Transcultural Psychiatry 2014, Vol. 51(3) 299–319 !

The Author(s) 2014

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DOI: 10.1177/1363461514536358 tps.sagepub.com

Editorial

Rethinking Historical Trauma

Laurence J. Kirmayer
McGill University

Joseph P. Gone
University of Michigan

Joshua Moses
Haverford College

Abstract
Recent years have seen the rise of historical trauma as a construct to describe the impact
of colonization, cultural suppression, and historical oppression of Indigenous peoples in
North America (e.g., Native Americans in the United States, Aboriginal peoples in
Canada). The discourses of psychiatry and psychology contribute to the conflation of
disparate forms of violence by emphasizing presumptively universal aspects of trauma
response. Many proponents of this construct have made explicit analogies to the
Holocaust as a way to understand the transgenerational effects of genocide.
However, the social, cultural, and psychological contexts of the Holocaust and of
post-colonial Indigenous “survivance” differ in many striking ways. Indeed, the com-
parison suggests that the persistent suffering of Indigenous peoples in the Americas
reflects not so much past trauma as ongoing structural violence. The comparative study
of genocide and other forms of massive, organized violence can do much to illuminate
both common mechanisms and distinctive features, and trace the looping effects from
political processes to individual experience and back again. The ethics and pragmatics of
individual and collective healing, restitution, resilience, and recovery can be understood
in terms of the self-vindicating loops between politics, structural violence, public
discourse, and embodied experience.

Keywords
Trauma, transgenerational transmission, Indigenous peoples, social determinants of
health, structural violence, Holocaust, genocide

Corresponding author:
Laurence J. Kirmayer, Institute of Community & Family Psychiatry, 4333 Côte Ste Catherine Rd., Montreal,
Quebec H3T 1E4.
Email: laurence.kirmayer@mcgill.ca
300 Transcultural Psychiatry 51(3)

Introduction
Recent years have seen the rise of historical trauma as a trope to describe the long-
term impact of colonization, cultural suppression, and historical oppression of
many Indigenous peoples including Native Americans in the United States and
Aboriginal peoples (First Nations, Inuit and Métis) in Canada.1 The initial
impact of European contact on the Indigenous populations of the Americas was
a massive loss of life through infectious diseases and violent encounters that has
been called the “American Indian Holocaust” (Thornton, 1987). The emergence of
the settler-controlled nation state was associated with explicit policies aimed at
cultural suppression and forced assimilation of Indigenous peoples through the
Indian residential/boarding schools and systematic out-adoption in what some
have described as “cultural genocide.” Increasing recognition of this history has
influenced the collective identity of Indigenous peoples as well as individuals’
modes of self-fashioning. Historical trauma offers an explanation for continuing
inequities in health and wellbeing and a focus for social, cultural, and psychological
interventions. Politically, it has led to explicit recognition of past violence and, in
Canada, to a formal apology from the government, processes of compensation,
as well as a Truth and Reconciliation Commission (Niezen, 2013).
The concept of historical trauma in relation to the postcolonial experiences of
Indigenous peoples in North America first emerged in the behavioral and health
sciences literature during the mid-1990s (Gone, 2014; Maxwell, 2014; Prussing,
2014; Waldram, 2014). Initially, it was described as a complex and intergenera-
tional form of Posttraumatic Stress Disorder (PTSD) resulting from European
conquest and colonization (Brave Heart, 1993, 1999; Duran & Duran, 1995).
The concept obtains its rhetorical force by consolidating two preexisting con-
structs: historical oppression and psychological trauma (Gone, in press). The ori-
ginal motivations for formulating historical trauma were to contextualize
Indigenous health problems as forms of postcolonial suffering, to de-stigmatize
Indigenous individuals whose recovery was thwarted by paralyzing self-blame,
and to legitimate Indigenous cultural practices as therapeutic interventions in
their own right (Gone, 2013). Alongside these emancipatory goals, however, the
proponents of Indigenous historical trauma have been mainly mental health pro-
fessionals or advocates who make use of established discourses within behavioral
healthcare systems and services. The result has been a complicated negotiation of
ideas and values that appears to vacillate between emancipatory idealism (moti-
vating approaches that re-socialize the medical) and pragmatic realism (defaulting
to approaches that medicalize the social).
In the two decades since its introduction, historical trauma has proliferated
widely in both scholarly and grassroots community discourse about Indigenous
health concerns. As a result, the term has come to signify various ideas for different
constituencies (or even for individuals within the same constituency, such as two
prominent medicine men from the same northern Plains reservation who construed
historical trauma in distinctive ways; see Hartmann & Gone, 2014). In its most
Kirmayer et al. 301

colloquial form, the concept is used merely as a synonym for postcolonial dis-
tress. But this latter term is technically more encompassing than the concept of
historical trauma insofar as postcolonial refers to the contemporary as much as
to the historical, and distress refers to broad forms of suffering that can be
much less circumscribed, persistent, and debilitating than trauma (for an exam-
ple of an elaborated discourse of Indigenous postcolonial distress that does not
depend on the notion of psychological trauma, see Gone, 2007). In its most
refined form, the concept has been characterized by what Hartmann and Gone
(2014) summarized as the “Four Cs” of Indigenous historical trauma: (i)
Colonial injury to Indigenous peoples by European settlers who “perpetrated”
conquest, subjugation, and dispossession; (ii) Collective experience of these inju-
ries by entire Indigenous communities whose identities, ideals, and interactions
were radically altered as a consequence; (iii) Cumulative effects from these inju-
ries as the consequences of subjugation, oppression, and marginalization have
“snowballed” throughout ever-shifting historical sequences of adverse policies
and practices by dominant settler societies; and (iv) Cross-generational impacts
of these injuries as legacies of risk and vulnerability were passed from ancestors
to descendants in unremitting fashion until “healing” interrupts these deleterious
processes.
In seeking to understand the transgenerational effects of historical trauma and
processes of recovery, some Indigenous scholars and mental health practitioners
have made explicit analogies to the Holocaust and its health impacts on the Jewish
people. The discourses of psychiatry and psychology contribute to this analogy by
emphasizing presumptively universal aspects of trauma response (Fassin &
Rechtman, 2009). However, the social, cultural, and psychological contexts of
the Holocaust and of post-colonial Indigenous “survivance” (Vizenor, 1999)
differ in many striking ways. Indeed, the comparison suggests that the persistent
suffering of Native peoples in North America reflects not so much past trauma as
ongoing structural violence. The comparative study of genocide and other forms of
massive, organized violence can do much to illuminate both common mechanisms
and distinctive features, and trace the looping effects from political processes to
individual experience and back again. However, each human catastrophe has
its own history, social dynamics, and corresponding patterns of individual and
collective response rooted in culture and context.
The papers in this issue of Transcultural Psychiatry explore current understand-
ings of historical trauma among Indigenous peoples and their implications for
mental health theory and practice. The papers are drawn from a workshop orga-
nized by the authors in association with the Division of Social and Transcultural
Psychiatry at McGill University and the Network for Aboriginal Mental Health
Research, funded by the Institute for Aboriginal Peoples Health of the Canadian
Institutes for Health Research. In this introductory essay, we consider some of the
issues involved in approaching Indigenous history in terms of trauma as well as the
limits of the analogy to the Holocaust as an explanatory model and rhetorical
strategy.
302 Transcultural Psychiatry 51(3)

Recognizing the American Indian Holocaust

For them [Indians] the arrival of the Europeans marked the beginning of a long
holocaust, although it came not in ovens, as it did for Jews. The fires that consumed
North American Indians were fevers brought on by newly encountered diseases, the
flashes of settlers’ and the soldiers’ guns, the ravages of firewater, the flames of villages
and fields burned by the scorched-earth policy of vengeful Euro-Americans. The
effects of this holocaust of North American Indians, like that of Jews, was millions
of deaths. In fact, the holocaust of the North American Tribes was, in a way, even
more destructive than that of the Jews, since many American Indian peoples became
extinct. (Thornton, 1987, p. xv-xvi)

As described in the contributions by Gone (2014), Maxwell (2014), Prussing (2014),

and Waldram (2014) in this issue, notions of historical trauma have their own his-
tory, reflected in changing patterns of understandings of the experience of colon-
ization, the identity of Indigenous peoples, and political and bureaucratic
institutions and arrangements. These have occurred in parallel with changes in per-
spective about other major historical events as well as within the field of mental
health itself.
Although the Holocaust or Shoah was discussed in the 1950s in the United
States, it only became part of popular discourse during the 1960s, with a series
of news events, publications, and media productions (Dean, 2004). The trial of
Adolf Eichman in Israel in 1961, the publication of Raul Hilberg’s (1961) The
Destruction of the European Jews and, especially, the NBC TV miniseries
Holocaust served to bring attention to the Shoah and to make it part of popular
historical knowledge (Shandler, 1999). Over the years, the Holocaust has come to
stand for incontestable genocide and the most extreme forms of evil, and this
recognition has contributed to international efforts to protect human rights
(Levy & Sznaider, 2004).
Following the recognition of the Holocaust in popular culture, many minority
peoples in the United States and elsewhere saw the value of drawing analogies
between the Nazi Holocaust and their own traumatic histories. For Indigenous
peoples in the Americas, the publication of Thornton’s (1987) American Indian
Holocaust and Survival: A Population History Since 1492 set the stage for this
kind of comparison. Thornton made a rhetorical link between the Holocaust and
the precipitous drop in the Native American population after European contact.
Subsequent authors argued for more detailed parallels and even direct connec-
tions. Stannard (1992) and Churchill (1997, 2004) applied the term Holocaust to
refer to the devastation of Indigenous peoples wrought by the diseases, violence,
and policies of cultural oppression brought by settlers and colonizers. In doing
so, they explicitly rejected the kind of exceptionalism that sees the Shoah as a
unique event that cannot be compared with other genocides. Indeed, Stannard
went so far as to claim that Hitler was inspired by America’s success at killing its
Kirmayer et al. 303

Indigenous peoples: “on the way to Auschwitz the road’s pathway led straight
through the heart of the Indians and of North and South America” (Stannard
1992: 246).2
This rhetoric was taken up by others to condemn the policies of the colonial
regime and the nation state (MacDonald, 2007). For example Neu and Therrien
(2003) drew parallels between Canadian handling of Aboriginal issues and the
bureaucratic machinery of Nazi genocide (Bauman, 2000). Bureaucratic forms of
genocide coupled the rational pursuit of order and efficiency with emotionally
charged ideas about the threats represented by the racialized “other” portrayed
as savage, uncivilized, or degenerate. In both cases, racial ideologies supported
ethnic cleansing processes aimed at ridding society of the “weeds” of the uncivilized
(Neu & Therrien, 2003, p. 13) or, in a still more dehumanizing metaphor, ridding
the body politic of its “lice”.
One function of making these historical parallels has been to recognize and
valorize Indigenous peoples as victims of violent oppression at the hands of
European colonizers and their regimes. Certainly there is ample evidence of violent
acts of aggression, dislocation, and cultural suppression driven by ideas and poli-
cies that were racist and, in some cases, explicitly genocidal. However, much of the
death and destruction visited on Indigenous peoples was not the result of a delib-
erate policy of extermination but a byproduct of colonial expansion and expropri-
ation (Gone, in press). Infectious disease was the greatest killer by many orders of
magnitude and, while in a few instances disease may have been deliberately spread,3
most contagion was unintentional—a consequence of the inadvertent transmission
of virulent strains bred in European cities to which the inhabitants of the Americas
had no pre-existing immunity and no time to acquire it (Sioui, 1992).
This early history of the decimation of Indigenous populations by infectious
disease gave way to a process of struggle with settler society and incorporation into
the emerging nation state. Indigenous peoples occupied land that the settlers
wanted and were repeatedly pushed back to the margins. At the same time, they
constituted a worry for the nation state, which needed to address the glaring
inequities created by colonization. This led to specific forms of cultural oppression
and structural violence that are not well captured by the analogy with the
Holocaust or, indeed, other genocides.
Despite the evident limitations of the comparison, trauma theory has argued for
broad commonalities in the response to massive violence. The assumption is that
there are universal processes of psychological adaptation that give rise to predict-
able forms of psychopathology for victims and their descendants. Historians
and other social scientists have taken up this mental health theory. For example,
following this reasoning, MacDonald (2007) suggested that Holocaust scholarship
can contribute to the understanding of Indigenous history, by

comparing the psychological legacies of atrocities on survivors and their families.

Using psychology, we can see that even if the events are fundamentally different,
individual experiences of trauma may be very similar. . . The comparative study of
304 Transcultural Psychiatry 51(3)

trauma and how it is transmitted to future generations can help reveal inter-group
commonalities about how traumatic events are experienced at individual and family
levels, where such legacies are most keenly felt. (MacDonald, p. 1010)

There are several dilemmas with this strategy. As Table 1 outlines, there are
profound differences between the kind of trauma experienced and the subsequent

Table 1. Comparison of Holocaust and Indigenous Historical Trauma.

Holocaust Indigenous Historical Trauma

Pre-trauma Context  ethnic-religious group living  many culturally distinct groups

within European societies  mainly small-scale
 mainly urban communities
 many highly integrated into  many rural and remote
local communities  limited exchange with
 literate tradition other Indigenous groups
 racial ideologies of  oral traditions
degeneracy  racial ideologies of primitivism
Types of violence  isolation in ghettos  colonization, violent conflict
 appropriation of property  forced displacement by
 deportation to labor and settlers and soldiers
concentration camps  forced assimilation through
 systematic mass residential schools, with separ-
extermination ation from family, physical and
sexual abuse
 systematic out-adoption
Types of loss  massive loss of life through  massive loss of life through
murder and starvation in spread of infectious diseases
camps  sporadic losses from violent
 destruction of communities conflict
 destruction of communities
 suppression of culture,
language, religion
Post-trauma context  survivors moved to other  survivors returned to rural,
countries to join existing remote communities or
communities of diaspora moved to urban settings
 achieved high level of social where Indigenous commu-
integration nities are loosely organized
Larger social context  longstanding recognition  recent recognition of impact
of Holocaust as of residential schools (TRC)
genocide  limited recognition of other
forms of cultural oppression
or discontinuity
Kirmayer et al. 305

repercussions for survivors and their descendants. The violence experienced by

Indigenous peoples has more often involved strategies of forced assimilation
and marginalization rather than outright murder. While the Holocaust was a
time-limited series of events covering about a decade, the events that constitute
historical trauma for Indigenous peoples in the Americas lasted hundreds of
years. Survivors of the Holocaust were able to move far away and start new
lives, often with the support of diasporic communities that were already well-
established and thriving. Indigenous peoples have been divested of their own
lands and frequently relocated to marginal spaces marked by deprivation and
neglect, far from the centers of power and economic activity. Jews who survived
the Holocaust were able to return to an unbroken religious and cultural tradition
grounded in the biblical text of the Torah and commentary of the Talmud and in
patterns of communal life that are similar among groups living in many coun-
tries. Indigenous peoples had the reproduction of cultural knowledge and trad-
itions across the generations disrupted by religious suppression and the
residential/boarding schools.
There are also important differences in the meaning of collective identity and
memory. All of these may have bearing on how people understand and address
historical trauma. For example, Kidron (2012) has shown how cultural differ-
ences in the use of collective memory, modes of coping, and regulation of emo-
tion affect the experience of Jewish descendants of Holocaust survivors and the
children of Cambodian survivors of the Pol Pot genocide. Judaism and Buddhism
adopt very different strategies of remembering and counsel different approaches
to adaptation.
Accounts that treat the cultural oppression of Indigenous peoples as equivalent
to genocide may also reify the notion of culture in ways that may be problematic
for Indigenous peoples. Certainly, the explicit assault on their cultures, languages,
and traditions has made ‘culture’ a salient concept for Indigenous peoples, and
respecting, restoring, and revitalizing culture seems like a very specific remedy. But
culture is not a static, monolithic body of tradition unresponsive to time and cir-
cumstance. Cultures are heterogeneous, hybrid, and constantly evolving. Indeed, it
is impossible to imagine that the encounter of diverse peoples would result in
anything less than profound changes in their respective traditions. Even in small-
scale societies, people participate in cultures in disparate ways, and the new con-
texts that have transformed Indigenous communities mean that individuals have
many different options that include weaving together strands from multiple trad-
itions. At issue then is not simply the recuperation, vitality, and preservation of
‘culture’ as such but the role of individual and collective agency, and the oppor-
tunity to redress enduring inequities of power.

The Canadian Context

While Indigenous peoples throughout the Americas have faced many similar
challenges, the history and politics of nation states have influenced their
306 Transcultural Psychiatry 51(3)

subsequent trajectories. Certainly, many Indigenous populations were victims of

intentional killing through conflict, spread of infectious disease, and massacres
throughout the eighteenth century, and some groups, like Newfoundland’s
Beothuk First Nation, were entirely eliminated through low-intensity conflict and
starvation. However, in Canada, the most widespread and longstanding forms of
oppression involved the national system of residential schools designed to eradicate
Indigenous languages and cultures (Miller, 1996). In response to policies advocat-
ing forced assimilation as a solution to “the Indian problem,” and following the
pattern of boarding schools in the United States, Indian residential schools were
first established in Canada in the mid-1880s, mandated by the federal government
but run by the Christian churches (Milloy, 1999). The curriculum consisted of
general education and basic vocational skills: industrial arts for boys; sewing,
cooking and other domestic activities for girls. By the time the last residential
school closed in the 1990s, more than 140,000 Aboriginal children had been sub-
jected to this education that systematically denigrated their Indigenous languages,
culture, and spirituality as well as disrupting family ties and community involve-
ment in child rearing.
The scale and scope of this system of forced assimilation only became widely
known with the publication in 1996 of the Report of the Royal Commission on
Aboriginal Peoples. The 5-volume report, based on oral testimony collected in
hearings across the country as well as extensive historical and scientific scholarship,
documented multiple forms of mistreatment: the forced assimilation and cultural
suppression wrought by the residential schools, accompanied by staggeringly high
death rates as well as alarming levels of physical and sexual abuse in these institu-
tions; forced relocations of Aboriginal communities; and the bureaucratic machin-
ery of the Indian Act, which banned Indigenous customs and gave rise to multiple
forms of “internal colonialism.”
Largely in response to the threat presented by some 2000 lawsuits, in 1998, the
Canadian government presented a “statement of reconciliation” to First Nations,
Inuit and Métis accompanied by a $350 million “Healing Fund” to redress the
wrongs of the residential school system (Brant Castellano, Archibald & Degagné,
2008). The government also established a new ministry called the Indian
Residential Schools Resolution Canada in 2001, and set up a dispute resolution
model for addressing allegations of abuse and providing compensation. Although
the compensation process is ongoing, it is likely that the final sums awarded will be
in the billions of dollars, making this the largest legal settlement in Canadian his-
tory. At a more symbolic level, the government also created a Truth and
Reconciliation Commission (TRC), which crossed the country holding hearings
and collecting testimony on the legacy and impact of the residential schools
(Niezen, 2013). In addition to bearing witness to the accounts of survivors, many
of whom have talked about their experiences for the first time in this venue, the
TRC aims to create a research centre and archive of oral history and related
documentation to ensure that a more complete history of the schools becomes
part of the national narrative for future generations.
Kirmayer et al. 307

Intergenerational Trauma

Like children of Jewish Holocaust survivors, subsequent generations of

American Indians also have a pervasive sense of pain from what happened to
their ancestors and incomplete mourning of those losses. (Brave Heart & DeBruyn,
1998: p. 64)

In addition to valorizing collective history and working for redress and reparations
for past wrongs, the notion of historical trauma serves as a way to think about
transgenerational effects. The theory is that the traumatic events endured by com-
munities negatively impact on individual lives in ways that result in future prob-
lems for their descendants. The means of such transgenerational transmission are
varied (e.g., through impaired parenting or distressing narratives), and are some-
times proposed to include previously unrecognized mechanisms (e.g., through epi-
genetic processes or unspecified spiritual means) beyond more ordinary or
commonly accepted notions such as “cycle of abuse” theories (i.e., the idea that
abused children will grow up to be abusive parents, who will subsequently trau-
matize their own children). This overdetermined transmission of risk is conjectured
to accumulate across generations such that the second and third generations will
also suffer from mental health problems that can be attributed to colonial violence
inflicted on their ancestors.
Establishing definite causal linkages across generations in the case of historical
trauma is exceedingly difficult, perhaps even impossible. Studies are necessarily
retrospective and constrained by limited data and recall bias. The fact that indi-
viduals attribute their problems to past events does not prove a causal link.
Indeed, as with looping effects more generally, the more popular the historical
trauma concept becomes the more likely individuals are to think about their
problems in this way and to produce narratives and attributions that confirm
the model. Somewhat perversely, then, Indigenous cultural identity may itself
come to primarily signify ancestral victimization in a manner that “pulls for”
adoption of a narrow and overgeneralized form of historical consciousness that is
expressed by rote endorsement of attributed psychological distress. Assessment
and analysis of such attributions (e.g., the cross-sectional correlation of a parent’s
past attendance in residential/boarding school with mental health problems
in later generations) cannot possibly disentangle past and present causal
processes. Evidence of an effect of level of exposure to violence in residential/
boarding schools in previous generations with current problems is more suggest-
ive but because mental health problems are common, multiply caused, and non-
specific, interpretive uncertainty will always remain. As a result of these
complexities, Mohatt, Thompson, Thai, and Tebes (2014) have proposed that
historical trauma is best conceptualized as a form of public narrative so as
to shift “the research discourse away from an exclusive search for past causal
variables” (p. 128).
308 Transcultural Psychiatry 51(3)

Still, studies of the transgenerational impacts of the Holocaust have revealed

evidence of persistent effects, with increased risk of depression, anxiety, and PTSD
(Levav, Kohn, & Schwartz, 1998; Sagi-Schwartz, van IJzendoorn, & Bakermans-
Kranenburg, 2008; Sigal, 1998, 1999; Sigal & Weinfeld, 1989, 2001). In general,
studies with clinical samples tend to find more clear-cut effects on descendants of
survivors (Eitinger, 1998; Kellerman, 2001; Yehuda, et al., 1998). However, clinical
samples may be biased both in terms of rates of comorbidity and patterns of
attribution. Community-based studies sometimes show effects on the second gen-
eration but these are attenuated across generations with much smaller effects on the
third generation (or no effect at all). For example, van IJzendoorn, Bakermans-
Kranenburg, and Sagi-Schwarz (2003) conducted a meta-analysis of 32 studies
involving 4,418 research participants and concluded that “in the set of adequately
designed nonclinical studies, no evidence for the influence of the parents’ traumatic
Holocaust experiences on their children was found. Secondary traumatization
emerged only in studies on clinical participants, who were stressed for other rea-
sons” (p. 459). Of course, community-based studies tend to use less sensitive meas-
ures and cannot match the process of exploration possible in a careful clinical
interview. In any case, the relative success and influence of Jewish people through-
out the diaspora in the wake of the Holocaust would seem to contradict (or at least
seriously complicate) the claim that historical trauma is prone to “snowballing”
across generations into formidable legacies of distress and disability.
In this issue, Bombay and colleagues (2014) review the evidence for transgenera-
tional effects of historical trauma among Indigenous peoples in Canada. A few
studies have documented the impact of residential schools on the subsequent health
of attendees, including life expectancy, risk of violent death, and mental health
problems. A smaller number of studies have documented correlations between
levels of exposure to residential school and to specific traumas in parents and
symptomatology in their children and grandchildren (Bombay, Matheson, &
Anisman, 2011; Elias et al., 2012). Of course, the experience of children is not
the same as their parents or grandparents who went to residential schools.
Although some may experience abuse, far more often they feel the effects of par-
ental anxiety, depression, and preoccupation. This kind of difficulty may have quite
different effects on health and well-being, some of which may be subtle or reveal
themselves only in conjunction with ongoing adversity. As we have noted, a variety
of mechanisms have been proposed for transmission across the generations (Evans-
Campbell, 2008). Whitbeck and colleagues (2004a,b) developed measures of con-
scious re-experiencing of thoughts, feelings, and symptoms that were reportedly
tied to historical trauma, and used these to establish links between the lived present
and the ancestral past, but of course this methodology is confounded with available
narrative and other discursive templates.
The potential pathways are complex. As outlined in Figure 1, intergenerational
transmission may occur at many levels, including: interpersonally, through altered
parenting; within families, which may be disrupted by loss of members or exposure
to stressors like domestic violence; at the level of the community, when many
Kirmayer et al. 309

Figure 1. Transgenerational Transmission of Historical Trauma

The diagram depicts some of the hypothetical pathways through which the effects of trauma and
loss may be transmitted across generations through processes at multiple levels, including: epi-
genetic alterations of stress response; changes in individuals’ psychological well-being, self-esteem,
and self-efficacy; family functioning; community integrity and cultural identity; and the continuity of
identity and collective efficacy of whole nations or peoples. (Adapted from Kirmayer et al., 2007).

individuals and families are impacted by disturbances of social networks and

experiences of safety and solidarity that affect health; and at the level of nation,
where the suppression of culture and the disruption of family and community
threaten the continuity of whole peoples. Additionally, recent work identifying
epigenetic processes in stress and trauma transmission point toward biological
levels (McGowan, et al., 2009). Although proponents of historical trauma have
been quick to seize on this postulated mechanism of transmission (Walters et al.,
2011), the temptation to participate in fashionable forms of biological reductionism
(Kirmayer & Gold, 2012) may not serve the emancipatory goals of Indigenous
decolonization (Prussing, 2014). Moreover, there is no reason to assume that epi-
genetic mechanisms—which appear to be reversible with appropriate life experi-
ences—would not operate in service to intergenerational resilience as much as to
intergenerational trauma. Finally, while postulated biological mechanisms are
310 Transcultural Psychiatry 51(3)

sometimes seen as providing a more fundamental level of analysis and understand-

ing, it is important to recognize that each of the levels involves unique processes
that are not reducible to the lower levels, although there may be complex inter-
actions across levels. Privileging one level of explanation will not only lead to
an incomplete picture but may also impede understanding of the processes
at other levels.
There have been efforts to frame the effects of Indian residential/boarding
schools in terms of a discrete Residential School Syndrome. This construct is prob-
lematic for several reasons: (i) the pathway from trauma to outcome is complex and
influenced by many factors; (ii) the effects of these schools are extremely variable
because of differing exposures and responses and do not comprise a single,
well-defined syndrome; and (iii) the framing of distress in terms of a psychiatric
syndrome medicalizes a social problem in politically problematic fashion
(Chrisjohn, Young, & Maroun, 1997).
As with other attempts to describe trauma syndromes related to PTSD (such as
“complex PTSD”) the range of symptoms included is so broad as to cover most
common mental health problems. Hence, it is hard to demonstrate any specificity
of cause or symptomatic expression. In fact, trauma exposures are common in both
Indigenous and non-Indigenous populations (Manson, Beals, Klein, Croy, & AI-
SUPERPFP Team, 2005). It is possible that the effects of trauma are greater within
some Indigenous communities in which a higher proportion of the population was
affected by a large-scale and sustained traumatic exposure (Brave Heart &
DeBruyn, 1998; Duran & Duran, 1995; Gagné, 1998). Exploration of any such
differential impacts, however, would require that proponents of Indigenous histor-
ical trauma begin to historicize and contextualize their claims in association with
specific family and community experiences in a much less sweeping and essentia-
lized fashion.
The broadening of the construct of historical trauma to include historical grief
and loss introduces other complicating themes and dynamics. While trauma implies
a kind of psychological wounding, usually anchored or framed in terms of PTSD
(or, when violence occurs in key caretaker relationships and is pervasive and
enduring, complex PTSD), grief is a normal emotion attendant on loss of import-
ant relationships. Grief can become a mental health problem in its own right when
it does not resolve over time, but the boundary between normal and pathological
grief remains contested (Horwitz & Wakefield, 2007). Loss is an event that can
become an individual and collective problem when it involves basic resources,
relationships, values, or meaning systems necessary for psychological strength
and well-being (Lear, 2006). For students in the Indian residential/boarding
schools, the losses often included not only family but also important aspects of
identity, including language and culture. For Indigenous families and communities,
the losses included their children and a sense of control over their own lives and
futures. The degree of loss, of course, presumably varied depending on the circum-
stances of student placement in the schools; coercive removal of children from their
homes for enrollment in distant residential/boarding schools was one kind of
Kirmayer et al. 311

experience, but voluntary placement of children by their parents at these schools

also occurred for a variety of reasons (Child, in press; Fontaine, 2010; Standing
Bear, 2006). And, of course, the large numbers of Indigenous students to attend
residential/boarding schools never amounted to even a majority of school aged
youth within Indigenous communities.

Uncovering Structural Violence and Inequality

Much of the literature on Indigenous historical trauma conflates historical events,
thereby reducing suffering and distress to some kind of uniform transhistorical/
cultural phenomenon such that it becomes possible, in theory, to compare Native
colonial distress and Jewish Holocaust distress. But while Brave Heart and
DeBruyn (1998) cited literature on the Holocaust to support their claims, arguing
that children of survivors in both communities share patterns of behavior and
symptoms, they left out the fact that, for the most part, children of Holocaust
survivors are doing better than their parents by most conventional non-psychiatric
measures: educational attainment and income. In many Indigenous communities,
however, this is not the case. Rates of suicide, alcoholism, and domestic and sexual
violence are far higher than national averages and, in some communities, have
actually increased during the last 20 years. This suggests that while traumatic
experiences of ancestors could in theory play some causal role, other more prox-
imate causal factors must predominate to account for this increased incidence of
suffering within contemporary populations.
Although the historical suppression of their cultures and identities has been
recognized by Indigenous peoples as a cause of suffering, and the restoration of
culture has been posited as a specific remedy (Gone, 2013), this focus on culture
may also have limiting effects on how the causes of distress are framed and how
redress is sought. By obscuring the ongoing forms of material dispossession and
political domination, the discourse linking Indigenous culture and historical
trauma may deflect attention from the fundamental structural causes of distress.
Healing then is framed in terms of therapy for psychic wounds (Million, 2013)
rather than in terms of how people might find meaningful livelihoods within
increasingly difficult constraints and imagine a viable future rooted in the material
realities necessary for reproducing thriving communities at the local level.
The structural factors that contribute to current mental health problems for
Indigenous peoples include the disruption of traditional patterns of subsistence,
the undermining of community autonomy, the mass expropriation of aboriginal
lands and resources, and the creation of enormous economic inequalities (King,
Gracey, & Smith, 2009; Richmond & Ross, 2006). For Indigenous youth, this
translates into a profound disjunction between traditional lifeways and the
modern opportunities to pursue their own life projects in the rural and remote
communities where many Indigenous people live. The challenges within
Indigenous communities are compounded by the ambivalent attitudes of the
larger society that include the persistence of negative images or stereotypes of
312 Transcultural Psychiatry 51(3)

Indigenous peoples in the popular imagination. In many instances, the bureaucratic

machinery that now governs access to resources for Indigenous communities con-
tinues to work at cross-purposes to local communal identity and solidarity.
Another key area of ongoing dispossession that has received relatively little dis-
cussion in the mental health literature is the impact of large-scale resource extrac-
tion on Indigenous communities (Dombrowski, 2001, 2014). Particularly in the
Canadian north, communities are under extraordinary pressure to open land to
extractive industries. While these developments bring jobs and infrastructure, they
radically alter community dynamics. Local consequences include rapidly increasing
inequality, irreparable environmental disturbance, and an overwhelming influx of
outside laborers. These changes have, widespread impacts on community wellbeing
that extend beyond the processes and outcomes commonly considered within the
trauma-and-healing framework (Million, 2013).
For researchers, recognition of these issues suggests that studies of historical
trauma must be balanced by analyses of how political and economic dynamics
interact with community wellbeing, and how those forces can be aligned to produce
contexts that allow individuals and communities to pursue ways of living that they
value (Sen, 2011). For clinicians, it points to the need to supplement “cultural
safety” and “cultural competence” with structural competence, including systematic
attention to (and engagement with) the social determinants of health (Metzl &
Hansen, 2014).

The Uses of Historical Trauma

The construct of historical trauma has been deployed not only in mental health, but
also in politics and in public projects of identity. For mental health practitioners,
the construct provides a focus and a way to enter into individual stories of suffer-
ing, to locate causes, ascribe responsibility, valorize the person’s struggle, and
mobilize more effective responses. The processes of healing in clinical interventions
include narrating suppressed or inchoate experience to give it form, experiencing
the empathic witnessing and understanding of an other, and achieving recognition
of one’s predicament as part of larger social injustices that warrant redress.
Politically, the construct was used to advance legal claims for compensation in
Canada for wrongs perpetrated by agents of church and state through the residen-
tial schools and the policy of forced assimilation. In that nation at least, the result
has been a formal government apology and monetary compensation (Niezen,
2013). This political recognition has brought a measure of public acknowledgement
and promises to strengthen that awareness by building an archive and influencing
the education of subsequent generations.
These are worthy goals and meaningful accomplishments, but taken together
they result in certain tensions and potential contradictions. There are tensions
within the process of restorative justice itself, in which perpetrators (in this case
government and the churches) may hope for forgiveness and rapid closure in ways
that do not fit the needs of those injured and aggrieved (Niezen, 2013). Forms of
Kirmayer et al. 313

restorative justice like the TRC may try to exploit the process of bearing witness to
testimonies from individuals as a path to collective recognition and resolution
(Avruch, 2010). This raises problems of re-traumatization and the containment
of both individual and interpersonal conflicts that may erupt. What works best
for psychotherapy is a flexible process of meaning-making that fits the unique
experiences of the individual. What works best for political influence toward
restorative justice may be a powerful, coherent, and consistent narrative that
ignores the vagaries of individual experience. In short, that which aims toward
the therapeutic cannot necessarily achieve justice, and that which achieves justice
may not be therapeutic (Furedi, 2004). Moreover, the violence of the residential
schools reached into families and communities in ways that sometimes render the
simple opposition of victim and perpetrator unhelpful. Finally, while Indigenous
peoples’ histories of colonization, violence, and dispossession need to be widely
known and acknowledged, this must be coupled with recognition of their individ-
ual and collective resilience, which a persistent and widespread emphasis on trauma
as such tends to occlude. Studies of resilience among Indigenous peoples identify
diverse sources of adversity and a correspondingly wide range of individual and
collective responses (Denham, 2008; Kirmayer et al., 2011).

Conclusion
The notions of historical trauma, loss, and grief have drawn attention to the
enduring effects of colonization, marginalization, and cultural oppression in the
lives of Indigenous peoples and communities. The recognition that the violence and
suffering experienced by one generation can have effects on subsequent generations
provides an important insight into the origins of mental health problems. However,
the kinds of adversity faced by each generation differ, and the construct of trauma
does not capture many of the important elements that are rooted in structural
problems, including poverty and discrimination. Understanding the ways in
which trauma impacts mental health requires a broader view of identity, commu-
nity, adaptation and resistance as forms of resilience.
Approaching the predicament of Indigenous peoples through analogies with the
Holocaust leads to distortions and blind spots. Specific historical wrongs require
their own modes of understanding and have their own moral imperatives. We need
a typology of the kinds and mechanisms of cultural oppression, group subjugation,
and genocide that traces effects from ideology and policy to structural, institu-
tional, and interpersonal violence (and back again). In the case of Indigenous
peoples, this would include the longstanding rhetoric of racialized primitivism,
the doctrine of terra nullius, the motives and machinery of colonization, and the
material reality of small-scale, dispersed communities negotiating invasion by
diverse but technologically advanced and avaricious settlers in different times
and places. The subsequent processes of nation building, urbanization, bureaucrat-
ization, and technocracy, which in their latest versions include the globalizing
forces of neoliberal capitalism, are also important parts of the picture. As shown
314 Transcultural Psychiatry 51(3)

clearly by the papers in this issue, trauma is not a natural kind or category but
rather a specific way to punctuate both the temporal stream and spatial distribution
of events with political, moral, and practical implications.

Notes
1. In Canada, the official collective term for First Nations, Inuit and Métis is “Aboriginal
peoples”. In keeping with recent usage, we have used the term “Indigenous” as the
broadest term and used other more specific terms when referring to particular geographic
or historical groups.
2. To raise concerns about the limitations of these analogies is not to say there is nothing to
be learned from comparison of the Holocaust (or other genocides) with the assault on
Indigenous peoples—or even that there are not some direct links. For example, like many
Germans of his generation, as a youth, Hitler was a fan of Karl May’s books on the
American West. Hitler frequently referred to Russians as “redskins,” and made explicit
parallels between German attempts to conquer Russia and the efforts to colonize the
American frontier (MacDonald, 2007).
3. Although the idea of deliberately infecting enemies with disease has been widespread
since the colonial period, the only conclusively documented episode in which colonizers
attempted to infect Native Americans took place at Fort Pitt in 1763 (Dowd, 2013; Finn
2000).

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Laurence J. Kirmayer, M.D., is James McGill Professor and Director of the Division
of Social and Transcultural Psychiatry in the Department of Psychiatry, McGill
University. He directs the Culture & Mental Health Research Unit at the Institute
of Community and Family Psychiatry, Jewish General Hospital in Montreal, where
he conducts research on culturally responsive mental health services, the mental
health of indigenous peoples, and the anthropology of psychiatry. He founded and
directs the annual McGill Summer Program in Social & Cultural Psychiatry and
the Network for Aboriginal Mental Health Research. He co-edited the volumes:
Understanding Trauma: Integrating Biological, Clinical, and Cultural Perspectives
(Cambridge University Press); Healing Traditions: The Mental Health of Aboriginal
Peoples in Canada (University of British Columbia Press); and Cultural
Consultation: Encountering the Other in Mental Health Care (Springer). He is a
Fellow of the Canadian Academy of Health Sciences.

Joseph P. Gone, Ph.D., is Associate Professor of Psychology (Clinical Area) and

American Culture (Native American Studies) at the University of Michigan in Ann
Arbor. He has published more than 40 articles and chapters exploring the cultural
psychology of self, identity, personhood, and social relations in indigenous com-
munity settings vis-a-vis the mental health professions, with particular attention to
therapeutic interventions such as psychotherapy and traditional healing. A Fellow
of the American Psychological Association, he had served on the editorial boards
of six scientific journals and reviewed manuscripts for an additional 45 journals in
the behavioral and health sciences. A recipient of several fellowships, he accepted a
residency at the Center for Advanced Study in the Behavioral Sciences at Stanford
Kirmayer et al. 319

University in 2010. In addition to two early career awards for emerging leadership
in ethnic minority psychology, Gone received the 2013 Stanley Sue Award for
Distinguished Contributions to Diversity in Clinical Psychology from Division
12 of the American Psychological Association. In 2014, he was named a Fellow
of the John Simon Guggenheim Memorial Foundation.

Joshua Moses, Ph.D., is visiting assistant professor of anthropology and environ-

mental studies at Haverford College. His work focuses on two main areas: indi-
genous wellbeing and the impacts of resource extraction, dispossession and
inequality, primarily in arctic communities; and disaster response and prepared-
ness, with a focus on the role of religious communities and leaders.