title: Indigenous Knowledge Approach to Successful Psychotherapies with Aboriginal Suicide Attempters.
abstract: Suicide is disproportionately common among Aboriginal people in Canada.
  
  
  
  Life stories were collected from 54 Aboriginal suicide attempters in northern Saskatchewan. Constant comparison techniques and modified grounded theory identified common themes expressed.
  
  
  
  Three common plots/themes preceded suicide attempts: 1) relationship breakup, usually sudden, unanticipated, involving a third person; 2) being publicly humiliated by another person(s), accompanied by high levels of shame; and 3) high levels of unremitting, chronic life stress (including poverty) with relative isolation. We found 5 common purposes for suicide attempts: 1) to "show" someone how badly they had hurt the attempter, 2) to stop the pain, 3) to save face in a difficult social situation, 4) to get revenge, and 5) don't know/don't remember/made sense at the time, all stated by people who were under the influence of alcohol and/or drugs at the time of their suicide attempt. We found 5 common beliefs about death: 1) you just cease to exist, and everything just disappears; 2) you go into the spirit world and can see and hear everything that is happening in this world; 3) you go to heaven or hell; 4) you go to a better place; and 5) don't know/didn't think about it.
  
  
  
  The idea of personal and cultural continuity is essential to understanding suicide among First Nations youth. Interventions targeted to the individual's beliefs about death, purpose for suicide, and consistent with the life story (plot) in which they find themselves may be more successful than one-size-fits-all programs developed outside of aboriginal communities.
authors.affiliation: Coyote Institute, Orono, Maine Eastern Maine Medical Center Family Medicine Residency, Bangor, Maine Acadia Hospital, Bangor, Maine University of New England, Biddeford, Maine mehlmadrona@gmail.com.
authors.forename: Lewis
authors.initials: L
authors.lastname: Mehl-Madrona
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D007198:Indians, North American / Q000208:ethnology*; D008297:Male; D011613:Psychotherapy / Q000379:methods*; D012525:Saskatchewan / Q000208:ethnology; D013406:Suicide, Attempted / Q000208:ethnology* / Q000517:prevention & control*; D055815:Young Adult
keywords: Aboriginal suicide attempters; indigenous; knowledge; psychotherapy