This story discusses topics of suicide, abuse and self-harm.

"When you survive abuse and you turn to alcohol and drugs and self-harm and sex and all of the vices that we use, you start to carry a shame and you wonder if you even deserve to be healed. Are you worthy? Are you worthy of good things? Are you a good person?"

Mandi Howard says that kind of shame and self-doubt have tormented her throughout her life.

Starting as a child, she survived experiences that deeply marked her psychology.

"The loss of parental figures through death or just leaving. I survived sexual abuse from the time I was very young until my teens. I survived killing myself, multiple, multiple, multiple times of suicide attempts and the self medicating, the self harm... I survived myself."

Mandi is Mi'kmaq, originally from Eel River, N.B.

Mandi Howard, a client of Aboriginal Services at Toronto's Centre for Addiction and Mental Health, experienced a releasing ceremony under the guidance of elder, Cynthia White. (CBC / Marc Apollonio)

Now, she lives in Toronto, where she works as a nurse.

Each week, Mandi heads to the Centre for Addiction and Mental Health (CAMH) in downtown Toronto, for psychological support.

Specifically, she heads to CAMH's Aboriginal Services department where — in a group setting — she receives traditional Indigenous healing from Mohawk elder, Cynthia White.

Today, Mandi's group is undergoing a special ceremony, one that has been in the works for some time: a releasing ceremony.

In downtown Toronto a crane towers over the structure of a sweat lodge in the Aboriginal Services ceremonial grounds at the Centre for Addiction and Mental Health. (CBC / Marc Apollonio)

Several weeks ago, Cynthia, the elder, asked the group to begin focusing on the thoughts, memories and feelings that cause them distress; she asked them to write them down on a piece of paper.

Today, Cynthia's clients have come with their pieces of paper.

Mandi says the things she wrote down — the thoughts and fears that cause her the most anguish — are all about self doubt.

"My fear of abandonment, my fear of being alone, of always feeling like I just don't add up to enough for other people, that no matter how hard I try, no matter what I put out, no matter what intention I walk with, I feel invisible."

Cynthia White an elder with Aboriginal Services at Toronto's Centre for Addiction and Mental Health. (CBC / Marc Apollonio)

There are six clients in this group, including Mandi; four women and two men.

Cynthia has them gather around in a circle and then performs a pipe ceremony.

The group smudges and sings.

Cynthia brushes them with an eagle feather.

As the preparations for the releasing ceremony continue, Mandi's distress is visible: she's shaking and crying.

Cynthia gets her clients to wrap their paper lists in small squares of red fabric; they also add tobacco and other sacred medicines.

The group moves out to CAMH's Aboriginal ceremony grounds — a small yard sandwiched between the walls of the hospital and a large, noisy construction site — and lights the sacred fire.

Cynthia prepares the group with more instructions and then begins to sing.

Mandi and the five other members of the group take turns approaching the fire and throwing in their small red bundles.

They take their time, appearing to be working through big emotions, several of them breaking into tears .

"Once we got to that fire and we started to sing the Mi'kmaq Eagle Song, the sun came out, grandfather sun came out, kissed warmth on my eyes and I stopped crying and I knew that it was finally okay. It was okay to let it go. And that's the moment when I walked around the fire and knelt down and gave thanks for that moment and thanks for that validation that I'm ready."

Cynthia leads her clients back inside; the atmosphere is clearly lighter than before the releasing ceremony.

"I let it go and all I could do was smile after," says Mandi. "It really does feel like a weight is lifted off your soul."

Back inside, everyone takes up a drum and begins singing traditional songs.

Thunder Water Woman, a participant in an Indigenous healing ceremony performed by Aboriginal Services at the Centre for Addiction and Mental Health in Toronto. (CBC / Marc Apollonio)

Some of them know the words to the songs; others follow, by reading the phonetically spelled-out words on pages in a plastic binder.

Frequently, they mess up the words or lose the rhythm on their drums. Everyone laughs.

Mandi says however significant the releasing ceremony might be, for her, it's just one step in a long process.

But she says, she's deeply committed to following the Indigenous method of healing.

"I have a long, long road ahead of me to let go of a lot of things that I hold," said Mandi. "But slowly I'm learning just how incredible I really am, like in a very non-conceited way ... And realizing that all the things I thought my whole life made me different, are really what my people still are gifting to me in my blood and memories and my dreams."