In a dusty lot on the Navajo reservation, a cleansing ceremony is about to take place. Women sit on rickety chairs outside a hogan, (a circular, squat Navajo home with a dirt floor). A line of parked cars sizzle in the Southwestern sun. Suddenly, a pack of horses rushes into view. They stop just short of the hogan, their hooves beating up a cloud of dust.
A man appears in the doorway – an unassuming figure, dressed in a work shirt, jeans, and cowboy boots. He is a medicine man who has spent decades learning ancient Navajo healing techniques. He waits for the lead rider – the patient – to dismount and then ushers him inside.
For the next hour, the spiritual leader, Alfred Gibson, conducts an "enemy way" ceremony, a form of Navajo therapy that cleanses physically and mentally ill individuals by forcing them to confront their pain.
The technique is increasingly being used across the American West to help native American soldiers deal with the traumas of war.
While healers on Indian reservations have always employed such methods, the government offers most returning native American soldiers standard Western psychological counseling and medical help. Now, however, native American leaders and the Department of Veterans Affairs are teaming up to use both approaches in hopes of better serving the needs of Indian soldiers.
Mr. Gibson, for one, works during the week as a counselor at the Na'nizhoozhi Rehabilitation Center, a treatment facility in Gallup, N.M., run by tribal entities and the local county government. To help patients battle addiction and psychological trauma, Na'nizhoozhi often pairs psychotherapy and medication with sweat lodge ceremonies and drumming sessions. But the goal, Gibson says, is always to "do away with the medication – to help patients learn the traditional ways of healing."
Similarly, Veterans Affairs hospitals throughout New Mexico now run special programs for native American vets that include talking circles, sweat lodge ceremonies, and gourd dances. "We have to allow native Americans the opportunity to explore the culture that has been damaged, if not taken away," says Dr. James Gillies, a psychologist in the post-traumatic stress disorder (PTSD) clinic at the VA Medical Center in Albuquerque, N.M. "To be a soul doctor is to embrace the souls of the people you work with."
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Native American vets have a real need for this kind of attention. Tribal members join the military at higher per capita rates than almost any other minority group. They also tend to suffer disproportionately from the effects of war – as evidenced in high drug-abuse and suicide rates among returning soldiers. Studies have shown that native Americans who served in Vietnam were far more likely to struggle with PTSD than white soldiers.
Counselors and tribal leaders believe a more "holistic" approach to treating the problem – combining traditional and modern methods – should help a new generation of soldiers now returning from Iraq.
"The 'enemy way' ceremony rejuvenates them," says Gibson. "The songs, prayers, drumming, and herbs we use cleanse the body from the effects of war."
The morning after the ceremony, Gibson and I sit on a sagging couch in the empty hogan. I ask if he believes one healing ceremony can provide a long-term release from the psychological imprint of combat. Gibson says that a series of ceremonies are often required, each addressing a different aspect of the patient's illness. "And it depends on the individual," he says. "It's just like a person who's addicted to alcohol. If he wants to get help, he will get better. But if he's two ways about it, it won't help him."
Dr. Gillies sees the benefits of marrying both approaches. He says modern Western therapy teaches vets "how to think about trauma" in a systematic and linear fashion. The basic treatment asks combat veterans to talk about their painful experiences in war. "We ask them to slow [the experience] down," Gillies says. "To approach it again and again." Each time, the memory is supposed to be a little less painful.
The concept is similar to that behind the "enemy way" ceremony, but it lacks the cultural and spiritual foundation that forms the basis of Gibson's work. After working on the Acoma Pueblo reservation outside Albuquerque, Gillies began to see that the Indian veteran population responded to this added cultural component. They are dealing with what he calls "intergenerational trauma": The struggles they've faced as native Americans often compound the effects of their PTSD.
With its lamps and bookshelves, Gillies's office feels like a small study. The young-looking doctor has the kind of relaxed demeanor that puts his patients at ease. While traditional psychotherapy and medication have their place, he says, you also have to work "within the mythology, the ritual" of the people you're dealing with.
Twice a month, Gillies moderates a talking circle made up of mostly Vietnam-era native American vets. The meeting has no formal structure, and participants say there is less interruption than during normal group therapy sessions.
Gregory Gomez, an Apache Indian who served with the Marine Corps in Vietnam, participates in the talking group. He says it helps him be "a little more rested, a little stronger to deal with the outside society."
Mr. Gomez, a large, expressive man with a gray ponytail and a single red feather earring, has a degree in social work and is well versed in Western forms of therapy. He also participates in the VA's standard PTSD program and meets with Gillies for individual counseling. But the talking circle addresses what he calls his "Indian world-view." "We're dealing with our spiritual needs," he says. "In other groups, there's a void."
Gomez doesn't have an easy definition for what spirituality is. As he puts it: "It's 24/7, a way of life. It's not a religion, but [the notion that] we don't own anything in this world. Our job is to help Mother Earth."
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The sweat lodge is another cleansing tool centered around the connection to Mother Earth. Gillies and his native American patients convinced the VA medical center in Albuquerque to build one on a sandy plot behind the PTSD clinic.
"It's a place for cleansing our soul," says Ambrose Willie, a reed-thin man who served with the Army in Vietnam. Mr. Willie surveys the construction site, scrutinizing a series of prairie dog holes. In his barely audible voice, he wonders how to remove the rodents. Ultimately, he decides that prairie dogs and humans can cohabitate. The sweat lodge "teaches us to live in harmony with our surroundings," he says.
Willie explains that the main elements of the sweat lodge – fire, water, and stone – represent the basic elements of nature. He and Gomez have long anticipated the lodge's completion. They believe it can bring them one step closer to mental stability. "When we leave the doorway," Willie says, "our mind, body, and spirit are one."
Up in Window Rock, Ariz., 170 miles north, Gibson holds a similar view. "When soldiers go overseas, we give them warrior ceremonies to armor and protect them against the battle," says the medicine man. "When the soldier comes back, we have to remove that armor, to help him reconnect with his home."