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Walking the Red Road: Indigenous Healing for Trauma and Addiction


Indigenous ways of life promote interconnectedness to all things on earth and beyond, recognizing that we are inherently connected to everything and everyone at once. In the Native way, change is seen within the context of a circle. The circle implies connection to Creator first and foremost, and only from this sacred place can we find balance within ourselves and connection to unci maka (earth) and each another. The process of healing our families and communities takes many different individuals and systems actively integrating cultural lifeways into mental health and substance use treatment models.

Over the last five hundred years across the United States, American Indian people have endured waves upon waves of structural oppression. From forced removal from Native land, massacres, and the outlawing of cultural and spiritual ways of life to the establishment of boarding schools to systematically assimilate Native children (Little, 2018), the American Indian people survived. In 1879, the United States government established the first boarding school: Carlisle Indian Industrial School in Pennsylvania (“Past,” n.d.). There would eventually be 367 boarding schools across the United States tasked with assimilating American Indian individuals, according to the National Native American Boarding School Healing Coalition (n.d.). Structural racism forced American Indians to live with fear of being hurt physically, being attacked, or fearing for their lives if they spoke their native language and lived their ancient ways of life. Federal laws even exist that discriminate specifically against this population (Heinsius, 2019). The past has left a lasting impact on this community and its members’ mental health intergenerationally. Often called “epigenetics,” there is scientific proof that the memories and experiences of our ancestors are passed down to us in our DNA. Today, many descendants of those who endured historical trauma live with the long-term effects: posttraumatic stress disorder (PTSD), depression, shock, and grief (Schiele, Gottschalk, & Domschke, 2020; SAMHSA, 2014).

A Personal Story: J. Carlos Rivera

I have faced many adversities in my life, and they have ultimately guided me to resiliency, discipline, and a sense of direction. I was raised without both my parents and became a ward of the court at age thirteen, resulting in me spending most of my adolescent years in treatment programs, group homes, and youth authorities. Through the process of treatment and recovery I found a greater purpose in life that inspired and motivated me to establish a healthy foundation for my family. Today I am proud to celebrate sixteen years on the Red Road (i.e., sobriety, long-term recovery), and I dedicate myself to supporting others on their own healing journeys.


Overall, our mental health in Indian country is very unpredictable, and even when things are good the pain is still there. The spirit of trauma is there, waiting to be activated, but it is not just the trauma; it is also the grief. Grief can be triggered by relationships within families and sometimes relationships can be so fragmented—it is often challenging to be in good relationships with others.

Parents are often teaching themselves to be the parents they want to be to their children, but they were never given the opportunity to be children themselves. Both men and women must acknowledge this for themselves and learn to heal from the trauma both that they have experienced in their lifetimes and that they have inherited. Intergenerational trauma shows up in many ways, including addiction, depression, child abuse, domestic violence, and suicide (SAMHSA, 2014). Rivera reflects on stories shared by those he has supported on their journeys through grief and recovery from trauma: “Every human being wants to feel a sense of belonging, but so many of us spiral into questioning our worthiness, into addiction, into depression, into not valuing our own lives. The pain is so deep that you do not want to feel it anymore. It is that hurtful and that painful that you do not want to be here anymore.” Over time each person will learn how to respond in their own time, in their own way. During that time, mothers and fathers may have to step away from their children to process and learn about where the trauma comes from, how to break the cycles of violence and pain, and how to heal by connecting with approaches that reflect American Indian values and ways of knowing.

There are a lot of challenges facing American Indian and indigenous communities today. The knowledge and understanding that there are choices is an indicator that the transformation of trauma is in progress. “Each of us have arrived where we are at today because our experiences that have shaped us into who we are,” Rivera shares. “I need not be afraid of facing whatever challenges that come up from my grief and trauma. In ways, I invite it because I know that the more I heal, the more happiness I am going to receive.” Rivera also explains that “I want to have as many complete relationships as possible. When my mom died in 2010, our relationship was complete and I said everything I needed to say to her before she died. I said, “I love you, I am mad at you, and I forgive you.’”

Understanding American Indian Clients

There are many theories, concepts, and interventions in modern clinical psychology that are effective for individuals presenting with mental health and/or addiction issues, but that do not typically encompass indigenous philosophy and teachings, often leaving some clients going through treatment feeling not seen for who they are or misunderstood entirely. This is the first misstep that many facilities, providers, and counselors make when working with American Indian relatives (i.e., clientele). Treatment is a doorway into change, hope for healing, and creating a new vision for the future. In therapy we seek to not only explore our internal world to build insight, but also to learn new skills in order to create new habits and behavioral change. Within the circle, everyone is a participant in sharing; even as listeners they are witnessing and supporting healing as a community. Circles allow for fathers, mothers, sisters, brothers, aunties, uncles, cousins, grandparents, friends, and extended family to share their stories for themselves and for each other to heal from the past and be in the present by acknowledging the shared trauma from multiple perspectives. Rivera shares, “What we are doing today—from right here and back home, up north and south—is sharing a story of a lot of our people. We have made spiritual agreements to help, but we are living with the trauma we are working through to heal and show up as helpers.”

Although we often highlight the grief that was passed down to us generationally from our ancestors, they also passed down resiliency from generation to generation. Across the nation, circles are creating safe spaces where American Indian people can show up to support each other. Rivera states:

We are letting ourselves be seen and heard within indigenous communities as people who have needed help and who are able to support others on their healing journeys. We are healing with others while we are still healing ourselves. Outside of circles, we often keep ourselves from others for fear of being categorized and being judged. This is because we have a long history of being misunderstood by western society for our beliefs, our remedies, and our cultural ways.

In the indigenous world, there is a very real fear of being not strong enough, not reliable, or too emotional. But we must ask ourselves: Why are we unable to openly talk about these struggles without being considered damaged goods? There is so much to be learned from circles, where people can share freely their past, their present, and their future. We have learned that there are rules, and right and wrong ways. We have been socialized by school and the modern society, but the concept of failure is not ours. There is no fear of failure in indigenous ways of knowing, only the best- versus worst-case scenario. This is resiliency.

Circles are safe spaces for transformation and healing to occur. Rivera notes that American Indian and indigenous people “have the skills and solutions to heal today and the option to heal with space to do things that our grandparents did not have the space to do. The only thing holding us back is ourselves. Our own thinking and our own unresolved pain and grief are holding us back from healing, and learning the culture and traditions.”

The Red Road

Reinventing what healing looks like for American Indian people today is defined by their communities individually and uniquely. Like sacred ceremonies, traditions, and cultural knowledge, the misinterpretation and outlawing of Native ways of knowing does not change its value and validity, past or present. “Today we are not justifying, we are not asking for permission to do it,” Rivera reflects. In western culture, the role of “counselor” is often earned by going to college and earning a degree. But in indigenous communities, trusting someone with your thoughts and opening yourself up to healing together requires trust and honesty with yourself and others. One way American Indian and indigenous people access this is on the Red Road.

Today, Rivera passes on the teachings from circles through his organization Generation Red Road. The mission of Generation Red Road is to revitalize and promote intergenerational healing by utilizing indigenous teachings that provide harmony for individuals, families, and communities. With various approaches, theories, and interventions being brought to the forefront every few years in the mental health and substance use fields, it is an honor to share more about traditional indigenous teachings that have brought healing and hope to many people across the globe for decades. The Red Road approach was developed in 1980 by Gene Thin Elk, Lakota from the Great Sicangu Nation (Rosebud Sioux Tribe), to address disparities in the substance use field as it relates to the American Indian population (Thin Elk, 1993). Thin Elk went through treatment and found his sobriety in the early 1980s, and after connecting to others seeking sobriety he began to develop a treatment model based upon spiritual and cultural components that addressed addiction and mental health issues. Thin Elk is an internationally known consultant of indigenous healing methods dealing with recovery from substance abuse and psychological trauma. He originated the Red Road approach from therapeutic and holistic healing processes by incorporating the modern medical model of addressing disease into the traditional Lakota cosmology and healing methods that address the disease of personhood and social structure.

“Walking the Red Road” means to live a life free of drugs and alcohol along with practicing cultural ways of life to bring more balance and fulfillment internally and within our relationships. The Red Road is the intersection between the spiritual and physical worlds in which we know Creator and our ancestors continue to guide us with their love and energy so we can experience the physical realm in beautiful and powerful ways. It is a road for anyone and does not carry judgment or imply perfection. It is a way of life that individuals can make their own, and that promotes wellness, connection, and a focus on the next generation. Walking the Red Road is a sacred, lifelong journey that is a process of giving back with gratitude for all we receive along the way.

The medicine wheel is a source of healing and has medicine within each area that helps guide individuals along the Red Road of recovery. There are four quadrants within the medicine wheel: physical, mental, spiritual, and emotional.

These components are identified in the Red Road approach as the “four therapy targets” and represent many things collectively such as developmental stages in our lives, the sacred four directions, and various other teachings which often differ between tribes. In the Lakota way, there is a prayer—Mitakuye Oyasin, which translates to “all my relations”—that signifies how all things are interconnected. As mentioned previously in regards to intergenerational trauma, there have been many historical moments that are detrimental to indigenous people. Mass genocide, colonization, boarding schools, enslavement, relocation, massacres, and many other forms of historical trauma have created current conditions of poverty, mental health issues, high addiction rates, and a disconnection from spiritual lifeways for some individuals. As a part of healing from these traumas and the accompanying grief, we must look within to identify the areas that are the most impacted by collective, historical, and personal traumas. Through ceremony, prayer, and community we are able to seek guidance and heal our spirits, minds, and bodies through sound, color, and movement.

Within the circle, there is no beginning or end. It is a continuous journey and process that can hold space for both difficult and positive aspects of life. There is no right and no wrong, only healing—healing reinvented with every story shared.


Bonnie Lockhart
Bonnie Lockhart, MSW
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Bonnie Lockhart, MSW, is a member of the Sherwood Valley Band of Pomo Indians and was raised on the Pinoleville Indian Reservation. She is a community organizer, program developer, youth advocate, weaver, and artist who invests her time in projects that nurture intergenerational healing through community building and culture.

J Carlos Rivera
J. Carlos Rivera
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J. Carlos Rivera is the behavioral health director at American Indian Health and Services located in Santa Barbara, California, and the founder of Generation Red Road, Inc., located in Sioux Falls, South Dakota. Rivera is an enrolled tribal member with the Sherwood Valley Band of Pomo Indians and is also of Mexican descent. He received his chemical dependency and human services studies at the American River College. Rivera served as a substance abuse treatment provider for eleven years at Indian Health Services in Sacramento, California, providing services to adult men and women on parole, juvenile offenders, and other referrals from the Department of Corrections. He has also been an active committee member for the Juvenile Justice and Delinquency State Committee for California, appointed by Governor Jerry Brown.