Walking the Path Home: Rematriating Healing for Indigenous Women Overcoming Substance Use
Maria sits in the treatment center's waiting room; her daughter curled against her side. She has tried before—programs where she felt observed but never seen, where trauma was discussed but not honored, and where her ancestors’ names were absent from the healing room. Those programs asked her to stop using substances but never helped her return to her body, her ancestors, her ceremony, her identity as a mother, or to the land that still remembers her.
This time feels different.
Here, healing is not about “fixing” her. It is about returning her to who she has always been.
Here, trauma is not a diagnosis, but a story held across generations—one that becomes medicine when spoken, witnessed, and transformed through community, land, and ceremony. Here, she is not only asked to stop numbing—she is invited to root deeper, listen closer, and find her original belonging again.
From Trauma-Informed to Healing-Centered & Culturally-Driven
Many programs say they are trauma-informed. But Indigenous women need approaches that:
Recognize colonial harm and cultural strength
Prioritize belonging before behavior
Treat substance use as an adaptation to unsafety, not personal or cultural failure
Understand the body as land, story, and memory
Center culture, ceremony, language, and kinship as core treatment—not add-ons
Healing isn't only about reducing symptoms—it is about restoring relationship.
This is Rematriation.
A return to land, body, rhythm, belonging, and ancestral knowledge.
A return to matrilineal power, community responsibility, and sacred identity.
A return to dignity, sovereignty, and life force.
Historical Strengths Are Interventions
Colonial systems pathologize Indigenous women.
Indigenous systems remember them powerful.
Research and Indigenous-developed programs show that healing deepens when we activate:
Cultural identity & language
Intergenerational mentorship & Elders
Land-based practice and foodways
Ceremony, song, and drumming rhythm
Collective nervous system regulation (polyvagal relational safety)
Ancestral narratives of endurance, brilliance, and survival
Roles as mothers, aunties, and knowledge keepers
Story medicine and constellation-based remembrance
Kinship networks and community responsibility
Land, plants, and seasonal cycles as co-regulators
In Indigenous healing frameworks, strength is not a trait—it is a lineage.
A Healing-Centered Model for Indigenous Women
Most substance-use programs focus on stopping the behavior. Some trauma programs focus on understanding the pain.
We need programs that do both — and go further.
We need programs that recognize:
Addiction is often a response to trauma and disconnection.
Indigenous women and families carry historical and generational wounds tied to colonization.
Healing happens through belonging, identity, culture, land, and relationships, not just worksheets and coping skills.
People recover not only by addressing harm, but by remembering who they are and where they come from.
So instead of only asking:
“How do we stop harmful behavior?”
Our curriculum for providers working with Indigenous women asks:
“How do we help you return home to yourself, your culture, your body, your ancestors, and your future?”
Key Ideas
Healing is not only about stopping substance use.
Healing is about returning to land, language, spirit, identity, and relationship.
Culture is treatment.
Story, ceremony, rhythm, and kinship are medicine.
Women aren’t “clients” — they are relatives, knowledge keepers, mothers, aunties, future ancestors.
Recovery is not leaving the past behind — it is honoring it and transforming it.
Why This Matters
Most treatment programs were not designed for Indigenous people.
This curriculum rematriates healing — bringing it back into Indigenous hands, voices, and worldviews.
It blends clinical science, neurobiology, and ancestral science.
It invites participants to rebuild safety not only inside themselves, but in:
their families
their communities
their spirit and identity
their nervous systems
their relationships with land and ancestors
It is not just trauma-informed.
It is healing-centered, culture-rooted, land-honoring, and future-building.
This is not only recovery.
It is returning home.
Four Pillars of Rematriated Recovery
Remembrance
Storywork, ancestral practices, land teaching, Indigenous neuroscience, lineage healing
Regulation
Polyvagal practice, rhythm (drum, dance, song), breath, somatic mapping, seasonal attunement
Relationship
Circles, kinship webs, auntie systems, Elders, community healing, reparative relational field
Rematriation
Cultural identity, language, plant medicine traditions, food sovereignty, mother-role support, ceremony
Healing is not “leaving trauma behind.”
Healing is bringing the wound to circle and restoring its sacredness.
Integrated Mother–Child Healing
Research emphasizes programs where mothers and children heal together: attachment repair, cultural family teachings, mother-child land-based activities, and collective caregiving models
Our model expands this through ideas around:
Parenting in ceremony
Re-indigenizing family systems
Teaching kinship roles (not nuclear parenting alone)
Auntie circles and shared caregiving
Intergenerational ritual healing
When a mother heals, a nation heals.
Culture is not “supportive.” Culture is treatment.
Recommendations for Practice
For Treatment Providers
Implement trauma-informed care approaches that specifically address historical and intergenerational trauma alongside individual trauma experiences.
Integrate cultural elements meaningfully rather than superficially, working closely with Indigenous cultural advisors and traditional healers.
Address the whole family system, recognizing that women's recovery impacts multiple generations and that children's wellbeing is often central to women's motivation for change.
Provide gender-specific programming that addresses the unique needs and experiences of Indigenous women within the context of their cultural identity.
For Program Developers
Partner with Indigenous communities in developing and implementing programs rather than adapting existing models without community input.
Measure culturally relevant outcomes beyond just substance use, including cultural connection, family functioning, and community involvement.
Ensure adequate program duration and intensity to address the complexity of issues Indigenous women face.
Provide comprehensive support services including childcare, transportation, housing assistance, and connection to ongoing community supports.
For Policymakers
Increase funding for Indigenous-led treatment programs that have demonstrated effectiveness in serving Indigenous women.
Address systemic barriers that prevent Indigenous women from accessing and completing treatment.
Support research that specifically examines effective treatment approaches for Indigenous women rather than assuming findings from other populations are generalizable.
Recognize cultural healing practices as legitimate treatment interventions worthy of funding and support.
A Vision Forward
Maria leaves her first circle with tears on her cheeks—not from pain, but from recognition.
She is not broken.
She is returning.
Her ancestors are not stories—they are regulating forces in her nervous system.
Her healing is not solitary—it is ceremony, kinship, land, and memory.
Treatment does not “give” her culture. It reminds her she has always carried it.
This is the work:
To walk with women as they come home to themselves, to their lineage, to land, and to future generations who deserve to inherit strength—not silence.
When Indigenous women heal, we do not simply recover.
We restore, we reweave, we rise, we remember, and we rematriate the world.
References
Brave Heart, M. Y. H., Elkins, J., Tafoya, G., Bird, D., & Salvador, M. (2011). Wicasa Was'aka: Restoring the traditional strength of American Indian boys and men. American Journal of Public Health, 101(S2), S274-S278.
Dell, C. A., & Acoose, S. (2008). Aboriginal women and substance abuse intervention: Program review. Government of Canada.
Fillmore, C. A., Dell, C. A., & Kitty, D. (2014). Indigenous women's journey of healing from substance use and trauma. International Journal of Indigenous Health, 10(2), 3-22.
Greenfield, B. L., & Venner, K. L. (2012). Review of substance use disorder treatment research in Indian country: Future directions to strive toward health equity. American Journal of Drug and Alcohol Abuse, 38(5), 483-492.
Marsh, T. N., Coholic, D., Cote-Meek, S., & Najavits, L. M. (2015). Blending Aboriginal and Western healing methods to treat intergenerational trauma with substance use disorder in Aboriginal peoples who live in Northeastern Ontario, Canada. Harm Reduction Journal, 12(1), 14.
Marsh, T. N., Cote-Meek, S., Toulouse, P., Najavits, L. M., & Young, N. L. (2015). The application of two-eyed seeing decolonizing methodology in qualitative and quantitative research for the treatment of intergenerational trauma and substance use disorders. International Journal of Qualitative Methods, 14(5), 1-13.
Najavits, L. M. (2002). Seeking Safety: A treatment manual for PTSD and substance abuse. Guilford Press.
Olson, K.R. (2025). Inviting the sacred wound into circle: re-storying an Indigenous mind-body medicine framework for healing. Breyer State Theology University.
Spillane, N. S., Schick, M. R., Kirk-Provencher, K. T., Nalven, T., Goldstein, S. C., Crawford, M. C., & Weiss, N. H. (2023). Trauma and substance use among Indigenous peoples of the United States and Canada: A scoping review. Trauma, Violence, & Abuse, 24(5), 3297-3312.
When the Healer Needs Healing: Understanding Compassion Fatigue in Indigenous Communities
It's 2 AM and you're still awake, your mind replaying the crisis call that came in just as you were about to leave the office. The teenager on the other end of the line was in so much pain that their words seemed to carve themselves into your chest, joining the collection of other people's traumas that have taken up permanent residence in your heart. You tell yourself it's part of the job – that caring deeply is what makes you effective. But lately, that caring feels more like drowning than healing.
You used to feel energized by your work, passionate about serving your community. Now you catch yourself dreading certain phone calls, avoiding eye contact in the grocery store with families you've worked with, and feeling a bone-deep exhaustion that no amount of sleep seems to touch. The stories of abuse, addiction, suicide, and loss that walk through your door every day have begun to feel like they're happening to you. And perhaps most troubling of all, you're starting to feel numb to pain that should matter – including your own.
If this resonates with you, you're experiencing something that has a name: compassion fatigue, secondary trauma, and/or vicarious trauma. But more than that, you're experiencing the weight that comes with being an Indigenous helper in a community where historical trauma runs as deep as your commitment to healing does.
You're not broken. You're not weak. You're a human being absorbing the pain of a people who have endured centuries of systematic harm, and your nervous system is responding exactly as it should to prolonged exposure to trauma. The question isn't how to stop caring – it's how to care sustainably while honoring both your calling and your own need for healing.
The Unique Weight We Carry
Working in Indigenous communities as an Indigenous person creates a perfect storm for compassion fatigue. Unlike mainstream helping professionals who can go home to communities untouched by the traumas they witness at work, we live within the very systems we're trying to heal. The historical trauma we're helping others process; it lives in our DNA too. The poverty, racism, and loss we witness daily; it's woven into our own family stories.
We carry multiple layers of trauma simultaneously:
Historical Trauma – The intergenerational pain of genocide, forced removal, boarding schools, and cultural suppression that affects every family in our communities, including our own.
Community Trauma – Ongoing losses, crises, and challenges within our small, interconnected communities where everyone knows everyone, and professional boundaries become deeply personal.
Vicarious Trauma – Absorbing the specific traumatic experiences of the people we serve, which fundamentally changes how we see the world and our sense of safety in it.
Secondary Trauma – The stress reactions we develop from prolonged exposure to others' trauma responses, which can mirror symptoms of PTSD even when we haven't directly experienced the traumatic events.
Cultural Trauma – The ongoing stress of navigating systems not designed for us while trying to preserve and revitalize cultural practices that have been systematically attacked.
When Your Medicine Becomes Your Heartache
In many Indigenous cultures, being a helper isn't just a job – it's a calling, often recognized through ceremony, dreams, or family lineage. We're taught that our purpose is to serve our people, sometimes at great personal cost. This sacred calling can become complicated when it conflicts with our human need for boundaries and self-care.
The symptoms of compassion fatigue often sneak up on us slowly:
Emotional exhaustion that feels different from regular tiredness – a soul-deep depletion that rest doesn't touch.
Cynicism and detachment where you find yourself becoming distant from clients, colleagues, or even family members to protect yourself from feeling too much.
Decreased empathy that might shock you – suddenly feeling irritated by people's pain instead of moved by it or finding yourself judging clients for choices you used to understand.
Physical symptoms like headaches, digestive issues, sleep problems, or getting sick more often as your immune system weakens under chronic stress.
Intrusive thoughts about clients' traumatic experiences that invade your personal time, dreams, or quiet moments.
Hypervigilance where you're constantly scanning for danger, checking on people, or feeling responsible for outcomes beyond your control.
Identity confusion where the line between your professional identity as a helper and your personal identity becomes blurred, making it hard to know who you are outside of your work.
The Stories That Live in Our Bodies
In Indigenous communities, we understand that stories have power – they can heal or harm, connect or isolate. The traumatic stories we hear daily as helpers don't just pass through us; they take up residence in our bodies, our dreams, our relationships. We begin to see the world through the lens of all the worst things that can happen, because we've witnessed them happening to the people we care about.
Maria, a social worker on a reservation in Montana (not her real name or community), describes it this way: "I used to love taking my kids to community events. Now I can't look at any child without wondering what's happening to them at home. I scan every adult male for signs he might be an abuser. I've lost the ability to see my community through innocent eyes, and I hate that these cases have stolen that from me."
This hypervigilance, this loss of innocence, is a normal response to abnormal exposure to trauma. But it's also unsustainable. When we carry everyone's pain, we may have little room left for joy, hope, or the simple pleasures that make life worth living.
The Cultural Context of Self-Care
Here's where it gets complicated for Indigenous helpers: contemporary western approaches to self-care often feel selfish or culturally inappropriate. We've been taught that putting our people first is our highest value. Taking time for ourselves, setting boundaries, or saying no to requests for help can feel like we're abandoning our responsibilities to our community.
But our ancestors knew that we've sometimes forgotten: a depleted helper helps no one. In traditional times, healers and helpers were supported by the community precisely because their wellness was understood to be essential to everyone's survival. They weren't expected to pour from empty vessels – they were honored, protected, and nurtured so they could continue serving.
Self-care isn't selfish – it's a sacred responsibility. When we take care of ourselves, we're protecting our ability to serve our people for the long haul instead of burning out and becoming another casualty of the trauma we're trying to heal.
Healing the Healer: Traditional and Contemporary Approaches
Recovery from compassion fatigue requires both professional strategies and cultural healing. Here's what that can look like:
Ceremony and Ritual – Regular participation in sweat lodge, smudging, prayer, or other traditional practices that help discharge negative energy and restore spiritual balance. Each Tribal Nation, cultural and community has their own ways of expressing and healing from grief. If you are unfamiliar with yours, seek out an Elder of Knowledge Keeper.
Connection to Land – Time in nature isn't just relaxing for Indigenous people – it's medicine. Regular connection with Mother Earth helps ground us and reminds us of our place in the larger web of life. She can transform and transmute what we are willing to give to her. If you’re having an anxiety attack, try placing your hands directly on her and ask her to take the burden. She knows how to utilize this energy and send it back up in a healthy way.
Elder Wisdom – Seeking guidance from Elders who understand both the weight of serving the community and the necessity of maintaining balance. Their perspectives can help us reframe our struggles as part of a larger spiritual journey.
Cultural Practices – Engaging in activities that connect us to our identity beyond our role as helper – dancing, drumming, beading, hunting, gathering, or speaking our language are all ways of grounding ourselves in culture as both prevention and healing medicine.
Professional Boundaries – Learning to separate our personal worth from our professional outcomes, setting limits on availability, and creating clear transitions between work and personal life. Our ancestors did this. If you contact a Traditional Healer today, they will tell you when they are and are not available. We need these boundaries to keep ourselves healthy.
Trauma-Informed Self-Care – Understanding that our reactions are normal responses to abnormal situations and developing specific strategies for processing vicarious trauma. Traditional practices went far beyond trauma-informed care; they were holistic and incorporated Spirit. They were both healing-centered and culturally driven. We can bring these practices back to heal our Relatives while also caring for ourselves.
Community Support – Building relationships with other Indigenous helpers who understand the unique challenges we face, either locally or through online networks can be a huge support. People who live in small or interconnected communities face different challenges than those in large cities. Get support where it is meaningful to you.
The Practice of Sacred Boundaries
Setting boundaries as an Indigenous helper requires reframing how we think about service. Instead of being available to everyone all the time, we can practice "sustainable service" – being strategically available in ways that allow us to serve our community over decades rather than burning out in years.
This might mean:
Having specific hours when you're available for crisis calls and sticking to them (except for true emergencies)
Creating rituals to transition between work and personal time
Learning to say "I care about you, and I'm not the right person to help with this right now"
Developing referral networks so you don't feel solely responsible for every person's well-being
Taking regular time away from work or from the community without guilt
Engaging in activities that have nothing to do with helping others
Reclaiming Joy as Resistance
One of the most insidious effects of compassion fatigue is the loss of joy. When we're constantly exposed to pain, it's easy to forget that happiness, laughter, and lightness are not only acceptable but also necessary. Consider how often and how effectively our ancestors used humor to connect. In the context of historical trauma and ongoing oppression, joy becomes an act of resistance.
Our ancestors danced even during the darkest times. They told funny stories around fires, played games with children, celebrated small victories, and found reasons to laugh even when their world was scary or overwhelming. They understood that joy wasn't frivolous – it was fuel for survival.
Reclaiming joy might mean:
Scheduling time for activities that make you laugh
Surrounding yourself with people who remind you that life contains beauty and humor
Celebrating small victories in your work and personal life
Engaging in cultural activities that connect you to the resilience and strength of your people
Practicing gratitude for the privilege of being trusted with people's healing journeys
Creating Healing-Centered Workplaces
If you're able to influence workplace culture, consider how your organization can better support Indigenous staff dealing with compassion fatigue:
Cultural Accommodation – Allowing time for ceremony, traditional healing practices, and cultural obligations without penalty.
Beyond Trauma-Informed Supervision – Training supervisors to recognize signs of vicarious trauma and respond with support rather than criticism. Providing regular support circles for providers to share their stories, humor, and heartache.
Workload Management – Recognizing that working in Indigenous communities with high trauma exposure requires smaller caseloads and more support.
Debriefing and Processing – Regular opportunities to process complex cases in culturally appropriate ways, possibly including traditional healing practices.
Professional Development – Training on vicarious trauma, self-care, healing-centered, culturally driven solutions, and cultural healing approaches specific to Indigenous contexts. When available, ensure that these are specific to yourself, your Relatives (clients), and your community.
Employee Assistance – Access to culturally competent counseling and support services that understand the unique challenges Indigenous helpers face.
The Long Path of Healing
Recovery from compassion fatigue isn't a destination – it's an ongoing practice of balancing service with self-preservation, caring for others while caring for yourself. It requires daily choices to honor both your calling as a helper and your humanity as someone who deserves care, rest, and joy.
Some days you'll get the balance right. On other days, the weight of your community's pain may threaten to overwhelm you. Both experiences are standard parts of this sacred and challenging work. What matters is that you continue to return to the practices that restore you, seek support when needed, and remember that taking care of yourself is also taking care of your loved ones.
Your ancestors survived impossible odds so you could be here, doing this work, carrying forward their commitment to healing. But they also survived so you could experience joy, peace, and the fullness of life. Honoring them means serving your community AND thriving personally.
Your community needs you to model what sustainable service looks like, not what exhaustion achieves. Your family needs you to be present and grounded, not depleted and detached.
You entered this work because you have a healer's heart. Now it's time to turn some of that healing toward yourself. Your heart has absorbed so much pain on behalf of your people – it's time to fill it back up with the medicine it needs to keep beating strong.
The path of the helper has always required great strength. But the most significant strength isn't the ability to absorb infinite pain – it's the wisdom to know when to set it down so you can keep walking forward, carrying your people's hope instead of their trauma, their possibilities instead of their problems.
Your healing matters. Your well-being matters. Your joy matters. Not just because you deserve it – though you absolutely do – but because your community needs helpers who are whole, healthy, and sustainable. The work will always be there. The question is: will you be there to do it, thriving and well, for years to come?
That teenager who calls at 2 AM doesn't just need someone to answer the phone. They need someone who has enough light left in their own heart to help them find their way back to theirs. That light depends on you taking care of the healer within you with the same dedication you bring to caring for everyone else.
Our Culture Is Medicine: Why Indigenous Healing Approaches Transform Modern Workplaces
Discover how Indigenous healing wisdom transforms organizational culture through culturally-driven, healing-centered approaches that go beyond trauma-informed care.
"Our culture is medicine. When we connect people back to their culture, their identity, their language, their ceremonies, that's healing," shared an Indigenous healer in Gabbe et al’s groundbreaking 2012 research on Indigenous approaches to trauma recovery. This profound truth challenges our understanding of healing in modern organizational settings.
While mainstream workplace wellness programs mainly focus on stress management and work-life balance, Indigenous communities have employed holistic healing practices for thousands of years. These proven methods offer transformative solutions for all organizations, particularly those facing high turnover, burnout, and workplace trauma.
The Limitation of Western-Only Approaches
Traditional Western workplace interventions often focus on symptoms rather than root causes. Employee assistance programs, mental health days, stress reduction workshops, and even trauma-informed trainings offer temporary relief. Still, they rarely tackle the deeper cultural and systemic issues that cause workplace harm.
Indigenous healing wisdom understands that true wellness comes from connection – to culture, community, purpose, and identity. When organizations honor these bonds, they foster lasting transformation rather than short-term solutions. They look at the big picture rather than providing a short-sighted bandage.
Holistic Indigenous approaches recognize that mind, body, spirit, and community are interconnected. They don’t just consider these individual components; they understand how they work together. Workplace stress isn't just a mental health issue – it affects physical health, spiritual connections, and community relationships. Effective organizational healing must address all these aspects.
Relationship-Centered Practice offers a fuller perspective. While Western models often focus on individual treatment, Indigenous wisdom emphasizes healing in relationship. Lateral violence, workplace conflict, and organizational trauma are community issues that require community solutions.
Cultural Grounding engages every aspect of the human experience. Every organization has a culture, and each culture has its strengths. Indigenous approaches help organizations recognize and develop their existing cultural assets, rather than imposing external solutions.
Prevention Over Crisis Response promises a long-term solution. Traditional Indigenous practices emphasize maintaining wellness rather than reacting to crises. Organizations that adopt this approach experience lower turnover, higher morale, and stronger community bonds.
Organizations implementing culturally driven, healing-centered, holistic approaches will see significant improvements:
Enhanced Team Collaboration: When teams recognize lateral kindness versus lateral violence, they foster supportive rather than competitive environments.
Improved Leadership: Indigenous mindful leadership principles assist leaders in making decisions that consider seven generations of impact.
Reduced Burnout: Holistic strategies for preventing vicarious trauma help helpers and healers maintain their work.
Stronger Community Connections: Organizations that respect Indigenous wisdom foster trust with the communities they serve.
The Science Behind Ancient Wisdom
Recent research confirms what Indigenous communities have always known. Studies show that culturally grounded healing methods are more effective than Western-only interventions for Indigenous populations (Rodaughan et al., 2024). When people feel connected to their cultural identity, they demonstrate greater resilience, better mental health, and stronger community bonds.
Neuroscience research confirms Indigenous views on trauma and healing. The mind-body-spirit connection that Indigenous traditions highlight aligns with our current neurobiological understanding of how trauma impacts the entire person, not just the mind.
Moving Beyond Trauma-Informed to Healing-Centered
Trauma-informed care asks, "What happened to you?" Healing-centered approaches ask, "What's right with you?" and "How do we build on your strengths?" This shift from deficit-based thinking to a strength-based practice transforms an organization's culture.
Healing-centered organizations do more than prevent re-traumatization – they actively foster environments where individuals can thrive. They acknowledge that each person brings wisdom, resilience, and cultural strengths to their work.
Implementing Indigenous Wisdom in Your Organization
Start with Building Relationships: Begin by establishing genuine connections with Indigenous Knowledge Keepers, Elders, and community leaders. This isn't about appropriation – it's about respectful learning and partnership from key community members through consistent, respectful relationship-building over time.
Honor Existing Strengths: Every organization possesses cultural wisdom and community ties. Indigenous approaches help you recognize and build on what is already effective. Evidence shows that focusing on strengths will boost productivity, team morale, and retention.
Think Seven Generations: Reflect on how your decisions affect employees, communities, and future generations. This traditional Indigenous principle demonstrates what all organizations aim for – sustainable, positive change. Research shows us that it's not just money or respect that employees value – it’s the impact on their families and communities that fosters loyalty.
Embrace Holistic Practice: Address workplace wellness from multiple dimensions – mental, physical, spiritual, and community bonds. Make space for ceremony, cultural expression, and meaningful community involvement. When we can bring our authentic selves to the workplace – and that is reflected back to us through what we see, hear, smell, and taste - we are more hopeful and productive.
Indigenous healing methods offer profound wisdom for today's organizational challenges. By recognizing that culture is medicine, organizations can move beyond surface-level fixes to foster lasting change. We understand that culture serves as a form of prevention and healing. Let’s harness it where we need the most help in our organizations.
The question isn't whether your organization needs healing – every workplace has experienced some form of trauma, conflict, or disconnection. The real question is whether you're ready to adopt approaches that honor the whole person and foster conditions for collective thriving.