Residential school syndrome

Issue: BCMJ, vol. 43 , No. 2 , March 2001 , Pages 78-81 Clinical Articles

ABSTRACT: Residential school syndrome is a suggested diagnostic term that might be appropriately applied to survivors of the Indian residential school system. Many of these former students have presented to the author with sufficiently similar concerns to suggest a common etiology. The suggested diagnostic criteria may further the discussion of what appropriate care might be provided. Many of the suggested diagnostic features are similar to the diagnosis of post-traumatic stress disorder, but with specific cultural impact. Healing of this disorder has important long-term implications for Canadian society.

Whether Indian residential schools are seen as an attempt at benevolence or a plan to annihilate a culture, many native people who attended the schools present with symptoms similar to those of post-traumatic stress disorder. This constellation of symptoms has come to be known as residential school syndrome.

Throughout Canada, and particularly in British Columbia, the Indian residential school issue is a significant problem. Litigation is currently underway or planned, with a potential liability of several billion dollars. The defendants are the Government of Canada and a number of churches. The plaintiffs are the alleged victims of the Indian residential schools. The schools were established by the Government of Canada, with the actual operation of the schools delegated to a number of Christian churches.

In BC, the schools operated from approximately 1863 to 1984, and as many as 10,000 native children across Canada were attending residential schools in the 1960s. Many children alleged psychological, physical, and sexual abuse during the time of their residential school attendance, and many of those now-adult survivors allege continuing negative impact of their experiences. The continuing negative impact is what has come to be called residential school syndrome; although there is no general agreement as to what such a syndrome might be.

In 1635, Governor Champlain stressed the fact that leaving children with the missionaries would improve relations with the Huron. This appears to be the first attempt to establish boarding schools for First Nations children in Canada.[1] In British Columbia the schools operated from 1863 to 1984, when St. Mary’s was finally closed. In all, there were 16 such schools in BC operated by the Government of Canada, the United Church, the Anglican Church, and the Roman Catholic Church. Attendance for every native child between the ages of 7 and 15 became mandatory in 1920.[2] From one point of view the schools were an enlightened attempt to educate native children in English, mathematics, and practical skills. From a First Nations’ point of view, the schools were an arrogant, Eurocentric, cynically calculated attempt to destroy indigenous cultures in order to obtain resources without hindrance.

An overview of traditional cultures in BC should help readers understand the impact of the Indian residential schools. Because there are more than 100 bands in BC, this overview will necessarily be a summary, and not entirely accurate for any particular band.

Most cultures in what is now BC were matrilineal and matriarchal, clan-based, and highly developed. Populations were stable and appropriate to the food supply. The societies were communal, with the elderly and less fortunate cared for by the more successful. Most societies were of the hunter/gatherer sort, with inherited rights to resources of specific land and sea areas.

Marriage within clans was prohibited, and clan membership across tribes was recognized. There were six major language groups, along with regional variations. There were specific birth, naming, puberty, marriage, divorce, and funerary rituals, as well as specific beliefs in cosmology and the afterlife. Wars were not unusual, but also were not general.

The feast system was a means of public recognition and sanction of important events, ranging from the bestowal of inherited names to the resolution of conflict between tribes.

There were secret societies to which only the invited might belong. The initiation rituals, known as the spirit quest, often involved prolonged deprivation and the finding of spirit/ animal helpers who would persist during the life of the individual.

Into this intensely evolved set of societies came Europeans with technologically advanced material goods, demands for territory, and entrenched ideas of proper social conduct, land use, and religion. They were insistent that their ideas were correct and believed themselves to be benevolent to the First Nations.

Some treaties with the First Nations were signed by the Government of Canada and the First Nations peoples were allowed land reserves. Many of the treaties were never observed, but the First Nations peoples were relegated to the reserves. (In 1920, the same year that attendance at Indian residential schools was made mandatory for First Nations children, the British Columbia Indian Lands Settlement Act implemented recommendations reducing reserve lands to less than 0.36% of the total area of British Columbia, without the consent of First Nations people.) Not surprisingly the population dwindled to near-extinguishment.

In the late 1800s, the Indian residential school system was established. Eventually, there were 16 such schools in BC, the last being closed in the 1980s. Children were taken from their homes and confined in schools in isolation from their families and cultures. They were instructed in Christianity, mathematics, and farming and ranching.

I have heard, in my own practice, of no instruction in the English language. Instead, most patients I have seen indicate that they were simply punished for speaking their own language. There is an apocryphal story of children being punished by being forced to kneel on broken glass in front of a cross with a needle propped under their tongue as a punishment for speaking their own language. I have not personally seen a patient to whom this was done, but the story is widely believed.

Certainly it is the case that many masks, regalia, and ritual artifacts were confiscated and burned as pagan works of the devil—or simply held and later sold for profit.

The Nuu-chah-nulth Tribal Council has done a large survey of Indian residential schools affecting their people.[1] Their report indicates that, across Canada, there were 11 schools in operation in 1880, 88 schools in 1909, and 60 remaining open in the 1960s. In the 1940s, 8000 native children were attending and in the 1960s 10,000 native children were attending. Forty years later many of those children and their descendants survive and continue to show evidence of the effects of the residential school system.

Of 96 individuals interviewed by Nuu-chah-nulth interviewers, 30% to 83% indicate that they were victims of abuse in some form, and more than half indicate that they continue to have need of counseling, therapy, or healing.

For most people who attended Indian residential schools, there is no symptomology other than that similar to other people who have attended a boarding school for an extended period of time. However, for a significant minority of Indian residential school students, there is symptomology quite similar to post-traumatic stress disorder. More specifically, there are recurrent intrusive memories, nightmares, occasional flashbacks, and quite striking avoidance of anything that might be reminiscent of the Indian residential school experience.

At the same time, there is often a significant detachment from others, and relationship difficulties are common. There is often diminished interest and participation in aboriginal cultural activities and markedly deficient knowledge of traditional culture and skills. Often there is markedly increased arousal including sleep difficulties, anger management difficulties, and impaired concentration. As might be the case for anyone attending a boarding school with inadequate parenting, parenting skills are often deficient. Strikingly, there is a persistent tendency to abuse alcohol or sedative medication drugs, often starting at a very young age.

Some or all of the symptomology is referenced by the term residential school syndrome, but there is no formal agreement, even among health-care personnel dealing with the survivors of the Indian residential schools, on exactly what the diagnostic criteria should be. Those criteria presented in Table 1, modelled after DSM-IV,[3] are simply offered as a suggestion.

As all of the Indian residential schools are now closed, any person presenting with this constellation of symptoms presently has, by definition, a chronic disorder lasting months or years.

This definition of the term residential school syndrome is somewhat similar to that of post-traumatic stress disorder as defined in DSM-IV. Both residential school syndrome and post-traumatic stress disorder share criteria that the person has undergone or witnessed some degree of trauma and that his or her response was fearful or helpless. The two diagnoses share requirements of re-experiencing, avoidance, and increased arousal.

The residential school syndrome diagnosis is different from that of post-traumatic stress disorder in that there is a significant cultural impact and a persistent tendency to abuse alcohol or other drugs that is particularly associated with violent outbursts of anger. The residential school syndrome diagnosis also highlights possible deficient parenting skills.

Chrisjohn et al[4] have suggested another set of criteria for the diagnosis of residential school syndrome. These criteria are reproduced in Table 2. Chrisjohn’s conclusions are worth quoting. "We really don’t care whether or not anyone appreciates our attempt at humor. Like a lot of comedy, this parody has its roots in reality: that it is not the aboriginal peoples who are sick, but the society that, among other things, created the residential schools. The inability to face up to that fact, for whatever reasons, is a festering wound that bears dealing with."

Whether the residential school syndrome describes the children traumatized by the Indian residential school system or those in authority who created the possibility of such traumata, children were damaged. To deny the existence of the damage is to deny these now-adult survivors the possibility of redress and compensation.

Into this syndrome of chronic distress has come the current litigation. Some residential school syndrome survivors have had the unprecedented courage to hire lawyers to represent them before the courts and seek redress. What they want is not complicated: recognition of wrongdoing, apologies, money for their losses of potential careers and relationships, and healing of the symptoms of residential school syndrome.

Though rarely explicated, the healing process is not unknown or arcane. Some of it occurs in healing centres known and funded as alcohol and drug treatment centres. The funding is based on the essentially racist view that native people are peculiarly subject to alcohol and drug abuse. Treatment of that problem is presumed to be all that is required. Those who work at the treatment centres know otherwise. Their actual work is necessarily far broader and includes, as it must, treatment of the residential school syndrome.

A second aspect of healing is the outpatient follow-up in the home community. There are very few resources for the necessary follow-up, and the demands are often excessive. The utility of local therapists is also limited in that they are often relatives of potential clients, and many people will not use therapeutic services due to issues of confidentiality.

In some cases, traveling therapists visit the villages on a regular and continuing basis. Once trust is established, the services of these therapists are often well utilized. I have been one such therapist and the approach I use is modelled after Patricia Resick’s cognitive processing therapy for rape trauma.[5]

The Indian residential schools are now closed, and some survivors have recovered from their traumata and pressed for compensation and recognition. Their efforts have brought the issues to attention and some efforts to assist in healing of the injuries have begun. If these efforts are adequately funded and sufficiently expanded, residential school syndrome can perhaps be eliminated within the generations currently alive. Without sufficient efforts, residential school syndrome will continue to reverberate through yet more generations.

An earlier version of this paper was presented at the World Association for Social Psychiatry, August 1998, Vancouver, BC; at the Fifth International Conference in Clinical Medicine of the World Police Medical Officers, August 1999, Vancouver, BC; the Yukon Medical Association, Nov. 1998, Whitehorse, Yukon; and at meetings of family physicians in 1999 in Terrace and Smithers, BC.


1. Nuu-chah-nulth Tribal Council. Indian Residential Schools: The Nuu-Chah-Nulth Experience. Report of the Nuu-chah-nulth Tribal Council Indian Residential School Study, 1992 - 1994. Port Alberni, BC: Nuu-chah-nulth Tribal Council, 1996. 
2. Miller JR. Shingwauk’s Vision: A History of Native Residential Schools. Toronto, ON: University of Toronto Press, 1996:41-42. 
3. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994. 
4. Chrisjohn R, Young S, Maraun M. The Circle Game: Shadows and Substance in the Indian Residential School Experience in Canada. Penticton, BC: Theytus Books Ltd., 
5. Resick PA, Schnicke MK. Cognitive Processing Therapy for Rape Victims: A Treatment Manual. Newbury Park, CA:Sage Publications, 1993.

Dr Brasfield is a psychiatrist in private practice in North Vancouver and a clinical associate professor in the Department of Psychiatry at the University of British Columbia, where he is a consultant psychiatrist to the Health Psychology Clinic. His private practice is focused on First Nations people, and he provides regular psychiatric outreach services to the Heiltsuk community of Waglisla, BC.

Charles Brasfield, MD, PhD, FRCPC. Residential school syndrome. BCMJ, Vol. 43, No. 2, March, 2001, Page(s) 78-81 - Clinical Articles.

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Bernice says: reply

Hi, would you say that Residential School Syndrome is something that mental health workers across Canada are aware of?
And would they use it as a diagnostic tool, especially when faced with Indigenous people initially presenting with alcohol/drug abuse, violent tendencies or say depression. I am curious if someone goes to these mobile mental health clinics, or community mental health groups, would they be willing to explore a diagnosis of RSS, and treat it as such, and not merely focusing on the initial problem? Thank you.

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