Helping Native American Women with PTSD

In our time, the world has witnessed numerous human rights violations and the most scandalous is violence against women. This is primarily caused by discrimination which denies women of equal opportunities with men in all aspects of life. General Recommendation 19 issued by the Convention on the Elimination of all Forms of Discrimination against Women (CEDAW) made it very clear that violence is a form of discrimination (Dauer, 2006). Indigenous women in the US are the most represented victims of brutal sexual violence.

The likelihood that Native American or Alaska Native women are raped or sexually assaulted is more than twice that of any other women in the US. Interviews by Amnesty International (2008) are testaments on the ubiquity of sexual violence among Native Americans. Although rape is in itself an act of violence, evidence suggests that indigenous women sustain additional violence in the hands of their perpetrators, mostly non-Native.

Logistic regression analysis by Yuan et al. (2006) revealed that history of childhood maltreatment, alcohol dependence, and marital status were significant predictors of sexual abuse among Native American women. Sexual violence against Native American women can be traced back in history at the infamous Trail of Tears and the Long Walk. Rape is said to be a very powerful tool of conquest and intimidation (Weaver, 2009). Most of society’s discriminatory attitudes towards Native American are still existent in present-day American society and culture which have increased the rates of violence against them and helped protect attackers from due process of law.

There are in existence treaties, the US Constitution and federal law that establish the political and legal framework between tribal nations that are federally recognized numbering to more than 550 and the federal government. These Indian tribes that have achieved federal recognition are autonomous under US law; therefore they can exercise jurisdiction over their citizens and land and maintain intergovernmental ties with each other and the US government. It is the mandate of the federal government to exercise legal means to protect the rights and well-being of Native American peoples (Amnesty International, 2008).

Mostly investigators consider these racist incidents as stressors resulting in psychophysiological disease while only a few conceptualize these as forms of trauma. In 2002, Walters and Simoni (as cited in Bryant-Davis & Ocampo, 2005) pointed out that racism is unresolved trauma among Native American women which leads to post-traumatic stress disorder and depression. Carter, Lo, Milliora, Sanchez-Hucles, Villena-Mata, and Wyatt also adopted this paradigm. This clinical construct can potentially be utilized in treating disorders that have adversely affect victims of these abuses.

Therefore it is necessary to assess the level of severity of the incident first when investigating the traumatizing impact of these experiences. Lo et al. (2001) and Woodard (2001) as cited in Bryant-Davis and Ocampo (2005) identified racism as a significant predictor of PTSD in other racial backgrounds particularly Asian and African Americans. Survivors experiencing PTSD manifest these symptoms: intense fear, helplessness, or horror; re-experiencing the traumatic incident; avoidance or numbing; and increased arousal after a traumatic event.

In contrast to non-traumatic stress, traumatic stress requires restructuring because the individual is constantly haunted by fear and experiences destabilization (McFarlane & Girolama, 1996 as cited in Bryant-Davis & Ocampo, 2005). Heckman, Cropsey and Olds-Davis (2007) cited that while there are no empirically “well-established” PTSD treatments, there are “probably efficacious” treatments which include exposure treatment, stress inoculation training, eye movement desensitization retraining (EMDR), stress management, and pharmacological treatments with antidepressants.

There are two salient parameters psychologists should consider when treating PTSD- anger and guilt for several reasons. Pretreatment anger has been shown to be associated with poor outcome based on studies by Foa et al. (1995), Taylor et al. (2001) Cahill et al. (2003), Taylor (2003), van Minnen, Arntz, and Keijsers (2002) (as cited in Stapleton, Taylor, & Asmundson, 2006). Likewise Pitman et al. (as cited in Stapleton, Taylor, & Asmundson, 2006) found that anger or guilt elevated during the course of prolonged exposure therapy.

Moreover, no difference in general symptom reduction was detected among various PTSD treatments (Taylor, 2004; van Etten & Taylor, 1998 as cited in Stapleton, Taylor, & Asmundson, 2006) when compared to EMDR or selective serotonin reuptake inhibitors. However, these three treatments were better than supportive therapy, benzodiazepines, tricyclic antidepressants, and hypnosis. Presently there is limited literature on the application of certain PTSD therapies on Native American rape survivors so that case management will be clearly understood. Therefore this justifies the proposed study.

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