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</FONT><P ALIGN="CENTER">MINORITY SUPPLEMENT</P>
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</FONT><B><FONT SIZE=4><P ALIGN="CENTER">WHAT IS THE RELATIONSHIP OF SUICIDE, ALCOHOL ABUSE, </P>
<P ALIGN="CENTER">AND SPIRITUALITY AMONG THE INUPIAT?</P>
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<FONT SIZE=2><P ALIGN="CENTER">SUBMITTED BY</P>
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<P ALIGN="CENTER">CATHERINE SWAN REIMER, Ed.D.</P>

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<P ALIGN="CENTER">With grateful acknowledgement to Mrs. Vernita Vestal who accompanied and served as an interpreter for this research</P>
<P ALIGN="CENTER">and all the Inupiat participants from the villages of Village #1, Village #2, Village #3, and village #4.</P>
<P ALIGN="CENTER">A special tribute to a female elder , one of the participants, who passed away in the Spring of  2002.</P>
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<P ALIGN="CENTER">May 15, 2002</P>
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</FONT><B><P ALIGN="CENTER">INTRODUCTION</P>
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<P>For the Inupiat people from Northern Alaska, spirituality is inseparably inter-twined with the concept of Personal Well Being (PWB)  (Reimer, 1996, 1999).  An important aspect of PWB for an Inupiat person is to be well grounded in their spirituality, which includes a strong belief in a personal God, and to be in harmony with their surroundings, their community, and their environment. This, they believe, protects them from illness, and negative spiritual forces (Reimer, 2000). The purpose of this study is twofold: (1) to investigate the relationship between suicide, alcohol abuse and spirituality, as understood by the Inupiat when they speak of PWB translated as happiness or aarigaa, both as an explanatory model of illness (Kleinman, 1991), and as part of an Inupiat person's worldview; and (2) to investigate the protection and nurturing factor of <I>aarigaa</I> which includes community involvement and spirituality (Reimer 1996; 1999) in relation to alcohol abuse.  This study was funded through a minority grant from NIAAA and sponsored by the University of Alaska Fairbanks' People Awakening Project.</P>
<B><P ALIGN="CENTER">Background and Significance</P>
<I><P ALIGN="CENTER">Suicide</P>
</B></I><P>Researchers and mental health workers have studied many aspects of mental health service delivery and the larger social environment to facilitate positive outcomes for suicide prevention since 1897, when Durkheim hypothesized that suicide was a result of social disorganization. Theories of suicide have promulgated since then.  Lester's (1972; 1983; 1992; 2000) review of suicidal theory spans over 100 years; sociological; socio-psychological; physiological; psychological; and rationality theories were mentioned.  These studies consistently found individuals to be severely depressed, hopeless, and disturbed and subjects were found to have lower self-esteem, higher stress, and to be originating from dysfunctional families (Lester, 2000).</P>
<P>In multivariate studies, Native Americans have higher rates of suicide than the general population, (Lester, 2000; Middlebrook, D., LeMaster, P., Beals, J., Douglas, K., Novins, M., &amp; Manson, S.; Moscicki, 1997). There is a growing interest in Native American youth because of this high rate of suicide (Wissow, L, Walkup, J., Barlow, Al, Reid, R., Kane, S. (2001), 2.4 times more suicides than the U.S. "Other Races" rate of 13.0 per 100,000 (Indian Health Service, 1997).  Suicide among Native American youth ages 15-24 was estimated to be three to four times higher than that of other groups (EchoHawk, 1997).  Summarizing findings by geographical location, the Alaska Area (Indian Health Services description) had the highest suicide rates (30.7 per<U> </U>100,000), followed by the Albuquerque area, which had 25.8 per 100,000 (Wallace, Calhoun, Powell, O'Neil, &amp; James, 1996).  Alaska Natives have higher rates of suicide than other Native Americans (Berman &amp; Leask, 1994). </P>

<P>Suicide among American Indians and Alaska Natives adolescents and young adults are often found in clusters, i.e. etiologically linked in a series to other suicides in time and place (Bechtold, D. 1988; Keane E., Dick R., Bechtold D., &amp; Manson, S. 1996). Young females tend to be at risk for suicidal ideation (Middlebrook, et. al.,1997) , while young men are at risk for suicide (Van Winkle &amp; May, 1993). Berlin (1987) described a series of cultural factors in Indian adolescent suicide.  He noted such factors as parents being unemployed and alcoholic; failure to live the traditional ways of lifestyle and worship; and adoption into Anglo families.  Borowsky, Resnick, Ireland, and Blum (1999) found that depression, substance use, loss of a family member or friends to suicide, availability of firearms, female sex, and a history of physical or sexual abuse have been associated with suicide attempts. A previous attempted suicide is the most important correlate for youth suicides (Borowsky et. Al. 1999).  </P>
<P>Suicide is often alcohol and drug-related and victims use violent methods such as hanging and guns (May &amp; McClosky, 1998). Moreover, high rates of acculturation are found among communities experiencing high rates of suicide (May &amp;Van Winkle, 1994). Reasons vary among tribes.  Novins, Beals, Roberts, and Manson (1999) found the heterogeneity of suicide ideation among three different American Indian tribes were consistent with each tribe's social structure, support systems, conceptualization of death and individual and gender role among 1,353 high school students.</P>
<P>Informants in a previous NIAAA preliminary study (Reimer, 2000) and in this study stated that they had been told that, in the past, elders who had become a burden to the family would go off and die, but this was not considered suicide.</P>
<P>In the last thirty years suicide has increased among the Inupiat and continues to be a problem; especially among males who have a high incidence of suicide (Gessner, 1997; Strickland, 1997).  In a study (2000) by Maniilaq (unpublished) stated that within a ten-year period from 1990 to 1999, there were three completed suicides with two attempts in the village of Village #3 with a population of under 400.  Village #1 with a population under 400 had three completed suicides and three attempts.  Village #4 had 12 completions and 84 attempts with a population under 3000.  Village #2 with a population under 800 had 7 completions and 18 attempts. For eight villages in the region, most of the completed suicides for the years between 1990 and 1999 were males between the ages 15 to 59 and three females between the ages of 20 to 34.  Suicide attempts by age group and sex during these years showed a greater increase of attempts by woman than men in the age bracket from 15 to 24.  47.7 percent of the suicides were completed by firearms, and suffocation accounted for 21 deaths for each group.  Drug ingestion was 54.7 percent for 93 attempts between the years of 1990 to 1999.  Firearms and suffocation were preferred method for males in completed suicide while drug ingestion was the preferred method for females for suicidal attempts. Both suicide attempts and completions took place at home, with averages being in the 80's percentile rank; most individuals were single (70's percentile rank). </P>
<B><I><P ALIGN="CENTER">Alcohol</P>

</B></I><P>Alcohol abuse is a major factor in suicides among all people and increases the risk for suicide and is associated with 50% of all suicides and 5-27% of alcoholic's suicides (Robins , L. N., Helzer, J. El., Weissman, M.M. 1994). Depression is often common with alcoholics (Murphy, 1992) because of the Serotonin link between these two illnesses (Sellers, Naranjo, and Peachey (1981). There has been a strong association between mental disorder and substance use among completed suicides (Conwell, Duberstein, Cox, Herrmann, Forbes, &amp; Caine, 1998; Dorpat &amp; Ripley, 1960); Rich, Young, &amp; Fowler, 1986).  Consistent findings among psychological autopsy that reconstruct a victim's psychological state prior to death as well as psychiatric problems and symptoms, behavior, and life circumstances during the weeks before death is that psychiatric disorder and/ or substances use is present in about 90% of all suicides.  The most common disorder is affective disorders, followed by substance use and schizophrenia (Conwell &amp; Brent, 1995).  Moreover, 90% of youth who commit suicide have a psychiatric disorder, primarily depression (Brent, Perper, Goldstein, 1988; Brent, Perper, Morittz, Allman, Friend, Roth, Schweers, Balach, &amp; Baugher, 1993; Shaffer, Garland, Gould, Fisher, &amp; Trautman, 1988).  </P>
<P>With or without a comorbid mood disorder alcohol is the most frequent substance identified with suicide completions and attempts (Andrews, 1992; Brent, Perper, Allman, 1987; Garrison, McKeown, Valois (1993); Rich, Young, Fowler, 1986). </P>
<P>In Alaska, alcohol is the number one problem in behavioral health risk factors. The Alaska Native Commission (1994) warned that if alcohol continued among the Alaska Natives, it would permanently cause social, cultural, physical and emotional well being to worsen.  Problems continue to abound:  suicide, accidental death, alcohol poisoning, family problems, and fetal alcohol syndrome (Herring, 1999; Egeland , Perham-Hester, Gessner, Ingle, berner, Middaugh , 1998). There were 45 suicide deaths in the Region from 1991 through 2000, representing 10.3% of the Statewide suicide deaths (438) during that period (Bureau of Vital Statistics, Alaska Division of Public Health, 2002).  Among Alaska Native males between 15-24, 72% of suicides were linked to alcohol (Hickle, Lowe, Clarke, Steuber, &amp; Whistler, 1994). Among the Inupiat male, alcohol was involved in both suicide attempts and completions by 52.1% as compared to marijuana with which<B> </B>was only 0.09%<B> </B>(Maniilaq, 2000).<B> </B>No history of mental health problems was linked to 52.3% of the Inupiat completed and 48.8% of the attempts over a period from 1991 to 2000.  Major contributing factors for all Inupiat suicides were divorce/separation (29.4%); relationship conflict (15.0%; substance abuse (10.7%).</P>

<P>Aoun and Gregory Natives (1998) suggest that because of the low rate of association with bipolar disorder and binge drinking, Alaska Natives have different inheritance patterns; other researchers confirm this (Long, Knowler, Hanson, Robin, Urbanek, Moore, Bennet, &amp; Goodman, 1998). </P>
<P>Early post-contact alcohol related suicide research among Alaska Natives was not found, as confirmed by Young, (1992).  Little information was found, either orally (Inupiat recorded tapes from Rasmussen Library) or in the literature, before 1940.  Alcohol, beginning in the fifties, became a major factor in completed suicides (Fortuine, 1989; Harras, 1987; Kttl &amp; O. Bixler, 1993); Muir, 1915/1979; Reimer, 2000).</P>
<P>Borowsky, Resnick, Ireland, and Blum (1999) identified protective factors among Alaska Native youth such as discussing problems with family or friends, emotional health, and connectedness to family.   Community ordinances have helped by limiting the local sale and use of alcohol in the villages (Berman &amp; Hull, 1997). and Mohatt (2001) suggest that cultural and spiritual processes provide protective factors in understanding the sobriety process for Alaska Natives.<B>  </B>Reimer's (1999; 2000) Inupiat study found spirituality, a component of their values, to be a strong protective factor for wellness and alcohol prevention.</P>
<B><I><P ALIGN="CENTER">Spirituality</P>
</B></I><P>Spirituality provides meaning and coherence, nurtures beliefs, interconnectedness of all life, relationships with others and the natural world (Antonovsky, 1980; Lowery, 1998).  The literature suggests that spirituality is a major factor in promoting health and well being (Dana, 1993; Bensley, 1991; Ellis &amp; Smith, 1991; Ellison, 1983; Ellison &amp; Smith, 1991; Katz, 1993; 1997; Matson, 1995; Reimer, 1996; Witmer &amp; Sweeney, 1992).<B>  </B>Research<B> </B>also<B> </B>suggests<B> </B>that spirituality is a protective factor against suicide (Hoelter, 1979; Jacobs, 1967; Nelson, 1977; Stack, 1981; Stack, 1983) and alcoholism <B>(</B>Moss, Edwards, Edwards, Janzen, &amp; Howell (1985).  The Christian religion, among the Inupiat, has been reported to have a negative relationship between religiosity and suicide (Gartner, Larson, Allen, 1991). Negative attitudes toward suicidal behavior have been reported (Bascue, Inman, &amp; Kahn, 1982), and religious people reported experiencing fewer suicidal impulses (Reynolds and Nelson, 1981). </P>

<P> Native American spirituality has been generally discussed by various authors: Deloria (1973), Underhill (1965).  Black Elk (1932; 1951), and Lame Deer (1976),  have contributed to a global understanding of Native Spirituality among Indians who had lost the oral traditions of their tribe (Reimer, 1996).  The influence of their work can be seen in Native American healing (Braswell &amp; Wong, 1994; Schact, Tafoya, &amp; Mirabla, 1988); and the development of the Medicine Wheel that uses the holistic model to describe spirituality (Bopp, 1987; Gunn Allen, 1986; Neihardt, 1961).</P>
<P>However, the existing literature does not provide a clear definition of Alaska Native spirituality among the other major Alaska Native groups, which are the Aleut, Athabascan, Haida, Inupiat, Tlinkgit, Tsimpshean, and Yup'ik. There have been a few Native writers who have written about spirituality relative to their specific tribe.  One such work is Kawagley's (1993) who discussed spirituality as it relates to the Yup'ik culture and Napoleon (1991) who discusses the impact on Western culture on the indigenous culture's spirituality. Hazel and Mohatt (2001) discuss cultural and spiritual processes by defining an Alaska Native worldview with emphasis on a Yup'ik Eskimo theory for alcohol recovery.</P>
<P>Some equate Alaska Native spirituality with values (Beiser &amp; Manson, 1987; Christensen, 1982).  Sullivan (1992, p.29) states that spirituality is " a personal or cultural way of living certain values in one's life.  Other researchers discuss values such as one's relationship to each other and relationship to the land (Fienup-Riordan, 1990; Freeman &amp; Carbyn, 1988; Locust, 1988; Kawagley, 1993; Reimer 1996, 1997).  As in Reimer's work (1996, 1997), Fienup-Riordan defined the power of the mind and the directive of considering one's thoughts and behaviors so as not to offend the spirits of the animals and environment or harm another person.</P>
<P>Works that define spirituality for Alaska Natives are sparse and often limited in scope and understanding. For example, Anderson (1977) proposed that spiritual beliefs were shaped because of the need for food. Oquilluk (1973) attributed a more complex meaning to spirituality based on oral history.  According to Inupiaq oral history, as the weather and environment became more severe through many generations, more complex interaction with the spirit world also evolved. Shamans emerged and gained power as mediators between the people and the spiritual and began requiring strict obedience to certain laws and taboos, which, if broken, caused dire consequences. The current construct of spirituality for the Inupiat is complex and is inextricably intertwined with their long history in Northern Alaska, with the environment (land, water, sky, animals, weather), with their ancient spirituality rooted in shamanism with its highly ritualized relationship to the spirit world (often negative), and with Christianity.  </P>

<P>Traditional Inupiat spirituality is mostly discussed in relation to shamans, spiritual practices and taboos (Brandson, 1996); Mendenhall, Sampson &amp; Tennant, 1989), rituals (Grim, 1983), beliefs (Reimer, 1996; 1999) and the introduction to Christianity by early missionaries (Mendenhall, Sampson &amp; Tennant, 1989). Even the Inupiat I<I>litqusiat, </I>which lists a set of values, including spirituality, which serves as an impressive model for regaining community well being (Beiser &amp; Manson, 1987; Christensen, 1982; and Kleinfeld, 1982) does not define spirituality; nor do recorded tapes (Rasmussen Library at UAF) of Inupiat speakers and elders offer a definition. The literature does explore the impact of Christian religion on Inupiat spirituality. </P>
<P>Hazel and Mohatt (2001) discuss cultural and spiritual processes by defining an Alaska Native worldview with emphasis on a Yup'ik Eskimo theory for recovery.  When administering their Spiritual/Cultural Awareness survey (43 items), spirituality was described in terms of Christianity and indigenous concepts.  Spirituality as related to sobriety was described in terms of spirits, God, the church, and connection to the land through subsistence activities.  This was also found in Reimer's (1997) book <I>How to Counsel the Inupiat Eskimos.</P>
</I><P>Although some attention has been directed to the multiple dimensions of the positive aspect of Inupiat spirituality as it relates to happiness or personal well being and the community (Reimer, 1996, 1999, 2000), negative aspects such as spirit possession and visitation from dead relatives and friends have not been adequately explored.  In a preliminary study funded by the NIAAA, Reimer (2000) investigated this spiritual phenomenon and found evidence that there was a relationship to suicide.  Inupiaq Elders believe the aforementioned encounters experienced by individuals are overpowering, often accompanied by physical struggles between spirits and the individual, often followed by suicide.</P>
<P>There is significant anthropological literature on the subject of spirit possession, primarily in Africa (Kenyon, 1999; Boddy, 1989; Werbner; Al-Safi; Hurreiz, Sayed Hamid &amp; Lewis, 1991; Grotber, 1990;Body, 1988;Kahana, 1985, Nelson, 1972); Vontress, 1991; Young, 1975) but also among diasportic Africans in the Caribbean (Crapanzano, Garrison, 1977. Moreover, significant Christian literature on possession could be found primarily under demonization or demon possession( Berends, 1975; Dickason, 1987; Copestake, Kildahl, 1964; Molony 1993; Nauman, 1974;  Roskik, 1997). Bull, (2001) proposes a phenomenological method of therapeutic exorcism for dissociative disorders by using the patient's view of perceived demons and spirituality to expel these spirits. However, exorcism and possession is often seen as primitive, non-scientific or non-psychological among secular therapists (Bull, 2001). There is literature that supports the interpretation that demons are alter personalities (Frazer, 1993; Ross, 1993) and a few authors are beginning to consider exorcism ritual on dissociative identity disorder (DID) Fraser, 1993; Ross, 1993; Young, 1993). Some Christian therapists believe in demons and the need for exorcism, but emphasize this be done only after assessing mental health especially DID (Friesen, 1991; Rosik, 1993.  These authors also warn that DID can coexist with spiritual possession in some cases.  </P>

<P>&#9;Little was found among the American Indian/ Alaska Native literature to support the idea of spirituality as it relates to spiritual phenomenon; specifically possession and visitations by the deceased. Clarke, (1995) and Johnson, (1994) discuss Swinomish Tribal visitations of the deceased talking to youth contemplating suicide which can serve as an identifiable clue to an impending suicidal attempt. Pavlik (1997) affirms Native American spirituality and traditional knowledge and the existence of the supernatural mostly based on ritual and oral knowledge and the work of Vine Deloria, Jr. (1990).  Carl Sagan's work (1995) is severely criticized by Pavlik because he dismisses tribal spiritual knowledge as being superstitious and not scientific. </P>
<P>In summary, although there is research about spirituality and suicide, and suicide and alcohol, there is little research on the relationship of spirituality, both negative and positive, and its relationship to alcohol and suicide based on Native American explanations and perspectives.  Reimer's (1996, 2000) previous work indicates that personal well being and community cohesiveness serve as a protective factor against alcoholism and suicide.  However, no research was found in this review that provides a comprehensive description of Inupiat spirituality or the spiritual phenomena described by the Inupiat (Reimer, 2000). Kleinman (1991) noted that different cultural groups possess different explanatory models regarding illness beliefs and the causation of illness. Effective interventions must target these culturally based models for the cause of illness in order to be plausible to an individual from this cultural group, acceptable as an intervention, and thereby, to be effective.  </P>
<P>Finally, the purpose of this research is to establish the foundation for a better understanding of how the Inupiat perceive illness and healing within their worldview and to define the relationship between spirituality, suicide, and alcoholism.  Further, this study explores the protection and nurturing factors of <I>aarigaa,</I> which includes community involvement and spirituality in relationship to alcohol abuse and suicide.</P>
<B><P ALIGN="CENTER">Methods</P>
<I><P ALIGN="CENTER">Sample</P>
</B></I><P>The four villages in Northwest Alaska were visited because a preliminary interview with selected Elders identified them as potential suicide risk and "trouble spots" based on current and past suicides. Each of the villages is located in the Northwest Arctic Borough.  The sale and importation of alcohol is banned in three of them. The 4<SUP>th</SUP> village allows no sale of alcohol, but importation or possession is allowed. Subsistence is an integral part of the lifestyle for all the Inupiat Eskimos in these villages, which may include salmon, freshwater fish, moose, caribou, mountain sheep, waterfowl and berries as well as seal, walrus, and whales from the ocean.  Most of the people depend on the subsistence lifestyle as part of their economy and food source; jobs are scarce, especially in the smaller villages.  The schools, village governments and councils, the Native corporations, airlines/air carriers and local stores provide year round jobs</P>

<P>A total of twenty participants who were identified as knowledgeable of suicide, spirituality, and alcoholism were selected through elder and IRA selection and approval. The original plan was to include 16 participants with an equal distribution of male and female of elders and young people between the ages of 18 to 33 from each village.  Instead the number of participants was increased to 20 in the age group of 21 to 88, the average age being 50, with 11 men and 9 women interviewed. Because of their cultural expertise and knowledge of spirituality and possession, two middle age males were selected from two different villages and two young adults were included in the sample.  The following is the breakdown: Village #4 - two males (1 young and 1 elder) and two young females. Village #1 had three females (2 elders and 1 young), two males (1 elder and 1 young). Village #2 - three females (2 elders and 1 young), three males (1 elder, 1 middle age, 1 young); Village #3 - three males (1 elder, 1 middle age, 1 young) and one young female.</P>
<B><P ALIGN="CENTER">Procedure</P>
</B><P>Qualitative research methodology was used in this study to explore the relationship between suicide, spirituality, and alcohol among the Inupiat.  Before interviewing the participants, a literature review, described above, was conducted to<U> </U>explore current studies, early writings, and oral history related to Inupiat spirituality, alcoholism, and suicide housed in the oral history archives of the University of Alaska Fairbanks</P>
<P>An interview schedule was devised that asked two major general questions with probes used throughout the open-ended questions after five Inupiat consultants (elders and young people) refined and simplified them for the Inupiat population.  The main questions were: <I>Could you tell me some reasons why you think Inupiaq men (women) take their lives?  What contributes to personal happiness and feeling good and lessens happiness and feeling good? </I>Probes explored the Inupiat word <I>aarigaa </I>or happiness and feeling good, the communities' contributions to this protective factor, and an exploration of Inupiat spirituality (Appendix A). </P>
<P>.  Mrs. Vernita Vestal accompanied Dr. Reimer and served as the Inupiat interpreter at each of the four sites.  Dr. Reimer identified key words and phrases on spirituality and happiness from Mrs. Vestal, participants, her cousin, and her mother who is Inupiat, born in Village #1.</P>
<P>Inupiat cultural experts were identified by the Inupiat community and were recruited as consultants and completed a consent form. Following informed consent, consultants were interviewed using the interview schedule with probes to further delineate information on the relationship of spirituality, alcohol, and suicide.  Audio recordings of the sessions were made and notes were taken during each interview. The tape interviews were transcribed verbatim.  Typed copies of the verbatim interviews were sent back to the respondent for review and to confirm that what was transcribed was what they said.  All recommendations for change or clarification by the participants were made to the transcriptions. To ensure that consultants were not harmed by the interview, this researcher called each participant after the interview. All procedures were reviewed and approved by the University of Alaska Fairbanks Institutional Review Board for the Protection of Human Subjects.</P>

<B><P ALIGN="CENTER">Qualitative Data Analysis</P>
</B><P>The challenge of the data analysis phase of the study was to make sense of the substantial data collected, to synthesize the information, to identify meaningful patterns, and to "construct a framework for communicating the essence of what the data revealed" (Patton, 1990, p. 371-372) in a relatively short time.  Grounded theory analysis (Strauss, &amp; Corbin, 1990) was used to identify theories and concepts.  To  understand the complexity of the material, it was necessary to gain an understanding of the data from several different perspectives.  The following approaches were used to identify the emerging themes: (1) examining the participants' responses to the interview questions and form categories along with two other individuals with significant background and professional work among Native American cultures; (2) checking for reliability, a sample of the categories, after they had been coded; (3) reviewing auxiliary notes taken during and after each interview; (4) reading the participant's responses several times after listening to the tapes; and (5) examining the coding results to identify general themes and relationships among the categories of responses. Research mentors reviewed the material and provided suggestions.  For validity purposes, respondants were sent their original manuscripts to check for error or request any changes. </P>
<P>The interview questions are grouped under the three following major themes for purposes of analysis: suicide, alcoholism, and spirituality using First-level analysis followed by Second-level analysis to deepen the understanding of the major constructs and the inter-relationships between them.</P>
<B><P ALIGN="CENTER">RESULTS</P>
</B><P>&#9;The following are the results based on the research questions. Three main categories are discussed: Alcoholism, Suicide, and Spirituality.  The alcoholism and suicide results are also integrated in the Spirituality section.  Greater detail is given to Spirituality; in particular, the sections titled Cultural Spirituality and Non-Ordinary Spiritual experiences since alcohol and suicide are related to these constructs and little could be found in the literature pertaining to these constructs.</P>
<B><P ALIGN="CENTER">Alcoholism</P>
</B><P>The Inupiat participants were aware of the changing drinking patterns since the 60's in that drinking was pervasive in the villages prior to that time, but without any suicidal behavior.  According to a young woman when she was younger, people use to be out "hollering in streets, out in the open."  That kind of behavior has stopped.  An elder shared how dysfunctional drinking norms learned from miners, whalers, and other Westerners were integrated with the Inupiat value of sharing, he said, "That's who we learned to drink from.  When you had it, you drank till it was all gone and everybody drank cause we shared with everybody." Some saw alcohol as a Native problem, not being able to drink like other races, i.e. - "hold their liquor" or "social drinking".  Others saw alcoholism as a spiritual problem. Divorce, physical and sexual abuse, job loss, depression, guilt and shame, and opening up the person to negative spiritual forces were problems associated with substance abuse.  A few participants mentioned generational issues such as children of alcoholics and co-dependency, but others did not know how to explain or deal with the alcoholic behavior because they do not understand the problem.</P>
<P>Fetal Alcohol Syndrome and Effects were mentioned as well as a decrease in health and ability to work and maintain a job.  Many accidents occur when a person is under the influence, especially when driving a snowmobile or ATV.  Some participants are aware of how difficult it is to be physically addicted, while others said they could just make up their mind and quit because it was a spiritual disease.</P>

<P>Other drugs, mostly marijuana, in addition to alcohol, have become a problem and some believe that the drugs and alcohol contribute to suicidal behavior.  Some participants believed that alcohol and drugs relieved not only personal and social problems and associated tensions, but also spiritual ones.  <I>Alliiqtu</I>,<I> </I>or when something is really bothering a person's mind, alcohol is a way to escape from it but it may open the mind into more serious spiritual problems such as possession.  </P>
<P>Many of the suicides, it was said, were caused by relationship problems while under the influence of alcohol.  Most of the relationship problems for both men and women who either attempted or completed suicides occurred because of the ending of a relationship. However, alcohol was often the main cause for relationship breakup because of physical abuse, infidelity, jealousy, fighting, absenteeism, and children suffering from the alcoholic relationship. A young Village #3 woman thought it was ironic that people killed themselves, and said, "alcohol is the cause of your pain and you turn to alcohol for comfort?"</P>
<P>The impact of alcoholism undermines the Inupiat culture, chipping it away, generation by generation; happiness, feeling good, Inupiat values, and subsistence, the foundation of Inupiat culture, are affected.  A young Village #4 male discussed how the cultural side is affected by drinking.  Sadly, he said, </P><DIR>
<DIR>

<P>A lot of them are not Christians, they are not saved, they have no idea about spiritual warfare, but they do understand that maybe their cultural side is not as strong as it should be and they cannot draw from that well.</P></DIR>
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<P>Elders are affected with sadness when they see the culture eroding and their loved ones hurt; those elders who could be potential leaders are either too ashamed to or they are still drinking.  Fortunately, a couple of male elders quit, one said this about his alcoholism affecting his cultural side,</P><DIR>

<DIR>

<P>I tried to be honest when I was a little kid.  I took pride in being honest.  I took pride in stopping and helping whoever needed help, it didn't matter who it was.  When I started drinking all of that changed.</P></DIR>
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<P>Everyone in the villages is affected or influenced by alcohol.  Parents are drinking more and even representatives serving the villages are accused of not living the Inupiat values and Inupiat life since some of them abuse and import alcohol.</P>
</FONT><B><FONT FACE="New Times Roman" SIZE=3><FONT FACE="New Times Roman" SIZE=3><P ALIGN="CENTER">Suicide </P>
<P>&#9;</B>Each of the participants in this study remembered suicide events in their village at different periods.  A Village #1 elder remembered the first suicide happening in 1940, while another elder from Village #4 didn't think there were any suicides before 1960.  A Village #2 male thought the first suicides happened in the 1950's when two women committed suicide in his village.  But it wasn't until the 1980's that everyone's attention was focused on the problem because there were twelve suicides in fourteen months, four times the national average.</P>
<P>&#9;Reasons given for suicide are complex, historical, and holistic in nature. Two different worldviews clashed when the Europeans and Euro-Americans arrived in Northern Alaska and began interacting with the Inupiat.  The Inupiat values and spirituality were tribal and collective, whereas the Europeans values were individualistic and possession-oriented. The Inupiat culture was completely transformed when the Europeans first colonized the region and brought with them their disease, religion, education, social systems, economics, legalities and law, subsistence regulations, and language.  Participants mentioned that the Inupiat people were looked down upon, degraded, and the culture was not valued, and judged to be inferior.  One male elder from Village #4 said that the high rate of "suicide is a spiritual problem and a collective problem causing traumatic shock for over a hundred years<B>."</P>
</B><P>&#9;An elder from Village #4 discussed problems associated with contact with the Europeans who believed in their personal privilege and their notion of "Manifest Destiny" seen in the way they oppressed and forced assimilation through education, laws, economics, population control (hysterectomies), and the settlement of Eskimo villages.  They introduced dysfunctional drinking patterns and the abuse of women. Others mentioned there was a rapid decline of tradition: especially the Inupiat dance and ritual ceremonies.  There was also the loss of language and values, and tribal medicine practices dependent on the natural environment.  Native rights were lost by taking away the land, and animals.  Boarding schools broke up the family system; many children did not learn how to parent their children.  With the strong moral codes broken, child abuse, especially sexual abuse; all led to unresolved trauma, depression, alcoholism, and suicide.  The elder from Village #4 also said, "So more deeper depression starts to set in.  The one point I want to make here is that suicide is a <I>spiritual decision</I> and that's the decision."</P>

<P>Personal reasons for committing suicide are all intertwined in the issues described above.  In general, as seen from the individual experience, most participants felt that the main causes of suicide are alcoholism and drugs, and relationship problems with family and friends. More specifically, depression, psychological problems, and social isolation were mentioned as possible causes. Participants also mentioned dysfunctional families, especially problems with sexual abuse, lack of discipline and communication, and lack of parenting skills.  Sexual preferences and loss of jobs and going to prison were mentioned less frequently. Possession and visitation by spirits was also believed to cause suicide or attempted suicide; contributing to this are mind-altering drugs that open up an individual's mind to these phenomena. Other minor influences mentioned are <I>copycat</I> influences and <I>pacts </I>made with friends.</P>
</FONT></FONT><FONT SIZE=3><P>One elder from Village #4 felt that unless you "fixed all," no one would really be fixed. Participants felt the whole community itself had to face some of the major social and psychological problems that the people have kept hidden.  Young people were more open and talked about child and sexual abuse as well as other community secrets.  It is believed that the victims as well as the perpetrators use alcohol to numb their problems and keep themselves in denial.  Without meaningful programs and sustained efforts to address these issues, participants believed the problems will continue. Therefore, according to many of the participants, it is necessary to examine how the community and its institutions may be contributing to suicide.  These will be discussed under Inupiat Spirituality. </P>
</FONT><FONT FACE="New Times Roman" SIZE=3><FONT FACE="New Times Roman" SIZE=3><P>Participants discussed both the attempts and completed suicides. Attempts and completed suicides were done by overdosing on medicine, slitting the throat, drowning; hanging; but the most common method for both attempted and completed suicides was the use of a gun. </P>
<B><I><P ALIGN="CENTER">Attempts</P>
</B></I><P>&#9;  Two participants discussed their own suicide attempts, while others discussed family member's attempts.  (A breakdown of the attempts and completed suicides can be seen in Appendix B.).   Reasons for attempting suicide were relationship problems, problems with the judicial system, emotional problems, depression, self-esteem issues and inability to cope with the larger Non-Native society.  Alcohol was often a contributing factor. There were three cases of possession, one of which (young female) was intervened and stopped by exorcism.  </P>
<P>Some interventions were made by the health clinic staff, family and friends, church members, the churches, and through intercessory prayers as in the case when the person's gun would not fire after four attempts. This is usually not the case when handling guns.  One young man warned about the danger of guns because of their "light triggers" which are set for hunting. He said from his own experience, and from what he heard from others, some would think about suicide, actually put the gun to their head, and think they have some control of the gun.  This was not case of a 22 year-old student who was a "little mentally unstable" and concerned about his income taxes that he did not know how to pay. Alcohol was not involved when he shot himself under the jaw and left a hole, "the size of a half dollar." Later when he woke up in the recovery room, he said, "What happened?"  According to the nurse, he was dead for three to four minutes.</P>

<B><I><P ALIGN="CENTER">Completed</P>
</B></I><P>&#9;Completed suicides involved the family, friends, and community members of the participants in his study.  Of the suicides discussed by the participants, there was only one young woman from Village #1 who committed suicide, while the other suicides were young adult males. See Figure 1 for a breakdown of gender, age, the relationship to participant, alcohol related, reason, spiritual possession, warning sign and who gave the report.  </P>
<P>Most completed suicides also involved drinking alcohol, while four of the mentioned suicides, it is known, did not involve alcohol.  Some participants did not know whether the suicide they discussed involved drinking or other drugs. Guns (most popular method), hanging, and drowning were the methods discussed.</P>
<B><I><P ALIGN="CENTER">Interventions</P>
</B></I><P>Elders want to see stronger families talking to each other and the young to express themselves and talk about their problems.  As one Village #2 elder female said, "Smiling at them and talk to them and make them understand that you love them hard." For the Inupiat, talking is often indirect (Reimer, 2000); it may be through stories or giving examples that one talks about personal issues.   The difficulty one has in talking directly can be seen when a mother confessed she did not want to offend her son by talking directly to him about her fears.</P>
<P>Young people are changing communications, as one Village #4 woman expressed a more open and assertive style where she would not let someone keep problems to oneself but share with her what was going on in personal thoughts about suicide.  She said, "I am not going to let it happen where I can't talk to you anymore, you are going to get it out and tell me what's up."</P>
<P>&#9;Other interventions that are effective will be discussed under Inupiat spirituality.</P>
<B><I><P ALIGN="CENTER">Warning Signs</P>
</B></I><P>A few of the young people mentioned typical warning signs like giving away gifts, change of mood from depressed to happy and others taught by the Maniilaq suicide prevention program.  Participants mentioned the following warning signs in order of frequency:  alcohol, (the "knock out punch" that according to a Village #4 young male pushes them over the edge); depression; isolation; dysfunctional family and relationships problems; and spiritual visitation or possession.</P>

</FONT></FONT><FONT SIZE=3><P>&#9;A young female mentioned  "loners" as a potential warning sign, this may be difficult because many young Inupiat men are quiet and shy.  Being a loner coupled with any of the above warning signs or if someone in the family or a close friend committed suicide or died, this person should be watched.  </P>
<P>&#9;Other warning signs included a change in the way a person looks at you, a change in the eyes, fear in the eyes, and an elder's intuitive knowledge that something is wrong.</P>
</FONT><FONT FACE="New Times Roman" SIZE=3><FONT FACE="New Times Roman" SIZE=3><P>Information can be found in Appendix B for both completed and attempted suicides specific to each village with information on the relationship to speaker, alcohol related, how it was done, the reason, related to spiritual possession and warning signs.</P>
</FONT></FONT><B><I><FONT SIZE=3><P ALIGN="CENTER">Reasons</P>
<P>&#9;</B></I>The following were reasons why a person would consider suicide, others may be found in the section titled Inupiat spirituality.  </P>
<P>&#9;Teachers were criticized for not understanding the culture, language, communication and learning styles of the students, often pushing young people to failure and even suicide by their insensitivity and lack interest and knowledge.  Administrators were criticized for not giving school boards more local control, not developing effective discipline policies, and not integrating prayer and faith into the school day. </P>
<P>Parents were not immune to criticism either. Some thought that some parents did not cooperate with the school and support its policies, especially on discipline.  One Village #3 young woman said,</P><DIR>
<DIR>

<P>Some parents really give teachers hard time, yet they are the parents we know who have troubled kids because of what is going on in the home.  I have seen that happen many times.  Certain times, parents are not willing to listen to both sides.  They come up with their own conclusions.  A lot of people are stubborn that way and want to believe their children and stick by them even though they know they have done wrong.</P></DIR>

</DIR>

<P>&#9;Participants identified the tribal council, town council, IRA, judicial system, and health department as community agencies; all of these agencies need to be working together.  When programs act separately and not in unison with each other, they contribute to the problem of suicide. Some complained about the lack of effective AA meetings and hoped that they could improve them by integrating cultural and Inupiat values.</P>
</FONT><FONT FACE="New Times Roman" SIZE=3><FONT FACE="New Times Roman" SIZE=3><P> </FONT></FONT><B><I><FONT SIZE=3>&#9;</I>Spirituality</P>
</B><P>&#9;To understand the relationship of spirituality to alcoholism and suicide it is necessary to define Inupiat spirituality since it has not been adequately defined in the literature, and participants did not give a clear definition; although each provided aspects of what constituted Inupiat spirituality.  One young male from Village #4 saw the importance of establishing a definition, he said, "We have to define spiritual too.  There is that spiritual between God and between Satan and there is the cultural spiritual side too".</P>
<P>&#9;Participants discussed<I> cultural spirituality and religiosity</I> when asked to describe what spirituality meant to them.  They also discussed <I>non-ordinary spiritual experiences, which is the third category of spirituality.  </I>This third construct also gives insight into Inupiat spirituality.  Each will be discussed in relation to suicide and alcoholism.</P>

<B><I><P ALIGN="CENTER">Cultural Spirituality</P>
</B></I><P>&#9;Although no one gave a clear definition of spirituality, each participant discussed its aspects, with Inupiat Values mentioned most frequently in relation to <I>cultural spirituality</I>.  The many aspects of spirituality include shamanism; transmission of spiritual teachings; Inupiat values; spiritual as source of power and strength; subsistence and the environment; reciprocal relationship between behavior, positive thought, happiness, and the environment; activities supporting cultural spirituality; spirituality as connection; and integration of cultural spirituality with Christianity.  Cultural spirituality is a complex construct representing the above nine domains; each of which will be discussed.  </P>
<I><P ALIGN="JUSTIFY">Shamanism</P>
</I><P>&#9;Shamanism played a pivotal role in the spiritual lives of the Inupiat before the arrival of Christianity because, according to participants, it structured their spirituality and daily life, defined their worldview, and provided some control over the natural elements involving survival. The Inupiat relinquished direct communication with the source of their spirituality to the shamans who possessed extraordinary powers that either helped or hindered the Inupiat through their healings and control of the environment and events, but taxing and even killing Inupiat when they broke certain taboos.  </P>
<P>&#9;Elder village participants, 70 and older, had mostly negative comments about the shamans, believing that they received power from evil spirits and the devil.  Elders talked about Robert Sam who preached that shamanism was "dark magic" beginning about 1898.  Many, about that time were grateful to embrace Christianity because they no longer had to follow strict taboos such as not eating fish and caribou at the same time, or handling them, at the same time.</P>
<P>A few elders talked positively about the shaman, describing such gifts as helping to interpret dreams, see into the future, and heal. A Village #2 elder male said,</P><DIR>
<DIR>

<P>The <I>ahgnatquq</I> (shamans), some of them were demon possessed.  They had power to do supernatural things.  Some of my ancestors were like that. <B>… "</B>People say all <I>ahgnatquq </I>(shaman) are bad, I do not believe that.  My gramma had the ability to heal." </P></DIR>

</DIR>

<P>  What many now believe about the shaman or <I>ahgnatquq</I> , according to a Village #4 elder, was tainted information from the missionaries who labeled shamanism terrible and heathen in order to convert the people to Christianity.<I> </I> The majority of elders said they were relieved that Christianity replaced the shamans and their evil powers.  Yet, some believe that the shamans are trying to make a comeback, since there have been reports that family ancestors who once possessed these powers were appearing to young family members and influencing them to take their lives. Some young people have tried to gain some of these powers, according to a Village #2 man whose own father had to fight off family shaman spirits.  His first cousin requested these powers and received them, but these powers turned against him; later he killed himself.  He said, "I tried to help him but I couldn't because this person had gone too far… I know several who were like that."</P>
<P>Other villages reported the shamans showing up.  A Village #1 elder said, "I know it spotted one family last year, old grampa bothering the whole family.  Nowadays it's coming back.  It start coming back and they you will start seeing kids going to a funeral (suicide)." </P>
<P>&#9;Some are looking at this power and integrating it with Christianity.  According to a middle age Village #2 male, it can only be used within the protective shield of Christianity.  He said, "So the power is now still in you, do you see what I mean?  You have a capacity to be a shaman or you have the capacity to be a healer in the Lord."</P>
<P>Maniilaq has become a model for many who were able to integrate spiritual power with a Divine Source. This revered Inupiaq man named Maniilaq was born around 1850.  He was guided by the revelations from what he called the "Brother in the Sky," who told him to not follow the taboos and laws of the shamans.  He broke many taboos and encouraged others to do the same. According to an elder from Village #2, Maniilaq was divinely protected.</P><DIR>

<DIR>

<P>And then these ahgnatquq from outlying villages, I don't know how many of them… they tried to get him.  He was all by himself in a little tent, they tried to get him from any direction.  They couldn't though.  He was glowing too.  There was a glowing all around him.  They couldn't get him. </P></DIR>
</DIR>

<P>&#9;The general consensus among those interviewed was that Maniilaq had special gifts that were greater than the shaman's power.  He is seen as a hero to many, a prophet to some, a precursor heralding Christianity, and a man who could have been destined to become a great <I>ahgnatquq </I>(shaman).</P>
<P>&#9;Participants recommended that the history of shamanism and stories about Maniilaq should be taught in the homes, schools, and even by church leaders so young people understand the dangers of dealing with the occult and shamanism.  It could help those young people who are being "recruited" not to be afraid to talk about it and get help from the elders.  Most community members are afraid to discuss this spiritual phenomenon, but elders believe it is important to educate the young on shamanism and how alcohol opens the mind for these spirits to suggest they commit suicide.</P>
<I><P>Transmission of spiritual teachings</P>
</I><P>&#9;The grandmother played a very important part in passing on knowledge, stories, and correct behavior; parents, grandfathers and elders were also mentioned, but not as frequently as the <I>aana</I>.  Often it was she who taught they young boys to hunt and fish.  The elders were remembered for their teachings on spirituality, especially in relation to the land and spiritual encounters. </P>

<P>&#9;Often elders are described as "the door to the past."  Some people felt that the elder's are not transmitting spiritual knowledge to the young today because of fear the young will dabble in shamanism. Moreover, one elder felt some hesitation in acknowledging his role as an elder because of guilt over past alcoholic behaviors.  He said, "As we get older, we move to the role of elder.  Some are not prepared."  He felt others felt the same,  "They are afraid they are not good Inupiat to take on the role."</P>
<P>&#9;Participants would like to see the elders teach in the schools and help the community understand cultural spirituality. Elders need to pass on their knowledge to middle age people, who are the next in line to becoming community spiritual leaders. Elders have much to offer young parents on disciplining their children and how to teach them. A few elders felt that young people were giving in to alcoholism, substance abuse, and suicide because they had not developed a strong internal disposition and character through hard work and daily survival activities such as chopping wood, bringing in water, and helping with all the chores.  Throughout the interviews elders complained about the lack of discipline and loss of Inupiat values that are no longer being passed on to the children.  They would like to see these offered through the Corporation and Mental Health Center.  </P>
<I><P>Inupiat Values</P>
</I><P>&#9;Participants agreed that to have an Inupiat spirit one must know and live the Inupiat values contained in the <I>Inupiat Ilitqusiat</I>.  This<I> </I>value system grew out of not only the traditional teachings, but also from the examples that the elder's lived.  </P>
<P>&#9;The most frequent value mentioned among the four villages was <I>respect the elder</I> and then good things will come to you which also creates a reciprocal relationship between the people and the land (environment). </P>

<P>All the Inupiat Ilitqusiat values were mentioned to, or experienced by, the interpreter and researcher during the visits to the four sites.  Values mentioned were: <I>subsistence</I> (mentioned frequently by young and old<I>); hard work; love for children; sharing; spirituality; domestic skills; hunter success; knowledge of family tree; knowledge of language</I>; <I>hard work; respect for nature; and family roles</I>.  The values discussed throughout the interviews were: <I>humility; avoidance of conflict; respect</I> <I>for others</I> (clearly evidenced by the way we were treated); and <I>cooperation</I>.  <I>Humor</I> was discussed and experienced, for example, during the interviews of two elders who were singing and having fun through their story telling. </P>

<P> A young Village #4 woman saw this researcher struggling with luggage and immediately carried them.  Whenever she could, she said she would help elders coming in from out of town.  This kind of behavior is starting to fade among the young people.  An elder male from Village #1 complained that the young were interrupting elder's communication and teachings on the CB (Citizen's Band Radio).  One was also reported to have said, "I hope elders die right away, die right now."  The elders worry about the young who will not have the strong well of culture to draw from and especially the values that are the foundation of the Inupiat culture.  One young male from Village #4 said,</P><DIR>
<DIR>

<P>I think they need to have to fill that cultural spirituality; they need to build that well and fill it up because when they reach down there and find nothing, then that is when things can be bad<B>. </P></DIR>
</DIR>

</B><P>&#9;Participants would like to see the schools integrate culture, language, and the Inupiat values in the school system.  One elder said it was important that they not only teach them (the values) but also live them.    Moreover, young and old both see the need to integrate these values in all suicide and alcohol prevention efforts.</P>
<I><P>Spirituality as a source of power and strength</P>
</I><P>Many talked about the cultural spirituality being a source of pride and strength and a deterrent from suicide and alcoholism by helping them cope with stressful situations. One young man said when experiencing stress while attending the University said,</P><DIR>
<DIR>

<P>You have to say, "I have certain things, I know certain things that they don't know.  They may have better clothes than me, I know something that they don't know."  And you have to be able to draw from that and that is what I mean when I talk about the cultural spirituality.</P></DIR>
</DIR>

<P>&#9;Elders gained exceptional powers through common sense and experience.  They could tell the weather by the way their bodies hurt, especially through the joints, but they also possessed strong, personal powers which made young people both fear and respect them. As expressed by this Village #2 middle age man,  "because they don't know what kind of power he has and things like that…because way back then, all they had to do was think…. And it happens."</P>
<P>&#9;There were several powers and strengths noted during the interviews, both positive and negative powers. The positive were expressed by the gift of dreams and interpretation of dreams; intuition or sixth sense; near-death experiences; intercessory prayer (intervention); personal power; healing; spiritual protection; weather prediction; ability to sense danger; prophesy; and exorcism.  Spiritual gifts and experiences seen as negative were levitation; personal power; possession; mind power (subliminal thinking); shaman visitations; post-death experiences, and magic. The term <I>negative spirituality</I> is used in reference to such experiences, but in particular to possession and spirit or shaman visitation.</P>
<P>&#9;Participants discussed the relationship of spirituality to alcoholism and suicide during the interviews. Positive spirituality manifests itself in people who are happy and positive, <I>aarigaa</I>!  Conversely negative thoughts, poor self-esteem, and feeling like a failure open one up to negative spirituality. One young Village #4 male wanted to see spirituality manifested stronger in the alcoholism prevention and treatment programs.  An elder from Village #4 pointed out that alcohol and drug abuse is a spiritual disease that has an effect on suicide because it makes the spirit weaker.  He said, "So all of this is coming together and we start having suicide."   </P>
<P> &#9;Elders wanted to see spirituality integrated into the curriculum because cultural spirituality is not something that is dissected and practiced at home or church but should be the foundation of one's life, including in school. They believed that it should be taught with cultural activities. </P>

<P> <I>Subsistence and the Environment</P>
</I><P>Considered the greatest of teachers, the land and the living things have a strong link to Inupiaq spirituality.  Subsistence or living off the land and water, hard work and survival skills, respect for the total environment were, and still are, values that are inextricably linked to Inupiaq spirituality.  Unlike Christianity, Inupiat spirituality involves the responsibility to take care of the land. The land though, at certain locations, may harbor negative or positive forces.  This is because the land itself and the spirit of the land or <I>nuna</I> are one and the same. These places where the land possesses negative forces are those places where a shaman may have died.  It was only through touching his dogs that an elder Village #3 male was able to free himself from starting to float above the earth because of entering a haunted area. </P>
<P>The land is also benevolent and aided in spiritual growth through the practice of everyday survival skills such as "driving a dog team (at ten years old), get wood, hardships of bringing in water, and being totally self-sufficient (Village #2 elder)." </P>
<P>Even though the young could not give definitions for spirituality other than a few who discussed it in terms of religiosity, all young participants except one discussed their relationship to the land and/or subsistence.  Some camped all winter and fished; this brought much happiness.</P>
<P>It is recommended that the young be taught subsistence activities to strengthen character, and teach Inupiat values.  Young people should know about the spiritual areas that may cause problems and how to protect themselves.  Whenever possible be it church camps, school, or family activities, teach the subsistence lifestyle to the young.</P>
<I><P>Reciprocal Relationship between behavior, positive thought, happiness and the Environment</P>
</I><P>Participants mentioned the importance of a good mind (positive thinking) and as alcohol alters the mind it affects everyone in the community, successful living, and the offspring.  This causes more and more guilt, and people drink to deal with their grief and guilt.  Alcohol as a depressant causes mental agony, and in combination with the mental frame of mind it creates, opens the mind for  negative spirits to enter, increasing suicidal behavior.  This all impacts the environment, and a vicious cycle is created.</P>

<P>Some of the young people do not know the teachings on the reciprocal relationship.  Some do; one Village #3 young woman said, "If you do certain things (good), whatever you catch (animals) will come back."&#9;</P>
<P>In this study, most of the participants stressed the importance of happiness and its relationship to spirituality and the relationship of spirituality to subsistence and the environment.</P>
<P>&#9;The Inupiat word for happiness differed among participants.  According to an interpreter from Nome this is due to the different dialects.  Some used the word <I>aarigaa, quviasruk, toothclick,</I> <I>avatoo, quvainaq, nagoortune, nagooruk,; </I>and<I> koovayukshuk. </I> In English each had minor distinctions. </P>
<P>&#9;Most used the English word "happy" when discussing spirituality.  "Well, if you are happy, you are spiritual" was said by a Village #2 elder female and echoed by other elders and middle age men who saw a happy attitude to help others.  One elder said, "Because of his good attitude, good spirituality all the time, you are down and somehow he would come in and lift your spirit up for you." </P>
<P>&#9; The Inupiat remembrance of what caused unhappiness in their youth is similar to what causes unhappiness as adults. These things that cause unhappiness also break down cultural spirituality.  Those mentioned are family problems, which included sexual, physical, and emotional abuse; abandonment; losing family members; and alcohol abuse.  Others are: peer rejection, boarding schools, moving out of the village, difficult transitions from one stage of growth to the next, early marriages causing changes in existing family relationships, and Western/European contact.</P>

<P>&#9; There were some differences between what caused unhappiness in one's youth and as an adult.  Today, there are more legal problems that involve prison, tax requirements, and child support; they all cause stress. Family problems, especially child sexual abuse and other abuses are mentioned more openly than in the past.  Also mentioned was the eroding of Inupiat culture and dependency and deference to the Western culture. A Village #4 male said,</P><DIR>
<DIR>

<P>That pride and self-esteem is voided.  Normally they say we don't have any police, we need to fix our police, if you ask them what we can do.  "Go find a White guy to come in and take care of things."</P></DIR>
</DIR>

<P>Suicide issues were also mentioned as a source of unhappiness by all participants; community members grieved, especially over young people taking their lives. Some participants mentioned the difficulty they had in reconciling the fact that the person who kills himself/herself is condemned to Hell.  Most people do not discuss the person after the funeral because of shame and guilt. Furthermore, village participants complained about the possession (spirits possessing a person) and visitation (spirits visit and talk to a person or they see them) issues that have surfaced more frequently in the last 20 years.  These problems caused worry and anxiety and impact happiness and well being.&#9;</P>
<P>Most of the answers to the question of "What makes you feel happy today" and "What made you happy in your youth" elicited similar responses.  Although some had concerns about Eskimo dancing making a comeback in some villages, others said that observing and participating in Eskimo dancing brought feelings of happiness. In general, the young people interviewed said they are happier when they are assertive and take responsibility for their own actions.  A Village #1 young male said, "You got to do it yourself and just go forward and do what you have to do."  Most of the young men and women interviewed had quit drinking or using drugs and in most cases felt happy, with the exception of one girl who missed some of her drinking friends who no longer socialized with her. </P>
<P>It is recommended that parents, schools, and community members begin to teach this kind of spiritual knowledge about behavior, thought, and happiness to their children and provide activities to support happiness so that young people can understand the reciprocal relations and take responsibility for their thoughts and behaviors. </P>
<I><P>Activities supporting cultural spirituality</P>

</I><P>The older participants felt that the young people are bored and are not active and busy doing the traditional activities anymore that support cultural spirituality.  For them, when they were young there were many fun activities that supported spirituality.  Most of these activities involved extended family life; church and community activities and subsistence activities.  Some mentioned Eskimo motion dance; sports; playing outside; dog sledding; playing ball; watching movies; helping with chores; listening to stories; all types of subsistence activities; and camping and small trips with the whole famil

MINORITY SUPPLEMENT

WHAT IS THE RELATIONSHIP OF SUICIDE, ALCOHOL ABUSE,

AND SPIRITUALITY AMONG THE INUPIAT?

 

 

SUBMITTED BY

CATHERINE SWAN REIMER, Ed.D.

 

 

 

With grateful acknowledgement to Mrs. Vernita Vestal who accompanied and served as an interpreter for this research

and all the Inupiat participants from the villages of Village #1, Village #2, Village #3, and village #4.

A special tribute to a female elder , one of the participants, who passed away in the Spring of 2002.

 

 

May 15, 2002

 

INTRODUCTION

For the Inupiat people from Northern Alaska, spirituality is inseparably inter-twined with the concept of Personal Well Being (PWB) (Reimer, 1996, 1999). An important aspect of PWB for an Inupiat person is to be well grounded in their spirituality, which includes a strong belief in a personal God, and to be in harmony with their surroundings, their community, and their environment. This, they believe, protects them from illness, and negative spiritual forces (Reimer, 2000). The purpose of this study is twofold: (1) to investigate the relationship between suicide, alcohol abuse and spirituality, as understood by the Inupiat when they speak of PWB translated as happiness or aarigaa, both as an explanatory model of illness (Kleinman, 1991), and as part of an Inupiat person’s worldview; and (2) to investigate the protection and nurturing factor of aarigaa which includes community involvement and spirituality (Reimer 1996; 1999) in relation to alcohol abuse. This study was funded through a minority grant from NIAAA and sponsored by the University of Alaska Fairbanks’ People Awakening Project.

Background and Significance

Suicide

Researchers and mental health workers have studied many aspects of mental health service delivery and the larger social environment to facilitate positive outcomes for suicide prevention since 1897, when Durkheim hypothesized that suicide was a result of social disorganization. Theories of suicide have promulgated since then. Lester’s (1972; 1983; 1992; 2000) review of suicidal theory spans over 100 years; sociological; socio-psychological; physiological; psychological; and rationality theories were mentioned. These studies consistently found individuals to be severely depressed, hopeless, and disturbed and subjects were found to have lower self-esteem, higher stress, and to be originating from dysfunctional families (Lester, 2000).

In multivariate studies, Native Americans have higher rates of suicide than the general population, (Lester, 2000; Middlebrook, D., LeMaster, P., Beals, J., Douglas, K., Novins, M., & Manson, S.; Moscicki, 1997). There is a growing interest in Native American youth because of this high rate of suicide (Wissow, L, Walkup, J., Barlow, Al, Reid, R., Kane, S. (2001), 2.4 times more suicides than the U.S. “Other Races” rate of 13.0 per 100,000 (Indian Health Service, 1997). Suicide among Native American youth ages 15-24 was estimated to be three to four times higher than that of other groups (EchoHawk, 1997). Summarizing findings by geographical location, the Alaska Area (Indian Health Services description) had the highest suicide rates (30.7 per 100,000), followed by the Albuquerque area, which had 25.8 per 100,000 (Wallace, Calhoun, Powell, O’Neil, & James, 1996). Alaska Natives have higher rates of suicide than other Native Americans (Berman & Leask, 1994).

Suicide among American Indians and Alaska Natives adolescents and young adults are often found in clusters, i.e. etiologically linked in a series to other suicides in time and place (Bechtold, D. 1988; Keane E., Dick R., Bechtold D., & Manson, S. 1996). Young females tend to be at risk for suicidal ideation (Middlebrook, et. al.,1997) , while young men are at risk for suicide (Van Winkle & May, 1993). Berlin (1987) described a series of cultural factors in Indian adolescent suicide. He noted such factors as parents being unemployed and alcoholic; failure to live the traditional ways of lifestyle and worship; and adoption into Anglo families. Borowsky, Resnick, Ireland, and Blum (1999) found that depression, substance use, loss of a family member or friends to suicide, availability of firearms, female sex, and a history of physical or sexual abuse have been associated with suicide attempts. A previous attempted suicide is the most important correlate for youth suicides (Borowsky et. Al. 1999).

Suicide is often alcohol and drug-related and victims use violent methods such as hanging and guns (May & McClosky, 1998). Moreover, high rates of acculturation are found among communities experiencing high rates of suicide (May &Van Winkle, 1994). Reasons vary among tribes. Novins, Beals, Roberts, and Manson (1999) found the heterogeneity of suicide ideation among three different American Indian tribes were consistent with each tribe’s social structure, support systems, conceptualization of death and individual and gender role among 1,353 high school students.

Informants in a previous NIAAA preliminary study (Reimer, 2000) and in this study stated that they had been told that, in the past, elders who had become a burden to the family would go off and die, but this was not considered suicide.

In the last thirty years suicide has increased among the Inupiat and continues to be a problem; especially among males who have a high incidence of suicide (Gessner, 1997; Strickland, 1997). In a study (2000) by Maniilaq (unpublished) stated that within a ten-year period from 1990 to 1999, there were three completed suicides with two attempts in the village of Village #3 with a population of under 400. Village #1 with a population under 400 had three completed suicides and three attempts. Village #4 had 12 completions and 84 attempts with a population under 3000. Village #2 with a population under 800 had 7 completions and 18 attempts. For eight villages in the region, most of the completed suicides for the years between 1990 and 1999 were males between the ages 15 to 59 and three females between the ages of 20 to 34. Suicide attempts by age group and sex during these years showed a greater increase of attempts by woman than men in the age bracket from 15 to 24. 47.7 percent of the suicides were completed by firearms, and suffocation accounted for 21 deaths for each group. Drug ingestion was 54.7 percent for 93 attempts between the years of 1990 to 1999. Firearms and suffocation were preferred method for males in completed suicide while drug ingestion was the preferred method for females for suicidal attempts. Both suicide attempts and completions took place at home, with averages being in the 80’s percentile rank; most individuals were single (70’s percentile rank).

Alcohol

Alcohol abuse is a major factor in suicides among all people and increases the risk for suicide and is associated with 50% of all suicides and 5-27% of alcoholic’s suicides (Robins , L. N., Helzer, J. El., Weissman, M.M. 1994). Depression is often common with alcoholics (Murphy, 1992) because of the Serotonin link between these two illnesses (Sellers, Naranjo, and Peachey (1981). There has been a strong association between mental disorder and substance use among completed suicides (Conwell, Duberstein, Cox, Herrmann, Forbes, & Caine, 1998; Dorpat & Ripley, 1960); Rich, Young, & Fowler, 1986). Consistent findings among psychological autopsy that reconstruct a victim’s psychological state prior to death as well as psychiatric problems and symptoms, behavior, and life circumstances during the weeks before death is that psychiatric disorder and/ or substances use is present in about 90% of all suicides. The most common disorder is affective disorders, followed by substance use and schizophrenia (Conwell & Brent, 1995). Moreover, 90% of youth who commit suicide have a psychiatric disorder, primarily depression (Brent, Perper, Goldstein, 1988; Brent, Perper, Morittz, Allman, Friend, Roth, Schweers, Balach, & Baugher, 1993; Shaffer, Garland, Gould, Fisher, & Trautman, 1988).

With or without a comorbid mood disorder alcohol is the most frequent substance identified with suicide completions and attempts (Andrews, 1992; Brent, Perper, Allman, 1987; Garrison, McKeown, Valois (1993); Rich, Young, Fowler, 1986).

In Alaska, alcohol is the number one problem in behavioral health risk factors. The Alaska Native Commission (1994) warned that if alcohol continued among the Alaska Natives, it would permanently cause social, cultural, physical and emotional well being to worsen. Problems continue to abound: suicide, accidental death, alcohol poisoning, family problems, and fetal alcohol syndrome (Herring, 1999; Egeland , Perham-Hester, Gessner, Ingle, berner, Middaugh , 1998). There were 45 suicide deaths in the Region from 1991 through 2000, representing 10.3% of the Statewide suicide deaths (438) during that period (Bureau of Vital Statistics, Alaska Division of Public Health, 2002). Among Alaska Native males between 15-24, 72% of suicides were linked to alcohol (Hickle, Lowe, Clarke, Steuber, & Whistler, 1994). Among the Inupiat male, alcohol was involved in both suicide attempts and completions by 52.1% as compared to marijuana with which was only 0.09% (Maniilaq, 2000). No history of mental health problems was linked to 52.3% of the Inupiat completed and 48.8% of the attempts over a period from 1991 to 2000. Major contributing factors for all Inupiat suicides were divorce/separation (29.4%); relationship conflict (15.0%; substance abuse (10.7%).

Aoun and Gregory Natives (1998) suggest that because of the low rate of association with bipolar disorder and binge drinking, Alaska Natives have different inheritance patterns; other researchers confirm this (Long, Knowler, Hanson, Robin, Urbanek, Moore, Bennet, & Goodman, 1998).

Early post-contact alcohol related suicide research among Alaska Natives was not found, as confirmed by Young, (1992). Little information was found, either orally (Inupiat recorded tapes from Rasmussen Library) or in the literature, before 1940. Alcohol, beginning in the fifties, became a major factor in completed suicides (Fortuine, 1989; Harras, 1987; Kttl & O. Bixler, 1993); Muir, 1915/1979; Reimer, 2000).

Borowsky, Resnick, Ireland, and Blum (1999) identified protective factors among Alaska Native youth such as discussing problems with family or friends, emotional health, and connectedness to family. Community ordinances have helped by limiting the local sale and use of alcohol in the villages (Berman & Hull, 1997). and Mohatt (2001) suggest that cultural and spiritual processes provide protective factors in understanding the sobriety process for Alaska Natives. Reimer’s (1999; 2000) Inupiat study found spirituality, a component of their values, to be a strong protective factor for wellness and alcohol prevention.

Spirituality

Spirituality provides meaning and coherence, nurtures beliefs, interconnectedness of all life, relationships with others and the natural world (Antonovsky, 1980; Lowery, 1998). The literature suggests that spirituality is a major factor in promoting health and well being (Dana, 1993; Bensley, 1991; Ellis & Smith, 1991; Ellison, 1983; Ellison & Smith, 1991; Katz, 1993; 1997; Matson, 1995; Reimer, 1996; Witmer & Sweeney, 1992). Research also suggests that spirituality is a protective factor against suicide (Hoelter, 1979; Jacobs, 1967; Nelson, 1977; Stack, 1981; Stack, 1983) and alcoholism (Moss, Edwards, Edwards, Janzen, & Howell (1985). The Christian religion, among the Inupiat, has been reported to have a negative relationship between religiosity and suicide (Gartner, Larson, Allen, 1991). Negative attitudes toward suicidal behavior have been reported (Bascue, Inman, & Kahn, 1982), and religious people reported experiencing fewer suicidal impulses (Reynolds and Nelson, 1981).

Native American spirituality has been generally discussed by various authors: Deloria (1973), Underhill (1965). Black Elk (1932; 1951), and Lame Deer (1976), have contributed to a global understanding of Native Spirituality among Indians who had lost the oral traditions of their tribe (Reimer, 1996). The influence of their work can be seen in Native American healing (Braswell & Wong, 1994; Schact, Tafoya, & Mirabla, 1988); and the development of the Medicine Wheel that uses the holistic model to describe spirituality (Bopp, 1987; Gunn Allen, 1986; Neihardt, 1961).

However, the existing literature does not provide a clear definition of Alaska Native spirituality among the other major Alaska Native groups, which are the Aleut, Athabascan, Haida, Inupiat, Tlinkgit, Tsimpshean, and Yup’ik. There have been a few Native writers who have written about spirituality relative to their specific tribe. One such work is Kawagley’s (1993) who discussed spirituality as it relates to the Yup’ik culture and Napoleon (1991) who discusses the impact on Western culture on the indigenous culture’s spirituality. Hazel and Mohatt (2001) discuss cultural and spiritual processes by defining an Alaska Native worldview with emphasis on a Yup’ik Eskimo theory for alcohol recovery.

Some equate Alaska Native spirituality with values (Beiser & Manson, 1987; Christensen, 1982). Sullivan (1992, p.29) states that spirituality is “ a personal or cultural way of living certain values in one’s life. Other researchers discuss values such as one’s relationship to each other and relationship to the land (Fienup-Riordan, 1990; Freeman & Carbyn, 1988; Locust, 1988; Kawagley, 1993; Reimer 1996, 1997). As in Reimer’s work (1996, 1997), Fienup-Riordan defined the power of the mind and the directive of considering one’s thoughts and behaviors so as not to offend the spirits of the animals and environment or harm another person.

Works that define spirituality for Alaska Natives are sparse and often limited in scope and understanding. For example, Anderson (1977) proposed that spiritual beliefs were shaped because of the need for food. Oquilluk (1973) attributed a more complex meaning to spirituality based on oral history. According to Inupiaq oral history, as the weather and environment became more severe through many generations, more complex interaction with the spirit world also evolved. Shamans emerged and gained power as mediators between the people and the spiritual and began requiring strict obedience to certain laws and taboos, which, if broken, caused dire consequences. The current construct of spirituality for the Inupiat is complex and is inextricably intertwined with their long history in Northern Alaska, with the environment (land, water, sky, animals, weather), with their ancient spirituality rooted in shamanism with its highly ritualized relationship to the spirit world (often negative), and with Christianity.

Traditional Inupiat spirituality is mostly discussed in relation to shamans, spiritual practices and taboos (Brandson, 1996); Mendenhall, Sampson & Tennant, 1989), rituals (Grim, 1983), beliefs (Reimer, 1996; 1999) and the introduction to Christianity by early missionaries (Mendenhall, Sampson & Tennant, 1989). Even the Inupiat Ilitqusiat, which lists a set of values, including spirituality, which serves as an impressive model for regaining community well being (Beiser & Manson, 1987; Christensen, 1982; and Kleinfeld, 1982) does not define spirituality; nor do recorded tapes (Rasmussen Library at UAF) of Inupiat speakers and elders offer a definition. The literature does explore the impact of Christian religion on Inupiat spirituality.

Hazel and Mohatt (2001) discuss cultural and spiritual processes by defining an Alaska Native worldview with emphasis on a Yup’ik Eskimo theory for recovery. When administering their Spiritual/Cultural Awareness survey (43 items), spirituality was described in terms of Christianity and indigenous concepts. Spirituality as related to sobriety was described in terms of spirits, God, the church, and connection to the land through subsistence activities. This was also found in Reimer’s (1997) book How to Counsel the Inupiat Eskimos.

Although some attention has been directed to the multiple dimensions of the positive aspect of Inupiat spirituality as it relates to happiness or personal well being and the community (Reimer, 1996, 1999, 2000), negative aspects such as spirit possession and visitation from dead relatives and friends have not been adequately explored. In a preliminary study funded by the NIAAA, Reimer (2000) investigated this spiritual phenomenon and found evidence that there was a relationship to suicide. Inupiaq Elders believe the aforementioned encounters experienced by individuals are overpowering, often accompanied by physical struggles between spirits and the individual, often followed by suicide.

There is significant anthropological literature on the subject of spirit possession, primarily in Africa (Kenyon, 1999; Boddy, 1989; Werbner; Al-Safi; Hurreiz, Sayed Hamid & Lewis, 1991; Grotber, 1990;Body, 1988;Kahana, 1985, Nelson, 1972); Vontress, 1991; Young, 1975) but also among diasportic Africans in the Caribbean (Crapanzano, Garrison, 1977. Moreover, significant Christian literature on possession could be found primarily under demonization or demon possession( Berends, 1975; Dickason, 1987; Copestake, Kildahl, 1964; Molony 1993; Nauman, 1974; Roskik, 1997). Bull, (2001) proposes a phenomenological method of therapeutic exorcism for dissociative disorders by using the patient’s view of perceived demons and spirituality to expel these spirits. However, exorcism and possession is often seen as primitive, non-scientific or non-psychological among secular therapists (Bull, 2001). There is literature that supports the interpretation that demons are alter personalities (Frazer, 1993; Ross, 1993) and a few authors are beginning to consider exorcism ritual on dissociative identity disorder (DID) Fraser, 1993; Ross, 1993; Young, 1993). Some Christian therapists believe in demons and the need for exorcism, but emphasize this be done only after assessing mental health especially DID (Friesen, 1991; Rosik, 1993. These authors also warn that DID can coexist with spiritual possession in some cases.

Little was found among the American Indian/ Alaska Native literature to support the idea of spirituality as it relates to spiritual phenomenon; specifically possession and visitations by the deceased. Clarke, (1995) and Johnson, (1994) discuss Swinomish Tribal visitations of the deceased talking to youth contemplating suicide which can serve as an identifiable clue to an impending suicidal attempt. Pavlik (1997) affirms Native American spirituality and traditional knowledge and the existence of the supernatural mostly based on ritual and oral knowledge and the work of Vine Deloria, Jr. (1990). Carl Sagan’s work (1995) is severely criticized by Pavlik because he dismisses tribal spiritual knowledge as being superstitious and not scientific.

In summary, although there is research about spirituality and suicide, and suicide and alcohol, there is little research on the relationship of spirituality, both negative and positive, and its relationship to alcohol and suicide based on Native American explanations and perspectives. Reimer’s (1996, 2000) previous work indicates that personal well being and community cohesiveness serve as a protective factor against alcoholism and suicide. However, no research was found in this review that provides a comprehensive description of Inupiat spirituality or the spiritual phenomena described by the Inupiat (Reimer, 2000). Kleinman (1991) noted that different cultural groups possess different explanatory models regarding illness beliefs and the causation of illness. Effective interventions must target these culturally based models for the cause of illness in order to be plausible to an individual from this cultural group, acceptable as an intervention, and thereby, to be effective.

Finally, the purpose of this research is to establish the foundation for a better understanding of how the Inupiat perceive illness and healing within their worldview and to define the relationship between spirituality, suicide, and alcoholism. Further, this study explores the protection and nurturing factors of aarigaa, which includes community involvement and spirituality in relationship to alcohol abuse and suicide.

Methods

Sample

The four villages in Northwest Alaska were visited because a preliminary interview with selected Elders identified them as potential suicide risk and “trouble spots” based on current and past suicides. Each of the villages is located in the Northwest Arctic Borough. The sale and importation of alcohol is banned in three of them. The 4th village allows no sale of alcohol, but importation or possession is allowed. Subsistence is an integral part of the lifestyle for all the Inupiat Eskimos in these villages, which may include salmon, freshwater fish, moose, caribou, mountain sheep, waterfowl and berries as well as seal, walrus, and whales from the ocean. Most of the people depend on the subsistence lifestyle as part of their economy and food source; jobs are scarce, especially in the smaller villages. The schools, village governments and councils, the Native corporations, airlines/air carriers and local stores provide year round jobs

A total of twenty participants who were identified as knowledgeable of suicide, spirituality, and alcoholism were selected through elder and IRA selection and approval. The original plan was to include 16 participants with an equal distribution of male and female of elders and young people between the ages of 18 to 33 from each village. Instead the number of participants was increased to 20 in the age group of 21 to 88, the average age being 50, with 11 men and 9 women interviewed. Because of their cultural expertise and knowledge of spirituality and possession, two middle age males were selected from two different villages and two young adults were included in the sample. The following is the breakdown: Village #4 - two males (1 young and 1 elder) and two young females. Village #1 had three females (2 elders and 1 young), two males (1 elder and 1 young). Village #2 - three females (2 elders and 1 young), three males (1 elder, 1 middle age, 1 young); Village #3 - three males (1 elder, 1 middle age, 1 young) and one young female.

Procedure

Qualitative research methodology was used in this study to explore the relationship between suicide, spirituality, and alcohol among the Inupiat. Before interviewing the participants, a literature review, described above, was conducted to explore current studies, early writings, and oral history related to Inupiat spirituality, alcoholism, and suicide housed in the oral history archives of the University of Alaska Fairbanks

An interview schedule was devised that asked two major general questions with probes used throughout the open-ended questions after five Inupiat consultants (elders and young people) refined and simplified them for the Inupiat population. The main questions were: Could you tell me some reasons why you think Inupiaq men (women) take their lives? What contributes to personal happiness and feeling good and lessens happiness and feeling good? Probes explored the Inupiat word aarigaa or happiness and feeling good, the communities’ contributions to this protective factor, and an exploration of Inupiat spirituality (Appendix A).

. Mrs. Vernita Vestal accompanied Dr. Reimer and served as the Inupiat interpreter at each of the four sites. Dr. Reimer identified key words and phrases on spirituality and happiness from Mrs. Vestal, participants, her cousin, and her mother who is Inupiat, born in Village #1.

Inupiat cultural experts were identified by the Inupiat community and were recruited as consultants and completed a consent form. Following informed consent, consultants were interviewed using the interview schedule with probes to further delineate information on the relationship of spirituality, alcohol, and suicide. Audio recordings of the sessions were made and notes were taken during each interview. The tape interviews were transcribed verbatim. Typed copies of the verbatim interviews were sent back to the respondent for review and to confirm that what was transcribed was what they said. All recommendations for change or clarification by the participants were made to the transcriptions. To ensure that consultants were not harmed by the interview, this researcher called each participant after the interview. All procedures were reviewed and approved by the University of Alaska Fairbanks Institutional Review Board for the Protection of Human Subjects.

Qualitative Data Analysis

The challenge of the data analysis phase of the study was to make sense of the substantial data collected, to synthesize the information, to identify meaningful patterns, and to “construct a framework for communicating the essence of what the data revealed” (Patton, 1990, p. 371-372) in a relatively short time. Grounded theory analysis (Strauss, & Corbin, 1990) was used to identify theories and concepts. To understand the complexity of the material, it was necessary to gain an understanding of the data from several different perspectives. The following approaches were used to identify the emerging themes: (1) examining the participants’ responses to the interview questions and form categories along with two other individuals with significant background and professional work among Native American cultures; (2) checking for reliability, a sample of the categories, after they had been coded; (3) reviewing auxiliary notes taken during and after each interview; (4) reading the participant’s responses several times after listening to the tapes; and (5) examining the coding results to identify general themes and relationships among the categories of responses. Research mentors reviewed the material and provided suggestions. For validity purposes, respondants were sent their original manuscripts to check for error or request any changes.

The interview questions are grouped under the three following major themes for purposes of analysis: suicide, alcoholism, and spirituality using First-level analysis followed by Second-level analysis to deepen the understanding of the major constructs and the inter-relationships between them.

RESULTS

The following are the results based on the research questions. Three main categories are discussed: Alcoholism, Suicide, and Spirituality. The alcoholism and suicide results are also integrated in the Spirituality section. Greater detail is given to Spirituality; in particular, the sections titled Cultural Spirituality and Non-Ordinary Spiritual experiences since alcohol and suicide are related to these constructs and little could be found in the literature pertaining to these constructs.

Alcoholism

The Inupiat participants were aware of the changing drinking patterns since the 60’s in that drinking was pervasive in the villages prior to that time, but without any suicidal behavior. According to a young woman when she was younger, people use to be out “hollering in streets, out in the open.” That kind of behavior has stopped. An elder shared how dysfunctional drinking norms learned from miners, whalers, and other Westerners were integrated with the Inupiat value of sharing, he said, “That’s who we learned to drink from. When you had it, you drank till it was all gone and everybody drank cause we shared with everybody.” Some saw alcohol as a Native problem, not being able to drink like other races, i.e. - “hold their liquor” or “social drinking”. Others saw alcoholism as a spiritual problem. Divorce, physical and sexual abuse, job loss, depression, guilt and shame, and opening up the person to negative spiritual forces were problems associated with substance abuse. A few participants mentioned generational issues such as children of alcoholics and co-dependency, but others did not know how to explain or deal with the alcoholic behavior because they do not understand the problem.

Fetal Alcohol Syndrome and Effects were mentioned as well as a decrease in health and ability to work and maintain a job. Many accidents occur when a person is under the influence, especially when driving a snowmobile or ATV. Some participants are aware of how difficult it is to be physically addicted, while others said they could just make up their mind and quit because it was a spiritual disease.

Other drugs, mostly marijuana, in addition to alcohol, have become a problem and some believe that the drugs and alcohol contribute to suicidal behavior. Some participants believed that alcohol and drugs relieved not only personal and social problems and associated tensions, but also spiritual ones. Alliiqtu, or when something is really bothering a person’s mind, alcohol is a way to escape from it but it may open the mind into more serious spiritual problems such as possession.

Many of the suicides, it was said, were caused by relationship problems while under the influence of alcohol. Most of the relationship problems for both men and women who either attempted or completed suicides occurred because of the ending of a relationship. However, alcohol was often the main cause for relationship breakup because of physical abuse, infidelity, jealousy, fighting, absenteeism, and children suffering from the alcoholic relationship. A young Village #3 woman thought it was ironic that people killed themselves, and said, “alcohol is the cause of your pain and you turn to alcohol for comfort?”

The impact of alcoholism undermines the Inupiat culture, chipping it away, generation by generation; happiness, feeling good, Inupiat values, and subsistence, the foundation of Inupiat culture, are affected. A young Village #4 male discussed how the cultural side is affected by drinking. Sadly, he said,

A lot of them are not Christians, they are not saved, they have no idea about spiritual warfare, but they do understand that maybe their cultural side is not as strong as it should be and they cannot draw from that well.

Elders are affected with sadness when they see the culture eroding and their loved ones hurt; those elders who could be potential leaders are either too ashamed to or they are still drinking. Fortunately, a couple of male elders quit, one said this about his alcoholism affecting his cultural side,

I tried to be honest when I was a little kid. I took pride in being honest. I took pride in stopping and helping whoever needed help, it didn’t matter who it was. When I started drinking all of that changed.

Everyone in the villages is affected or influenced by alcohol. Parents are drinking more and even representatives serving the villages are accused of not living the Inupiat values and Inupiat life since some of them abuse and import alcohol.

Suicide

Each of the participants in this study remembered suicide events in their village at different periods. A Village #1 elder remembered the first suicide happening in 1940, while another elder from Village #4 didn’t think there were any suicides before 1960. A Village #2 male thought the first suicides happened in the 1950’s when two women committed suicide in his village. But it wasn’t until the 1980’s that everyone’s attention was focused on the problem because there were twelve suicides in fourteen months, four times the national average.

Reasons given for suicide are complex, historical, and holistic in nature. Two different worldviews clashed when the Europeans and Euro-Americans arrived in Northern Alaska and began interacting with the Inupiat. The Inupiat values and spirituality were tribal and collective, whereas the Europeans values were individualistic and possession-oriented. The Inupiat culture was completely transformed when the Europeans first colonized the region and brought with them their disease, religion, education, social systems, economics, legalities and law, subsistence regulations, and language. Participants mentioned that the Inupiat people were looked down upon, degraded, and the culture was not valued, and judged to be inferior. One male elder from Village #4 said that the high rate of “suicide is a spiritual problem and a collective problem causing traumatic shock for over a hundred years.”

An elder from Village #4 discussed problems associated with contact with the Europeans who believed in their personal privilege and their notion of “Manifest Destiny” seen in the way they oppressed and forced assimilation through education, laws, economics, population control (hysterectomies), and the settlement of Eskimo villages. They introduced dysfunctional drinking patterns and the abuse of women. Others mentioned there was a rapid decline of tradition: especially the Inupiat dance and ritual ceremonies. There was also the loss of language and values, and tribal medicine practices dependent on the natural environment. Native rights were lost by taking away the land, and animals. Boarding schools broke up the family system; many children did not learn how to parent their children. With the strong moral codes broken, child abuse, especially sexual abuse; all led to unresolved trauma, depression, alcoholism, and suicide. The elder from Village #4 also said, “So more deeper depression starts to set in. The one point I want to make here is that suicide is a spiritual decision and that’s the decision.”

Personal reasons for committing suicide are all intertwined in the issues described above. In general, as seen from the individual experience, most participants felt that the main causes of suicide are alcoholism and drugs, and relationship problems with family and friends. More specifically, depression, psychological problems, and social isolation were mentioned as possible causes. Participants also mentioned dysfunctional families, especially problems with sexual abuse, lack of discipline and communication, and lack of parenting skills. Sexual preferences and loss of jobs and going to prison were mentioned less frequently. Possession and visitation by spirits was also believed to cause suicide or attempted suicide; contributing to this are mind-altering drugs that open up an individual’s mind to these phenomena. Other minor influences mentioned are copycat influences and pacts made with friends.

One elder from Village #4 felt that unless you “fixed all,” no one would really be fixed. Participants felt the whole community itself had to face some of the major social and psychological problems that the people have kept hidden. Young people were more open and talked about child and sexual abuse as well as other community secrets. It is believed that the victims as well as the perpetrators use alcohol to numb their problems and keep themselves in denial. Without meaningful programs and sustained efforts to address these issues, participants believed the problems will continue. Therefore, according to many of the participants, it is necessary to examine how the community and its institutions may be contributing to suicide. These will be discussed under Inupiat Spirituality.

Participants discussed both the attempts and completed suicides. Attempts and completed suicides were done by overdosing on medicine, slitting the throat, drowning; hanging; but the most common method for both attempted and completed suicides was the use of a gun.

Attempts

Two participants discussed their own suicide attempts, while others discussed family member’s attempts. (A breakdown of the attempts and completed suicides can be seen in Appendix B.). Reasons for attempting suicide were relationship problems, problems with the judicial system, emotional problems, depression, self-esteem issues and inability to cope with the larger Non-Native society. Alcohol was often a contributing factor. There were three cases of possession, one of which (young female) was intervened and stopped by exorcism.

Some interventions were made by the health clinic staff, family and friends, church members, the churches, and through intercessory prayers as in the case when the person’s gun would not fire after four attempts. This is usually not the case when handling guns. One young man warned about the danger of guns because of their “light triggers” which are set for hunting. He said from his own experience, and from what he heard from others, some would think about suicide, actually put the gun to their head, and think they have some control of the gun. This was not case of a 22 year-old student who was a “little mentally unstable” and concerned about his income taxes that he did not know how to pay. Alcohol was not involved when he shot himself under the jaw and left a hole, “the size of a half dollar.” Later when he woke up in the recovery room, he said, “What happened?” According to the nurse, he was dead for three to four minutes.

Completed

Completed suicides involved the family, friends, and community members of the participants in his study. Of the suicides discussed by the participants, there was only one young woman from Village #1 who committed suicide, while the other suicides were young adult males. See Figure 1 for a breakdown of gender, age, the relationship to participant, alcohol related, reason, spiritual possession, warning sign and who gave the report.

Most completed suicides also involved drinking alcohol, while four of the mentioned suicides, it is known, did not involve alcohol. Some participants did not know whether the suicide they discussed involved drinking or other drugs. Guns (most popular method), hanging, and drowning were the methods discussed.

Interventions

Elders want to see stronger families talking to each other and the young to express themselves and talk about their problems. As one Village #2 elder female said, “Smiling at them and talk to them and make them understand that you love them hard.” For the Inupiat, talking is often indirect (Reimer, 2000); it may be through stories or giving examples that one talks about personal issues. The difficulty one has in talking directly can be seen when a mother confessed she did not want to offend her son by talking directly to him about her fears.

Young people are changing communications, as one Village #4 woman expressed a more open and assertive style where she would not let someone keep problems to oneself but share with her what was going on in personal thoughts about suicide. She said, “I am not going to let it happen where I can’t talk to you anymore, you are going to get it out and tell me what’s up.”

Other interventions that are effective will be discussed under Inupiat spirituality.

Warning Signs

A few of the young people mentioned typical warning signs like giving away gifts, change of mood from depressed to happy and others taught by the Maniilaq suicide prevention program. Participants mentioned the following warning signs in order of frequency: alcohol, (the “knock out punch” that according to a Village #4 young male pushes them over the edge); depression; isolation; dysfunctional family and relationships problems; and spiritual visitation or possession.

A young female mentioned “loners” as a potential warning sign, this may be difficult because many young Inupiat men are quiet and shy. Being a loner coupled with any of the above warning signs or if someone in the family or a close friend committed suicide or died, this person should be watched.

Other warning signs included a change in the way a person looks at you, a change in the eyes, fear in the eyes, and an elder’s intuitive knowledge that something is wrong.

Information can be found in Appendix B for both completed and attempted suicides specific to each village with information on the relationship to speaker, alcohol related, how it was done, the reason, related to spiritual possession and warning signs.

Reasons

The following were reasons why a person would consider suicide, others may be found in the section titled Inupiat spirituality.

Teachers were criticized for not understanding the culture, language, communication and learning styles of the students, often pushing young people to failure and even suicide by their insensitivity and lack interest and knowledge. Administrators were criticized for not giving school boards more local control, not developing effective discipline policies, and not integrating prayer and faith into the school day.

Parents were not immune to criticism either. Some thought that some parents did not cooperate with the school and support its policies, especially on discipline. One Village #3 young woman said,

Some parents really give teachers hard time, yet they are the parents we know who have troubled kids because of what is going on in the home. I have seen that happen many times. Certain times, parents are not willing to listen to both sides. They come up with their own conclusions. A lot of people are stubborn that way and want to believe their children and stick by them even though they know they have done wrong.

Participants identified the tribal council, town council, IRA, judicial system, and health department as community agencies; all of these agencies need to be working together. When programs act separately and not in unison with each other, they contribute to the problem of suicide. Some complained about the lack of effective AA meetings and hoped that they could improve them by integrating cultural and Inupiat values.

Spirituality

To understand the relationship of spirituality to alcoholism and suicide it is necessary to define Inupiat spirituality since it has not been adequately defined in the literature, and participants did not give a clear definition; although each provided aspects of what constituted Inupiat spirituality. One young male from Village #4 saw the importance of establishing a definition, he said, “We have to define spiritual too. There is that spiritual between God and between Satan and there is the cultural spiritual side too”.

Participants discussed cultural spirituality and religiosity when asked to describe what spirituality meant to them. They also discussed non-ordinary spiritual experiences, which is the third category of spirituality. This third construct also gives insight into Inupiat spirituality. Each will be discussed in relation to suicide and alcoholism.

Cultural Spirituality

Although no one gave a clear definition of spirituality, each participant discussed its aspects, with Inupiat Values mentioned most frequently in relation to cultural spirituality. The many aspects of spirituality include shamanism; transmission of spiritual teachings; Inupiat values; spiritual as source of power and strength; subsistence and the environment; reciprocal relationship between behavior, positive thought, happiness, and the environment; activities supporting cultural spirituality; spirituality as connection; and integration of cultural spirituality with Christianity. Cultural spirituality is a complex construct representing the above nine domains; each of which will be discussed.

Shamanism

Shamanism played a pivotal role in the spiritual lives of the Inupiat before the arrival of Christianity because, according to participants, it structured their spirituality and daily life, defined their worldview, and provided some control over the natural elements involving survival. The Inupiat relinquished direct communication with the source of their spirituality to the shamans who possessed extraordinary powers that either helped or hindered the Inupiat through their healings and control of the environment and events, but taxing and even killing Inupiat when they broke certain taboos.

Elder village participants, 70 and older, had mostly negative comments about the shamans, believing that they received power from evil spirits and the devil. Elders talked about Robert Sam who preached that shamanism was “dark magic” beginning about 1898. Many, about that time were grateful to embrace Christianity because they no longer had to follow strict taboos such as not eating fish and caribou at the same time, or handling them, at the same time.

A few elders talked positively about the shaman, describing such gifts as helping to interpret dreams, see into the future, and heal. A Village #2 elder male said,

The ahgnatquq (shamans), some of them were demon possessed. They had power to do supernatural things. Some of my ancestors were like that. … “People say all ahgnatquq (shaman) are bad, I do not believe that. My gramma had the ability to heal.”

What many now believe about the shaman or ahgnatquq , according to a Village #4 elder, was tainted information from the missionaries who labeled shamanism terrible and heathen in order to convert the people to Christianity. The majority of elders said they were relieved that Christianity replaced the shamans and their evil powers. Yet, some believe that the shamans are trying to make a comeback, since there have been reports that family ancestors who once possessed these powers were appearing to young family members and influencing them to take their lives. Some young people have tried to gain some of these powers, according to a Village #2 man whose own father had to fight off family shaman spirits. His first cousin requested these powers and received them, but these powers turned against him; later he killed himself. He said, “I tried to help him but I couldn’t because this person had gone too far… I know several who were like that.”

Other villages reported the shamans showing up. A Village #1 elder said, “I know it spotted one family last year, old grampa bothering the whole family. Nowadays it’s coming back. It start coming back and they you will start seeing kids going to a funeral (suicide).”

Some are looking at this power and integrating it with Christianity. According to a middle age Village #2 male, it can only be used within the protective shield of Christianity. He said, “So the power is now still in you, do you see what I mean? You have a capacity to be a shaman or you have the capacity to be a healer in the Lord.”

Maniilaq has become a model for many who were able to integrate spiritual power with a Divine Source. This revered Inupiaq man named Maniilaq was born around 1850. He was guided by the revelations from what he called the “Brother in the Sky,” who told him to not follow the taboos and laws of the shamans. He broke many taboos and encouraged others to do the same. According to an elder from Village #2, Maniilaq was divinely protected.

And then these ahgnatquq from outlying villages, I don’t know how many of them… they tried to get him. He was all by himself in a little tent, they tried to get him from any direction. They couldn’t though. He was glowing too. There was a glowing all around him. They couldn’t get him.

The general consensus among those interviewed was that Maniilaq had special gifts that were greater than the shaman’s power. He is seen as a hero to many, a prophet to some, a precursor heralding Christianity, and a man who could have been destined to become a great ahgnatquq (shaman).

Participants recommended that the history of shamanism and stories about Maniilaq should be taught in the homes, schools, and even by church leaders so young people understand the dangers of dealing with the occult and shamanism. It could help those young people who are being “recruited” not to be afraid to talk about it and get help from the elders. Most community members are afraid to discuss this spiritual phenomenon, but elders believe it is important to educate the young on shamanism and how alcohol opens the mind for these spirits to suggest they commit suicide.

Transmission of spiritual teachings

The grandmother played a very important part in passing on knowledge, stories, and correct behavior; parents, grandfathers and elders were also mentioned, but not as frequently as the aana. Often it was she who taught they young boys to hunt and fish. The elders were remembered for their teachings on spirituality, especially in relation to the land and spiritual encounters.

Often elders are described as “the door to the past.” Some people felt that the elder’s are not transmitting spiritual knowledge to the young today because of fear the young will dabble in shamanism. Moreover, one elder felt some hesitation in acknowledging his role as an elder because of guilt over past alcoholic behaviors. He said, “As we get older, we move to the role of elder. Some are not prepared.” He felt others felt the same, “They are afraid they are not good Inupiat to take on the role.”

Participants would like to see the elders teach in the schools and help the community understand cultural spirituality. Elders need to pass on their knowledge to middle age people, who are the next in line to becoming community spiritual leaders. Elders have much to offer young parents on disciplining their children and how to teach them. A few elders felt that young people were giving in to alcoholism, substance abuse, and suicide because they had not developed a strong internal disposition and character through hard work and daily survival activities such as chopping wood, bringing in water, and helping with all the chores. Throughout the interviews elders complained about the lack of discipline and loss of Inupiat values that are no longer being passed on to the children. They would like to see these offered through the Corporation and Mental Health Center.

Inupiat Values

Participants agreed that to have an Inupiat spirit one must know and live the Inupiat values contained in the Inupiat Ilitqusiat. This value system grew out of not only the traditional teachings, but also from the examples that the elder’s lived.

The most frequent value mentioned among the four villages was respect the elder and then good things will come to you which also creates a reciprocal relationship between the people and the land (environment).

All the Inupiat Ilitqusiat values were mentioned to, or experienced by, the interpreter and researcher during the visits to the four sites. Values mentioned were: subsistence (mentioned frequently by young and old); hard work; love for children; sharing; spirituality; domestic skills; hunter success; knowledge of family tree; knowledge of language; hard work; respect for nature; and family roles. The values discussed throughout the interviews were: humility; avoidance of conflict; respect for others (clearly evidenced by the way we were treated); and cooperation. Humor was discussed and experienced, for example, during the interviews of two elders who were singing and having fun through their story telling.

A young Village #4 woman saw this researcher struggling with luggage and immediately carried them. Whenever she could, she said she would help elders coming in from out of town. This kind of behavior is starting to fade among the young people. An elder male from Village #1 complained that the young were interrupting elder’s communication and teachings on the CB (Citizen’s Band Radio). One was also reported to have said, “I hope elders die right away, die right now.” The elders worry about the young who will not have the strong well of culture to draw from and especially the values that are the foundation of the Inupiat culture. One young male from Village #4 said,

I think they need to have to fill that cultural spirituality; they need to build that well and fill it up because when they reach down there and find nothing, then that is when things can be bad.

Participants would like to see the schools integrate culture, language, and the Inupiat values in the school system. One elder said it was important that they not only teach them (the values) but also live them. Moreover, young and old both see the need to integrate these values in all suicide and alcohol prevention efforts.

Spirituality as a source of power and strength

Many talked about the cultural spirituality being a source of pride and strength and a deterrent from suicide and alcoholism by helping them cope with stressful situations. One young man said when experiencing stress while attending the University said,

You have to say, “I have certain things, I know certain things that they don’t know. They may have better clothes than me, I know something that they don’t know.” And you have to be able to draw from that and that is what I mean when I talk about the cultural spirituality.

Elders gained exceptional powers through common sense and experience. They could tell the weather by the way their bodies hurt, especially through the joints, but they also possessed strong, personal powers which made young people both fear and respect them. As expressed by this Village #2 middle age man, “because they don’t know what kind of power he has and things like that…because way back then, all they had to do was think…. And it happens.”

There were several powers and strengths noted during the interviews, both positive and negative powers. The positive were expressed by the gift of dreams and interpretation of dreams; intuition or sixth sense; near-death experiences; intercessory prayer (intervention); personal power; healing; spiritual protection; weather prediction; ability to sense danger; prophesy; and exorcism. Spiritual gifts and experiences seen as negative were levitation; personal power; possession; mind power (subliminal thinking); shaman visitations; post-death experiences, and magic. The term negative spirituality is used in reference to such experiences, but in particular to possession and spirit or shaman visitation.

Participants discussed the relationship of spirituality to alcoholism and suicide during the interviews. Positive spirituality manifests itself in people who are happy and positive, aarigaa! Conversely negative thoughts, poor self-esteem, and feeling like a failure open one up to negative spirituality. One young Village #4 male wanted to see spirituality manifested stronger in the alcoholism prevention and treatment programs. An elder from Village #4 pointed out that alcohol and drug abuse is a spiritual disease that has an effect on suicide because it makes the spirit weaker. He said, “So all of this is coming together and we start having suicide.”

Elders wanted to see spirituality integrated into the curriculum because cultural spirituality is not something that is dissected and practiced at home or church but should be the foundation of one’s life, including in school. They believed that it should be taught with cultural activities.

Subsistence and the Environment

Considered the greatest of teachers, the land and the living things have a strong link to Inupiaq spirituality. Subsistence or living off the land and water, hard work and survival skills, respect for the total environment were, and still are, values that are inextricably linked to Inupiaq spirituality. Unlike Christianity, Inupiat spirituality involves the responsibility to take care of the land. The land though, at certain locations, may harbor negative or positive forces. This is because the land itself and the spirit of the land or nuna are one and the same. These places where the land possesses negative forces are those places where a shaman may have died. It was only through touching his dogs that an elder Village #3 male was able to free himself from starting to float above the earth because of entering a haunted area.

The land is also benevolent and aided in spiritual growth through the practice of everyday survival skills such as “driving a dog team (at ten years old), get wood, hardships of bringing in water, and being totally self-sufficient (Village #2 elder).”

Even though the young could not give definitions for spirituality other than a few who discussed it in terms of religiosity, all young participants except one discussed their relationship to the land and/or subsistence. Some camped all winter and fished; this brought much happiness.

It is recommended that the young be taught subsistence activities to strengthen character, and teach Inupiat values. Young people should know about the spiritual areas that may cause problems and how to protect themselves. Whenever possible be it church camps, school, or family activities, teach the subsistence lifestyle to the young.

Reciprocal Relationship between behavior, positive thought, happiness and the Environment

Participants mentioned the importance of a good mind (positive thinking) and as alcohol alters the mind it affects everyone in the community, successful living, and the offspring. This causes more and more guilt, and people drink to deal with their grief and guilt. Alcohol as a depressant causes mental agony, and in combination with the mental frame of mind it creates, opens the mind for negative spirits to enter, increasing suicidal behavior. This all impacts the environment, and a vicious cycle is created.

Some of the young people do not know the teachings on the reciprocal relationship. Some do; one Village #3 young woman said, “If you do certain things (good), whatever you catch (animals) will come back.”

In this study, most of the participants stressed the importance of happiness and its relationship to spirituality and the relationship of spirituality to subsistence and the environment.

The Inupiat word for happiness differed among participants. According to an interpreter from Nome this is due to the different dialects. Some used the word aarigaa, quviasruk, toothclick, avatoo, quvainaq, nagoortune, nagooruk,; and koovayukshuk. In English each had minor distinctions.

Most used the English word “happy” when discussing spirituality. “Well, if you are happy, you are spiritual” was said by a Village #2 elder female and echoed by other elders and middle age men who saw a happy attitude to help others. One elder said, “Because of his good attitude, good spirituality all the time, you are down and somehow he would come in and lift your spirit up for you.”

The Inupiat remembrance of what caused unhappiness in their youth is similar to what causes unhappiness as adults. These things that cause unhappiness also break down cultural spirituality. Those mentioned are family problems, which included sexual, physical, and emotional abuse; abandonment; losing family members; and alcohol abuse. Others are: peer rejection, boarding schools, moving out of the village, difficult transitions from one stage of growth to the next, early marriages causing changes in existing family relationships, and Western/European contact.

There were some differences between what caused unhappiness in one’s youth and as an adult. Today, there are more legal problems that involve prison, tax requirements, and child support; they all cause stress. Family problems, especially child sexual abuse and other abuses are mentioned more openly than in the past. Also mentioned was the eroding of Inupiat culture and dependency and deference to the Western culture. A Village #4 male said,

That pride and self-esteem is voided. Normally they say we don’t have any police, we need to fix our police, if you ask them what we can do. “Go find a White guy to come in and take care of things.”

Suicide issues were also mentioned as a source of unhappiness by all participants; community members grieved, especially over young people taking their lives. Some participants mentioned the difficulty they had in reconciling the fact that the person who kills himself/herself is condemned to Hell. Most people do not discuss the person after the funeral because of shame and guilt. Furthermore, village participants complained about the possession (spirits possessing a person) and visitation (spirits visit and talk to a person or they see them) issues that have surfaced more frequently in the last 20 years. These problems caused worry and anxiety and impact happiness and well being.

Most of the answers to the question of “What makes you feel happy today” and “What made you happy in your youth” elicited similar responses. Although some had concerns about Eskimo dancing making a comeback in some villages, others said that observing and participating in Eskimo dancing brought feelings of happiness. In general, the young people interviewed said they are happier when they are assertive and take responsibility for their own actions. A Village #1 young male said, “You got to do it yourself and just go forward and do what you have to do.” Most of the young men and women interviewed had quit drinking or using drugs and in most cases felt happy, with the exception of one girl who missed some of her drinking friends who no longer socialized with her.

It is recommended that parents, schools, and community members begin to teach this kind of spiritual knowledge about behavior, thought, and happiness to their children and provide activities to support happiness so that young people can understand the reciprocal relations and take responsibility for their thoughts and behaviors.

Activities supporting cultural spirituality

The older participants felt that the young people are bored and are not active and busy doing the traditional activities anymore that support cultural spirituality. For them, when they were young there were many fun activities that supported spirituality. Most of these activities involved extended family life; church and community activities and subsistence activities. Some mentioned Eskimo motion dance; sports; playing outside; dog sledding; playing ball; watching movies; helping with chores; listening to stories; all types of subsistence activities; and camping and small trips with the whole family.

In general, subsistence activities, including hunting, fishing, whaling, picking plants and berries, and camping are still popular. Some schools are integrating Inupiat stories and craft making in their curriculum. Maniilaq’s Spirit Camp, sports involving other communities, and Eskimo Olympics and Eskimo dancing in some villages were reported to bring happiness, which in turn supports spirituality because it involves the whole community.

Eskimo Dancing is the most controversial of all the Inupiat traditional activities, yet it is considered a spiritual activity. It reflects the Inupiat’s life, brings happiness and allows people to come together as a community “like it used to be.” A Village #2 middle age male whose whole family danced wanted traditional dancing to come back, since it gave the people an identity through expression of self and of story telling. Moreover, through dance they are expressing themselves about their Inupiat upbringing. He said,

Kivaluk dance, Ivuluk dance, whereas in whaling community they dance about seals and things like that. But here, ours would be inland. They are telling the stories. What would be wrong with telling the stories while you are dancing?

Some participants were upset because alcohol has taken its toll on the transmission of cultural knowledge and activities. Parents and extended family members did not teach their young about hunting, fishing, carving, dog teaming. One young female from Village #3, said that young people today are not taught and “learn what they see in their home and they think that is life.”

In the past, the school was the center of Inupiat community life and helped maintain unity in the community through activities providing by school staff, including a nurse who acted as a counselor and provided health aid. This has all changed. Participants discussed some of the problems that schools face today that they believe are related to a lack of activities, especially after school; without them, discipline problems increase. The community severely criticized a recent closing of a school gym for all students in order to punish a few students. There were those who wanted to see more suicide and alcohol prevention activities sponsored by the village and regional organizations. Most programs sponsored by outside agencies go to the larger towns , but very few trickle down the small villages. Several mentioned that they appreciated the recent Suicide Prevention Summer Camp. Requests were made that Mental Health Center and the Corporation provide more resources to help pay for swimming pools, equipment, computers, recreational centers, and sports equipment to help reduce young people’s boredom and lack of activities. Moreover, there was unanimous agreement among the older generation that the whole community get involved, including the law enforcement, health department, tribal and city councils, and parents to organize and support activities for the young to supplement drug and alcohol prevention.

Spirituality as Connection

Some equated spirituality as connection. A Village #3 middle age male discussed the power of spiritual connection especially when the community got together for anaktaq (Eskimo Olympics), he said,

Something of that spiritual because that spiritual thing is very powerful…it is hard to explain … but it gives us a sense of that we are part of the whole… a unity within our people… we need to see that. I guess that in the older days, in the younger days we saw that.

Unity and connection is shown through action and working together as a community, and helping the old and young. While it is important to follow the Inupiat values, according to one elder, everyone needs to do so. He said,

But the difference here is that although we probably have individuals that can’t take these values and say, “yup, that’s what I’m going to do” and they can take care of themselves, most of us cannot. Because, we’re connected, unless all of us are ok, you know, we’re not ok and so that’s why I am harping on the tribe because these are tribal feelings.

This spiritual connection is a strong belief because as one Village #1 elder female said “You are part of the Spiritual Being.”

Participants all felt substance abuse and suicide impacted the villages and eroded the positive sense of unity. Participants experienced different reactions to suicidal events. Experiences recorded were shock, alarm, surprise and guilt. One elder from Village #1 had to be sedated after her grandson committed suicide. Since these are small communities with extended families and strong friendships among community members, not only do individuals suffer but also the whole community whose members are stunned and feel the loss. Within hours, friends and family members from other villages and towns know of the incident via e-mail and the telephone. Family members suffer because the whole family is shamed. They often feel personal guilt and shame because they did not intervene and feel helpless, as in the case a young man, who shortly after his brother’s suicide, killed himself in a snowmobile accident. He had spent weeks grieving alone. As one Village #4 woman said, “everything is hush, hush.” One Village #2 elder said that they “don’t know how to deal with suicide and they are in denial… big time because they don’t understand why.”

The Inupiat villages in this study are connected through relationships and shared values, and a suicide affecting one village will affect other villages. Recently, for example, when a young person from another village committed suicide in the village of her boyfriend, this village was concerned that the other village would blame them for the suicide. They were afraid of possible repercussions, since they might blame that boy’s family and community for her death. Fortunately, the other village didn’t, but one participant said it was difficult for the people in both villages. There was tension between the members of both villages when the home villagers picked up the body of the young woman; eye contact was avoided.

Substance abuse, especially alcohol, impacts unity and connection in serious ways by breaking down personal, family, and community relationships as the alcoholic progresses through his/her disease. Often it is not the alcoholic who is ostracized, as in the past, but rather those who quit drinking, especially among the young who no longer fit in with the substance-user crowd.

Participants made many suggestions that would support Inupiat unity and connection. Villagers would like to see the Mental Health Center, the Corporation, Indian Health Service and the University of Alaska get involved with parenting classes, activities, better counseling, and suicide and alcohol prevention. Some felt the intervention and prevention programs are too focused on the individual rather than the whole system. Fixing one person is a temporary solution because the Inupiat are all connected; what affects one has repercussions for the whole group. They would like to see a holistic approach to alcohol and suicide prevention, emphasizing the Inupiat values, history of the people, and the cycle of trauma, integration of Eskimo subsistence activities, crafts, and Eskimo dancing to support Inupiat identity. One woman mentioned the importance of having transition-type activities to help the young move into adulthood.

Other parts of the system need to be involved. Law enforcement needs to take a proactive stance to keep villages dry; this includes the tribal and city councils being strong enough to lay down laws and get people to live by them, and community members need to become involved even if it means turning in family members. Parents need to establish unity through cooperating with the schools and schools need to include the parents in setting up policies and being included. Furthermore, the School Boards should have a strong voice and help determine policies, as well as to insure the integration of Inupiat culture, values, and language into the classroom. Churches are asked to work cooperatively with other churches as well as be involved in community decision-making. All organizations, including elder input should be under the umbrella of the IRA to make sure that the whole system supports the Inupiat values, Inupiat lifestyle, and belief system be they education, law enforcement, health and human services, or the churches. The fighting and arguing between agencies need to stop.

Other suggestions that impact unity and connection were mentioned, such as creating jobs for Inupiat people and addressing sanitation problems. When people get sick, everyone is affected in a negative way. Diseases are inevitable; germs pass quickly when there is no running water and toilets. Most of the villagers of Village #1 suffered with colds, pneumonia, and influenza, with elders suffering the most when this researcher visited the village.

There is the question as to why village people are not filling community jobs. For instance, in Village #3, many people feel they will be punished if they take a job in the villages; rent goes up and the increased earnings do not offset the higher increase of rent. Some young people recommended creating jobs that are aligned with the Inupiat lifestyle and to increase local control of subsistence activities and land use by the people.

Integration of Cultural Spirituality Within Christianity

Contemporary Inupiat spirituality reflects traditional Inupiat spirituality even though the Church sought to eliminate the traditional cultural spirituality. A Village #3 elder male, however, said that Christianity and Inupiat spirituality “was a good fit”. An elder Village #2 female expressed the integration of Christianity and Inupiat culture when she said, “When you find out someone is in trouble, take them to Church and gatherings. Go out and eat with this one or invite them. Religion with young folks, connection with elders.” As she gave us some Eskimo food she said, “Sharing is good, huh!”

The discussion on Religiosity, below, will provide a deeper understanding of the integration of Inupiat cultural spirituality and Christianity and how it relates to suicide and alcoholism.

Religiosity

In general, the Christian churches were praised since they brought happiness to the people as well as protecting them from the evils of shamanism. The older participants and many of the younger participants felt very positive about their affiliation with their church. There were some who felt the churches really needed to improve, but overall most of the participants embraced Christianity and supported their local churches. Missionaries made a significant impact on Inupiat spiritual life, as is evidenced by the enduring loyalty to their particular Christian denomination in a given village. The Friend’s, Baptist, and Episcopalian were the most frequent churches mentioned.

The influence of the churches upon Inupiat culture

The Inupiat described the church as anaq (being delivered) from shamanism and evil spirits. Two doctrines to this day influence the Inupiat people. One is the Calvinistic doctrine, which emphasizes teachings on punishment and hell, has had a strong control and influence on many Inupiaq people. A Village #4 elder described the other as newer doctrine that stressed love and forgiveness, often referred to as the “love doctrine, which is more aligned with Inupiat beliefs and supports the culture, especially the spiritual aspect of happiness. A few participants considered the provincialism, the harsh judgments, the cliquish behavior, and condemnation of sinners based on the Calvinistic doctrine as “anti-Inupiat”. Within the Calvinistic doctrine there is a strong delineation between what constitutes good and evil. God, the devil, and evil spirits are clearly defined. God and the devil both vie for the souls of the living. Hell is the final destination for those who commit suicide.

Churches support the Inupiat culture by using the Inupiat language during church services and by celebration activities (Christmas, Easter, Thanksgiving) that support unity and connection. Moreover, Christianity has preserved unity by providing a common belief system and encouraging local control over the churches and even interpreting the Bible with the Inupiaq worldview and values. Certain Inupiat values blend easily with Christian values such as helping others especially the elderly, orphans and the widowed; sharing; and the emphasis on not lying or cheating. However, one elder complained that having more than one church in a small village broke down community unity as they vie for members, encouraging factions.

The following gives a detailed overview on how religion is perceived by the participants interviewed. A constant theme is Christianity’s powerful intervention over negative shamanism, alcoholism, and suicide.

Inupiat practice of religion today

Participants referred to religion as making a difference in their spiritual life and acting as a deterrent to substance abuse and for those who considered suicide as a way to deal with their problems. Faith was the common word defining Christian spirituality. The Inupiat integrated Christian faith with Inupiat cultural spirituality. It was through faith and prayer that the weather could change; subsistence hunting and fishing improve; and minor miracles such as when a Village #2 elder male who’s “working faith brought in a moose.” Even a boat engine with a broken block could travel up river, arriving safely in a village through a Village #2 male’s faith in the Lord. Young people who did not go to church still requested prayers from the elders, especially to stop unwanted spirit visitations.

Christian activities help develop one’s faith, but also create shared meanings to promulgate the teachings. Common Christian activities include attending church regularly; singing; Bible study and reading; volunteering; teaching Sunday School; praying for others; helping others; sharing; attending funerals and helping grieving families. Popular among the young and old is the Singspiration where members meet informally and bring musical instruments such as guitars and sing, pray, and share. Often it is held in someone’s home and in between songs there is much laughter and talking. Everyone likes it because of the atmosphere of freedom. It also supports community building and happiness that it brings to the group.

There has been an influence of the Southern Baptist spirituality in Village #4 and in Village #2. This can be seen by the “speaking in tongues”, more “hollering” in the Village #4 Friend’s church, and discernment, and exorcism. The majority of churchgoers do not endorse these kinds of activities, and people involved in exorcism from one village were labeled “devil workers.”

It wasn’t uncommon to go to church on Wednesday, Saturday and Sunday in the 1920’s, 30’s, and 40’s. Now, it is reported, there are fewer attending churches, especially the young. In Village #2, for example, with a population over 700, only fifteen to twenty attend church regularly, reported an elder Village #2 female. Nowadays, there are numerous and competing activities and obligations that divide people’s time (especially the younger villagers) as well as frequent travel away from the villages at all times of the year.

Even though the young participants described their spirituality in terms of religion, the elders in all four villages are worried about the young people’s lack of church attendance. Several stated that attending church is a way to protect oneself from evil spirits and suicide. Many are not going to church, which made an elder Village #1 female wonder how the youth would learn about Heaven and Hell and understand the consequences of suicide on their immortal soul. Several participants indicated that the young are aware of the power of prayer and especially the elder’s strong prayers.

Those young people who started going to church stated they were amazed at how well their life changed for the better. One young man said he liked church because of “quitting drugs, alcohol, and cigarettes, chewing and read your Bible and go to Church and learn about God and Jesus.”

Conflicts within the church bothered many participants, which they thought did not support community cohesiveness.

Church Conflicts and Strengths

Some problems mentioned were disagreement on theological principals, especially concerning “water Baptism”, Eskimo dancing, continual repetition of fundamental practices without mature teachings to create mature Christians, disagreement over scheduling problems, fear of talking about Shamanism among community members, and church members talking negatively about other churches. Some members were criticized for being overly judgmental and cliquish and afraid to deal with the issues of spiritual possession or visitations while other members were heroic in their attempts by visiting victims, praying over them, and in some cases casting out these uninvited entities through exorcism

Others praised the pastors and felt that the ministers and the church were the first line of defense against suicide. A young Village #2 male said that when he was having suicidal thoughts, it was the pastors who helped him through it. An elder Village #2 male and a female pastor had saved several young people from committing suicide by talking to them and praying for them. A Village #1 male praised a pastor who was able to help him through a spiritual crisis when a heavy spirit was upon him. An elder Village #2 female said it was through the church and through prayer the village people were able to get rid of bad shamans and force a band of Indians from another village, who intended to raid her village, to turn back.

The churches are cooperating and uniting in some ways. Together, the Friend’s Church and the Episcopalian Church prayed at a haunted site that earlier had driven a young male to his death. According to a Village #1 elder male the ghost, that appeared as a “black figure” no longer bothered the villagers.

Prayer and devotion have had positive impact on individual lives, have driven away evil spirits, and even healed an elder’s grandson who was battling cancer. Elders spend hours praying for the safety of their young.

Two elder Village #2 females said that the greatest strengths of the church are that they have helped foster happiness and feeling good; they instill positive thoughts and emotions among the villagers. Two men believed that if the Inupiat used their full Christian potential they could be like Paul the Apostle, “you just walk and the very shadow that you cast can heal people.” He believed the churches had strength but were still held in bondage because they were still living in fear and tied to teachings that were not releasing the gifts of the Spirit.

Participants offered recommendations to the churches. Most of the churches no longer “glorify” those who commit suicide during the services and burials, but some participants were upset because they were still doing this; thus giving the young the false impression that they too would be glorified if they took their life.

Furthermore, the churches generally failed to discuss with their congregations preventive measures, such as explaining the possibility of negative spiritual encounters and how to protect one self, and how alcoholism diminishes spirituality and opens the door to negative spirituality. They need to address these issues. Young people no longer go to church because it is not relevant to them, and many wish there were more activities focusing on the young. Participants would like more discussion about allowing Eskimo dancing since it nourishes self-esteem and cultural pride. Furthermore, they would like to see churches cooperating with other churches to preserve unity and be involved in community decision-making.

Non-ordinary Spiritual Experiences

Throughout the interviews, the Inupiat shared spiritual experiences that were non-ordinary that were either life enhancing and positive, or invasive and negative. Non-ordinary spiritual experience can be described as subjective experiences that involve the supernatural; thus they have typically not been reported and validated by the research community. Yet the Inupiat believe that some experiences are the reason people take their lives. Furthermore, substance abuse is believed to set the stage for some of these strange experiences to happen.

Spiritual Events

The non-ordinary spiritual experiences mentioned include: dreams; hearing voices; moving objects; visual experiences; environmental experiences; shaman experiences; visitations; and possession. Visitation and possession will be discussed at length since they impact alcoholism and suicide among the Inupiat, and are termed negative spirituality. Those experiences that involved alcohol or drugs will also be identified and how they are related to suicide.

Dreams may warn of danger, even spiritual danger; or visitation by evil spirits; or impending death. Young people were often frightened of dreams because they saw spirits of those who passed away and often sought elders to help them stop such dreams through prayer.

With respect to the visitation of spirits and of possession, participants described hearing voices; sometimes from a beloved relative or the voices of suicide victims trying to entice living relatives to come and join them. An elder Village #2 female said that these are really evil spirits trying to convince the young that they will be going to a really nice place. “Come on buddy, come on buddy, it is good over here.”

Visual experiences are richly varied. In Village #3, an elder lady near death saw deceased friends appear at her bedside. A young Village #2 man saw the devil and told his friend about it. A young female from Village #4 remembered how as a child she could see the silhouette of a man with a “Dick Tracy” hat, even her dogs saw it and barked frantically at it. Village #2 elders tell how a young man’s former friends had committed suicide. He said, “I see them.” He saw their faces smiling as they talked to him.

One middle age Village #2 male described his experience when I asked if he actually saw them.

Yeah, the form of them and the voices that they carry are the same kind of voices that person I have known them for a long time have. It is the same kind of voice… I think it is a spirit because I know it is not him (relative); it is the evil spirit trying to fool.

A young male who committed suicide in Village #1 described, “a black figure that looked like a man and was bothering him.”

One elder male from Village #3 experienced his garage door opening automatically. This never scared him. “Before I get to it. Opens up by itself. I don’t know how many times.”

Another Village #3 male said he saw a little red Bible move by itself out of a bag on his bed. This was his beloved deceased grandmother’s Bible. Some participants thought the land to be possessed. A Village #2 middle age male said, the Nuna is the spirit of the land and it’s not always benevolent. Some places become haunted because some old shaman spirit lives there or because something tragic happened there. According to a Village #3 elder, it is not only the Inupiat that are bothered by spirits or possession, but Whites as well. One Village #3 elder male, while visiting a place that was haunted, was lifted off the ground and had to touch his dogs to become grounded. A Village #1 elder mentioned that there are some sites that scared this elder villager because something or someone was always bothering his dogs when he traveled through the area. He would shoot his gun in the air trying to scare it away.

Not only the land, but animals also can create havoc from the spiritual realm. According to a Village #1 elder, a villager shot his lead dog. For years after that he was haunted as the dog would appear and bite him on the back. Such killing is a result of breaking a traditional taboo of not being cruel to animals.

Invitation to become a shaman, feared and shunned by the Inupiat because of its relationship to the devil, was a common experience discussed by a few elders and a middle age man. A Village #3 elder said that spirits “wanted me to be a shaman but I got away from them.” He intervened and helped a young man through prayer and by talking to him when he was being bothered. A Village #2 middle age male reported how his father was visited several times and even had to physically fight with these shamans with all his strength to be freed of them. Other relatives of his, including himself, was visited by shaman spirits who he considered evil.

Conversely, a young man asked to become a shaman, and called upon the devil to make him one since his prayers to God, he believed, were not very effective. According to this Village #2 participant, the devil gave him intelligence and different gifts. In the end “he went berserk, he went crazy” and only through drugs could he be calmed.

Visitations

Spirits or ghosts are said to make their appearance to many people. Some of these spirits appeared in order to comfort people such as in the case of an elderly Village #3 woman whose friends appeared at her deathbed or when a grandmother would often make her appearance to her beloved grandchild in a friendly non-threatening way.

Others appeared for no reason as when a Village #1 elder, who, as a young girl, was walking on the beach and she saw someone who wore Khaki clothes and she did not know it was a ghost until she came face to face with him and he suddenly disappeared

Other visitations and appearances had to do with family and friends who had committed suicide and who had appeared to family members and relatives. Village #2 elders and a middle age male had convincing stories about young people who asked for prayer, even though they were not practicing Christians, because something or someone was bothering and frightening them. These young people described in detail the identities of these people. A Village #1 elder believed one male killed himself after his brother drowned after being haunted, and now his brother was haunting him.

A family asked a Village #2 middle age male to pray for the removal of a spirit haunting his family’s children’s bedroom because the children were having difficulty sleeping. Some of these spirits exhibit extraordinary strength as described by a Village #2 male who entered the haunted bedroom. Feeling this powerful force that dropped him to his knees, he said, “When I started praying and we were able to get rid of it. I prayed until that feeling left and it was gone.”

In an informal meeting in Village #4, a young Village #1 woman told how two threatening spirits held her down and tried to smother her when she was young. She said she cried out the name of Jesus and they vanished.

Seven participants mentioned that visitations frequently occurred when a person was alone.

A young Village #3 female said a Noorvik man had been drinking for many days. He said he had visions of three men who had previously committed suicide. They told him “It is better if you come and join us.”

Most of these experiences took place in the villages, and the information was from personal experiences or from close relationships such as family and friends, and some from other community members.

Possession

The phenomenon of possession is similar to visitation. The difference is that spiritual possession completely overpowers the individual’s mind and spirit often leading to a sudden change of personality, unusual behavior and mannerisms, and emotional anxiety and fear sometimes leading to suicide. The word the Inupiat used for something taking over is alliiqtu. The following are several stories of possession.

An elder from Village #3 remembers a young fourteen-year-old girl, once possessed, became so strong that no one was able to hold her down.

Something got into her. That’s the spirit we’re talking about. And if you see somebody like that don’t be afraid, don’t be afraid…because the fear up there really bothering her, she gets powerful. No one was able to hold her. And the only way how to get that out by prayer and that grandma, that grandmother she was hollering at someone just like it was a person… to try to stop that spirits from bothering her anymore.

In another village, an adult male from Village #2 discussed the possession of a young thirteen-year-old, and his wife’s and his role in helping with the exorcism that followed.

A young girl was normally gregarious and friendly but suddenly changed dramatically in behavior and attitude. She showed signs of nervousness and agitation. The Youth director and his wife were asked by the mother to help them get rid of “these demons”. The young girl demonstrated both physically and mentally that she was possessed. Terrible sounds came out of her, and she became very powerful as she fought the group. Through intense prayer and exorcisms, three spirits came out of her. Everyone was relieved when she accepted Jesus and returned to her normal self. Later she confessed that as her grades were falling and she rebelled against any kind of authority, the spirits were telling her to kill her brother and to “waste kids away at school… and do that to herself (kill herself).”

The next account represents both visitation and possession. Three Village #1 people discussed this story in detail about a young man from another village shredded to pieces when caught in a conveyer belt at Portside. It is reported that his spirit started haunting another Village #1 employee at that site. These three also mentioned the word allitook. The young man came back after his death and appeared as a “black figure” in the building where he had stayed and people even heard him on the CB. At the Portside barracks, while the young man from Village #1 was trying to sleep, this “black figure” started to bother him; the two were once roommates. No one listened or tried to help the Village #1 man when he cried and screamed for help. One elder said,

The Whites heard him. “I need some help in this room!” He could see the spirit and it talked to him and he didn’t know what to do. He started running from his room, and some fellows from Village #1 that were there tried to grab him. He took off clothes and was hollering and ran around in the tundra and then with the “devil’s fear in him and chased by that guy”, he drowned himself.

The Village #1 elder who fished his body out of the water with a huge fishhook said his hands were still clenched as if he was fighting. He mentioned that he had heard that this same apparition that haunted the Village #1 man had made an appearance in Village #4 and someone even witnessed another man fighting and struggling with the “black figure”.

How non-ordinary phenomena are identified

The phenomena presented here were identified and discussed in various contexts by the participants. There were reported good spirits and evil spirits. Some spirits were identified as shaman spirits and were equated with the devil or evil spirits trying to recruit “new shamans.” A few believed that family or friends who appeared were really themselves, while most believed it was the devil who was impersonating them. A Village #3 middle age male said, “Most of our people, most of the elders believe it is the work of the devil…evil…it is affecting them (suicide, visitation, and possession cases).

A female elder from Village #2 said, “And then they could go into you and start talking to you. When they are fighting with spiritual we always say, “donowiki”… they are wrestling with the spirit.”

This, it was said, is not a human battle but a spiritual battle because Satan is the opponent. According to a Village #3 elder, Satan wants souls and tries to get into “your being and get you out of control.”

One Village #1 elder thought that they could be the spirits of those who committed suicide who are roaming the earth. “They stay in the world, they just bothering the… yeah, like ghosts, the ones that you can’t see but try to get young kids to you know…(suicide)”

Shaman visitations were experienced by at least one participant from each of the villages of Village #3, Village #1 and Village #2. Spirits trying to impersonate dead relatives were reported at all four villages. One Village #4 male said he did not believe in either possession or visitations. Two elder females from Village #1 and Village #2 thought there may be possession, but questioned the reliability of those reporting the incidents.

Villagers also discussed some possible explanations for these strange experiences. These possible explanations, called “Trigger Events,” are those events that precipitated the non-ordinary spiritual experiences as described by the participants of this study.

Trigger events

Some participants from the three villages believed alcohol and drugs opened the mind to visitations and possession, including the DT’s. Two participants mentioned DT’s, but they also thought that drinking causes a person to see spirits and, according to a Village #2 elder male, alcohol “opens the door to satanic forces to prod you on to commit suicide.”

Severe trauma was believed to “open the door” to some of these non-ordinary spiritual experiences. Trauma took the form of losing family members who died violently; close friends killing themselves; a young man witnessing a friend killed in a tragic accident; loss of a girlfriend or relationship problems; and going to jail.

Participants from all four villages mentioned that visitations were most likely to occur when a person is alone. An elder Village #2 female reported one boy told her, “Every time I am alone, they come around. They say, ‘kill yourself, it is real fun over here.’”

Sometimes the trigger event has to do with being in an area that is haunted as when a non-Native man who was building a runway quit because he was haunted by something at night. An elder remembered how scary it was when he took this worker’s place and sat on a bench with a piece of hide, he said,

It start coming there again and it was worse. I could hear it. And it get worse and I just moved and dropped that thing (animal hide) on the floor and that thing never come back.

There was no obvious reason or trigger event in some cases. One Village #2 Middle age male said, “it’s hard to say because this young girl was normally everyday nice girl.”

A middle age Village #3 male whose grandmother appeared to him while on vacation had no explanation as to why she chose that particular time to appear. A Village #3 elder mentioned a similar case when he said this about a young girl, “something got into her. That’s the spirit we’re talking about.” It is also thought that shaman spirits may appear to family members without any warning.

Reaction to the non-ordinary events

Most participants who discussed powerful negative experiences mentioned the emotion of fear. A Village #3 middle age male said this about visitations and possessions, they are “scary and can be catastrophic to a person.” Many said they keep these things to themselves lest they are labeled “crazy”. Going to sleep becomes a source of fear because the “voices” may start. Sometimes young men can become so fearful that they will sob in front of elders who pray for them and provide refuge.

However there were some who experienced good feelings, as in the case of the middle age male who felt the presence of his grandmother after she had passed on. Often the emotion may be relief, such as when one is able to overcome spirits or fearful events, an example was when a Village #3 elder was able to chase away an evil spirit haunting him by dropping a piece of hide on the floor.

Participants described physical reactions to such events, as when a Village #3 elder said, “Yeah, my back noticed it first… I could feel it.” This same gentleman started to rise off the ground when he visited a haunted place.

Signs of possession or visitation

Those bothered by spiritual powers begin to show physical changes in their appearance and behavior: talking differently, or by not talking, fidgeting, nervous behavior, avoiding eye contact, expressionless faces, and strange expressions in the eyes. A Village #2 middle age male said, “You could see it in her eyes…but when we were actually doing that (exorcism) we could see it, I could see the evil in her eyes.”

A Village #3 middle age male said that they are “atlokwik, not him anymore, not the way they use to be.” Persons who experience powerful negative spiritual experiences began to change mentally. He said they become “mentally off balance or sick but it is something else. It is some force outside of you and it controls that person and sometimes the person never gets well because whatever is bothering them is the problem.”

Because they are not sharing their feelings, inner turmoil worsens. A person turns for the worse when a shaman begins to take control of a person, according to a Village #2 male,

Even if in your mind…what it wants is a place to stay. In other words, he wants a home that is going to be comfortable in, you know. If you open just that up to him and he finds out you are receptive to that, he will make it look real good at first. But then once he gets a hold of you, then that is it. You will just turn around for the worse.

Behaviors change; one Village #2 male said, “They start talking different or they start talking bad. They start talking, but not themselves… like they use to be.” Isolation is common after possession experiences. A Village #1 elder female said, “they wouldn’t talk to us, they are alone and they tell nobody and then get worse and worse.” Family and friends from Village #1 and Village #2 participants become surprised when friendly faces appeared vacant and aloof.

Participants who described the spiritual as an outside force, which was powerful and evil, showed signs of fear themselves. The expression on their faces changed, and quickness of breath was evident with different participants who discussed these negative spiritual encounters. One male from Village #3 admitted his fear, and wondered about intervention when he said,

It seems like that they are not alone. There is something else out there. You would tell by looking at the person, what they are saying, what they are doing… things that they do maybe… distracted looking, scared, they would be scared. It is a scary thing. For me to think about it because I have seen people go through it. Yes, they will talk even when they are alone or some things will happen where they are at. It could just happen to anyone, anybody who… I know we might think they are mentally this, they are not there mentally, but something, an outside force. I don’t know if there is any kind of prevention, it seems that there is that force out there that could take over anybody’s life.

There was a ray of hope in this man’s demeanor and expression later when he discussed possible interventions through strong united community involvement.

Interventions

The admonition “Don’t be afraid” is one of the strongest interventions besides prayer. Community involvement is also important. Community involvement includes being aware of possible spiritual problems by noticing symptoms and intervening right away by talking and listening to the affected person. It is helpful to get the person involved in subsistence activities or crafts and share stories while doing these activities. There is advice to allow frightened people to talk about the experience and check up on them, be it a dream or just a “strange feeling.” It is important to talk about potential shaman experiences. Though some are afraid to talk, as reported by a Village #2 middle age male who said “the more that you hide it, the more that this thing has freedom to do whatever he wants… because our Inupiat people have that capacity…it is there anyway…yes.”

Other interventions mentioned are personal and congregational praying, “hollering” at the spirit, praying in tongues, reading scripture, and by commanding the spirit to leave through exorcism. One Village #1 elder put a Bible by his son’s head while he slept, whatever bothered him left the next day. A few elders believe it is important to explain to young children the consequences and dangers of shamanism and the occult by telling traditional stories. The people of Village #1 were helped when two church denominations joined together to rid the area of spirits who were haunting villagers.

All these interventions helped. Those who helped were happy that they could intervene; it was those relatives and friends who were not aware or did not know how to help who felt desolate and guilty after a friend or relative’s suicide. Alcohol often serves as a way to cope with the fear, giving a person the courage to end his life when this negative spirituality becomes unbearable. Participants believe that alcohol intensifies the problem by making the person more depressed and spirituality weakened, which serves as a defense against negative spirituality.

DISCUSSION

The Inupiat worldview is transforming and evolving as it continues to integrate the new with the old. Villages once inaccessible and isolated now embrace the world as new technology replaces old modes of communication, media, and transportation. Cultural meaning systems representing the world have an impact on feelings and actions (D’Andrade, 1989) as well as health, wellbeing, and healing (Vontress, 1991). When culture-specific interventions are developed for a specific population, if their worldview is not considered, ethical violations and cultural oppression will occur (Ibrahim, 1991).

There are two parts to this discussion based on the Inupiat worldview of the relationship between spirituality, suicide, and alcoholism. The first is a descriptive analysis of what the Inupiat had to say about these three constructs. The second presents two cultural models: 1) Spirituality, Suicide, and Alcoholism Process Model 2.) Healing Model based on Celebration Activity that utilizes spirituality as a protective factor against alcoholism and suicide.

Descriptive Analysis

In their discussion of the relationship between suicide, spirituality and alcoholism, the Inupiat provide insights into their worldview and offer explanations for symptoms often described as strange and bizarre behaviors that have been labeled as schizophrenia (Boag, 1970;); transitional maddness (Gussow, 1960), frenzied dissociative dissociative neurosis or shock and fright neurosis (Foulks 1972); atypical culture-bound psychogenic psychosis; Pibloktoq or Arctic Hysteria (Dick, 1995); hysterical state of dissociation (Lehmann 1985) or dissociative identity disorder (Fraser, 1993). From their cultural viewpoint, the Inupiat interpret this kind of behavior not as necessarily originating from mental illness but as a spiritual problem. Moreover, it is cohesive, systemic and holistic interpretation that provides a deeper understanding of the relationship between suicide, spirituality, and alcoholism.

In the Native worldview everything is related, interconnected, and what affects one, affects all. Thus, suicide is understood as both an individual problems, and as a collective problem; a symptom of the cultural upheaval and loss of culture (Lester, 2000). Cultural upheaval affects self-esteem, putting the Inupiat at risk for a variety of problems including depression and destructive behaviors. Suicide and alcohol, a way of coping with these life stresses, not only impacts the individual but the whole community, resulting in the perpetuation of helplessness and dysfunction which creates a collective and individual erosion of culture and spirituality.

The literature supports the relationship between suicide and alcohol as well as the relationship between suicide and spirituality. Nothing could be found on the relationship between spirituality, suicide, and alcoholism. Participants in this study discussed cultural spirituality and religiosity when they described what spirituality meant to them. A third category called non-ordinary spiritual experiences was derived from both these constructs that gives insight into this third aspect of Inupiat spirituality and provides a basis for the relationship between spirituality, suicide, and spirituality.

The older participants of Village #4, Village #3, Village #1, and Village #2 provided the greatest insights into what this research calls cultural spirituality, which is a component of Inupiat spirituality. Cultural spirituality is a complex construct defined within nine domains which are shamanism; transmission of spiritual teachings; Inupiat values; the spiritual as source of power and strength; subsistence and the environment; reciprocal relationship between behavior and the environment; activities supporting cultural spirituality; spirituality as connection; and integration of cultural spirituality with Christianity. These domains include both positive and negative attributes. For instance, the land, in general, may be a source of happiness and well being, but a specific region of land may be haunted and feared. Some spiritual teachings were often not transmitted to the young for fear they would be tempted to dabble in the occult and shamanism. Christianity and cultural spirituality have not always contributed to the cohesiveness and unity of the Eskimo community, and this has had an impact on spirituality as connection. Shamans, once the source of healing and purveyors of Inupiat spirituality, are now seen as evil and possibly are influencing the young in negative ways. Participants viewed many cultural activities in a positive way with the exception of Eskimo dancing; some still feared that it has a connection to shamanism. Spirituality has its dark side and is not always seen as a source of strength; the Inupiat believe there are dialectical forces at work, which cause tension and require constant vigilance. This is especially manifested in non-ordinary spiritual experiences, which include spiritual possession and visitations by the dead; the Inupiat see both as negative. Negative spirituality is used in this research to include possession and visitation.

Cultural spirituality and Christianity protect the community from negative spirituality and are most effective for prevention if they are included in educating the young. Teaching about shamanism, visitations, and possessions have been mostly omitted for fear that the young are vulnerable; they might fall prey to these forces and become ill. However, without this knowledge, they are defenseless to ward off harm originating from supernatural forces.

Some of the spiritual teachings have a direct relationship to alcohol and suicide. The older generation, recipients of these teachings, emphasize that alcohol opens the mind to depression, unhappiness, and negative spirituality, making it easier for the devil, shamans, and spirits to make visitations, cause possessions, influence suicidal ideation and suicide. The Inupiat believe visitations and possessions are real; can occur in normal people who have never had a history of mental illness; and originate from an outside force. The best defense is education and an increased awareness and practice of Inupiat spirituality.

The Inupiat would like spiritual teachings to be integrated and taught by the schools, churches, and parents and supported by the community for treatment and prevention against negative spirituality. Moreover, they believe Inupiat spirituality (cultural spirituality, religion, and non-ordinary spiritual experiences) also acts as a deterrent to substance abuse and suicide. Furthermore, all participants want to see an increase of cultural activities since they support Inupiat spirituality, help with aarigaa or happiness (a spiritual strength) and connect the community together.

The elders play an important role in suicide and alcohol prevention as teachers because of their cultural and spiritual knowledge. Further research needs to explore the non-verbal cues and intuition they mentioned that serve as warning signs. The elders also provided suggestions for interventions such as “talk to them” or “don’t be afraid.” Their suggestions worked because they were not only rooted in their spirituality but also good mental health practices. The recommendation to “be happy” to help alleviate spiritual problems, depression, alcoholism, and suicide may sound simple, but it is deeply and richly rooted in Inupiat spiritual philosophy of cause and effect, reciprocity, well-being, and spiritual protection.

Some adults have not been exposed to this knowledge because of cultural upheaval resulting in alcoholism and dysfunctional families, as well as because of the tremendous influences of the early Christian missionaries. Even though they may not fully understand cultural spirituality, they are the catalyst of change and are impacting some of the negative aspects of spirituality mentioned above as they integrate Western technology and its modern style of living and communication with their culture.

Young people interviewed are beginning to express a stronger internal locus of control as they move away from Inupiat social patterns, such as talking indirectly about problems or needs, not complaining, and not embarrassing others. They are confident in expressing their ideas, talking openly and in a more direct and assertive manner. They are breaking dysfunctional family rules found among typical alcoholic families by talking about the problems, expressing feelings, trusting themselves and others, and letting go of denial. Furthermore, they, with the middle age group, are questioning the teachings and beliefs of the churches, especially about Eskimo dance; and are introducing new forms of prayer and spiritual practices such as the Singspiration, that reflects community cohesiveness and happiness. The young as well as the older generation are expressing a new self-determination when they talk of the need for control over resources, hiring of local people, and teaching about the historical trauma of the past in schools and in the alcohol and substance abuse programs.

Regardless of the influence Christianity had in taking away their spiritual base, the Inupiat have continued to integrate their cultural beliefs, values, and traditional lifestyle, especially subsistence, with Christianity. Through faith and prayer, they now have direct access to the unseen power, God, rather the relying on the shaman as intercessor. Two participants discussed the possibility that the same power that flowed through the shamans could also flow through a person in a positive way, similar to their famous ancestor, Maniilaq. Other participants made the distinction that it had to be God’s power and not the devil’s power that flowed through the shamans. The challenge, according to the elders, is to openly discuss Inupiat spirituality with all its many dimensions and pass them on to the young, who have been a great cause of grief because of the high rate of suicide in the villages.

Cultures display rules that regulate what can be expressed or not expressed (Levy, 1989). Some elders are worried that in protecting the young from dabbling in shamanism, the community is missing the opportunity to learn from and pass on this knowledge about non-ordinary spiritual experiences from a traditional perspective. Early Inupiat elders discussed non-ordinary and shaman experiences through stories (Manderhill, Sampson, & Tennant ,1989) without a Christian interpretation. Some can be found in recorded (tapes) oral tradition (at the Rasmussen Library) by elders and the late Tribal doctor, Della Keats. These kinds of stories are still remembered by the participants; furthermore, some have experienced shamanistic visitations and witnessed possessions. When asked direct questions, participants openly discussed spiritual matters to the researcher and interpreter, both Inupiat. An open environment of this kind of shared communication has been lost. As one young woman said, “everything is hush, hush.” Other Tribes may not openly discuss these stories with outsiders, but through oral tradition they are shared and passed to other tribal members, creating an open environment and a continuation and flow of cultural understandings based on spiritual experiences and shared meaning.

Moreover, many indigenous people have created ceremonies or rituals to ward off dangerous entities that threaten equilibrium (Gunn Allen, 1986) especially after a death has occurred, and allows for a resolution of grief. The Swinomish Tribe has a ritual where they burn the deceased’s clothing and possessions or they are distributed to others. Some hold memorials after a year or more, thus completing the period of mourning. Within many tribes, “The recently dead are in a marginal, ambiguous and dangerous category” (Clarke, 1995, p.162). The Swinomish and other Northwest Tribes have similar experiences with visitations from the dead but they believe the visitation is the actual person and not an impersonation by the devil. They agree with Inupiat beliefs in that spirits can cause emotional or spiritual trouble as they remain around family members after they die. Spirits of the deceased want family members to join them to help relieve their own personal grief. They can haunt a house and bring harm to occupants. The funeral is now the only ritual that is accepted by the Inupiat when someone commits suicide with the exception of a small gathering with two churches praying to ward off the spirit of a deceased man haunting the site where he died.

Grief prevails among Native people (Gregory, 1994), and Inupiat communities experience collective unresolved grief since all villagers are related through friendship and family. No memorials are now given at funerals since they glorify the dead, which may influence the young people to take their lives, hoping for similar attention. Moreover, most Inupiat believe that if a person kills himself or herself they are doomed to hell, and this prohibits any further discussion of the person since there is no possibility of redemption. It has been reported that the silence surrounding the deceased becomes a source of tension, anxiety, and fear because of continuing unresolved grief . Some react emotionally by shutting down or isolating themselves in their grief, becoming depressed. Depression, according to the elders, opens the door for spiritual visitations. If these occur, the person becomes more isolated and fearful. According to the elders, fear gives energy to these negative spirits, thus giving them more power over its victim. Young people complain that “dead friends” ask them to join them through suicide. Elders believe some of the cluster suicides are the result of these visitations. These problems contribute to alcohol abuse and, as mentioned in this study, to suicide since alcohol gives the person courage to “pull the trigger.” Considerable education and discussion is needed in this area, led by the elders and shared by the whole community.

In summary, the results of this study indicate a need for further research with a larger population to further examine non-ordinary spiritual experiences and the implications for mental health, substance abuse and suicide prevention and education. Participants in this study indicate there is a relationship between spirituality, suicide, and alcoholism. There are spiritual powers that influence suicide and alcohol abuse. Alcohol is often the main factor contributing to suicide since it diminishes control, spiritual protection, and awareness and opens one to negative spiritual powers. The Community in the past protected young people against violence to self through Inupiat spirituality, storytelling, shared meaning and knowledge; and cultural activities that supported happiness (aarigaa) as related to subsistence living and the environment. Those participants who partake in these cultural activities feel they acted as a deterrent against alcohol and substance abuse.

Participants offered recommendations for both alcohol and suicide prevention and were optimistic that, with the help of community and outside agencies, standard interventions could be successful. Moreover, participants said that the Corporation, the Mental Health Center, and other mental health institutions should support these recommendations and change a system that has failed the younger generation, as evidenced by the continuing high rates of suicide. As one elder said, the whole system has to change and support a unified vision. Schools, churches, families, tribal institutions, all need to be involved to support spirituality and the Inupiat culture which, in turn, impacts alcoholism and suicide among the people.

 

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Appendix A

Interview Questions

 

 

Interview Questions

Questions

There will be two general questions with probes used throughout the open-ended questions:

Questions

There will be two general questions with probes used throughout the open-ended questions:

Could you tell me some reasons why you think Inupiaq men (women) take their lives?

Do you think alcohol plays a role in the suicides of Inupiaq men (women)? If so, how?

If the following does not come out in the interview, then the participants should be asked the following:

I’ve been told from my relatives that there may be spiritual forces that drive the person to suicide. What have you heard about this?

(If no experience) What do you think about this as a reason to commit suicide?

Is there something in the Inupiat culture or spirituality that could help to prevent these suicides?

What makes you happy and feeling good? What takes away happiness and feeling good?

What word would you like to use during this interview for happiness or feeling good? What is the Inupiaq word?

Point Hope people used the word aarigaa, would you feel comfortable with this word?

What do you remember about your youth that made you happy and feel good?

What do you remember about your youth that took away this happiness or feeling good?

What takes away happiness or feeling good today?

How does the school help or take away happiness and feeling good?

How does the community help or take away happiness and feeling good?

How does the Churches help or take away happiness and feeling good?

If the issue of spirituality has not been raised and clarified for the participant, then one can use the following as probes to explore the issue.

Please tell me more about how you understand spirituality?

What Inupiaq word best describes this spirituality for you?

How does spirituality help with happiness and feeling good?

 

Appendix

B

 

Suicide: Warning Signs, Completed and Attempts

 

Completed Suicides

Village 3

Gender,

Age

Relationship

To speaker

Alcohol

Related

How

Reason

Spirit Visitation

Warning signs

Reported by:

Boy

Neighbor’s son

No

Hanging

Teacher, girlfriend problems

Problems at school

Elder male

Boy, 15

Classmate

Yes

Gun

Not known

Not known

Young female

3 men

Community members: a father, son, son’s friend,

Yes

Gun

Pact

Maybe

They were heard to say that if one did it, the others would too

Young female

 

Village 2

Boy, 19

None

Yes

Girlfriend problems (Happened in 1980)

Not known

Elder female

Boy

Older brother

Yes

Quit talking

Young male

3? Male

18-33

“Best friends” Three or more, one was a cousin

Yes, all

2 of them had girlfriend problems

One saw devil

Attitude change; drinking problems, quit talking

Young male

Man

None

Yes

Girlfriend and daughter left him

Not known

Middle aged male

Boy

First cousin’s son

Yes

Gun

Dabbled in the occult

Yes

Shaman activity

Middle aged male

 

Village #4

Man

Uncle

Yes

Not known

Not known

Young female

Man

Rumored

No

Freaked out on video game

Yes

Not known

Young female

 

Village #1,

Man, 40

Next door neighbor, husband’s cousin

No

Gun

In-law troubles, no housing

(Happened in 1940)

No

Depression

Elder female

Boy

Grandson

No

No knowledge of why

No

No warning signs

Elder female

Girl

Visitor from Noatak

Yes

Froze to death

No knowledge (Was this an accident?)

Wandering from house to house

Elder female

Boy

Son of friends

No

Gun

Maybe because his twin cousins in Village #4 had committed suicide 3 years before

Possible

Stayed in room alone, 3 years of

isolating himself

Elder female

Man, 30

Brother of nephew’s friend

No

Drowned

Frightened by black figure that kept chasing him (Accident?)

Yes

Talked about it, acted possessed

Elder female

Man, 20

Nephew’s friend

Yes

Rammed snow machine into building

Last brother of man who drowned (above). Was this an accident?

Yes

Drinking, grieving

Elder female

Man

Nephew’s friend

No

Drowned

Frightened by black figure that kept chasing him

Yes

Talked about it, acted possessed

Elder female

Young woman

Member of the community

No

Hanging

Pregnant, unmarried, mother locked her out of the house

No

She told parents she would kill herself

Elder female

Man, 20 - 24

Classmate

No

Hanging

Didn’t know

No

No warning signs

Young male

Young man

Son

Shot

Father had premonitions

Elder male

 

 

 

 

 

 

 

ATTEMPTED SUICIDES

VILLAGE #3

Gender,

Age?

Relationship

To speaker

Alcohol

Related

How

Reason

Spirit Visitation

Intervention

Reported by:

Girl

Daughter

Yes

Drank some medicine

Father reprimanded her for her drinking

No

Made to vomit

Elder male

Man

Husband

No

Gun

She tried to leave him

No

Young female

 

 

VILLAGE #2

Man

Husband

Yes

Didn’t say

Couldn’t get a job due to felony record

No

Aunt talked him out of it

Young female

Young man

Himself, several times

Yes

Didn’t say

Thinking about his friends who had committed suicide

Evil spirit made him do it

Another friend talked him out of it

Young male

Man

Brother

Yes

Gun

Possession

Yes

Gun didn’t go off, 4 times. Participant was praying for him in another city.

Middle aged man

Girl

Member of community

No

Gun

She was possessed; planned to kill her brother, then herself

Yes

Participant and wife & her church friends prayed

Middle aged man

 

 

VILLAGE #1

None

Reported

 

 

VILLAGE #4

Young woman

Herself

Yes

Gun

Attempted several times; was scarred (disfigured), wanted to die

No

Gun jammed

Young female

Woman

Mother

Yes

Slit wrists

Not known

No

Saved at hospital

Young man

Boy

Student of his

Gun

Not known

No

Shot in head, survived

Young man