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Indigenous spirituality is a more complex phenomenon than the term spirituality alone, as generally understood, implies. Spirituality is closely bound up with culture and ways of living in Indigenous communities and requires a more holistic or comprehensive research approach. Two conceptual frameworks could help to orient Indigenous resilience research. One is the enculturation framework. Enculturation refers to the degree of integration within a culture, which can be protective in social behaviour, academic achievement, alcohol abuse and cessation, substance abuse, externalizing behaviours, and depressive symptoms. Instruments for measuring enculturation generally have three components: traditional activities, cultural identification, and traditional spirituality. A second conceptual framework is cultural spiritual orientation which distinguishes between cultural spiritual orientations and tribal spiritual beliefs. Enculturation and cultural orientations are protective against alcohol abuse, suicide ideation, and suicide attempts. New tools are emerging for measuring the multidimensional nature of culturally rooted spirituality in Indigenous communities, tools that are context-specific and often the product of collaborative design processes. As the ability of researchers to measure these complex processes advances and Indigenous communities take increasing charge of their own research, it should become easier to design interventions that take advantage of the cultural/spiritual dimension of Indigenous traditions to promote individual, family, and community resilience.
This review is part of a special issue of Pimatisiwin dedicated to Aboriginal resilience. The overall objective of this special issue is to support and promote Aboriginal resilience in a variety of contexts. One important resource for this may be Aboriginal spirituality. This review summarizes efforts to clarify the concept of Indigenous spirituality and to isolate it sufficiently to measure some of its effects.
Indigenous mental health professionals and social workers have taken the lead in promoting traditional spirituality and culture as possible resources in preventing and healing from alcoholism, substance abuse and addiction, suicide, and other behavioural and developmental pathologies which challenge many Indigenous communities of North America, especially their young people. In addition, Indigenous professionals consider traditional spirituality and culture as key appropriate responses to historical trauma and unresolved historical grief (see Fleming and Ledogar, 2008). They integrate traditional spirituality and culture into their practice, or develop professional practices from within traditional culture and its spirituality. This movement includes therapeutic interventions and individual counseling (Duran and Duran, 1995), small group psycho-educational interventions (Brave Heart, 1998, 2003; Brave Heart and DeBruyn, 1998), larger scale addiction recovery programs (Abbott, 1998) and suicide prevention programs (Goldston et al., 2008).
It is helpful to clarify the scientific basis of this work, so practitioners can evaluate their work, clarify concepts, distinguish what works well from what works less well, and develop new tools on the basis of a clearer intellectual understanding of the processes involved. Some researchers have already responded to this need and this review summarizes the tools and outcomes of recent research so that other researchers and practitioners, many of them Aboriginal, can take the work further.
We clarify the concept of resilience in Fleming and Ledogar (2008). The most common definition of resilience is “positive adaptation despite adversity,” and most authors consider the presence of some demonstrable substantial risk to be essential. Some Aboriginal authors prefer to see resilience as a natural, human capacity to navigate life well. All the literature we encountered on resilience and Indigenous spirituality situated resilience in risk situations, but this review deliberately did not limit itself to any specific types of risk or adversity to which Aboriginal spirituality may be a response.
From the broader literature on spirituality, before specifying it as Indigenous spirituality, we used a working definition provided by Wong et al., drawn from earlier work by Benson et al.: “the intrinsic human capacity for self-transcendence, in which the self is embedded in something greater than the self, including the sacred” and which motivates “the search for connectedness, meaning, purpose, and contribution.” According to this definition, spirituality is contrasted with religiosity which is defined as “one’s relationship with a particular faith tradition or doctrine about a divine other or supernatural power” (Wong et al., 2006; Benson et al., 2003).
We did not seek to define Indigenous spirituality. We looked for literature that used the term and the search itself showed Indigenous spirituality as a more complex concept than implied by the term spirituality alone in its general usage. It is clear that taking Indigenous spirituality into account in research requires a more holistic or comprehensive research approach.
We did not intentionally limit our inquiry to North America, but most of the published work on this subject had in fact been carried out in the United States, though some of the groups studied transcended American territorial limits to include members or relatives now situated in Canada.
Research on resilience and spirituality in an Indigenous context lacks a robust theoretical basis, or even a unified conceptual framework. We detected at least two conceptual approaches in the literature and tried to relate the existing results to either one or the other. But the concepts underlying both approaches are vague and may eventually be supplanted. Our main assumption, therefore, is that it is premature to categorize the theory too rigidly. In the discussion section below, we suggest some related lines of research that may eventually contribute to theoretical development in this field.
We conducted searches in the PubMed, PsychARTICLES, and SOCIndex databases, followed by reviews of key articles from the bibliographies of the articles identified, and a hand search of the online journal American Indian Alaska Native Mental Health Research: The Journal of the National Center. Keywords used were “Indigenous spirituality,” “Aboriginal spirituality,” “Native American spirituality,” and “American Indian spirituality,” each coupled with the term “resilience.” We subsequently used the “related items” feature of PubMed for additional material. The inclusion criteria used in this review were as follows:
Our search ran from the earliest dates covered by each database until mid-2007.
At the theoretical level, research appears to have developed along two distinct but related lines: enculturation and cultural spiritual orientation.
Enculturation is distinguished from acculturation, which is the degree of assimilation to majority or dominant culture. Enculturation refers to the degree of integration within a culture — it is intra-cultural. The enculturation process can occur together with other processes of socialization. An Aboriginal person in Canada, for example, might be well-enculturated but maintain some level of identification with the majority culture as well. An enculturated youth might in fact be bicultural, identifying with both traditional Indigenous and mainstream, or majority, cultures simultaneously. This perspective conceptualizes the complexity of cultural identification, moving away from simple either/or views (see Oetting and Beauvais, 1990/91).
The authors most associated with the measurement of enculturation as a protective or resilience factor among Native North Americans are Zimmerman et al. and Whitbeck et al. Zimmerman et al. seem to have initiated the field, while Whitbeck and his colleagues built on that work. Table 1 presents some of the measurement instruments used by enculturation researchers grouped into three categories established by Whitbeck, while Table 2 presents the principal outcomes of their research according to the same conceptual grouping.
Table 1 shows two important developments in the questions asked by Whitbeck in 2002, compared with Zimmerman in 1994. Under the category of cultural affinity or Native American identity Whitbeck chose a different set of questions, a set adapted from the work of Oetting and Beauvais (1990–91) which introduces the notion of success within Native American culture: how successful are the respondent and his/her family in Native American culture?
The second important development is the introduction of traditional spirituality as a concept separate from traditional activities. The concept includes both traditional spiritual activities and traditional spiritual values, but the precise content of either of these notions is not readily available to the non-Indigenous researcher. Furthermore, it appears that this content can and does change from one tribe or band to another. Its definition is based on consultations with tribal Elders.
Table 2 illustrates the initially tentative outcomes of research on resilience and enculturation. When Zimmerman and colleagues (1998 ) reported the first use of the instrument in research, their results were mixed. They did not find direct main effects of enculturation, but they did find that
… the influence of enculturation on alcohol and substance use interact with self-esteem. The enculturation hypothesis was supported by the finding that youth with the highest levels of self-esteem and cultural identity reported the lowest levels of alcohol and substance use. Support for the hypothesis was somewhat mitigated, however, by the finding that youth with low levels of self-esteem and high levels of cultural identity reported the most alcohol and substance use. (Zimmerman et al., 1998  , p. 215)
These researchers speculated that exposure to racist attitudes may have a negative effect on the self-esteem of Native American youth (Zimmerman et al., 1998  ).
When Whitbeck et al. reported on enculturation and academic success in 2001, they found a positive association between enculturation and school success. Self-esteem was also independently associated with school success. The researchers concluded that enculturation is a resilience factor in the development of Native American children. Their results support those of Zimmerman and colleagues (1994), although in the Whitbeck et al. model, enculturation did not interact with self-esteem.
In 2002, Whitbeck et al. reported on traditional activities, perceived social support, perceived discrimination, and depressive symptoms. In this case they used only the first component (traditional activities) of their three-part enculturation construct — leaving out cultural identification and traditional spirituality. The researchers found one significant interaction between discrimination and traditional practices: for those whose participation in traditional practices was above the mean, discrimination had almost no effect on depressive symptoms — the traditional practices acted as a buffer.
Whitbeck and colleagues were still encountering mixed effects in 2004 when they reported on enculturation, discrimination, historical loss, and alcohol abuse. They found, at best, a limited protective effect of traditional culture on alcohol abuse. It appeared that those who are highly enculturated are also those who report higher levels of historical loss. The authors suggest that traditional culture both sensitizes one to loss and serves as a protection from reminders of loss.
It is only with the most recent group of studies by Torres Stone et al. (2006), La Fromboise et al. (2006), and Yoder et al. (2006), that enculturation (including all three component concepts) appears to be protective against alcohol and other substance abuse and suicidal ideation. In Torres Stone et al., traditional activities and traditional spirituality were convincingly associated with alcohol cessation, but cultural identity was not. LaFromboise et al. found that age was associated with decreasing resilience. “With each year of increase in age (from 10 to 15 years), there was an associated lowering of resilience by a multiplicative factor of 0.626. This represents an approximate 10% decline in resilience with each year of age” (LaFromboise et al., 2006, p. 202). For Yoder et al., enculturation did not appear to be significant when analyzed in a simple relationship with suicidal thoughts, but when the researchers took all the other variables into account in a multivariate model it did become significant and proved to be the second strongest predictor variable (after drug use) of suicidal ideation. Based on previous work by Paulhus et al., the authors hypothesize that the other variables in the model “unleash the latent predictive power of enculturation that is not apparent at the bivariate level” (Yoder, et al., 2006, pp. 185–86).
Table 3 presents both questions used in, and outcomes from, the research reported by two groups whose conceptual approach is somewhat different from the enculturation group, Garroute et al. and Herman-Stahl et al. While Garroute et al.’s questions speak explicitly of spirituality, those of Herman-Stahl et al. do not. Thus the grouping of these within the same conceptual category is tentative at best.
Outcomes related to cultural spiritual orientations are presented in the lower part of Table 3. Garroutte et al. (2003) reported on spirituality and attempted suicide. Their study was part of a larger project called American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP) on alcohol abuse and dependence, drug abuse and dependence, major and minor depressive disorders, generalized anxiety disorder, panic disorder, posttraumatic stress disorder, and antisocial personality disorder. Their fully adjusted analysis found that those with a high score of cultural spiritual orientations were half as likely to attempt suicide as those without such an orientation. On the other hand, the analysis found no such association with either tribal spiritual beliefs or Christian beliefs. The researchers concluded that “the cognitive measures of belief may not adequately capture commitment to some forms of spirituality embraced by American Indian peoples, and that an alternative measure of spiritual orientations might be more valuable” (Garroutte et al., 2003, p. 1577).
Herman-Stahl et al. used cultural orientation
to denote an individual’s identification with and participation in his/her own culture as well as the dominant culture. Cultural orientation is a multidimensional, multidirectional process through which identification to the traditional and dominant culture occurs independently yet simultaneously. (Herman-Stahl et al., 2003, p. 48)
All the instruments we reviewed were designed to encompass the multidimensional nature of culturally rooted spirituality in Indigenous communities in North America. These dimensions include knowledge, emotion, decision, and sense of self-efficacy as well as relationships to family, peers and community. They also take in ritual, language, and relationships with the physical environment.
Although we did not conduct this review with specific outcomes in mind, the literature reviewed does lend itself to some generalizations about Indigenous spirituality in relation to two risk areas: alcohol abuse and suicide.
Four studies in this review assessed the impact of Indigenous spirituality on alcohol abuse among American Indians. These outcomes are presented in Table 2. The implication seems to be that involvement in traditional culture and its inherent spirituality helps to prevent the abuse of alcohol among Aboriginal people and may also aid individuals to recover from alcohol abuse.
Two articles reviewed here, one on suicidal ideation among youth and the other on attempted suicide, assessed the relation of Indigenous spirituality with suicide among Native Americans. These outcomes are also summarized in Table 2. These two studies suggest that spirituality may be an important component of the protective association that has been found by Chandler and Lalonde between cultural continuity, or cultural resilience, and youth suicide (see Chandler and Lalonde, 1998 and Fleming and Ledogar, 1998).
In addition to these outcomes, four of the studies on enculturation listed in Table 2 included an assessment of discrimination as a risk factor for decreased resilience. Perceived discrimination was found to be an important risk factor for decreased resilient outcomes, based on a composite measure of resilience (LaFromboise et al., 2006), and was found to be an important predictor of suicidal ideation among American Indian youth (Yoder et al., 2006). One study found that traditional practices, one component of the three-component construct of enculturation, was an important buffer to perceived discrimination (Whitbeck et al., 2002). Another found that enculturation did not buffer (neither mediated nor moderated) the effects of discrimination on alcohol use, but combined with historical loss did mediate its effects (Whitbeck et al., 2004). More research is needed to evaluate the potential buffering effect of Indigenous spirituality and traditional culture on the effects of discrimination.
A key knowledge gap is the applicability of enculturation and cultural spiritual orientations to Aboriginal populations living off-reserve. All of the studies reviewed here drew their samples from people who lived on or near reservations.
The heterogeneity of urban Aboriginal populations presents a challenge to this emerging body of research. Aboriginal populations in cities often comprise multiple cultural or national groups. Measuring enculturation under such circumstances is bound to be more difficult. CIETcanada is currently adapting the Whitbeck et al. enculturation instrument for use with an urban Aboriginal population in its Edmonton and Ottawa phase of the ACRA project, studying resilience factors for risky sexual behaviours related to HIV-AIDS, sexually transmitted infections, and blood-borne viruses (see Andersson and Ledogar, 2008).
Some encouragement to proceed in this area is provided by LaFromboise et al., whose sample included youth living off reservation but attending reservation schools. They reported that living on reservation was not significant for predicting resilience and concluded that this finding “attests to the salience of cultural involvement among American Indians, as well as their tenacity to maintain cultural affiliation despite continuous pressures for acculturation” (LaFromboise et al., 2006, p. 204). In addition, the authors indicate that the finding confirms the growth of cultural revitalization and ongoing community connections among American Indians regardless of residential location.
The instrument measuring cultural spiritual orientations may also be useful in the case of urban Aboriginal youth. While designed in collaboration with the tribal stakeholders of the specific American Indian tribe which participated in the study, its items are personal and global in nature.
Garroutte et al. found that cultural spiritual orientation predicted fewer attempted suicides, whereas neither Christian beliefs or traditional spiritual beliefs had any impact on attempted suicide (Garroutte et al., 2003). This finding is consistent with results of studies using the Spiritual Well Being Scale (SWBS) in non-Aboriginal populations on different outcomes (see Cotton et al., 2005; Tsuang et al., 2007). The SWBS, conceived in an evangelical Christian context, consists of two subscales called religious well being and existential well being scales (Ellison and Smith, 1991). Several SWBS studies report that existential well being significantly impacts health outcomes and/or health related behaviours, whereas religious well being does not. The authors of one such study, which assessed the impact of spirituality on anxiety in adolescents, argue that many people may hold abstract religious beliefs without these beliefs having much personal relevance for the believer. “Abstract religious beliefs that do not provide a sense of personal meaning and purpose would not be expected to have a negative relationship with anxiety” (Davis et al., 2003, p. 363).
The items in the existential well-being scale are:
Interestingly, both the instrument reported by Garroute et al. and the existential well being scale may have similarities with the Sense of Coherence (SOC) scale (Antonovksy, 1998). These similarities are significant because SOC has been found to affect a wide range of health outcomes (Eriksson and Lindstrom, 2006). Antonovsky reported that SOC has three underlying dimensions: comprehensibility; manageability; and meaningfulness. These reflected three levels of psychological functioning: cognitive (perceptual); instrumental; and motivational. The first three questions of Garroute et al.’s cultural spiritual orientation scale (see Table 3) seem to reflect the comprehensibility/cognitive dimension, while the fifth question seems to reflect the manageability/instrumental dimension and questions 4, 6–8 reflect the meaningfulness or motivational dimension. Antonovsky stated that the underlying inspiration, in his theory of salutogensis (“growth toward health”) and the related measurement instrument, was to explain the emergence of “order from chaos.” It is possible to detect a similar purpose in both the cultural spiritual orientation and the existential well being instruments. Perhaps Garroute et al.’s instrument taps into the same latent concept in language more meaningful to the Native Americans who participated in his survey. (CIET used a modified 9-item version of the SOC in the 1996 Nechi-2 study among 239 high school youth in Victoria, British Columbia, but did not find a significant association with smoking, alcohol abuse, or criminal involvement (see Andersson and Ledogar, 2008).
One obvious task for future research is to replicate in urban settings and among a variety of Canadian Aboriginal groups the findings on Aboriginal spirituality reported here, which are based mainly on evidence from a limited number of on-reserve Native American groups.
A second task is to investigate the role of Aboriginal spirituality in promoting resilience to other outcomes of concern, for example, sexual risk taking in relation to HIV-AIDS as well as to replicate the initial findings in the areas of youth suicide and alcohol abuse consistently for specific age groups. Careful evaluations of existing interventions that call upon spirituality as an instrument in both prevention and recovery work could also help in the effort to achieve greater conceptual clarity in this field.
The content of enculturation and cultural orientation remains fluid. Researchers have had similar results with some components of these concepts removed or changed from one community to another. Such changes may reflect the participatory nature of so much of the research on this subject. Because their content is so context-specific and so dependent on participatory design processes, factor analysis would be difficult if not inappropriate. Further research in the same communities may lead to greater insight into the spirituality of those communities (internal validity). Across communities, some instruments may be borrowed or adapted, but attempts to standardize instruments for generalized application in Aboriginal communities may be misguided.
Evidence is accumulating in favour of resilience from elements of a broad concept that includes cultural identity, participation in traditional activities, and “spirituality.” As the ability of researchers to measure these complex processes in respectful and collaborative ways advances, and as Indigenous communities take increasing charge of their own research, the cultural/spiritual dimensions of Aboriginal traditions should emerge even more strongly as key factors in efforts to foster and promote both personal and communal resilience.
In the introduction we pointed out that Indigenous mental health professionals and social workers have taken the lead in promoting traditional spirituality and culture as possible resources in the struggle against alcoholism, substance abuse and addiction, suicide, and other behavioural and developmental pathologies which challenge many Indigenous communities of North America, especially their young people. Most of this has been healing and recovery rather than preventive work. The literature we have reviewed indicates that traditional spirituality has an important role to play in the area of prevention as well. The exact content of the spirituality component in any preventive program is difficult to specify because Indigenous spirituality is deeply embedded in each person’s own cultural traditions which may well involve knowledge and practices that are sacred to those traditions and can be tapped in ways that differ somewhat with each tradition. But this should not prevent Aboriginal researchers from accompanying these preventive programs with careful evaluation to learn which elements of each tradition deserve particular emphasis in various contexts.
Programs in urban areas where traditions are mixed might well incorporate spirituality components based on the less specific models labeled “cultural spiritual orientation” and, again, involve Aboriginal researchers in evaluating their effectiveness. The spirituality component of this model has similarities, as we have seen, with spirituality identified in other, non-Indigenous, models. In tapping into their own spiritual traditions Aboriginal youth may well be making contact with something more universal. Aboriginal professionals and researchers who help their youth recover their own spirituality could thus be contributing to a broader movement.
Above all, Aboriginal spirituality should not be treated merely as an antidote to pathologies like substance abuse and suicide. It is a resource for “navigating life” and for transcendence.