.1% of these members experiencing PTSD in their lifetime (www.statcan.gc.ca, 2014).  This survey also pointed out that 48.4% of Regular Force members experienced some form of mental or alcohol disorder in their lifetime (www.statcan.gc.ca, 2014).  Veterans can develop PTSD from other things such as military sexual trauma (MST), interpersonal violence, and operational stress injuries (OSI) (Conard, Young, Hogan, & Armstrong, 2014; Rowe, Gradus, Pineles, Batten, & Davidson, 2009; Wanklyn, et al., 2016).  Wanklyn et al. (2016) conducted a Canadian study of active duty personnel and found that men were more likely to suffer from PTSD for deployment-related issues, nonsexual interpersonal trauma and an event happening to another whereas women were more likely to develop PTSD due to sexual trauma and nonsexual interpersonal trauma.  There were also a high number of women who had other or undisclosed trauma. 

    Military Sexual Trauma is defined as “sexual assault or repeated unsolicited threatening acts of sexual harassment that occurs during military service (Rowe et al., 2009 p.388).”  Kintzle et al., (2015) found in the United States and that between 9.5% and 33% of women had experienced an attempted or completed rape during their military service. These numbers increase significantly when all forms of harassment are included (Kintzle et al., 2015).  The numbers of women experiencing PTSD from MST are significantly higher that women with a civilian sexual assault (Himmelfarb, Yaeger, & Mintz, 2006; Kintzle et al., 2015).  The study conducted by Himmelfarb, Yaeger and Mintz (2006) found that women with MST had a fourfold increase in odds of having PTSD and that 60% of their sample that had experienced MST had PTSD.  This is thought to occur because of the military culture and the way the trauma is acknowledged if at all (Kintzle, 2015).  The military is based on unit cohesion.  It is based on the fact that you are part of a team and you are no longer an individual.  When a sexual trauma occurs in the military it breaks down the unit cohesion especially if the perpetrator of the violence is in the same unit as the victim (Kintzle, 2015).  The victim regularly has a hard time finding support and is often in fear of coming forward because of career consequences.  They also may have to see the perpetrator on a regular basis (Kintzle et al., 2015; Yaeger, Himmelfarb, Cammack, & Mintz, 2006).  Conard, Young, Hogan, and Armstrong (2014) found that 80-90% of MST goes unreported and victims often experience guilt, shame and non-trust. Kintzle et al., (2015) discusses how along with PTSD, victims of MST often develop multiple symptoms such as gastrointestinal problems, chronic fatigue syndrome, and eating orders to name a few.  Campbell and Raja (2005) discuss in their article how female veterans often experience the actual assault and then secondary victimization by the system.  Secondary victimization is defined by Campbell and Raja (2005) as “victim-blaming attitudes, behaviours and practices engaged in by community service providers which results in additional trauma for sexual assault survivors (p. 97).”  This could include encouraging the victim not to report, refusing to take the report, being told that the issue wasn’t serious enough, and asking if the victim resisted the perpetrator.  The study conducted by Campbell and Raja (2005) concluded that experiencing more secondary victimization of any type was strongly associated with PTSD symptomology.  They also found that over 70% of the participants in their study had been discouraged from reporting the assault and 83% who did report their assault and suffered secondary victimization were reluctant to ask for further help from anyone.  For years, the Canadian Military has engaged in secondary victimization practices which have ruined the careers of many soldiers (www.macleans.ca, 1998, 2014) leaving them suffering the symptoms of PTSD.    

     PTSD is characterized by negative alterations in cognition and mood and often causes the person affected to engage in coping strategies that are less than ideal (Vella, Milligan, & Bennett, 2013).  Veterans with PTSD are also more likely to report multiple health problems because of their constant hypervigilance and high levels of anxiety (Vella, Milligan, & Bennett, 2013).  Most veterans with PTSD have a high sense of disconnect with society and a high level of mistrust.   Dr, John Whelan (2016) writes in his book on Canadian Military mental health that military people have several inconsistencies and contradictions that they must come to terms with to deal with their mental health.  They must deal with the fact that they are taught to always put the unit and the well-being of others first, they are taught to hide weaknesses and work hard at overcoming them.  Military people become attached to the institution.  All their relationships are entwined in their unit.  They are taught that the military is their family, their comrades are their brothers/sisters.  When they are released they are suddenly on their own and without their family.  This is what causes much disconnect (Whelan, 2016).  This is often compounded by the difficulties they face trying to get medical help for conditions like PTSD which were a direct result of military service from institutions like Veterans Affairs Canada.

     For a veteran with PTSD to heal they need to find value within themselves and they need to attach or reconnect to something.  Kopacz and Rael (2016) speak about trauma and PTSD and how it is dehumanizing and a moral injury. They continue to say that the cost of a moral injury is psychological and spiritual.  Essentially they are saying that a moral injury is an injury to your soul or spirit.  Elder Albert Marshall (2017) stated that if physical damage or harm is done to you it is tolerable, however if your spirit is injured it will take a very long time to heal.  This trusted Mi’kmaq Elder speaks of Two-Eyed seeing and using the benefits of both Indigenous ways of living and Eurocentric Knowledge to come to terms with what is happening in the world today. He is quoted in Marsh, Coholic, Cote-Meek and Najavits (2015) as saying that “Two-Eyed Seeing refers to seeing through one eye with all the strengths of Indigenous knowledge and ways of knowing and from the other eye with the strengths of Western Knowledge and ways of knowing, and to use these eyes together, (p. 10).” This paper will attempt to answer the question of whether Two-Eyed Seeing could be the answer to heal our wounded veterans with PTSD.

    The literature review in this paper will focus on how nature and activities in nature have helped veterans with PTSD and their symptomology.  Due to the limited number of articles on veterans with MST, this writer has read many articles on nature and combat veterans and has inferred that this would help veterans with MST as the symptomology of the issues are essentially the same, the triggers may just be different. The writer knows this from personal experience.  The base of the paper will focus on how Indigenous ways of knowing nature can help people with PTSD and trauma heal.  The writer conducted some interviews and placed a question with regards to nature online for military members and veterans with MST to comment and this will be discussed. The writer has made some profound discoveries while conducting this research and would ask that any readers keep an open mind and remember that some conclusions are the opinion of the researcher and her only. 

Literature Review

     A search was conducted on Scholar’s Portal Journals for articles discussing veterans and nature related activities.  Another search was conducted regarding the benefits of being connected to nature.  There is much research as this has become an intriguing topic in society today.  Some relevant books on incorporating nature into healing were also reviewed. 

     Roszak, Gomes, and Kanner (1995) wrote the book Ecopsychology which refers to the fact that if we restore the Earth we can heal our minds.  There are many good chapters in this book written about reconnecting with the Earth and how this brings about spirituality and healing in our lives.  Western psychologists and psychiatrist are often obsessed with the physical, mental and emotional aspects of humanity and trying to heal those but most often the spiritual side is left out in treatment.  While this is a mainly Eurocentric-idea based book, the writer included this as it shows the need for people in general to connect to something bigger than their selves to have a sense of who they are. In Conn (1998) the writer discusses the needs of the Earth and the needs of the human individual as being interdependent and interconnected.   It is discussed how the psychological disconnection from nature is showing up as symptoms in psychotherapy practices across the world.  Conn (1998) states that human health must include active participation with all living beings, not just humans.  The definition of healthy that is used by this Conn (1998) is “to become who one really is, an authentic, unique, and connected being, exercising both assertive and integrative abilities, (p. 184).”  This is the closest Eurocentric theory that the writer could find to Indigenous ways of knowing nature. The writer wanted to include this to show that individuals today are starting to pay attention to the Earth and the disastrous effects that have taken place over the last couple of decades.   

     While many articles deal with the health benefits of nature for people in general the writer’s focus is on using nature as a healing tool for veterans with PTSD.  While using nature as a healing tool, there seems to be a sense of connection that has been missing for the individual.  Poulsen, Stigsdotter, and Refshage (2015) conducted a literature review of nature-assisted therapies for veterans with PTSD.  While conducting their research, they found it important to note that there were no negative results at all when looking at nature-assisted therapy for veterans.  They looked at different variables and found that nature had the potential to be a therapeutic resource for these veterans that were facing so many challenges.  When nature-assisted therapies are done within a group as in a wilderness adventure setting, the veteran regains a sense of connection by realizing that they can accomplish a task, no matter what it is.  It was also found that being together with a group of like-minded people was very beneficial as veterans often feel distant and alone (Poulsen, Stigsdotter, & Refshage, 2015). 

     Vella, Milligan, and Bennett (2013) looked at veterans with PTSD participating in outdoor recreation programs and how well it predicted improved psychological well-being.  It is acknowledged that conventional therapies are not working for these veterans and alternative therapies must be looked at.  The authors looked at 74 veterans given the opportunity to go on a fly-fishing excursion.  The results indicate that this experience of being in nature and learning to do something that requires attention and concentration left the veterans with an increased sense of psychological well-being.  There were significant reductions in anxiety, somatic disorders and PTSD symptoms which continued at the six-week follow-up (Vella, Milligan, & Bennett, 2013).  This was a pilot study but many benefits were found in the veterans who participated.  In addition to a decrease in PTSD symptoms the veterans were found to have increased attentiveness, serenity. and self-assuredness following the outdoor recreation program (Vella, Milligan, & Bennett, 2013).  This study also showed that the nature-based intervention provided a sense of distraction, reconnection and restoration which often helped veterans come back to a calm state of alertness (Vella, Milligan, & Bennett, 2013). 

     In a study done by Gelkopf, Hasson-Ohayon, Bikman, and Kravetz (2013) they looked at how a nature adventure rehabilitation program could benefit veterans with combat related PTSD from the Israeli Defence Force (IDF).  They found that while there were many viable treatments for PTSD, many veterans do not profit from these.  Veterans participated in a twelve-month sailing program where they were placed in groups and conducted sailing activities.  The veterans that participated in the program were compared to a group on a waiting list and it was found that they their PTSD symptomology was greatly reduced and noticeable to those closest to them.  Gelkopf, Hasson-Ohayon, Bikman and Kravetz (2013) also found that the more the veterans felt that they had control over their illness the less symptoms of PTSD they had.  This was thought to occur as this experience gave the veterans a sense of belonging and a sense of empathy from those around them. While the veterans still reported triggering behaviours, it was reported that the emotional outbursts surrounding these were more short-lived and manageable than had been previously.  This study gave the veterans an outlet in nature that they had previously not had and it allowed them to change the perceived control over their illness. 

     In a paper written by Hawkins, Townsend and Garst (2016) they discuss nature-based recreational therapy for military service members and using a strengths-based approach.  This paper found that most interventions that are used for PTSD symptoms are based on a person’s deficits and their limited functioning.  By using nature-based interventions with veterans you are using their previous military assets as well as providing them with internal and external strengths.  The restoration qualities of nature are found to reduce stress, arousal and anxiety (Hawkins, Townsend, & Garst, 2016).  It was found that when veterans participate in an exclusive group and are surrounded by other veterans with the same problems they can find a sense of togetherness that they only previously had when they were serving in the Military.  They conclude their paper saying that nature can be a practical rehabilitation therapy intervention, program and environment for veterans to heal but that it is important to use a strength based approach and not focusing on the deficits of the individual and what they cannot do (Hawkins, Townsend, & Garst, 2016).

     The Sierra Club Military Families and Veterans Initiative conducted a report on exploring the benefits of outdoor experiences on veterans in 2013.  This report suggests that women with PTSD who engaged in extended outdoor recreation found greater mental clarity, spiritual growth and a stronger sense of connection to others leaving more of a sense of “wholeness.”  The authors found that outdoor recreation experiences for veterans leave them with greater feelings of social connectedness and more optimistic about life even a month after participating in the program.  They also found that these experiences alter the way veterans look at their social and physical environments.  Increases in positive feelings were found in the most seriously ill veterans participating in these programs (Duvall & Kaplan, 2013). 

     The literature suggests that nature is beneficial to veterans and that participating in nature-based therapies does improve the quality of life of veterans that feel disconnected from society.  The writer believes nature gives a sense of attachment or belonging to something when the person feels like there is nothing else left.  More research should be conducted into the benefits of nature-based programs however, this writer believes that by using nature and Two-Eyed seeing this can contribute to better well-being of veteran

Methodology

     There are many articles on using the Medicine Wheel for healing and there are many on using nature as a healing device. This writer is going to discuss how using both processes could help veterans that are dealing with PTSD and not finding relief from their symptoms in mainstream therapy.  The writer will include anecdotes from veterans who have used nature as a healing tool and why.  In this writer’s personal experience, she has found that a number of veterans are turning to Indigenous Healers and Elders to find the healing that they need. 

     In the movie Healing the Warriors Heart (2014) it speaks about Indigenous veterans coming back from overseas.  It speaks about the injury to their soul and how it is important to have ceremony to overcome these experiences.  It also speaks about how Indigenous veterans are honoured among their people and often given a medicine bag to carry with them at all times while they are away.  Indigenous veterans are encouraged to tell their stories and purify themselves so that they do not isolate themselves and become sicker.  The veteran that was followed in the movie was given an Eagle feather for his service to show that he was appreciated and to help him heal from his broken spirit.  This writer can’t help but think that non-Indigenous soldiers have no ceremony at home, or people to even care that they are away.  There is not a huge amount of community involved with non-Indigenous soldiers unless a life is taken by war or by something like suicide.  One of the things the writer found most interesting in this movie was a quote from Sitting Bull.  He stated that if our warriors are well, our nations will be well.  If our warriors fall, our nations will fall.  It is imperative that we take care of the men and women that are serving our Country so that our Country will be strong.  When the Canadian government says they have no moral obligation to sick or wounded warriors that is a big blow to the psyche.  The movie shows how in the United States they have started building healing gardens and sweat lodges for the veterans with PTSD.  This was started by the Indigenous veterans; however more and more non-Indigenous veterans are finding it useful for their symptoms as well.   

     When a person enters the Military, they go through an acculturation process.  This is described in Walking the Medicine Wheel: Healing Trauma and PTSD by Kopacz and Rael (2016).  This involves assimilation, separation, marginalization and integration.  In the assimilation process the person goes to Basic Training and becomes like everyone else.  They get their haircut and they are taught that they are no longer an individual, they are a part of a team. They become a part of their new culture, the Military.  The individual is separated from those that they love as they are often posted far from their home and develop a new identity.  Kopacz and Rael (2016) state that the marginalization process is the most difficult for a person because they are stuck in between cultures.  They have rejected both their original culture and their new culture leading to feelings of anger, loss, grief and loneliness.  This marginalization process is what is affecting veterans with PTSD.  They no longer feel they are at home anywhere (Kopacz & Rael, 2016).  After reading up on marginalization and how veterans are stuck in a place where they feel they don’t belong in between cultures the writer began to draw the conclusion that veterans are finding healing within Indigenous circles because Indigenous people are also very marginalized (Kirmayer, Simpson, & Cargo, 2003). 

     Kirmayer, Simpson, and Cargo (2003) concluded that current trauma therapy and theories are all related to the actual disorder of PTSD and it being a psychiatric problem.  There needs to be more attention paid to the symptoms of the disorder such as attachment issues, trust issues, belief in a just world, a sense of connectedness to others and a stable personal and collective identity.  Although their study looked at promoting culture, community and mental health with Canadian Aboriginal peoples, it offered some good insight into how Eurocentric attitudes are not healing people with PTSD (Kirmayer Simpson, & Cargo, 2003). 

     Kopacz and Rael (2016) discuss how using the medicine wheel is a movement away from using medicine as a pill and realizing you have the power within yourself to heal.  As the writer has stated before many Indigenous Elders realize the symptoms of trauma are spiritual injuries and therefore balance needs to be restored to all four dimensions of a persons’ life (Marsh, Coholic, Cote-Meek, & Najavits, 2015). This includes the physical, mental, emotional, and spiritual aspects of a persons’ life (Twigg & Hengen, 2009).  Interestingly enough, Twigg and Hengen (2009) state that in order to heal and restore balance in your life you must transcend the ego instead of strengthening it.  They speak of a program in Saskatoon called Building a Nation where people can go to learn the teachings of the Medicine Wheel.  This program was originally designed for Indigenous people however more and more non-Indigenous people are turning to Indigenous ways of healing and realizing that their lives are unfulfilling because they are missing one of the four dimensions of the Medicine Wheel (Twigg & Hengen, 2009). 

     In The Wellness Wheel:  An Aboriginal Contribution to Social Work (2006) the authors discuss how social workers can use the Medicine Wheel in therapy.  It is said in the article:

            In their fundamental nature, human beings share many similarities with regard

            to the four components of the Medicine Wheel.  Their basic needs are the same;

            they feel similar emotions in similar situation; harmonious relationships, identity,

            recognition and a sense of belonging are all individual aspirations in all cultures;

            human beings of all backgrounds have capacity for creative, rational, logical and

            intellectual functioning; all humans have choice of thought and attitudes when

            confronted with moral and ethical issues; desires for the spiritual qualities of love,

            justice, unity and peace and for general happiness are universal (Margot & Lauretta,

            2006, p. 10.)”

The authors continue to discuss ways people can use the Medicine Wheel to come into balance and harmony in their own lives.  It gives exercises and guiding questions that people can use to see where they are out of balance in their lives and where they can improve (Margot & Lauretta, 2006).  This article shows how using the Medicine Wheel can promote healing in all dimensions of a person and how important it is to have holistic health.  Imbalance in any one of the four aspects of the Medicine Wheel can cause sickness and discomfort.  By using the Medicine Wheel and other Indigenous ways of healing the writer feels veterans can come to terms with the symptoms of PTSD and the feeling of loss of control over their lives. 

     The writer wanted to see how actual veterans felt about nature and their connection to it, what it meant to them.   In a secret online group of MST survivors, a question was posed as to whether anyone had found nature to be healing for them and if so how?  As these people asked not to be identified due to the nature of the issue the writer felt that it was important to state that many responses were that nature was the only place they found solace and could heal.  Some stated that nature had returned their sense of spirituality which had been lost to them when they were victimized.  In personal conversations with friends over the past few months the writer has found several individuals that have turned to Indigenous Elders for their healing.  It was stated by a friend who asked not to be named that when she found a Cree Elder to confide in, her healing began and she could finally get over the years of pain she had felt.  In a personal interview conducted with J. Pogue (2017) who has suffered from PTSD for several years for non-combat related issues the writer found that nature gave this individual a sense of peace, calm and a rush.  He spoke of how he loves to watch the animals and how when you watch them you recall how life should be.  The fact that animals just exist and are not rushed by a timeline is something that he wishes for humanity. J. Pogue (2017) feels that everything in life is inspired by nature, it is a very grounding centering experience which can bring you to present when you feel very overwhelmed.  He is thankful for where he lives even though it is in the city as he has many animal visitors and often spends his mornings outside just observing.  This helps to maintain his serenity in a world full of chaos.

Conclusion

     In Eurocentric views of mental health there is always a neurobiological explanation for the person’s illness.  Often the concepts of mind, body, emotion and spirit are left out along with a person’s desire for interconnectedness with family, land and community (Vukic, Gregory, Martin-Misener, Etowa, 2011).  Indigenous people have a strong connection to their land, family and community.  By engaging in their communities and always thinking of the welfare of the community it allows for healing (Vukic, Gregory, Martin-Misener, Etowa, 2011).  The writer believes that if veterans could think of themselves as communities and begin to use Two-Eyed Seeing in their healing then things could start to change for them. Veterans often suffer because they feel misunderstood.  They at one time were willing to give up their lives for their country, and then they find themselves unable to work due to PTSD symptoms and often turn to drugs or alcohol.  By becoming communities that support each other and by starting grassroots initiatives to promote healing among the community veterans could come together and help each other.  This paper has shown that nature is a very beneficial tool to use to reduce the symptomology of PTSD, and that by using the Medicine Wheel and other Indigenous ways of healing you can recover and become a whole person again. 

     This paper is limited in its scope as there are many Indigenous ways of healing such as smudging, prayer, ceremony, and sweat lodges that could have been discussed and shown how they could also benefit veterans with PTSD.  The main focus of this paper is that nature and a return to spirituality to heal your broken soul is what is needed to feel that veterans are again a productive member of society. By blending Indigenous healing methods with Eurocentric healing methods and using Two-Eyed Seeing to focus on the whole person and not just the disease that was created because a person was traumatized, veterans could find a healing path and return from the fact that they feel they don’t belong anymore.  This reconnection with nature is important as it provides a sense of belonging to something bigger than yourself.  With nature and its benefits often comes a return of self and a sense of attachment to something.  It is this writer’s hope that Indigenous ways of healing will get the recognition they deserve in mainstream society as it seems that these ideals are helping our wounded veterans across North America with PTSD, no matter the cause, and are worth more investigation. 

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