EVIDENCE-BASED IS A CRITERIA FOR BEST PRACTICE

So many things that we use as ordinary daily rules of “thumb” are averages or means or norms, which are mathematical concepts and “derived” from a set of accumulated data which might or might not actually include all the possible figures. Take for instance, IQ’s or Intelligence Quotas, which are simply test results from a specific population which are arranged in a standard bell curve. At the midpoint is the score of 100 and then the edges go out to maybe 200 on the high end but can’t go too far down on the low end without reaching into nonverbal intelligence, even nonhumans.

By varying the population tested or the kinds of questions asked or the ways of scoring, a person’s IQ might be almost anything, veering all over the place. And yet we are always speaking of IQ’s as though they were something real, immutable. The concept is so powerful that imitators speak of one’s Numerical IQ or Emotional IQ. And yet it never measures capacity -- only achievement on terms the testing society values. Dominant societies don't want to look at minority alternatives.

These days people are looking for physical evidence of thinking capacity: how fast can a neuron network? (How much wood can a woodchuck chuck?) How many neurons per cubic centimeter does a smart person have? We’ve gotten over the idea of size -- which the men really liked because men’s heads are bigger (ahem). There are tests of response times when asked a question or given a stimulus. (Once I tried out a reaction time mechanism that recorded how fast you could step on car brakes if something dashed out in front of you. I’m dangerously slow. Watch out.)

None of this has anything to do with wisdom or empathy or compassion or creativity or a host of other qualities that we consider valuable in a human. Like tenacity or a sense of humor. But mostly the trouble with IQ is that it only measures one society’s bell curve, which doesn’t fit a second society.

Now I’m going to take a big swerve. Lately I’ve been running into the phrase “best practices” which seems to come from practical occupations like building or plumbing or making something. There is sometimes a third word like “present best practices” or “recommended best practices.” The implication is that there are a variety of ways to approach a problem, but that some are better than others and the present consensus is that the described protocol -- indeed the PREscribed protocol is as given in “best practice” descriptions. Until developments in the field come up with something better.

Now I may surprise you with a new acronym: “evidence based practice” EBP and its context -- troubled post-colonial indigenous people like American Indians. I’m working from an article by Joseph P. Gone, another of the speakers coming up at the August 21 history seminar sponsored by Piegan Institute. “A Community Based Treatment for Native American Historical Trauma: Prospects for Evidence-Based Practice.”

Here's the approach:

1. Some aboriginal people “in pain” and self-medicating with drugs and alcohol were identified. They had come for help.
2. The helpers agreed with the idea of the “talking cure,” which assumes that if one recognizes and understands emotional pain, it will be at least made bearable.
3. Once a person has learned to reflect on and manage one’s inner life, further damage will be prevented.
4. An important part of this introspection is a reclaiming of one’s “indigenous heritage and spirituality.” This seems to be in part because it rejoins the connection to a life that was broken by colonialization when a big powerful outside force crushed a way of life that was centuries old. Not only was it made impossible by the changed circumstances (no more buffalo) but also it was labeled as shameful, punishable, worthless -- qualities which the individual felt applied to them. And there were many tragedies: families smashed, starvation, disease, death everywhere. The grieving was never complete.

So “evidence based practice” (EBP) and “evidence-based treatment” (EBT) are an approach to ordinary counseling that might include something like a sweat lodge or drumming, to lift up such a traditional practice into a re-ordering of a person’s inner world. This is NOT the same thing as some troubled third-generation Italian Vietnam vet from Brooklyn showing up and wanting to be spiritual as a way of escaping his own culture because he has become ashamed of it. Nor is it magic. It is EVIDENCE-BASED -- it has to show that it works and produce a theory about why.

Once I read about a feminist mental-health clinic in England where the counselors worked with struggling women all day and then had tea late in the afternoon to compare notes about what worked. Not gossip, but real effectiveness. A very civilized version (and culture based, too!) of this approach.

The next step is not just getting to healing but figuring out what specific principles or ceremonies of a specific people might be. Native Americans, for instance, are quite different in different tribes in spite of their having a common cause with their cultural distress. A sand-painting might work for a Navajo but not for an Eastern Woodland person. In a way this is a thing one might call “anthropological healing” where either a very informed outsider or a very trained insider could figure out the right moves. The rest of the paper describes one “healing lodge” in Canada and how it worked.

I love these short lists people come up with. I put them on 3X5 cards to carry around for a while and think about as talismans. Here is the short list of primary themes when these people had their own version of “teatime.”

1. “Emotional burdens” The pain of grief over early deaths and losses of family and reassurance often leads to substance abuse, loss of control in violence and a life that is just a big mess.
2. “Cathartic Disclosure” Recovering suppressed memories, letting out denied emotions, telling the secrets, confessing the rage and terror, will purge the pain and greatly diminish the energy drain.
3. “Self As Project Reflexivity” is learning to sort and recognize one’s inner dynamics. Journaling, group sharing, talking to one’s relatives about family patterns, art forms of every sort are all excellent practices when the goal is keeping one’s insides from getting in a knot.
4. “Impact of Colonization” is most dramatic when an individual is jerked out of one set of assumptions and forced into another. It’s not just a problem for Indians. Going into the army or off to college might do the same thing, but those will hopefully have an element of choice and consciousness, which is totally unlike having someone kidnap a child out of a yard and transport him or her off to a boarding school in an attempt to make the child white.

In a sense, our technological world is moving so quickly that we’re all feeling as though we’re colonized by the future. The evidence on which these protocols are based is useful for everyone.