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    6 hours ago

    Therapist: You know, when you drink or use drugs, it is a ceremony? Let me explain this to you. . . . You step up to the bar, leave your token just like when you go to a medicine person . . . , and request the kind of medicine you want. . . . Then you proceed to drink. . . . You have completed your ceremony. Now, the contract is in place. The medicine will give you what you want. It will keep its part of the bargain. Now it will be up to you to fulfill your part.

    Not surprisingly, the gravity of the situation for the patient begins to settle in:

    Patient: It sounds really serious when you talk about it like that. It sounds hopeless. I mean I already did these ceremonies to the spirit of alcohol. I can’t undo that. What do I do?
    Therapist: There are ways. In the spirit world, it’s all about etiquette and manners. So far, you have forgotten these. All traditions have manners when it comes to dealing with these forces.

    As an example, Duran colloquially recounts the story of Christ healing the Gerasene demoniac, emphasizing that a “deal” was struck enabling the spirits to enter a nearby herd of swine. Thus, Duran reassures the patient, referencing no less an authority than Christ Himself, that “deals” can be made in the spiritual realm.
    Spiritual transactions, of course, require ritual accommodations. It has already been noted that Duran sometimes burns “smudge” during his therapeutic sessions, but beyond this he also readily incorporates prayer, offerings, and “power objects” or “fetishes” in explicit recognition that “therapy is a ceremony” (p. 42):

    Therapist: Since you want to let go of the spirit of alcohol, you need to talk to it and ask what it wants in exchange for your spirit. I’m sure you can work out a deal. [Duran reaches for a “fetish” resembling a bottle of cheap “Dark Eyes” vodka.] Here is my friend. We can talk to it now. . . . Dark Eyes is already wondering if you’re going to have manners. You know as part of your Step 4 through Step 8 [in AA] that you also need to make amends to the medicine here.
    Patient: How do I do that? What do I say?
    Therapist: When you make an offering, you know what to do. You can offer tobacco, cornmeal, food, water, and such. It’s the intent that is important, and the spirit of alcohol will recognize the honesty of your spirit as you go into this new way of relating with awareness.
    Patient: I don’t have anything on me to give now.
    Therapist: Man, what kinda Indian are you? You’re out there in the world with no protection

    Thus, Duran facilitates the direct and overt communication between patient and spirit by retrieving the fetish and inviting communication “to get the patient to relate to the energy of alcohol and addiction in a mindful way . . . as part of the ongoing relationship to the spirit of alcohol” (p. 72).
    Finally, Duran procures some cornmeal or tobacco from his stash so that the patient can offer this to the fetish “with the intent that the spirit of alcohol will begin to relate to his spirit in a respectful fashion” (p. 73). The patient makes his offering and announces the following:

    Patient: Something happened when I did that. It’s as if the spirit recognized me. That is really something. Can’t believe that no one has ever talked about this. Except one of my grandmas once said something about this spirit stuff, but at the time I thought she was just talking old crazy stuff.
    Therapist: Yes, this knowledge is older than dirt. All of our grandmas knew this. We’ve just forgotten the way. This brings us back to the “Good Red Road.”

    Now that the patient has reconceptualized his problem with alcohol by virtue of the “decolonization” process facilitated in the preceding therapeutic interactions, a renewed relationship to himself, his community, and his cultural heritage will together support a renewed relationship to alcohol. In the end, beyond merely recovering from addiction, it is Duran’s hope that such patients will experience a “deeper healing of the spirit” (p. 18) involving “an existential reconnection with who they are as a Native person” (p. 66). Perhaps even more significantly, according to Duran, such patients “restore their humanity in a way that is harmonious with natural laws” (p. 14).


    Gone, J. P. (2010). Psychotherapy and Traditional Healing for American Indians: Exploring the Prospects for Therapeutic Integration. The Counseling Psychologist, 38(2), 166-235. https://doi.org/10.1177/0011000008330831