Agency embraces Native medicine for troubled vets

PRESCOTT, Ariz. — Albert Laughter kneels near the fire pit in the center of the tepee, arranging his ceremonial arrowheads, bowls and pipes. He lays out the all-important eagle feathers, reverently unwrapping them from an American flag.

The fifth-generation Navajo medicine man has trained most of his life to treat the people of his tribe with traditional healing methods: powwows, sacred dances, sweat lodges, purification ceremonies, herbs.

But these days his job is very different.

Albert Laughter is employed by the federal government. He primarily treats military veterans suffering from the trauma of combat. And the tepee in which he does much of his work sits not on an Indian reservation but on the grounds of the Bob Stump Veterans Affairs Medical Center in Prescott.

"I guess I'm a true 21st-century medicine man," Laughter said. "They call me on my cellphone to make appointments, and I get much of my work thanks to two modern wars — Iraq and Afghanistan — that began at the start of this century."

Today, as thousands of Native American troops return from combat tours in Iraq and Afghanistan, the question for health-care providers and an aging generation of American Indian veterans is how to prevent history from repeating itself.

Since World War II, when Navajo Code Talkers became an essential part of the U.S. armed forces, Native Americans have had some of the highest per-capita rates of military service of any demographic group in the United States.

Unfortunately, Native Americans also have faced some of the biggest difficulties upon returning home from combat. Studies of Native American vets from the Vietnam War era, for example, revealed alarming rates of suicide, drug abuse, alcoholism and homelessness, particularly when they returned from war to remote reservations with little access to mental-heath care.

Even more, a study of Vietnam-era Native American vets found they were twice as likely to suffer from post-traumatic stress disorder as their white comrades, a reality some researchers attribute to the fact that they often deeply identify with the indigenous populations they are sent to fight. The research also revealed that Native American troops were often more likely to be assigned risky combat roles, another reason for their high PTSD rates.

The approach gaining traction throughout the Western and Southwestern U.S. — home to some of the largest populations of American Indians — is this: Combine the most modern Western medical treatments with the most traditional Native American methods of healing.

Transferring practices

Dr. Jay Shore is a VA psychologist and assistant professor at the University of Colorado at Denver who specializes in treating American Indian veterans with PTSD. Times and techniques have changed: Using videoconferencing equipment, he treats dozens of veterans on reservations from Montana to South Dakota — all from his office in Denver.

"Isolation compounds PTSD," Shore said. "And many of these veterans live in extremely isolated places where a generation ago they never had access to the kind of help we're trying to give them today."

Shore routinely confers with a patient's tribal medicine man about treatment. He has gone so far as to fly to where his patients live in order to participate with them in "sweats," sacred American Indian ceremonies in which participants sit for hours in stifling steam lodges. The ceremony is believed to purify the mind, body and spirit, bringing peace and clarity.

The VA has opened five clinics that serve remote American Indian reservations and allow the kind of telemedicine Shore is doing. Four more are set to open in the next few months.

The clinics are run by Native American veterans who serve as a bridge between the American Indian population and the VA, which was deeply distrusted by Native American Vietnam vets who felt it did not offer any treatment applicable to them.

When the clinics were first conceived, VA officials approached tribal governments of dozens of sovereign American Indian nations for their approval, as well as to appoint formal liaisons between the Native American population and the experts ready to treat them.

"We realized that in order to help Native American vets, we had to have the Native American communities on board," said W.J. "Buck" Richardson, minority veteran program coordinator for the VA.

Few things have been as successful with American Indian communities as the VA's implementation of traditional healing practices, not just in clinics on reservations but in urban hospitals. The VA hospitals in Albuquerque and Prescott have started twice-monthly "talking circles," sacred Native American gatherings where it is believed that strength is transferred to whoever speaks from all who listen.

Full-circle psychology

James Gillies, the psychologist who leads the talking circle in Albuquerque, has found that the more he treats American Indians with PTSD, the more he understands how unique their cases are. Because troops are more likely to suffer PTSD if they have a lot of previous trauma in their lives, Gillies says Native Americans who have felt the consequences of having their land stripped away and their culture fade are highly susceptible to the disorder.

"Combat is just the final trauma," he said.

Clinicians who work with American Indian veterans report hearing them struggle with feeling they did to other native populations — the Vietnamese, the Iraqis — what was done to them and their ancestors.

"Identification with the enemy is something that has plagued minority vets for generations," said Michelle Kierstead, a Native American PTSD social worker at the VA Medical Center in Prescott. "They see children in places like Iraq that look like the children on their own reservations — dark-skinned and impoverished. They see themselves in them, and I believe this contributes to their high rates of PTSD."

Though extensive studies were done on Vietnam-era American Indian veterans, no research has been released regarding American Indian veterans of the wars in Iraq and Afghanistan. But clinicians predict research will reflect what was seen a generation ago. The difference will be if the new approaches to treatment and the availability of social services in remote areas can stop the current generation from falling into the same pitfalls as its elders.

On a recent evening, a young soldier about to depart for Iraq summoned a Navajo medicine man to his home. Family and friends gathered around Pvt. Dustin Thomas as a purification ceremony was performed.

"I guess people who didn't grow up with these traditions wouldn't understand them," said Thomas, 20. "But if you grew up with them and deeply believe them, they work for you."

The young man paused.

"Hopefully," he said, "we will do another one when I return home. Hopefully it will clear all the bad stuff that I see there away."