As a child and adolescent psychiatrist, I have had the honor of working closely with the Lakota community on the Pine Ridge and Rosebud Indian Reservations, as well as with young people from several Arizona tribes including the Tohono O’odham, Pascua Yaqui, and Navajo communities.

In the Lakota language, the sacred phrase Mitakuye Oyasin, which is translated as “we are all related” or “all my relations” says it all. When we honor each other, when we keep our egos in check, when we humble ourselves for the imperfect beings we all are, that’s when we can feel truly at peace, connected, loved, and have a sense of belonging to the rest of life.

When President Trump invoked the name “Pocahontas” to slur Sen. Elizabeth Warren, it provoked further emotional and psychological trauma for a people that have already been persecuted and marginalized by the government for generations.

Historical and intergenerational trauma, rooted in the genocide and cultural genocide that went on for decades, continues to impact the individuals, families and communities who survived. The contemporary science of epigenetics informs us of the physiological and biobehavioral mechanisms behind the statement “pain that is not transformed, is transmitted.”

Epigenetics is the study of how changes in genetic expression can occur based on environmental factors. Life experiences can change the health of individuals and these changes can also impact the health of their descendants. Sustained high levels of stress are known to contribute to such patterns, and research has demonstrated biological changes in the offspring of trauma survivors in populations ranging from Holocaust survivors, to individuals directly impacted by the 9/11 attacks, to American Indian populations. The good news is that these changes are reversible when people experience positive, nurturing and correcting life experiences.

Many American Indian children, adolescents and young adults are struggling to rise above extreme life challenges. Staggering rates of poverty, abuse and neglect, violence, drug abuse and suicide continue to take an unimaginable toll on these communities.

For example, the Indian Health Service reports rates of all causes of mortality in American Indians at 1.3 times higher than the national average, diabetes at three times higher, liver disease and cirrhosis at 4.8 times higher, and suicide at 1.7 times higher. In 2010, the American Psychiatric Association reported that three times as many American Indians lack health insurance compared to whites.

A majority of American Indian youth and families do not trust conventional mental health treatments offered, and there is a growing need for culturally-congruent, skill-building and empowering ways of providing mental health services for these communities.

Over the past seven years, a program of mind-body skills training for professionals in American Indian communities has been developed by a team from the Center for Mind-Body Medicine. This model, based on self-care skills training in small groups, involves training American Indian teachers, counselors, healthcare providers and community leaders in the science and practice of mind-body medicine techniques to better care for themselves. It also teaches them how to facilitate small groups using this model for children, teens and adults in the community. The techniques include meditation, guided imagery, biofeedback, emotional expression through the use of writing and drawings, mindful eating and nutrition, and movement.

Evidence-based in reducing stress, burnout and symptoms of post-traumatic stress disorder (PTSD), the model bridges the gap between indigenous practices that promoted mind-body-spirit connection with the emerging science of trauma recovery and resiliency. The skills help build a toolkit to promote better self-care, self-awareness and empowerment, and the small groups allow for a sense of safety, connection and mutual support for the participants and facilitators alike. Trained facilitators within the community weave the cultural needs of the community into their groups, making it their own, while receiving ongoing supervision and support as they hone their facilitation skills. With guidance from multiple tribal members and elders, the model has been piloted and shown to be a good fit for American Indian populations.

Support from several philanthropic foundations including Battery Powered, Swift Foundation, Windrose Fund, Mimi Fund, FISH Foundation, Open Road, and George Family Foundation has been instrumental in spreading and expanding the work to Pine Ridge, Rosebud and other tribes. The Little Wound School, a K-12 school on the Pine Ridge Reservation, was recipient of a three-year Administration for Native Americans grant for a first large-scale program of training professionals working with youth in schools to incorporate this work into the school curriculum for thousands of students in seven tribal schools on the reservation.

In these trainings, I have heard the stories of children and teens who find a safe space to share and process their grief, fears and anger, some for the very first time. I hear their dreams to help their relatives to heal and rise above pervasive struggles. I hear their empowered voices rising up with visions for their future: to become president of the United States, to support the downtrodden, and to be a just voice for the underserved.

Perhaps most profoundly, I hear the younger generation being able to reconcile modern science with wisdom of their ancestors and cultural practices that promoted resiliency to their people for thousands of years. One teenage girl who courageously shared about her trauma in a group made up of adults and teens said, “I never thought adults in my life would understand me; here I feel understood.” Another teenager felt safe enough to ask “What is poverty? Am I living in poverty?” while the group members supported her to find her own voice and answer to these simple yet profound questions.

I’m not American Indian, but I come from Iran, another indigenous ancient tribal community that has been ripped apart by outside influences, wars, religious fanaticism and oppressive regimes. Each of these communities has a wealth of culture, wisdom, language, ceremonies and rituals that have brought strength and resiliency to the people for many generations. For thousands of years, they have embodied living in a sacred way that is fully connected to nature, honoring all living beings, animals, plants, water and the earth itself as part of an interconnected web, filled with meaning, authenticity and beauty.

What is needed is to have the culture, heritage and ways of life of American Indians honored. We need a formal and authentic apology from President Trump and the government, in addition to reconciliation, and acknowledgement of the reality of historical trauma and the oppression from colonialism.