Historical Trauma in Black and Native Communities

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Of note : Netflix cooking show mentioned on episode is High on the Hog

Correction in episode: Iboga is grown in Gabon, Cameron and West Congo

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Dr. Loucresie Rupert: Welcome to Friday Night Soundbites with me, Dr. Loucresie Rupert. Join me as we discuss topics that center Black and other POC. Neurodiversity, Disability, LGBTQ, Adoption, and Trauma. Today, we have a very special guest. Someone that I absolutely adore. Sara Shadaram, Ameohne'e Walking Woman, is originally from Oklahoma, where she was raised by her Southern Cheyenne and first generation Iranian American families.

She is named after her great grandmother, Ameohne'e a medicine woman and survivor from Carlisle Indian Boarding School. Her mother was an IHS nurse who motivated her early interest in medicine. She pursued her college education as a University of Oklahoma Institutional Nominee, graduating with Special Distinction in 2008.

In 2012, she received her MD from the University of Oklahoma Health Sciences. in Oklahoma City with a special track in the School of Community Medicine in Tulsa, Oklahoma, where she pursued additional studies in public health. She and her husband, couples matched into Cleveland Clinic in Cleveland, Ohio.

At the Cleveland Clinic, she served as the primary chief resident during her adult psychiatry residency, medical student education liaison, resident member on the Care Path for Depression, and resident provider of shared medical appointments for women's mood disorders in East Side Cleveland. She served as the chief fellow after fast tracking into her child and adolescent psychiatry fellowship in 2015.

During this time, she gained unique experiences in the inner-city school psychiatry clinic, in a predominantly minority downtown charter school drawing upon her background and interest in medical education. She advocated for minority health through her grand rounds on historical trauma at the institute level, participating in the minority physician steering Committee, and continued her own mentorship to other minority residents and college students.

She continues to advocate for Native health issues through peer networking, which has both generated speakership opportunities and being recognized as a Phoenix Magazine's Top Doctor in 2021 and 2022. She is honored to care, serve, and be part of a community that continues to inspire resilience through connectedness in health.

So today we're going to talk about historical trauma in Black and Native communities, honestly mostly Native communities because I want to hear and just learn from, from Dr. Shadram but I might add a little bit here or there. So just kind of starting off, tell us how you decided to focus on Native, health care or Native mental health care and kind of how that's been going in your journey with that.

Dr. Sara Shadram: Yeah, so well, thank you for inviting me and letting me talk with you about historical trauma. It's I know that you and I have been planning some some time to be able to go over this same topic in different arenas. I do think it's important that people have an opportunity to hear about what it is and how it's impacted people in the community and who are also providing health care to the same community members actually grew up.

In the Indian Health Service, which is not a secret. A lot of our Native American community members have access to the Indian Health Service, and it's where we've obtained the majority of our health care. So [00:03:00] growing up in my community, that was the predominant way that we, were engaging with health care providers.

And I think one thing that we recognized was that, the, the long history with our relationship with the federal government, with even each other, and the way that we sell ourselves in communities going from our Reservation to this more urban lifestyle has been difficult. It's been, it's impacted people's lives in ways that only looking back now we say, okay, well, maybe if we just got over it, right, maybe that would be the way of moving forward.

And it's really not. It's recognizing where we come from and how the history that we've been experiencing as a community is an entity of itself where we're living through those experiences of our ancestors. And certainly, we pass through our family cultures as well. So that's, I would say that definitely sparked my interest in learning more about historical trauma it's kind of a selfish journey because I grew up in a community certainly impacted by this and it's been a discussion for at least in my family because we’re a little more medically oriented.

So we have the language to talk about it, but a lot of people don't a lot of families don't have the language to describe what is this experience that we're going through the what we do describe instead are things like a sense of loss of our culture, a sense of loss of connectedness. So much of what happens within Native American communities is centered around our identity within our family units, within not just the community, but like as a whole.

And I like to back up a little bit when I talk about Native American communities, because there is this idea of pan Indianism where all of American Indians are put into one monolithic demographic. And it's really not that. And as you and I have talked about before, it's hard to break that. When you grow up within a community where pan this pan Indian identity is accepted, even within the community that furthers that sense of loss and that unique identity.

Those cultural aspects that really explain someone's worldview are harder to see, and so we don't recognize that the sense of loss of language. Now, that being said, the communities talk about our history as resilient people so reframing the conversation from being victims of these multiple catastrophic experiences to, well, we are the survivors, those of us who are still here, now we survive those experiences, and that, Should become part of the conversation.

It's not just about loss, but it's about adaptability. It's about our own our own sense of still being here. We're not historical figures that's discussed in museums. And that's definitely an experience that I've had where I've walked through a museum and it said Cheyenne beadwork and I thought, oh, wait, hold on a second.

That name sounds familiar.

Dr. Loucresie Rupert: Right. So, yeah, I think, you know, I think a lot of black people specifically ADOS people, which I know can be a controversial term, but I use it just to simply mean American descendants of slaves, like here in the United States of America have that same sense of loss.

And I know for me personally that really started to heal as I got to know African peoples, you know, Nigerian Ghana, Ghanaian people, people from Sierra Leone, all, you know, all those different countries. And as I'm talking and learning about their customs and I'm like, Hey, that's similar to what we do, you know, black people in America do that's like this.

And it kind of showed me in a very powerful way that even with everything that those slaves went through not allowed to speak their language, you know, same in the Native communities, not allowed to practice their culture, they still were able to save and pass down some semblance of our culture.

And that was, I mean, that was amazing to me. Like there was a a show that came out on Netflix, I think maybe just last year, maybe a couple years ago that I cannot think of the name of right now, but it's ADOS African American guy goes to different countries in Africa and talks about food and then kind of relates it to the similar things that we have, you know, mostly in the South, because obviously that's where a lot of the slaves were and that has kind of traveled all throughout the United States, but you know, as I began to know people from these countries, I was having those same discoveries, like, that dish sounds like a take on, you know, jambalaya.

It sounds very similar. So that was, for me, that was very, that helped with my connectedness to the culture that I lost, which, you know, still not, like you said, it's not one culture, but at least I can see that my people really did what they could to preserve and pass down what they could to each generation.

And that was very powerful for me.

Dr. Sara Shadram: I think you bring up a really good point that where pan Indianism is discussed. We're reframing the conversation to be well, yeah, we have these shared experiences among the communities in our different nations that rewrite like this is how we created that a more resilient culture was adapting to what we could in order to survive, but that the shared experience among all our nations.

This is where we can create maybe a new Quote pan I pan Indian identity. One that is born out of a sense of resilience with each other, knowing that we're still recognizing the differences within our culture. So I like that. That's something that you that you highlighted there. It's a more nuanced discussion.

I think when people talk about historical drama. Right, right.

Dr. Loucresie Rupert: I do. This isn't specifically about historical trauma, but reading through your bio, you know, I saw that your grandmother was a medicine woman and a healer. I, I don't think we've talked lately, but I have been working with a spiritual advisor who's actually a psychiatrist, but she's done a lot, many years work in ancestral healing in different African and Indigenous cultures. And I've been working with her for two years just going, with my own like spiritual healing and working with trauma at a spiritual level. I, I take meds. I go to, you know, regular therapy. I do all that too, but I've also been working with her on, you know, on the spiritual level with trauma and healing that trauma that, that is my actual trauma and also, you know, that generational trauma.

And in the last, it was really, really interesting, fun, like funny because she just. Really can pick up on all these things. So like the last month I have been feeling the push to like, start learning this stuff myself, not just kind of being a recipient of it, but being able to help people in that same way.

And literally, I was thinking about that, like, just a couple, maybe a week, and within 48 hours, so about a week, I was thinking about it. She sent me a message to sign up for a workshop that a lady, lady was given on Iboga which is a plant that she uses to help with healing of trauma. And I think it's grown in Ghana, but I'm not 100 percent sure on that.

But anyway, there was a free, like, just quick workshop. But through that, of course, she had a link to a more lengthy workshop to really learn. And then that led me to a link to an indigenous medicine workshop. And I signed up for both of those. So within 48 hours, like she sent me that link. I signed up for those two classes, and then I'm doing a entrepreneur course through Cornell University online.

And that course started a couple of days ago. And one of the ladies in the course is also, you know, a medicinal not medicinal ancestral, what am I trying to say? Herbalist. Yes. And healer. And I was like, okay, like I hear you ancestors, like within 48 hours, you don't have to bombard me time and time again.

Like I'm listening, I'm going to learn. But did your grandmother pass any of that stuff down to you? And, and if she did, and do you use it in your day to day practice?

Dr. Sara Shadram: That's a really good question. It's complicated to talk about traditional healers within Native cultures because there is a sense of I don't know how to put it because there's not like a great you know, analogy.

But for, for instance, in my tribe, the, the sense of being able to provide medicine of some kind. Strongly linked to family lineage. It's also strongly linked to whether you're a man or a woman. As there's defined female and male medicine. And there's a lot of secrecy behind it. There's a lot, a lot of secrecy around it, even within those who are considered society people.

So we have special groups within our tribe hmm. They, they are expected to protect that knowledge and the people who carry it on there, and as a consequence again of historical trauma, there are aspects, though, of that medicine that cannot be passed down when all of the elders die, right, when they're no longer part of our community. Our everyday experience where we can just go to them.

My tribe is a strongly matrilineal and matriarchal tribe. This is the way that we're set up, at least in pre contact times, if you want to call it that. And then the stories and traditions that have been passed down orally, also get represented through dance, through the way that we present ourselves.

Now, whether any of that was passed down to me, and it's hard to tell because one thing I know that my great grandmother was known for her ability to read people. Okay, then I grew up to become a psychiatrist. So, I mean, I guess one could argue that that was a part of my upbringing. Was it culturally reinforced just for my family dynamics?

Was that considered or revered as a certain type of medicine? I'm not sure. There were medicines that were passed down that only went to the oldest daughters. And it seemed to be that in my family. So my mother. Was the only daughter of my grandmother, and my grandmother, I think, was actually the the youngest one.

So there was only so much that was passed down in that regard. However, I'm named after my great grandmother. So there's all of these, like, formalities that happen where you get honored in a different way. Now, there, there is again, as a consequence of historical trauma, as our community started interacting with other nations, we knew that the only way to practice certain aspects of our ceremonies is to blend it.

With what we were interacting with the tribes, what was working for them, what was acceptable to the dominant culture at the time. So you see a lot of our family members, or at least members in our tribe. I know in my family, it's quite mixed who moved toward the Native American church and the Native American church is really conglomeration.

It's almost like a mashup of certain ceremonies that are represented in different tribes through what would historically have been almost impossible to do. We have people who. Use the teepee, for instance, and there's peyote. Well, my tribe were northern plains, and so we wouldn't have been able to grow peyote up there.

But nonetheless, again, this is like a way of, of, of demonstrating resilience. That is a little at odds with the traditional culture that is passed down as, as a person who is Cheyenne, and there's distinctions made. Are you a Sundance person? Are you part of the Native American church? But that is a new thing.

That is, that is very new. I would say maybe in my generation, that has become more of a question in my parents generation and older. It was just more accepted. You could be any religion and also practice Sundance and also be part of the Native American church. It was just not, it was, there was no conflict.

They didn't see the conflict as being a barrier to it. Subscribing to all these different beliefs or at least putting it into their own world view. So when you're talking about like understanding more of the spirituality and getting engaged in that part of your health, that I have seen through our family's generations, different ways of how they approach it.

And when you talk about medicine, of course, it's gonna be impacted by that. So I don't know. I mean, maybe I am. Some people say I am in my family, but you know, it's not as concrete. I wish I had, you know, a recipe that I could share. But there are sayings, there are things that we do. That is considered part of the medicine and it's very, again, very mysterious.

So like a woman's medicine is so powerful. It's supposed to kill a man and here I'm thinking, you know, I really don't think that weapons of mass destruction is supposed to be the thing that gets handed down to me, but I suppose I should honor that.

Dr. Loucresie Rupert: But yeah, I think that's similar. So in, in ADOS communities, a lot of the kind of spirituality was rolled into voodoo and hoodoo, which is, you know, well known kind of in New Orleans, Louisiana area. My mom is from New Orleans. She was actually adopted, but she's from New Orleans. And I've been, I don't have like, I guess that scientific lineage to trace.

But I've been told by multiple people that are kind of able to pick up in that spiritual world that I come from a long line of healers. My mom definitely has some, you know, some talents that, that are not scientific that, you know, like one time she My brother called her lost in Louisiana. Like he was literally New Orleans lost in the middle of the swamp.

His phone died before he could tell her where she was and my mom drove straight to him and got him like, there's no scientific explanation for that. So I, you know, what I'm saying with that is yes, I think. Kind of that has passed. I think it's interesting that I've been told multiple times that I come from a long line of healers and I'm also a psychiatrist.

So, you know, like, yeah, like, it's like, somehow, somehow we're still drawn to what we're supposed to be doing, even though we don't even know what we're supposed to be doing, right? When we put that, well, at least I can say I didn't necessarily know that when I picked When I decided I wanted to be a psychiatrist, I wasn't thinking, I come from a long line of healers.

Let me jump into that.

Dr. Sara Shadram: Yeah, same. Like when I because I knew this as I was growing up and then I was like, oh, I'm gonna go to medical school. If anything, it became such an issue for, for me because I had some elders actually come up to me. I remember one time after leaving the Teepee in the morning from the ceremony that we had overnight.

When I'm, I think he was actually now he's actually the oldest elder in my family. And if he ever hears this, I'm totally calling him out on it. He said, I'm, I'm now learning medicine, but from, you know, white people. But I guess if I'm turning my back on the traditional healing practices or what would be expected of me being a part of this, this group and that I'm leaving.

So they, they not only that, but they saw me go into the practice of medicine formally studying in this Western way, not just that as projecting this personal part of me being in my lineage, but that I'm turning my back on my people. Because I'm physically having to leave Oklahoma and I did stay for you know, for medical school, but I did have to, I did have to leave eventually to pursue some of my own personal goals and, and I do see how, how powerful that is that draw because you want to be connected and I certainly still do Where I'm practicing now is I work with 100 percent Native American population, but it's not my tribe.

So I'm constantly learning and challenging my own beliefs that I had growing up about what it meant to be Native American. This, this romantic idea. And you don't want to subscribe to these stereotypes, but you were kind of raised in them. When they exist around you, even trying to correct it becomes exhausting.

And at some point you kind of wonder, well, maybe is there some nugget of truth in there? Are we supposed to be romanticizing being Native American or all the stereotypes, the stoic person who can't show emotions and, you know, underneath some of those stereotypes were perpetuated within our communities because it happened to align with survival.

Behaviors, right? You don't want to show that you're weak. You can't show and in some certain aspect that, that there's a vulnerability about you. or that there is something so much more to being Native American that therefore outsiders cannot easily become one. So you're trying to protect what you know and what's familiar to you.

Dr. Loucresie Rupert: Mm hmm.

Yeah, I you know, kind of grew up being like I'm a strong Black woman. I completely reject that because that has been used as a clutch to treat Black women any kind of way, throw everything at them, make them, you know, take on all the burdens. And we should just be able to do it because we're strong black women.

No, I'm not that strong. I need help. So it's kind of been taken from a tool of like what we had to do to survive. Cause I mean, our ancestors had to be very strong. But it's, it's just been, you know, it's a, it's a plus and minus. Like, yes, I am a strong woman in, in, in some respects. But I don't want to take on that mantle the way it's being used now to take on, you know, like you take care of everybody and don't ever take care of yourself.

I'm not about that. And I had to kind of grow into that because my mom, who I love, Absolutely. But my mom is like that. She will take care of everybody to the sacrifice of herself. And I'm like, you need to say no sometimes, even if it's to me, like, say no, like, you don't need to carry everybody's burden.

So let's talk about how do you want to approach historical trauma? Like, I don't know if you want to talk, if you want to talk about more on the other side, the resilience of trying to deal with it, like, how do you want to approach this?

Dr. Sara Shadram: Yeah, I think that's that would be That would be ideal. It's, but again, it's hard to talk about the resilience without acknowledging the pain that has come from behind those experiences.

So when I was learning formally about historical trauma through my training, which I had to, again, do mostly on my own, I in my medical training experience, I didn't have really a mentor who was also Native American that I could go to for questions like this. But what I did learn was. Why do I feel so excluded in certain circumstances?

Not that it was purposeful by any means, but that I just didn't feel quite as connected to what was going on that my peers went through. And they all had their own type of experience as well. And so I, I was, it forced me almost in a way to think about, well, even though I have this, what am I going to do about it?

I mean, historical trauma is such a heavy topic that it hits multiple levels of society from the individual to the community and to the culture that. When I started looking at the research behind how people approach this, you have to look at it from a community standpoint. One thing I had talked about in my historical trauma discussion during a ground grounds that I did in my residency training was that there is this tendency to pathologize historical trauma as if it is a disease process that we can just treat.

And so, like, when you want to think about how do I get through this, how do I treat this in my patient there's no medication that you can prescribe. There really is no individual therapy that you can prescribe. Because a lot of those are, well, evidence based targeted toward PTSD, you know, these defined things that we're looking at rather than looking at the individual within a family unit, within a culture, part of a community that is living and will be handed down.

Dr. Loucresie Rupert: Not only that, but you know, treating historical trauma ties into treating, quote unquote, treating racism. But how can you treat something that's still happening? Because the way you treat trauma is to remove people from the traumatic situation and then start treating them. We haven't been removed from anything.

Dr. Sara Shadram: Right. Well, exactly. These are ongoing experiences, and these are and sometimes historical trauma. It's just like the way you can describe what is going on, but it's really not the thing that might be bothering an individual at any one time because they weren't. You don't see it that way. So it's like one example is.

When I heard one of the elders in my tribe, she was describing what these stories were like telling children. So even the, the fairy tales or the nursery stories that you would pass down to very young children had changed. It was, a lot of it was based in fear. One of the stories had to do with a snake wrapping itself around a group of children.

And there's probably a lot that we could read into about what that means and how that, that is a metaphor for historical trauma. But when I think about it, what was lost? This is the story that we're, we're passing down to our, our family members. Not the story that it was in its, perhaps its original form.

So the healing process is, well, this is what we're doing, what could we do instead? It sounds simple, but it's, and it's not absolutely, because it's a change. And even that change is practicing the adaptability of our ancestors that gave us the resilience for where we are now. And the way, even the way that I'm talking about it is no longer focusing on historical trauma as being an individual experience, the one that we have gone through.

And while it has impacted each of us individually in a different way, it's something that we all share together. And so the interventions have gone toward that. They've gone toward creating talking [00:24:00] circles at least within some of the literature that I've looked at on in American Indian and Alaska Native communities.

Is talking circles. What kind of community inventions you can put into recreate this pro social, more connected experiences and also addressing those things that people have lost that have just kept perpetuating or have upheld the consequences of historical trauma.

Dr. Loucresie Rupert: What have some of those consequences been?

Dr. Sara Shadram:

Yeah. So like the loss of language there are more language programs that are being developed, including an early childhood language programs where on the, on the whole, it looks like childcare. Cause we all need childcare. That, that's, that's a big component of, especially when you're talking about parents who are undereducated.

The opportunities are not there. Horrible, horrible, you know, financial, economic situations that are happening particularly in some reservation lands, so parents have to work and then you entrust another individual and where would you, where, where is going to be the cultural [00:25:00] exposure? For your, your nation or for you unique to you and your family unit you could go down the street, maybe find a daycare that's like close to your job, which I, which would be ideal.

But what if your community had an early childhood program where it, it was infused with the culture, it was infused with the words, and if not the actual words, at least infused with the world view. So it's so seeing our language as being lost. Well, to, to a certain extent, maybe those are just words.

Maybe those words are still inherited because it's through our worldview that we see the world a little differently and it's affected certainly the way that we communicate, but we can still value what was passed down. So there, so that was just like one example of, of how some people have viewed the consequences of historical trauma being addressed by developing these cultural programs that Also, again, resurrect the things that we are losing directly.

Yes, but bringing those family units back, bringing trust back into your community where you have a a nation against strong community identity and we're broken apart into nuclear family groups. At one point in the in our American history We were taken from one of our air wherever we were settled to another state.

I think the tensions were increased the economic Potential economic opportunity for some of these families, but ultimately they moved back So there's something about that connected experience even being around people where substance abuse rates are high suicide rates are high Even being around them and experiencing the pain with your family, there's something that keeps us there.

And so what can we do on a community level to bring back some, some sense of connectedness that is in line with our cultural identity? And truly is healing that is going to move us forward. We're one generation, not that we're protecting them from our history, from the history, they should know it actually.

So they're, they recognize their own sense of resilience and what's been passed down, but to be much more aware of where that resilience came from and how we're continuing to be adaptable. There, there are some focus groups that were conducted to with elders, medicine men, and different tribal members.

And one of the studies that I, that I, by the way, this has been such a long time since I've, I've done my historical trauma talk. And I can't believe like some of it's like still wrote in my memory. Maybe that's just how powerful it was. This is my intervention for myself, having this ingrained in my, in my mind, but.

It was changing the perceptions of, of who we are within our, within our communities and, and looking at the emotional loss as being an opportunity for us to share, to do some shared grieving together instead of doing it alone. And there are different ways that, that family units can do that. But you know, like I said, sometimes those, those, those mechanisms that we put into place for our survival.

Was specific in a way that, yes, it protected the individual, but did not protect the culture. So I will show no emotion. I never grieve. I never cry. And that has to change.

Dr. Loucresie Rupert: Right. And do you think that is changing? It sounds like there are things put in, being put into place for that to change. It, it, it's, or there's a conversation

Dr. Sara Shadram: It's part of the conversation. The, the literature, unfortunately, the, the medical, then again, that's a whole other thing too. That the medical only capture so much because we have to have a willing participants, but at least colloquially from what I can pick up in my own personal anecdotes, I guess the, in my tribe, yes.

I, I am seeing more people participate. I know in our language programs we we've been creating more opportunities for for people within the community itself. Now, what, and this is hard to balance. What do you do about the people who don't live within your community anymore, even though they're a part of the tribe and they want to have that sense of connection.

So that, that's, that's been a big challenge. And some tribes are, are in different stages. I don't want to say anyone's further ahead because there's a lot of creativity that can happen in this area. And I, and I really hope that the, that our youth continue to challenge the ideas of even, even me. I mean, like I want them to challenge me.

They may come up with something that's so much more effective, but different tribes have different mechanisms that they've put in place as a way of overcoming this, whether they intentionally have done it or not. And that is something that needs to be acknowledged. I know in nations that have had more preserved or stronger cultural preservation programs, that's been one way that they've done it.

And again, that's a, that's a little bit more, you know, in your face, this is what we can do. These are the dances that we do. And it's great. I'm not, I'm not discounting all of that. It's that we should recognize where we are now because we're not trying to bring ourselves back to a time that none of us actually ever lived in.

And that's the remaining solution. I, and I run into that, especially in places where you see a lot of interfacing with other nations. It's who's the [00:30:00] most Native American who's not. Well, how do you do that? I mean, no one's going to win that competition by the way. But, but we act as if sometimes we're, we need to, because there's a sense of, I need to defend myself and my identity with my culture.

And I'm the most Native American because I said the most words. And I've had this happen to even myself when someone had said, Oh, well, you, you don't look like you're Cheyenne. Which is kind of funny because my Persian side tells me that I don't look Persian and my Cheyenne side says I don't look Cheyenne.

I don't know. I guess I don't look like either of them. But I remind them like, well, I did help with our Cheyenne language program. I did do that at one point and English was not my first language. It was my third language actually. So how much more Native American do I need to be? Right, right. Yeah, I think

Dr. Loucresie Rupert: I'm seeing the same kind of change and in the younger generations.

I think it's kind of the path that I see a lot of ADOS people taking specifically because we don't necessarily know exactly what tribe we come from. Although I did do an African ancestry test. And if that is correct, I do know what tribes I come from, but that isn't passed down to me I had to do like DNA testing.

But so a lot, I see a lot of, and of course, this isn't like there isn't studies on this because, as you said, they have to have willing participants and to be honest. There's lots of reason for Native and Black people to not be willing

to participate in this in these especially social media spaces that Black people are trying to reclaim their spirituality. their African spirituality in whatever ways they can. So, again, like the things I'm doing learning from people that have, that have learned from their ancestors their tribal ancestors.

My spiritual advisor has traveled like literally traveled and lived in places for a certain time to learn. I don't have the ability to do that yet, but hopefully I will one day. But a lot of that knowledge is, is, Like you said, we're not, we can't go back to I'm from this specific tribe because I'm not.

Like according to my African ancestry, I have like six tribes listed that I descend from at some point. So I have to kind of, we have to kind of forge what our identity is moving forward, but also connecting back to our African identity.

Dr. Sara Shadram: That's a good way of putting it, that there have, there's those connections that we have to see.

We have to recognize them first. All right.

Dr. Loucresie Rupert: So kind of closing a little bit. Are there any specific programs that you are working on or anything that you're doing? Any talks you have? I don't know if you've written any books, just anything that you're doing that you want to promote or talk about? Oh,

Dr. Sara Shadram: oh my gosh, that's a good question.

That's what's so nice about being around you is that I can't just like Learn about something. I got to be, what are you going to do about it?

Dr. Loucresie Rupert: Cause I was telling my best friend we've been best friends since fourth grade, but I was like, yeah, I'm doing this. I'm doing this, you know, I'm doing this entrepreneur course. I'm about to do this you know, Iboga course and this and that. She's like, you're always like learning. I'm like, you know what?

That's and I love learning, but I actually hate structure school always have, but I'm always taking some course. And I'm like, what is going on? So, well,

Dr. Sara Shadram: I guess then my, my my, my, it's not meant to be a cop out, but like things that I would, I would use this opportunity with you just to share that there, there just needs to be more, more discussion.

There needs to be more discussion about how we recognize historical trauma in. Not just our communities or our patients that we take care of, but also within the people delivering that care or people, a part of the health system. And this is, I know this is a little bit more nuanced because I'm a health care provider and I'm within a health care system where I'm at is that we have a majority of Native American workforce and the expectations on our practice.

Again, we're built by a dominant culture, not not one that we grew up or identified with. But certainly one that we decided to ascribe to because we got our education we went through that training and now we're bringing that, that education and knowledge back to our communities, even if it's a community that we're not directly a part of, we still consider it a part of that, again, pan Indian identity starts coming in here, but that is that shared experience that we're, that we're bringing back and what I am doing, at least in my practice is recognizing that and doing what I can to advocate for Those who can use that experience, I think, in a way to better inform how our medical or behavioral health practice is being done, we may need to challenge.

Some, some of the basis for what certain factors were developed. No, you cannot over disclose to your patients. Well, that's really hard to do whenever you're talking about taking care of a community where community identity is a, is, is foremost a part of how they develop trust. I say they, but I'm not, I'm a part of the bay.

I, I am both they, and I am them. That's difficult. I, I would hope that as a supervisor or as a mentor when I am talking with anybody who's within the healthcare field, that I'm allowing them to have that space to be vulnerable, to recognize that within themselves and not to be shamed from using it that experience to be more connected to the community in which they're part of, because now you're talking about a community where how can we expand it?

My sense of community now belongs not just with where I grew up it also belongs to this experience of you and I are sitting in this room within this building, within this hospital, and we both have a goal. It's no longer my job, and it's no longer your role. It's or just your problem. It's what can we do?

And that is what I'm learning from historical trauma in our, our interventions for recovery. It's very different. I know in psychiatry, we get taught this all the time. You gotta be very clean, like the fly on the wall, right? You're observing what is happening and you've got your space. You cannot just distract or anything with your own personal.

How do you weigh that against? Doing work with within this community. That's hard. It's a very difficult. I do see that as being a theme for my colleagues for people and other clinics who work within the similar setting that I do. And how do we rectify that? There are no evidence based studies for how we take, for instance, dbt and translate it.

over to this particular population because I might work within that population within a Native American community but it may not work within this one because these people are urbanized and maybe these people are not. I mean there's all these different factors that go on. Yeah, I think

Dr. Loucresie Rupert: the whole over disclosing thing. It’s very, you're Eurocentric and honestly, I don't, I, I do disclose like I'm neurodiverse, pretty much probably all of my patients know I'm neurodiverse, and know that I parent neurodiverse children, although I do not tell my children's story, because, you know, that's theirs, but obviously, I mean,

Dr. Sara Shadram: boundaries are important, yes, yes.

Dr. Loucresie Rupert: I'm quite obviously black and a woman, but you know, obviously, I don't think you need to put burden like your, your problems. You don't need a burden your patients with your problems, but I think that whole blank slate being completely separate is a Eurocentric thing that doesn't work in minority communities and not only minority communities.

It also doesn't work in white neurodiverse communities either. So I think that's a very specific neurotypical Eurocentric thing that really doesn't work for most of the people that we're treating. Absolutely. Absolutely.

Dr. Sara Shadram: You are, you, that is exactly, exactly what I see. It's, it is, it is difficult. You know what?

Because you've got the experience with your, with those communities, you, everything that you bring to your patient, right? Everything you bring, you, you bring your counter transference, you bring your biases, you bring all, and it is our job to process those, to recognize them. There are some tools, though, that you also inherently bring, and those should not be ignored because we need to be that blank slate that, that, that is really doing a disservice to the experience that you are trying to create with that patient.

And maybe that's part of it. Maybe that's, maybe that's no longer just about. The doctor patient role being defined with these very clear things again as a blank slate. I know in behavioral health, it seems to be that way. And I don't want to say that I'm speaking on behalf of all behavioral health providers either and certainly not not on behalf of all the medical specialties that are out there.

It's just that as a person who is a minority going through this, this dominant culture experience in my training, there are, there are these things that I have to rectify somehow and, and try to understand how am I going to navigate this once I am in this role because I don't feel connected to it now.

How am I going to, how am I going to honor. Being the medical professional that I was taught to be and should be versus who I am as an individual and what I'm bringing into that room.

Dr. Loucresie Rupert: So let's end on a kind of entertainment note. Have you seen Black Panther Wakanda Forever

Dr. Sara Shadram: forever? Oh my gosh. I wish I could.

My kids are sick right now because whatever's going around came to my house. But we are, we are, we are. Very

Dr. Loucresie Rupert: excited about it. I won't give any spoilers, but I will say it's a very strong metaphor for white people messing up stuff and then somehow the minority groups fight each other. Oh

Dr. Sara Shadram: my goodness, but

Dr. Loucresie Rupert: the black and native, like, oh my god, the black and native just The tribute to different Black and Native cultures in the movie is amazing.

You're going to love it when you see it.

Dr. Sara Shadram: Oh my goodness, I'm looking forward to it. Absolutely.

Dr. Loucresie Rupert: Well, on that note, we're going to end for today. I want to thank you again, Sara for for coming and doing the show. And we have got to get together and, and work on some stuff together. We've got to. Oh,

Dr. Sara Shadram: absolutely.

Absolutely. I think it would be explosive because we've got so much material and I think it'd be amazing.

Dr. Loucresie Rupert: Yes. All right. Well, you have a good week and everybody that's listening. I'll see you in a couple weeks. Bye. Thank you for joining us on Friday Night Sound Bites. I hope that we have fed your body, soul, mind, and spirit.

See you next time.

Friday Night Sound Bytes with Loucresie Rupert MD

Historical Trauma in Black and Native Communities

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