Narrative medicine

Barbara Aragon is used to living in two worlds. Her father was Pueblo and her mother Crow, and her upbringing, first in New Mexico on her father’s ancestral land and then in Montana on the Crow land where her mother came from, immersed her in two cultures. Since she came to California to pursue a master’s degree in social work at CSUS in the 1970s, Aragon has lived in two worlds in a different sense. For over 30 years Aragon has been putting her training as a social worker to use while remaining true to the principles of the Indian communities she was raised in. “The tribes in California welcomed me,” Aragon said. “They raised me professionally.” She now works as a consultant and volunteer with the American Indian Training Institute, a group focused on preventing and treating substance abuse among American Indians, and has worked with the Sacramento Native American Health Center, along with other agencies.

Could you describe some of the differences between Native and non-Native approaches to addressing substance abuse?

There are a lot of similarities. There are real differences, too. One [difference] is around integrating culture and values, especially ceremony, into the process of treatment. The other part is the importance of relationship building between what would be seen as the “helper” and the “client.” I don’t think we will see things in those terms, because it would be seen as a difference in power. But if you look at traditional medicine people or practitioners, there was this whole different level of help-seeking behavior, and there was a real strong sense of “we need to build a relationship.” Part of that was when you came to ask for something, you would often bring a gift as you asked. There was a protocol to asking for help. You didn’t set up an appointment. You might have set up a time: “Here is when I’m coming for ceremony.” But there was a certain relationship-building and protocol that I think is real important in Indian community and people need to know. I need to know who you are before I work with you, and so it’s not a one-way relationship. Because that’s creating that trust and that safe and sacred space for me to share with you what is my pain, what are my triumphs, what is my struggle—you’ve got to earn that, you know?

How do you feel that American Indian Training Institute and other groups you’ve worked with utilize “narrative therapy"?

I think those are concepts that a lot of times within treatment programs or within ceremony people don’t label—"We’re doing narrative therapy"—but as I was studying [social work], and especially around narrative therapy, I always chuckled because it seemed like people would say, “Wow, this is such a new thing.” The work that came out, especially from Europe, from some of the folks, the “pioneers” you know, [Michael] White, the pioneers of narrative therapy. … This is basically what has worked and what’s been done in Native American community because the use of traditional stories—the use of the sweat lodge, the use of talking circles—was basically narrative therapy. Narrative does a number of things. It tells how I got here. Story or narrative says, “This is where it all began.” It also tells what our values are—or what are my values, what’s important to me—because those values shape my behavior. It also tells about how to be in relationship. If you look at traditional stories, or even just sitting around talking, what you’re learning is, “How do I want to be in relationship?” Not only with other people, but also with nature and then with a spiritual being. And that’s what stories do, and with narrative therapy you begin to define that for yourself. How do I want to be in relationship with this world? With other people? What is my spiritual base?

Could you describe what challenges the organizations you are working with are facing?

Wow, there’s a lot. Every organization I’ve been involved in is going through a lot of change. That’s because there’s been a loss in resources or a change in resources, and so they’re struggling to still provide services that are needed in community, often with less resources than they had in the past. Trying to manage that change, and realizing it means that some programs and employees may not be there, it causes a kind of panic within the organization because they’re having an ethical dilemma.

But I see the plus side of that—because there’s always a plus—is that there are agencies reaching out to one another, willing to work together. … For me, that’s really exciting to see. That out of a loss of resources, there’s this coming together and really practicing traditional values.