The effect of embodied historical trauma on long-term musculoskeletal pain in a group of urban Māori adults

Abstract

Māori people experience higher rates of long-term musculoskeletal pain compared with European New Zealanders, despite being a demographically younger population. Like other indigenous colonized peoples Māori people also experience disproportionately high rates of trauma across a range of indicators from accidental injury, to domestic abuse and self-harm. This research explores the lived-experiences of a small group of urban Māori adults who have long-term musculoskeletal pain. The group is unique in that they are using an urban Māori healing service to address their pain and this thesis explores whether participants’ long-term musculoskeletal pain may in part be an embodied effect of historical trauma. Historical trauma is a term that has been developed by American Indian Alaskan Natives to describe the spiritual (mental/emotional/psychic) soul pain and suffering that their people continue to endure as a result of the traumatizing events of colonization. Massive historical losses of indigenous land, people, culture and language has occurred across the world and the ongoing detrimental effects of contemporary colonising artefacts such as assimilation practices, social and economic marginalization and embedded systemic racism contribute to the poor health status of many colonized indigenous peoples, which includes Māori people. This thesis situates long-term musculoskeletal pain within the broader context of Māori health inequity that may be linked to the historical and contemporary effects of colonization. This thesis argues that long-term musculoskeletal pain may be one of many disorders affected by dysregulation of the hypothalamic pituitary adrenal axis, which regulates the body’s neuroendocrine processes in response to physical, psychological, social and environmental stressors. Unequivocal evidence suggests that both prolonged and repetitive stress or a single cataclysmic traumatic event may lead to alterations in neuroendocrine function and if left unaddressed, may lead to changes in gene expression. Epigenetic research shows that such changes may be passed on to future generations of children whose poor social circumstances – low socioeconomic and education status and exposure to stressful environments – may predispose them to a host of diseases later in life. A Kaupapa Māori research approach and phenomenological methodology highlight Māori perspectives, Māori identity and te reo Māori language and culture as being highly salient to the meaning participants in this study make of their long-term musculoskeletal pain