- Barbara Mainguy, MA, MSW|Lewis Mehl-Madrona|Patrick McFarlane, LCSW, PMH-NP, FNP
- Alana Holt, BSN, MD, FRCPC, Psychiatrist, Clinical Practice Lead, University of Saskatchewan, Saskatoon, Saskatchewan, Canada|Kyle Schwartz, BSW, MSW, RSW. Social Worker, Student Wellness Centre, University of Saskatchewan
- Patrick McFarlane, LCSW, PMH-NP, FNP
M’iqmaq Elders Albert and Murdena Marshall of Eskasoni First Nation in Nova Scotia invented the expression “Two-Eyed Seeing” around 2003 to describe a unique collaboration at Unama’ki-Cape Breton University in Sydney, Nova Scotia) of indigenous knowledge keepers and academically trained scientists. In two-eyed seeing, one eye looks from the perspective of traditional Indigenous knowledge and epistemology, while the other gazes from academic scientific knowledge and epistemology. The goal was to reverse the privileging of academic knowledge and the dismissal of indigenous knowledge. The concept is represented by the word Eptuaptmunk in Albert’s language. Two-Eyed Seeing is spreading across Canada and is becoming more mainstream. In philosophy, the concept has been called “explanatory pluralism,” a term that suggests that more than one level of explanation exists for any phenomenon, that all levels may be equally valid, and that any given level need not make sense from the perspective of another level. This contrasts with the driving philosophy of contemporary biomedicine of positivism (one most correct answer exists and the conventional scientific paradigm will find it), reductionism (more fine-grained explanations are better), and the idea that one can control the world in order to perform experiments. Why does this matter for aiding indigenous people with addictions? Historically, the biomedical paradigm has not reached indigenous people well. Their philosophies are more holistic, implicitly aware of whole systems thinking, and aware of contextualizing behavior within communities and of interdependence and inter-relatedness. The biomedical approach has been individual, while a community-based approach can be more successful for indigenous people. We discuss the results of our interviewing traditional elders, holding talking circles in communities about substance use, creating a zoom forum in the days of coronavirus for discussions about indigenous approaches, and discussing with colleagues in indigenous contexts how to proceed. We found that a narrative approach in which we collaboratively create a story to explain the addiction that takes into account concepts of threat, power, and meaning and is grounded in an understanding of the effects of trauma (historical and contemporary) was well acceoted. Within this approach, a healing narrative is constructed which serves as a map for the person to move from being under the influence of a substance to being free from its influence. The idea of creating a community of recovery emerged as quite important for people recognized that being around substances leads to substance use. Some key concepts were important — that a substance has a spirit that must be recognized and respected, that addictions are passed to the next generation if not resolved in the current generation, and that people who use substances must be seen in the context of the suffering of the entire community.
- list three ways in which indigenous communities see the helping professions role in substance use differently from the biomedical paradigm.
- define two-eyed seeing and describe its history
- discuss ways in which substance use programs can be modified to achieve greater acceptance in indigenous communities.