title: Innovating through tradition: kava-talanoa as a culturally aligned medico-behavioral therapeutic approach to amelioration of PTSD symptoms

authors: Aporosa, S. 'Apo'

subjects: PTSD

abstract: Levels of post-traumatic stress disorder (PTSD), trauma-related distress, and subsyndromal PTSD, (here “PTS”) among combat soldiers and first responders are of international concern. In the broader population, a PTS global epidemic is attending trauma associated with the threatscape of the Anthropocene (increased extreme weather events, natural disasters, conflict, rising poverty, emerging infectious disease) as well as the legacy of the COVID-19 pandemic. PTS is also a health economic burden, with costs associated with treatment, long-term morbidity, and increased risk of mortality. In the Pacific region, rising PTS is associated with the existential threat of climate change and the economic and social legacy of colonization. There is an unmet therapeutic need for improved and culturally aligned PTS therapies in the Pacific and beyond. Medical standards of care for anxiety/PTS typically involve psychotropic interventions such as benzodiazepines (BDZ), tricyclic anti-depressants and anti-psychotic medications which have addictive potential, are only effective in the short term, are contraindicated for key populations such as the elderly and have significantly problematic track records in indigenous populations. Moreover, systemic racism both drives PTS in indigenous and other marginalized populations and limits the efficacy in such populations of conventional PTS therapies which are not culturally relevant or informed. Here, we describe the development of a novel, but traditionally grounded, approach to PTSD symptomatology in the context of Pacific populations. This approach has two elements: kava is a culturally significant Pacific drink used traditionally and in cultural practice, as a relaxant, to promote dialog in group settings, to aid in sleep and to manage anxiety. Its anxiolytic and sedative properties may link to the presence of kavalactones which are putative low potency γ-aminobutyric acid (GABA) ligands. Talanoa is a dialog practice common to most Pacific cultures. Our core hypothesis is that, combined, kava-talanoa will outperform current standards of care in PTSD symptom management as a culturally augmented cognitive-behavioral group therapy intervention. In this paper we review supporting literature, describe kava-talanoa pilot study findings and planned clinical trials, discuss important open questions, and present recommendations for broad-based transcultural applicability of this approach to global PTS burdens.

text: Innovating through tradition: kava-talanoa as a culturally aligned medico-behavioral therapeutic approach to amelioration of PTSD symptoms Levels of post-traumatic stress disorder (PTSD), trauma-related distress, and subsyndromal PTSD, (here “PTS”) among combat soldiers and first responders are of international concern. In the broader population, a PTS global epidemic is attending trauma associated with the threatscape of the Anthropocene (increased extreme weather events, natural disasters, conflict, rising poverty, emerging infectious disease) as well as the legacy of the COVID-19 pandemic. PTS is also a health economic burden, with costs associated with treatment, long-term morbidity, and increased risk of mortality. In the Pacific region, rising PTS is associated with the existential threat of climate change and the economic and social legacy of colonization. There is an unmet therapeutic need for improved and culturally aligned PTS therapies in the Pacific and beyond. Medical standards of care for anxiety/PTS typically involve psychotropic interventions such as benzodiazepines (BDZ), tricyclic anti-depressants and anti-psychotic medications which have addictive potential, are only effective in the short term, are contraindicated for key populations such as the elderly and have significantly problematic track records in indigenous populations. Moreover, systemic racism both drives PTS in indigenous and other marginalized populations and limits the efficacy in such populations of conventional PTS therapies which are not culturally relevant or informed. Here, we describe the development of a novel, but traditionally grounded, approach to PTSD symptomatology in the context of Pacific populations. This approach has two elements: kava is a culturally significant Pacific drink used traditionally and in cultural practice, as a relaxant, to promote dialog in group settings, to aid in sleep and to manage anxiety. Its anxiolytic and sedative properties may link to the presence of kavalactones which are putative low potency γ-aminobutyric acid (GABA) ligands. Talanoa is a dialog practice common to most Pacific cultures. Our core hypothesis is that, combined, kava-talanoa will outperform current standards of care in PTSD symptom management as a culturally augmented cognitive-behavioral group therapy intervention. In this paper we review supporting literature, describe kava-talanoa pilot study findings and planned clinical trials, discuss important open questions, and present recommendations for broad-based transcultural applicability of this approach to global PTS burdens.

year: 2025

title: Northland Region and its territorial authorities: Demographic profile 1986-2031

authors: Jackson, Natalie

abstract: This report outlines the demographic changes that have occurred in the Northland Region, as well as what trends are expected in the future.

text: Northland Region and its territorial authorities: Demographic profile 1986-2031 This report outlines the demographic changes that have occurred in the Northland Region, as well as what trends are expected in the future.

year: 2014

title: Using the stars to indigenize the public sphere: Matariki over New Zealand

authors: Hardy, Anna

subjects: Arts & Humanities

abstract: As the rate of affiliation to Christian identity continues to decline in Aotearoa New Zealand (only 49 percent of the population said they were Christian in the last census), public space has become more receptive to other forms of religiosity. In particular, community rituals around the winter movements of the Matariki (Pleiades) constellation have gained support since the year 2000. For instance, the capital city, Wellington, has replaced a centuries’ old British fireworks festival, Guy Fawkes, with an enlarged version of its Matariki celebrations: an action seen as a tipping point in the incorporation of Māori spiritual values into public life. Interactions between European colonisers and Māori have been characterised for more than 250 years by tensions between the relational thinking of Māori who see human beings as both participating in and constrained by an environment resonant with divine energies, and the quantitative, hierarchical, ‘Great Chain of Being’ model that had long been dominant among Europeans. Now, when the natural environment worldwide is under strain from population and economic pressures, it seems to some both appropriate and vital to look to epistemological and spiritual models that are intimately responsive to the specificities of location.

text: Using the stars to indigenize the public sphere: Matariki over New Zealand As the rate of affiliation to Christian identity continues to decline in Aotearoa New Zealand (only 49 percent of the population said they were Christian in the last census), public space has become more receptive to other forms of religiosity. In particular, community rituals around the winter movements of the Matariki (Pleiades) constellation have gained support since the year 2000. For instance, the capital city, Wellington, has replaced a centuries’ old British fireworks festival, Guy Fawkes, with an enlarged version of its Matariki celebrations: an action seen as a tipping point in the incorporation of Māori spiritual values into public life. Interactions between European colonisers and Māori have been characterised for more than 250 years by tensions between the relational thinking of Māori who see human beings as both participating in and constrained by an environment resonant with divine energies, and the quantitative, hierarchical, ‘Great Chain of Being’ model that had long been dominant among Europeans. Now, when the natural environment worldwide is under strain from population and economic pressures, it seems to some both appropriate and vital to look to epistemological and spiritual models that are intimately responsive to the specificities of location.

year: 2019