Sacred Conversations

Autumn_Bridge_StoweTalk therapy did not begin with Freud’s “talking cure”. Rather, strategic conversations have likely always been an important tool in the tool kits of Indigenous healers. My teachers often referred to deep, therapeutic discussions as “wisdom talks,” opportunities to speak with the elders, consider the problems in one’s ways, and, in the process, change one’s life.

Most likely, traditional healers have always known about “cognitive distortions,” those “crazy ideas” we all carry around with us, concepts and beliefs that make living in balance difficult. That said, it is important to understand that wisdom talks are only partially about the mind. Rather, they seek to balance mind, heart, and gut (intuition) in the service of the individual, and thus, the community, a community built on diversity and acceptance. Mind alone is not viewed as particularly trustworthy. Mind, heart, intuition, and spirit are all essential to human life, equally valued. We, as whole persons, are held in the arms of the larger community; community is then supported by innumerable beings, seen and unseen, that work with people to create continuity across generations. All of this occurs in a world saturated by relationship and Spirit. Thus, therapeutic conversations are understood to be about the sacred.

Contemporary Western talk therapies, on the other hand, are increasingly dominated by theories of mind, particularly those of the various Cognitive Behavior Therapies (CPTs). These theories are deeply rooted in Christianity, especially Protestantism, and the Puritan worldview of early European settlers. Oddly, practitioners and theorists of CPT seldom discuss these roots, preferring instead to believe CPT arises from an ideology neutral grounding in “science”. They further appeal to a host of studies that appear to validate the effectiveness of CPT as opposed to other treatment modalities, but which fail to challenge the totalizing agendas of CBT or its problematic relationship with Indigenous people. Apologists pay little attention to the narrow focus of CPT, (an over-focus that produces predictable research outcomes that are inherently decontextualized and, thus, problematic) nor any concerns Indigenous people may express about CBT in particular, or Western talk therapy in general. (CBT is not always culturally appropriate psychotherapy.) Further, CBT theorists largely ignore what Indigenous people might identify as cognitive distortions inherent in the ideology of CPT, namely the over-focus on mind and the view that problems exist primarily within the mind (or cognition) of the individual.

Further, the Protestant Ethic inherent in North American social ideology insists that poverty, illness, and disability are the result of the moral or genetic failure of the person, family, or ethnic group that faces the effects of the harm. This is the same ideology that blames women who are the victims of sexual assault. In the language of CBT, moral failure is replaced by the ubiquitous “cognitive distortion,” a substitution that sanitize and renders politically correct the dominant North American colonial ideology. Further, appeals to an abstract, uncritical view of “science” also support the dominant cultural agenda of erasing or pathologizing difference in the service of a totalizing system of belief.

CBT is a powerful tool; yet, seemingly inherently to CBT is a bias against the worldviews and day-to-day experiences of Indigenous people. My experience has been that CBT oriented clinicians and researchers too often dismiss culture based criticisms of CPT, insisting that CBT is, right out of the book or box, applicable to all people. All too often practitioners become focused on the thoughts of clients to the exclusion of heart, intuition, and spirit.  There is also a profound danger that practitioners will fail to understand, or worse, look down on, Indigenous world views and experience, and, thus, fail to appreciate the enormous influences of colonial social forces in the daily lives of Native clients. In doing so they risk assuming the ways oppressed people think about colonialism and ongoing genocide are more problematic than are the social forces themselves. This often results in denial of the multigenerational influences/oppressions of colonialism and a blaming of the victims. (Similar forces are at play in the lives with persons who are disabled.)

I offer these concerns as a person trained in both Western and Indigenous concepts/understandings of science and health care. Sadly, all too often I find myself providing services to individuals or families who are refuges from Western oriented clinical theory, especially CBT. Over the course of therapy, or as part of shamanic healing, I join them in considering the thoughts and ideas that shape their behaviors, ideas that may be cognitive distortions that make their lives more painful and difficult. Yet, we do this within a much larger worldview, one in which mind is only part of what makes us human, where community is central to the wellbeing of all beings, and in which the Earth and Cosmos are inherently alive. Within this frame, ideas that describe the world only as a set of resources, and the spirit realms as illusions, are understood to be both cognitive and spiritual distortions, errors that have justified the theft of Native lands and the use of genocide against Indigenous people around the world, and now threaten to make the planet unlivable.


10 thoughts on “Sacred Conversations

  1. Great post, filled with wisdom.
    It’s interesting for me, based in the UK, to get a sense of the difference in the ways mind therapies are evolving in different places. Here the CBT model is highly favoured by psychologists, and because it has been easy to demonstrate quick results….although often with little lasting benefit….it has been the model of work adopted by the NHS and insurance paid therapies. We don’t have so much insurance paid work over here, so the insurance companies don’t have as much sway over the direction of the work, and especially it’s timescale 🙂
    Psychotherapists here are mostly divided between person-centred work, where the individual experience is held in the highest esteem as the place from which all the work should proceed, and the psychodynamic or Jungian approaches, where the past is seen and experienced as inhabiting the present, so working on the internal world with all it’s feelings and thoughts is the focus.
    I love the way you describe the native approaches in the USA, that approach certainly holds much wisdom for us all.

    1. Thanks! Here the insurance companies drive the ship. That said, there is still some freedom to do other forms of therapy. There is great demand for culturally appropriate/sensitive therapy although I am not sure how much of that actually is done. When I look into the future I become more concerned….

  2. Great post, Michael. As McKenzie said, insurance companies are pushing for short term therapy and from my experience, short term doesn’t work for most people. It is like a band aid with no real change taking place. Behavioral therapy has similar short comings as those you identified for cognitive therapy. I read an interesting report on research done surveying therapists of different persuasions about the difficulty of change in therapy. Behaviorists were the group that felt that change was easiest – except for those behaviorists who had actually received therapy themselves. Some theories don’t seem to be developed out of what people really need, like relationship with the helping individual that is developed on trust established over a period of time and that comes from hearing what is important to the whole person. I went to a workshop by Elbert Ellis when cognitive therapy was first introduced. He became mean, actually verbally attacking the people who volunteered from the audience. If they didn’t conform to what he needed them to do, he attacked them.

    1. Hi Pat! Thanks for this thoughtful comment. I think the truth is that every ideologue is committed to their cause – probably even me (LOL!). Recognizing we are all travelers on the road might help….

  3. I have no experience at all with CBT. I’m not a clinician. When I’ve read about it though, I’ve always felt it somehow abusive – couldn’t have told you why – so I find this interesting and confirming and something to read more about and think more about as someone for whom I care deeply started therapy last week.

    I saw that you are reading up again about polio. I hope you are doing okay. Holding you in heart and prayer, Michael, and always grateful for what you share with us.

    Warmest regards,

  4. Thought-provoking post, Michael, as always. I think you touch on the value that some faith cultures place on the practice of confession. Although those of us in those religious groups know that forgiveness is between God and the person, there is a need to express, to verbally expunge, so to speak, those areas in which we feel we have missed the mark.

  5. It’s pretty scary to see how much control the insurance companies have in determining what techniques mental health practitioners can use to get reimbursed. CBT is useful but if it’s the only tool a practitioner has, I feel sorry for the clients. Especially when working with a culturally diverse client population, we need a very broad range of conceptualizing and intervening. Even when working with a more homogeneous population, a holistic model of intervention is always preferable. You are so right in pointing out the hyper-focus on thoughts/cognition in the mental health model. Isn’t it generally known by now that we are body/mind/spirit/soul entities embedded in cultural conditionings that intersect region, gender, race, ethnicity, sexual orientation, class and who knows what else?

    1. Rereading you comment I am reminded of how difficult things can get for clinicians and clients. Fortunately, there are many clinicians (probably the majority) who are committed to delivering person shaped, culturally appropriate/sensitive, services. It is important we continue to speak up, to insist on deep, well stocked. tool kits. Perhaps my appreciation for Narrative Therapy arises, at least in part, from NT’s insistence on context.

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