Confronting diabetes in sacred space
Native American talking circles are good medicine
They gather in respectful silence in the rosy desert twilight. They move their chairs into a circle and watch with rapt attention while an ordinary-looking man reverently kneels in the center of the circle and spreads a hand-woven blanket on the floor.
He carefully places upon this altar a variety of sacred items: an eagle feather, a bowl containing a stick of dried sage, a wooden rattle, drum sticks, a tobacco pouch, and an eagle-bone whistle.
"Sialim tage jiosh e-tonalic o-himetha," Gerard Kisto sings as he takes his seat in the circle. "Creator, hear us and have mercy and forgiveness upon us." Those who know the song quietly join this Pima traditional healer.
The last notes of the song trail off into silence. After a few moments, Kisto picks up the eagle feather and passes it to the person on his left.
He reminds those sitting in the circle to speak from their hearts. "Whenever you’re holding an eagle feather, you’re truthful in the words you speak. We native people regard this bird as sacred because it flies so high to the Creator and carries so much wisdom. It can tell if you’re being honest or not," says Kisto.
Over the next couple of hours, these members of the Pima tribe gathered at the reservation hospital in Sacaton, AZ, examine the effects of diabetes on their lives, their emotions, and their spirits. There are tears. There is wry laughter. There are pleas for help in coping with a disease that will never release its grip until the end of their days — a disease that is likely to affect their loved ones, friends, and neighbors.
Fighting the fear
"Fear is very often in front of us in the talking circle when we talk about diabetes," says Kisto. "This is a safe space where they can talk about their fears of what they might become. Everyone here has seen people losing limbs, becoming blind, and needing dialysis because of diabetes. They’re all afraid it will happen to them. And they’re afraid this will happen to their children."
As the eagle feather makes its way around the circle, everyone gets a chance to speak — as long as needed to say what needs to be said. Rapt and respectful attention is paid to each speaker. There is remarkably little coughing, shifting in chairs, and the usual fidgeting that is the norm in audiences.
"So many people never have a chance to speak and to be really heard," says Kisto. "The traditional talking circle gives everyone a chance to speak and to be listened to on a deep level."
Simply being heard fills a deep need for many people who feel they have never truly been heard in their lifetimes.
The Native American Pima people suffer the highest rates of Type 2 diabetes in the world. On the Gila River Reservation in southern Arizona, home to 11,500 members of the Pima and Maricopa tribes, 50% of the Pimas have Type 2 diabetes, according to the National Institutes of Health in Bethesda, MD. Virtually everyone is related to someone with the disease.
In conjunction with Western medical treatment, the talking circle is meant to help tribe members with diabetes learn more about their disease and treatment, while finding spiritual and emotional balance through connecting with others with the same disease and the same challenges.
There is a segment of the evening devoted strictly to education — anything ranging from foot care to nutritional advice to exercise and weight control plans — but the centerpiece is the spiritual connection that takes place within the sacred circle.
"When they’re first diagnosed, many people feel lost, somehow separate from others, even though diabetes is so common here," says Kisto. "In the sacred space we create for them, there is a feeling of connectedness. It’s a way of helping them realize that others carry the same burden and they can share it."
As a healer, Kisto says he is aware that the impetus for healing comes not from him, but from a higher power that comes through him like a clear tube. "When we begin to chant or talk, people draw on that healing power as they need it," he says.
Providing emotional healing
No one thinks Kisto can cure diabetes, but his talking circles can help participants find emotional strength and provide the spiritual nurturing and healing that is sadly needed among his wounded people, he says.
Modern medicine focuses on issues of confidentiality, but that policy makes people feel isolated with their disease, say the medical professionals who work with Kisto. The talking circle is a forum where patients can talk about it freely.
Kisto also offers sweat lodges — a traditional Native American healing rite in which participants sit inside a blanket- or tarp-covered structure that looks much like an overturned basket. Stones fire-heated to red-hot are carried inside the lodge, and when water is poured on them, steam opens pores, and many say, opens hearts and minds as well.
Although the sweat lodge originated with the Plains tribes, it is now widely used for healing by most Native American tribes. Inside the darkened basket-like structure, as their bodies are challenged to cope with the heat of the stones and steam, sweat lodge participants find their way through emotional and spiritual challenges as well.
"I’ve had people come to sweat lodges from their hospital beds. It is a powerful healing process," he adds.
Kisto carries his healing work to a wide number of hospitals, wellness centers, and to the general Native American populace throughout the Southwest.
As a part of his ministry of healing, he offers prayer ceremonies to those who request them, and he offers an ear to anyone who needs to talk, whether in a formal talking circle or not.
The talking circle is traditional to most Native American people. The circle increasingly is including those who provide medical care to patients with diabetes, and perhaps, has a place in the general medical setting for people of all races, says Brenda Broussard, RD, CDE, coordinator for the Native American outreach program, "Awakening the Spirit," sponsored by the American Diabetes Association (ADA) of Alexandria, VA.
Broussard, who is based in Albuquerque, NM, recalls a recent, powerful talking circle for members of the New Mexico Native American Nurses Association.
Thirty people, led by a Native American nurse-midwife, circled together in the ceremony. They began by dimming the lights and burning sage to clear the atmosphere and create scared space. Prayers to Father Sky, Mother Earth, and the four directions of the compass were offered. In this particular circle, Broussard says, a large oblong graphite stone was passed around clockwise while people talked. A sacred eagle feather, representative of the people’s connection to Great Spirit, was reverently laid on a blanket in the center of the circle, a reminder of the presence of spirit in each person’s life.
"It was a collective hearing and healing," Broussard says. "Imagine that many people listening intently and sending strength and prayer to each speaker. It was wonderful to see how much emotion came out — from those who are caring for patients with diabetes, for those who have family members with diabetes, and for those who have diabetes themselves."
Sometimes the leader would stand behind the person speaking with hands cupped near the speaker’s head, holding energy and helping free the person to speak openly.
"I don’t know where else in life most of us get that kind of support," she says.
The circles also are a unique way of finding consensus among members of a group, especially if there is dissent or a decision that needs to be made, Broussard says.
"It’s amazing to watch people talk things out, respecting others’ viewpoints and finding their way to agreement," she adds.
The ADA is very supportive of anything that can be done to help heal the whole person, Broussard explains.
Although talking circles are a Native American tradition, they have become less common on reservations in recent years, yet Broussard sees the value of their reintroduction into tribal life, especially for patients with diabetes. And she sees the possibility that similar circles can be helpful to people from other spiritual traditions.
"The key is not the actual format that is used, but the concept that people are heard and nurtured in sacred space," she says.
Key Points
- A spiritual dimension in diabetes management brings patients to new understanding of their disease.
- Native American traditional healers work to address the whole patient with diabetes.
- Native American talking circles give diabetes patients a safe place to talk about their disease.
Prevalence of Diabetes Among Native Americans
- Prevalence of Type 2 diabetes among Native Americans in the United States is 12.2% for those older than 19 years of age.
- One tribe in Arizona has the highest rate of diabetes in the world. About 50% of the tribe between the ages of 30 and 64 years have diabetes.
- Today, diabetes has reached epidemic proportions among Native Americans. Complications from diabetes are major causes of death and health problems in most Native American populations.
- Of equal concern is the fact that Type 2, or adult-onset diabetes, increasingly is being discovered in Native American youth.
Source: American Diabetes Association. "Awakening the Spirit" Native American outreach program. Alexandria, VA.
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