Reaction

The Counseling Psychologist

38(2) 236­–242
Moving Toward © 2010 SAGE Publications
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DOI: 10.1177/0011000009345532
Psychotherapy http://tcp.sagepub.com

Gerald V. Mohatt1

Unshimala yo hecel lena oyate ki nipiktelo.

[Have mercy upon us so that the people may live!]

A Lakota Sun Dance song

In 1951 the anthropologist and psychoanalyst George Devereux wrote

Reality and Dream, on his analysis of an American Indian patient. In the
prologue to the book, he summarizes his approach as such:

Whatever happened between Jimmy and myself on the personal level

happened between two men of good will and concerns only us: it con-
cerns two men united in a quest for common sense and common
decency by their common humanity, whose cornerstone is the individu-
ality of each of us. (p. xxxiv)

Although his statement may appear in stark contrast to the richness of cultural
description seen in Joe Gone’s article (2010 [this issue]) on the potential of
integrating traditional healing and psychotherapy, Devereux sees enormous
diversity in cultures; therefore, an interest or an investment in an aspect of
culture (such as the healing process) does not in and of itself tell us much.
Rather, it is the “meaning or the culture’s ethos” (p. 73) that is informative.
It is a nuanced view of the functioning of culture that Gone utilized to
compare two Native American healers to understand the healing process.
Gone is able to elucidate the dilemmas faced in developing an indigenous
psychotherapy, or counseling method, by comparison and contrast between
1
University of Alaska Fairbanks

Corresponding Author:
Gerald Mohatt, 311 Irving/IAB, Fairbanks, AK 99775
E-mail: gvmohatt@mac.com
Mohatt 237

a medicine man and an American Indian psychotherapist. It is this interplay

of seeking to find the human without separating the person from his or her
culture that defines much of Gone’s attempts to build a theoretical structure
for developing an indigenous psychotherapy. In other words, each healer
appears to resonate with the ethos of the Sun Dance song quoted above.
Bull Lodge (who is aroused by his compassion and pity for Yellow Man)
and Duran (in his work directed at the soul wounds) are both determined to
see that their work will allow the people to live. They show remarkable
compassion in their dedication to healing. So, too, does Gone with this most
thoroughly researched article. His effort demonstrates the same compassion
and the same desire proclaiming that the community’s vitality will grow—
that the people will live. One cannot say enough about the import of this
quality of compassion and pity as the point of departure for understanding
what it means to be a healer.
In my commentary, I focus on a number of issues that Gone raises that
I think are critical for Gone and others to move to the next stage of systemati-
cally identifying the processes and structure for a psychotherapy that comes
out of this land, this earth, and its First People in a place called America. My
sense is that he has identified many of these elements in his previous writings
and in this extensive comparison of approaches to build a theory for an indig-
enous approach to psychotherapy and counseling.

Grounding in Clinical or Healing Work

What appears missing in Gone’s work is a grounding in clinical realities.
There are no case examples from his clinical work that allow us to see how
he used his theory or attempted to integrate traditional knowledge into clini-
cal work. Although this article proposes to glean (from the comparison of
Bull Lodge and Duran’s healing work) a theoretical framework for an indig-
enous counseling, he elucidates more the inherent dilemmas that come from
cross-cultural differences between indigenous Gros Ventre healing and psy-
chotherapy and less an actual synthesis of the theory. Although I was looking
for more, I was most impressed with the careful research that he is doing, and
I believe that it will lead to theory. I think that he should ground and test his
theories in clinical work even if it is not his clinical work per se. Such a proj-
ect will have an enormous impact on the training of psychotherapists and so
lead to new methods of practice. For the majority of my commentary, I reflect
on what I think are the bedrocks of his theory that could guide the develop-
ment of a practice. I also want to comment on it from my own experience of
many decades of working with Lakota healers.
238 The Counseling Psychologist 38(2)

The Making of a Healer

Gone describes with beautiful detail how Bull Lodge and Duran were men-
tored and immersed in the experiences of transformation. Bull Lodge talks
much about his sacrifices and struggles that transformed him and gave him
access to power through contact with the “other than humans.” Gone did
what Katz (1982) did in describing how the K’ung become healers; he then
applied it to the concept of experiencing and acknowledging vulnerability as
key events in one’s transforming from a person to a healer. Each concept is
part and parcel of a new paradigm for training of healers. We need to ask our
students to closely examine where their desire to become healers originates.
What is the source of their power? Do they know what motivates their desire
to heal or to enter the profession of counseling or psychotherapy? Skills are
not eschewed in the training of either Bull Lodge or Duran; each focuses on
the transformation of the person rather than on only the acquisition of skills.
It is this attention to the transformation of the student, apprentice, or mentee
that will allow the future therapist to situate himself or herself as healer. This
attention to transformation and spiritual development should be a point of
departure for the training of contemporary counselors and psychotherapists
in the type of counseling that Gone is proposing.

“The Scrupulous Preclusion of Malignant

Intent and Ritual Malfeasance . . . ”
Gone calls for a transformation from a colonial perspective of pathology to an
understanding of the spirit and soul dimensions of a therapeutic relationship.
Two now-deceased medicine men, John Fire and Joe Eagle Elk, were both
clear that engaging in becoming a healer and practicing is fraught with danger.
The Duran soul psychotherapy calls our attention to the potential harm of
therapy and to the need for the transformation of the future therapist as an
antidote; such transformation should begin and continue for the therapist. In
my experience, it is central to all American Indian healing practice—an aspect
from which we speak is scope of practice: The healer talks about never going
beyond the requirements of his vision, never seeking or accepting cases that
are beyond the power that he was given; to do so risks harm to oneself and
his patient. Eagle Elk always said that one can make mistakes in conducting
a ceremony and that one might be clumsy and bashful about his work but that
the key is the intent and the substance. One must continually sacrifice oneself
so that one is humble and can resist the inevitable pull toward hubris, toward
thinking that the power is his and not a gift from another. One needs to continue
Mohatt 239

his transformation so that, if ready, he can receive the power to treat more seri-
ous illness. Clearly, Bull Lodge and Duran both understand this and are
scrupulously careful in their intentions and actions.

An “Effortful Concentration of Will”

Gone discusses what a Lakota medicine man told me was the most important
constituent of the healing ceremony. Eagle Elk told me that the power came
to him only infrequently and only when all attending the ceremony were of
one mind (see Mohatt & Eagle Elk, 2000). Those who participate in the cer-
emony must neutralize their idiosyncratic desires so that a single desire is
present for the healing of the person who sponsored the ceremony. This is
what will focus energy and bring the sacred power. He said that we should
not be praying for our auntie or for our sore toe but rather focusing all our
thoughts on the need of she or he who sponsors the ceremony. This fits well
with developing a counseling and psychotherapy that create a space in which
only the person and his or her needs are present. It allows our countertransfer-
ence to be useful in understanding the other and allowing him or her to speak,
and it allows for the therapist to respond to the patient and not to another.
Again, in our training of contemporary therapists, we need to help them to
discover how to create a neutral place for the client to speak without the
therapist’s theory or desire interfering. The idea of an effortful concentration
of will captures the challenge that we face to create this space for clients.
A significant factor that Gone discusses with great precision is that the effi-
cacy of healing comes from the “other than humans.” It is present because of
the relationship of the healer to these powerful forces and because of the pres-
ence of a community with a single desire for the healing of a person who
mobilizes a space in which power can work. Gone’s summary captures for me
the essence of the process: “In sum, the efficacy of traditional healing depends
wholly on the interpersonal rather than on the mechanistic, on the relational
rather than the technical” (p. 206). What challenges us in contemporary psy-
chology is how to understand power and spiritual forces. Our focus has
become so secular that the mystery of the healing process is often reduced to
the acquisition of skill rather than character, reflexivity, and spiritual intuition.
Gone does a service in bringing out the inherent areas of conflict that limit the
application of traditional healing to modern psychotherapy and the education
of healers rather than therapists. These barriers should not distract us from
seriously discussing the issues that he raises.
Gone’s comparison with Duran’s soul wound psychotherapy raises even
more significant questions about how feasible it is for a modern psychotherapy
240 The Counseling Psychologist 38(2)

to be based on traditional healing. His work is based firmly in a psychoana-

lytic perspective, as coupled with a deep spiritual understanding of healing
that originates from his work with traditional American Indian healers.
Gone questions whether there is the possibility to develop and evaluate a
new psychotherapy like Duran’s, and he indicates that Duran has similar
doubts about Western science’s evaluating a spiritually profound practice. But
let us just propose, as Gone suggests, that it is worth the effort to try. What
then is the task?
The article raises a number of key issues that are inherent in articulating a
practice from the theory. First, each traditional healer has his own inimitable
approach based on his vision. What does this imply for the development of
the psychotherapist? Will she or he have such a unique, if not idiosyncratic,
take on the common elements of healing that no common center of practice
can develop? My sense is that Gone and Duran are defining a center with
some critical common elements that could guide articulating a new form of
psychotherapy based on traditional healing.
Second, the efficacy of healing is spirit and the relationship to the “other
than humans.” This demands spiritual development, consciousness, and
intuition. Is there any possibility that a university or professional school would
take on this type of roll? Some places have tried; perhaps, the closest have been
some of the doctoral training programs in existential psychology—namely, the
Naropa Institute’s master’s program in contemplative psychotherapy and the
Indian Federated College of Saskatchewan’s masters in traditional psychother-
apy. So, others have tried; some have failed; but the effort remains alive.
Third, a methodology that can evaluate effectiveness and efficacy cross-
culturally may be the biggest hurdle, but I tend to be an optimist and so
believe in the great work coming from psychotherapy research groups (see
Luborsky & Crits-Christoph, 1990; Strupp & Binder, 1984; Weiss, 1993)
who are positing models for evaluating therapy using process methods rather
than the more cookbook-manualized approaches that have dominated con-
temporary evidence-based practices. I am not so sanguine as to think that this
task would be easy, but I think that it is critical to try. The question, then, is
why, as it relates to the cultural specificity issue that Gone raises.
Fourth, the development of an indigenous psychotherapy can and should
affect everyone given that it will speak to our deepest experiences as human
beings. It will touch soul and spirit, emotion, cognition, and the physical. It
will touch Native and non-Native alike because, in my assessment, the con-
cepts that Gone has outlined are issues not bound by culture. They concern us
as human beings or, as the Lakota say, the common person, ikce wicasa. So,
we should see the development of this type of therapy as transforming the
Mohatt 241

field and not only as a culturally specific form of therapy. My sense is that
Duran’s practice will work just as well for a non-Indian as it will for a tribal
member.

Summary
Gone has given us much to reflect on. He has begun to articulate a thorough
theory of healing that I think has great implications for the development of a
counseling and psychotherapeutic method rooted in the cultures of this land.
I think a few things are missing, such as humor and its place in healing, irony
as a form of humor, and a careful understanding of how the words of the
healer carry great power. Yet much is present in this wonderful piece of work
that calls on Gone and others to take it forward, beyond theory, to articulate
the principles in a way that leads to a practice that can become a stable part
of our repertoire of therapeutic practice with evidence on its effectiveness
and efficacy. Finally, I want to quote Thomas Carlyle from his book Past and
Present, which I found in a book by Shaffer and Barrows (2009) called The
Guernsey Literary and Potato Peel Pie Society, that summarizes the import
of this task of creating a psychotherapy of the soul:

Does it ever give thee pause, that men used to have a soul—not by
hearsay alone, or as a figure of speech; but as a truth that they knew,
and acted upon! Verily it was another world then . . . but yet it is a pity
we have lost the tidings of our souls. . . . We shall have to go in search
of them again, or worse in all ways shall befall us. (p. 101)

Declaration of Conflicting Interests

The author declared no conflicts of interest with respect to the authorship and/or pub-
lication of this article.

Funding
The author received no financial support for the research and/or authorship of this
article.

References
Devereux, G. (1951). Reality and dream: Psychothearpy of a Plains Indian. New
York: International Universities Press.
Gone, J. (2010). Psychotherapy and traditional healing for American Indians: Explor-
ing the prospects for therapeutic integration. The Counseling Psychologist, 38(2),
166-235.
242 The Counseling Psychologist 38(2)

Katz, R. (1982). Boiling energy: Community healing among the Klahari K’ung.
Cambridge, MA: Harvard University Press.
Luborsky, L., & Crits-Christoph, P. (1990). Understanding transference: The CCRT
method. New York: Basic Books.
Mohatt, G. V., & Eagle Elk, J. (2000). The price of a gift: The life and teachings of a
Lakota medicine man. Lincoln: University of Nebraska Press.
Shaffer, M. A., & Barrows, A. (2009). The Guernsey Literary and Potato Peel Pie
Society. New York: Dial Press.
Strupp, H., & Binder, J. (1984). Psychotherapy in a new key: A guide to time-limited
dynamic psychotherapy. New York: Basic Books.
Weiss, J. (1993). How psychotherapy works: Process and technique. New York:
Guilford Press.

Bio
Gerald V. Mohatt has worked with American Indian, Canadian First Nations, and
Alaska Natives since 1968. He was born and raised in the Midwest, Iowa and
Nebraska. In 1962 he first visited the Rosebud Reservation in South Dakota and
returned in 1968 to stay for the next 15 years working to establish the tribal college,
Sinte Gleska University. In 1983 he and his family moved to Alaska where he has
been since. He is Professor of Psychology and Director of the Center for Alaska
Native Health Research at the University of Alaska Fairbanks. He received his bach-
elors and masters degrees at St. Louis University and his doctorate at Harvard
University. Throughout his career he has focused on building new settings in rural
areas to increase opportunity for rural indigenous groups and research to increase our
knowledge base to design better methods of prevention and treatment. His research
and writing has been in the area of obesity and chronic diseases, resilience and sub-
stance abuse, cross-cultural healing, the ethics of research with indigenous groups,
and reform of schooling to increase success for Alaska Native and American Indian
children. Currently, he is conducting prevention research funded by NIH to create
evidence based practices directed at preventing alcohol abuse and suicide risk among
Alaska Native youth and their families.