Updated: Apr 15
*This paper was written with the permission of The Honorable Robert Yazzie Chief Justice of the Navajo Nation during a training for Navajo Restorative Justice and Peacemaking. I do not identify as Navajo and wish to extend my respect for the Navajo and all Indigenous/Native peoples. In which, I have tried to only write from Navajo sources directly when referring to Navajo philosophy and not from my own words. I would also like to acknowledge that while Indigenous philosophies would be extremely beneficial for western mental health practice, mental health for Indigenous folks is still extremely under-resourced in their own communities and the misappropriation of Native practices for western medicine is not condonable in any sense. In such, I would greatly appreciate the feedback and reflections for revision, additions, concerns, questions, or otherwise on this topic. With love, Morgan.
Navajo Philosophy and the Treatment of Eating Disorders
The prevalence of eating disorders is rising at a disturbing rate in America and around the world, especially among women and young girls. Ample research done on the link between attachment theory and eating disorders shows the link is significant (Olson, 2017). Specifically, Ainsworth’s (1965) classified anxious and avoidant styles of attachment within relationships. The four directions philosophy used in the Navajo peacemaking paradigm could be a beneficial treatment model for helping individuals suffering from eating disorders move from these insecure attachment styles to more secure ones. Ultimately, helping the individuals move to a healthier and happier, more holistic relationship to self, world, and others.
Eating disorders are mental health disorders involving certain patterns and behaviors of eating that cause severe illness, dysfunction, or even death. There are several different types of eating disorders. Each has its own dysfunctional behaviors which cause different health outcomes for the individual suffering from it. Two of these eating disorders include anorexia nervosa and bulimia nervosa. Both share the general characteristics of an individual’s intense, pathological fear of gaining weight, obsession with losing weight, and a severe dissatisfaction with their body (Olson, 2017, p.2). These disorders, do, however, have some differing characteristics.
According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013), a person diagnosable with Anorexia Nervosa must display persistent restriction of energy intake leading to low body weight; either an intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain; and disturbance in the way one’s body weight or shape is experienced, undue influence of body shape and weight on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013), a person diagnosable with Bulimia Nervosa must display recurrent episodes of binge eating. Binge eating includes eating, in a period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances accompanied by a sense of lack of control over eating during the episode. A diagnosable person must also display recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise. Other displays include the binge eating and compensatory behaviors both occur at least once a week for up to three months, self-evaluation is unduly influenced by body shape and weight, and the disturbance does not occur exclusively during episodes of Anorexia Nervosa.
There are many theories about the causes and onsets of eating disorders. However, as Olson (2017) notes, “Over 15 years of research supports the connection between attachment and eating disorders. Research has generally established a link between women with eating disorders and higher levels of attachment insecurity” (p. 14). Attachment insecurity is a term used to describe one style of attachment, which Mary Ainsworth developed as a result of her 1965 Strange Situation Procedure. “Through the ‘Strange Situation’ procedure, Ainsworth detected three types of attachment patterns, each of which corresponded with a distinct style of mother-infant interaction: secure, insecure-avoidant and insecure ambivalent” (Olson, 2017).
The two insecure attachment styles found to be associated with eating disorders are anxious and ambivalent. Individuals categorized as exhibiting an anxious attachment style could have excessive and preoccupied fear of being abandoned or unloved which keeps the individual hyper-vigilant with respect to relationship losses (Olson, 2017, p.11). Alternatively, individuals exhibiting an avoidant attachment style may have discomfort with closeness and intimacy with others whom they perceive negatively, subconsciously believe that others cannot be trusted to care for them without hurting them, and become overly independent and avoid needing others in order to protect their self -reliance, uniqueness, and control (Olson, 2017, p.11). Based on this research, it can be seen how an individual who suffers from an intense fear of being abandoned or unloved could develop a disordered obsession with being thin and desirable, and therefore, more loveable, thus causing the individual to develop an eating disorder to make this a reality. Similarly, individuals that suffer from discomfort with intimacy and closeness to the proximity of negative situations and relationships may develop an intense obsession with remaining in control, thus developing disordered patterns and behaviors around eating to gain a feeling of this.
If attachment insecurities cause individuals to seek the feelings of control, love, and connection they actually desire through relationships with self and others, then the Navajo philosophy model of the four directions could be a beneficial treatment model for eating disorder patients. By utilizing the four - direction model in eating disorder treatment techniques, it could help the individual move through their attachment insecurity styles and develop new relationships with the world, self, and others. Thus, alleviating the falsely beneficial distraction, fulfillment, and control that an eating disorder provides to individuals as a supplement for the lack of a secure and healthy attachment style to the world, self, and others.
Within the Navajo four direction philosophy, Lerma (2017) explains, “Each direction is associated with a Sacred Mountain that outlines the area within which the Diné are supposed to live according to the teachings of the Diyin Dine’é, or the Holy Ones” (p. 31). “Living within the boundaries of the Sacred Mountains should allow individuals to retain their proper distance and nearness toward the Four Sacred Elements” (Lerma, 2017, p. 31). This path is utilized to reflect an individual’s daily life patterns as well as through stages of maturity (Lerman, 2017, p.32). Thus, it can be seen as a reflection of how one relates and interacts with the world, self, and others. By utilizing the philosophy of moving through the four directions in relationships with the world, self, and others, individuals suffering from eating disorders might be able to transform the insecure attachment styles contributing to their disorder. This can be illustrated by showing how the specific symbolic attributes of each direction, North, South, East, West, can replace the insecure attachment styles of world, self and others in individuals with eating disorders, ultimately, stimulating healing.
In Navajo mountain philosophy of the four directions, East, or Ha’aaah, represents dawn, birth, beginning of life, a new beginning of each day, goal setting, visualizing, conceptualizing, developing mental strength capabilities, realization, creativity, reasoning, awareness, developing ideas, forming opinions, developing good memory skills and sensitivity, intellectual development, and becoming innovative (Long, 2015). This direction could be useful for treating insecure attachment styles by having the individual reason and intellectualize their relationships to self, world, and others. It could also be useful to help the individual develop a plan, goals, and intention of a new start. A leaving behind and letting go of negative relationship patterns and behaviors to make room for new positive ones. This direction could help the individual begin to visualize and conceptualize a more healthy, stable, and desirable relationship style.
The South, or Shádi’ááh, represents planning, identifying resources, gathering information, analyzing and expressing emotional stability, understanding identity capabilities and possibilities, becoming creative, generosity, caring through understanding of key, understanding love, emotional stability, developing awareness of good health and the importance of eating healthy foods and daily exercise, the importance of self-sufficiency, self-support, self-governance, recognizing one’s role and responsibilities in the clan and extended family and community (Long, 2015). This direction could be useful for treating insecure attachment styles by helping the individual make meaning of new relationships between self, world, and others. Helping the individual make meaning of a healthy relationship to self through nourishment and self – care. Additionally, helping the individual make healthy relationships with the world and others through the purpose of self within the family, community, and world. This direction could help the individual cultivate self - purpose, and meaning, helping the individual move towards the ability to implement more secure attachment styles to self, world, and others.
The West, or E’e’aah, represents life, what areas of life one is living within, acting out the plans and thoughts of the East and South directions, and coming to an end of a cycle (Sacred Bear, n.d.). This direction could be beneficial for treating insecure attachment styles by helping the individual let go of the behaviors and patterns that are not serving them. To support the individual in living the new patterns and behaviors that were planned in the previous directional phases. To aid the individual in coming to the end of one phase of life. This direction could help the individual come to peace with the transition of old insecurities keeping them from living in relation to self, world, and others with a more secure attachment style.
Finally, the direction of North, or Náhookos, represents darkness, mysteriousness, the aging process, spiritual wholeness, confidence, reflection, competency, evaluation, questioning, full implementation in strategic planning, goal setting, implementing, reviewing and revising an evaluation, displaying mental strength and emotional stability, comfortable living, understanding, lifetime learning and living well, obtaining a sense of balance with self and surroundings, and obtaining strong mental stability (Long, 2015). This sacred direction could be useful for treating insecure attachment styles by having the individual reflect and evaluate on the work they have done and the movement they have made during the other directional phases. It could stimulate the individual spiritual or religious recourses for healing. To enter the unknown in order to face the avoidant or anxious relations between them and self, world, and others. To reflect, evaluate, and revise their current state of relations so that transformation can continue to take place. Working with this direction could help the individual cultivate balance, and mental and emotional stability, in order to implement more secure attachment styles to self, world, and others.
It has now been illustrated how the Navajo four-direction philosophy could be beneficial to the treatment of eating disorders by utilizing the symbolic attributes of each direction to help the individual move from insecure attachment styles of relationships to self, world, and others to more secure ones.
Written by: Morgan Hopson, 2018
An Ethnologic Dictionary of the Navaho Language; 1910, The Franciscan Fathers.
Diagnostic and statistical manual of mental disorders: DSM-5. (2014). Washington: American Psychiatric Publishing.
Lerma, Michael. Guided by the Mountains: Navajo Political Philosophy and Governance. Oxford University Press, 2017.
Long, Clayton. “The Navajo Four Cardinal Directions.” Navajo People Culture History. N.p., 20 Jan. 2015. Web. 22 July 2017.
Navajo Nation Department of Diné Education
Olson, J. (2018). Treating attachment insecurities in women with eating disorders (Ps.D.).
Available from ProQuest Dissertations & Theses Global. (1917413377).
Yazzie, Robert. Personal Communication. 2017