A TANGLED WEB
Ottawa research explores the role of culture in building resilience
What matters more: nature or nurture, genes or environment?
It’s always been a big question for science, but in recent decades it has become apparent that it’s also not an either/or question. Biology can actually be changed by experience and, at the same time, culture has a role in how it plays out.
Carleton University and the Mental Health Research Institute at the Royal Ottawa Mental Health Centre have launched a new partnership to probe the role culture plays in mental health and resilience, the ability to recover from adversity. It’s a complicated but important knot to unravel. Some point to the alarming string of suicides among young people on First Nations reserves as an example. By some accounts, the youth suicide rate in indigenous communities is five times the national rate. Last year, Attawapiskat, a remote First Nation on James Bay with only about 2,000 residents, declared a state of emergency after dozens of people tried to kill themselves.
What is already known about the intersection of culture and resilience is thought-provoking. Surveys of Somali refugees who had settled in Ottawa found many had traumatic experiences, such as warfare or life-threatening situations. But the refugees found stressors in Canada — especially discrimination — more distressing than the original trauma, says social psychologist Dr. Kim Matheson, a professor of neuroscience at Carleton who is the research chair in the Carleton-Royal partnership.
In another study, respondents reported that traumatic experiences of discrimination affected well-being as much as being physically or sexually assaulted. People have biological responses to discrimination. When it is repetitive, intermittent or unpredictable, it can be particularly stressful, Matheson says.
It also appears that biological systems can be sensitized to repeated stress. Essentially, it primes the mind and body for a “hyper-reaction” to more stress, she says. There is evidence that life experiences going back even before birth can turn genes off or on. Stressful events won’t alter the genes themselves, but they will alter gene expression. The effect can be transmitted across generations.
Matheson’s biggest ongoing project is the Indigenous Youth Futures Partnership, working with First Nations organizations in the Nishnawbe Aski Nation region in northwestern Ontario with $2.5 million in funding over seven years from the Social Sciences and Humanities Research Council. She also heads a team working to prevent suicide in indigenous youth, an issue that disproportionately affects girls in that region.
People who are disadvantaged are more at risk of mental health problems. At the same time, culture can be the source of resilience. Matheson offers an example: a boy with numerous disadvantages who is determined to finish school because he knows it will help him have a better future. No one in the boy’s family has ever completed school. Many of his friends and cousins drink and he sometimes joins them. But sometimes he goes to the outdoor hockey rink and skates around hitting pucks into the goals. Occasionally, he gets a few friends to join him. Sometimes, he misses class because he wants to sleep in, but mostly he goes to school. He knows if he wants to go to college, he needs to save some money, and so he gets a job at Tim Hortons. Usually, he’s on time, because he knows for some people, this is important.
One day, the boy comes home from work and his drunk stepfather beats him. The boy leaves and goes to the home of an adult he can trust, who takes him in. “This way they don’t have to call child services, and so he won’t be taken away and can complete his school year. And he does,” says Matheson.
Everything you experience in life affects you in all four dimensions. In the indigenous world view, you’re a person who is affected by your environment. That environment also had a history. You can connect to historical experience without having experienced it yourself.
“I would call this boy resilient. He encounters numerous challenges and adversities, but he has identified an activity that keeps him healthy and out of trouble. He has some friends who he can lean on, and an adult who can help him. He has established a safety net. And he has an aspiration or goal that keeps him going.”
Gerald McKinley, a medical anthropologist at Western University, has been tracing accounts of suicide on Ontario reserves. While there were clusters of suicides on Manitoulin Island and in Moosonee in the early 1970s, dramatic increases in suicide rates in northwestern Ontario only appeared in the mid-’80s. It was a sudden tenfold increase, virtually overnight, he says.
Suicide is not a traditional aspect of any First Nations culture in Ontario, McKinley emphasizes. The root cause is the cumulative effects of colonization — residential schools, substance abuse, overcrowded and substandard housing, unsafe drinking water and food insecurity.
Medical anthropologist Michael Kral, for example, has noted that historical records in the Inuit population only mention suicide in the sick and elderly. In his research, youth and adults most often reported suicide in connection with romantic and family problems, or because it gave them a sense of solidarity with someone who had also taken their own life.
“Suicide for some has become a shared response to distress,” Kral wrote.
McKinley believes the answer to preventing suicide is in protective factors found in culture, such as social inclusion and social support. In his own suicide prevention work, he has seen that youth report an increase in resilience when they’re brought together for cultural activities. The most important step is when young people start planning events themselves.
“The strengths that they need to prevent suicide will be found in the culture. We’re all cultural beings,” he says.
Malcolm Saulis, an elder and a professor of social work, created a program at Wilfrid Laurier University that is based on the indigenous world view. He also taught a course in critical indigenous knowledge in social work practice.
Saulis urges his students to look at life holistically, and focuses on the “four directions” — emotional, mental, physical and spiritual. “This holistic notion enables us to comprehend the full array of human experience — even suicide,” he says.
In Saulis’s language, Maliseet, there are words for three different actions that lead to your own death. “Let’s not think of it as a horrific social phenomenon, but as a real dimension of life,” he says. “If it’s a natural phenomenon and you try to come up with a reason, it’s because they (those who attempt or commit suicide) have come up with a reasonable, rational, logical solution.”
Mainstream health has not given enough credit to two of the four directions — the emotional and spiritual aspects, he says. In the indigenous tradition, spirituality is complex: it is based on what gives meaning to life, what people have faith in, what they believe and what gives them hope. (It’s even more complicated — there are 25 other concepts related to spirituality, ranging from ancestors to medicine to water, fire and animals.)
“Everything you experience in life affects you in all four dimensions. In the indigenous world view, you’re a person who is affected by your environment. That environment also had a history. You can connect to historical experience without having experienced it yourself. We (indigenous peoples) have been affected holistically by our experience with Canada. Both Canada and the indigenous population has to heal from the experience we have had these many years,” he says.
“Some of the key thinkers in the field say these experiences are in your DNA. They are deeply rooted in your self,” he says. “In psychology, there’s the idea of the conscious and the unconscious. In the indigenous world, we would call it the physical world and the spiritual world.”
The buzz in medicine is all about individualized medicine, tailoring treatment to every patient’s biology. It’s important work, but there has not been enough research focusing on the interplay of cultural and environmental factors, says Dr. Zul Merali, the president and CEO of the Institute of Mental Health Research at the Royal.
Eventually, will there be preventive treatment for every person at risk of suicide?
“Certainly, if we could identify a clear biomarker or set of biomarkers that were consistently predictive of suicide, we could seek treatments to address or alter them,” says Matheson.
“If the expression of those markers is altered by experience, then we can also try to ensure the people are exposed to the experiences that enhance positive outcomes and try to override experiences that trigger negative outcomes.”
But it’s complicated. “Later experiences could also undo this work, and the individual could also be more sensitized to later events.”
Matheson is optimistic that in the long run, supports can be put in place that will prevent suicide among indigenous youth, but she’s not confident it will materialize in the next year. Parachuting crisis teams into communities when there’s an emergency is necessary, but not the long-term answer. That takes time and building trust. Part of it is in “capturing the hearts of people who can bring about change,” she says.
“I will know when a community has put in place the resources and people so that maybe 10 years from now, children who may have chosen that route won’t make that choice.”
The strengths that they need to prevent suicide will be found in the culture. We’re all cultural beings.