Using the Biopsychosocial Framework to Address the Ongoing Impacts of the Indian Residential School System and Colonization in Canadian Health Care Systems

Rebecca St. James, Jocelyn Marie Paul
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Abstract

Traumatic experiences during childhood can have significant, detrimental impacts on physical and mental health and negatively impact social functioning in adulthood. Such an understanding is imperative to providing adequate and well-informed health care to Indigenous populations residing on the land now called Canada. The Indian Residential School (IRS) system, which was in operation for over one hundred years, was one of the most violent colonial tactics implemented by Canada's federal government. This system was conceptualized to forcibly alienate Indigenous children from their families, communities, and culture to eradicate Indigenous culture and identity. Combined with witnessing violent acts perpetrated by colonizers against members of their community, the shared experience of being abducted from their families, and suffering physical, mental, emotional, and sexual abuse, led to widespread trauma amongst Indigenous people for generations. It is expected that such trauma has resulted in disruptions in attachment, social functioning and emotional development in individuals who survived the Indian Residential School system, thus potentially triggering a cascade of maladaptive, trauma-related behaviours through subsequent generations (termed intergenerational trauma). These writers recommend that healthcare providers consult a biopsychological framework when engaging with Indigenous individuals, especially Indian Residential School survivors and their relatives, as it emphasizes the multidirectional relationship between psychological, biological, and experiential factors implicated in an individual's well-being. Furthermore, such a framework may aid in contextualizing an individual's unique challenges within the broader scope of colonization.
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利用生物心理社会框架解决印第安寄宿学校制度和殖民化对加拿大医疗保健系统的持续影响问题
童年时期的创伤经历会对身心健康产生重大不利影响,并对成年后的社会功能产生负面影响。要为居住在现在被称为加拿大的这片土地上的土著居民提供充分、知情的医疗保健服务,就必须了解这些情况。印第安寄宿学校(IRS)系统运行了一百多年,是加拿大联邦政府实施的最暴力的殖民策略之一。这一制度的目的是强行将土著儿童与他们的家庭、社区和文化隔离开来,以根除土著文化和身份认同。加上目睹殖民者对其社区成员实施的暴力行为,从家庭中被绑架以及遭受身体、精神、情感和性虐待的共同经历,导致土著人世世代代普遍遭受创伤。据估计,这种创伤导致印第安寄宿学校系统的幸存者在依恋、社会功能和情感发展方面出现障碍,从而有可能通过后代引发一连串与创伤有关的适应不良行为(称为代际创伤)。这些作者建议,医疗服务提供者在与土著人,尤其是印第安寄宿学校幸存者及其亲属接触时,应参考生物心理学框架,因为该框架强调心理、生物和经验因素之间的多向关系,这些因素与个人的福祉息息相关。此外,这种框架还有助于将个人面临的独特挑战与更广泛的殖民化背景联系起来。
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