**1. Introduction**

In recent decades, numerous studies have documented problems associated with drinking alcohol among American Indians and Alaska Native peoples, however, little research has focused on developmental factors and whether or not they would contribute to Alaska Native sobriety and relapse prevention [1–6]. Some research has focused on the developmental stages and the appropriate treatment methods for each stage, with a primary focus on young adults and identity formation, and this chapter will build upon this work with a focus on alcohol treatment and recovery for older adults. This chapter will discuss the unique characteristics and experiences of Alaska Native people, how Alaska Native Elders achieve Eldership in their family and community and fulfill the role expectations in their family and community, and the role of generative acts and behaviors in their recovery narratives. This chapter will conclude with a discussion of motivational interviewing with older adults and how it can be used to help elders completing treatment to find their motivations through indigenous cultural generative acts and behaviors, which will serve as the foundation of a peer-based relapse prevention program for Alaska Natives and other indigenous populations of all ages.

#### **1.1 Alaska Native peoples**

The State of Alaska is two times the size of Texas and is home to over 700,000 people and 15% of those self-identify as Alaska Native [7], which are divided into five major groupings, including the Aleuts, Northern Eskimos (Inupiat), Southern Eskimos (Yup'ik Eskimo), Interior Indians (Athabascan), and Southeast Coastal Indians (Tlingit/Haida/Tsimshian). These groupings are based on cultural and linguistic similarities of people living in various regions of the state [8]. Each of these cultural groups are distinct, consisting of complex kinship networks, developed subsistence hunting and gathering practices and technologies, and unique languages, belief systems, art, music, storytelling, spirituality, and dance traditions to name a few [9]. Roderick details the commonalities among the Alaska Native cultural groups, including their relationship and connection to the environment. They honor both the land and waters upon which their lives depend, have respect for the fish and animals, and value community over individuality, sharing with others, and respecting and learning survival skills from their Elders [9].

According to the 2010 Census, there are 12,318 Athabascans, 7696 Aleuts, 20,941 Inupiat Eskimos, 9996 Tlingit/Haida/Tsimshian, and 27,329 Yup'ik Eskimos living in the State of Alaska (www.census.gov).

The older adult population is growing rapidly in the United States, with high rates in tribal communities. With this growth of the elders in Alaska Native, reservation, and urban communities comes the need for age appropriate treatment programs. Following Erik Erikson's stages of human development [10], this paper discusses the role of generativity (seventh stage) in the recovery process for AN older adults and how this developmental stage can be integrated into alcohol treatment for Alaska Native and other Alaska Native peoples to enable them to quit drinking and become role models for their families and communities. This chapter attempts to discuss the importance of generativity and redemptive narratives in the role development of "Elders" in tribal communities and argues for the incorporation of this developmental stage into a treatment program to prevent relapse for Alaska Native older adults struggling with alcohol use disorders and improve their quality of life.

Alaska Native community partners have repeatedly advocated for a shift from a problem-based to a strengths-based model of relapse prevention in alcohol treatment. Rather than focusing on problem behaviors and reasons why people drink and cannot recover, this approach highlights individuals and subgroups successful treatment outcomes or who have been protected from active substance use problems [11]. Rather than focusing on failures in alcohol treatment and recovery (e.g., relapse), community partners are highlighting reasons for sobriety and older adults sharing their recovery journey. This shift in focus was spearheaded by tribal leaders and researchers in Alaska in direct response to the Barrow Alcohol Study and the impending damage of this study on the lives of Alaska Natives. Obtaining a better understanding of those who are successful in their recovery contributes to our understanding of the protective factors from alcohol use disorders [3, 4, 12]

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*Alaska Natives in Recovery and Indigenous Cultural Generativity: Sharing Redemptive…*

and guide the development of alcohol intervention approaches built upon strengths found in the redemptive narratives. This need to pass along experiences and stories to serve as examples of recovery is one form of generativity, which Erik Erikson's seventh stage of human development. In particular, it is important to highlight cultural strengths that exist in native communities; these strengths include values based having a desire to pass on their experiences, wisdom, lessons, and cultural values and beliefs [11], specifically those experiences related to their experiences while drinking, their journey to recovery, and how they use those past experiences to help others on their own journey. We will refer to these as generative acts and behaviors.

A particularly important distinction in the later life role for Alaska Native older adults shared with many other American Indian and indigenous groups is that of Elder. In this paper, the term "Elder" is capitalized to differentiate this. In indigenous communities, community and family members respect their Elders, seek them for their knowledge, skills, and history, and this cultural convention distinguishes those who have practiced subsistence activities (gathering and harvesting traditional foods), engaged in healthy behaviors to maintain physical, mental, and spiritual health, taught others, and served as an integral part of their community as role models and leaders [13]. In this way, the role socialization that occurs across the lifespan that enables a community member to become an Elder in Alaska Native

This concept of *elder*, according to Erikson [14], was formulated in our middle years, a time when we had no intention of imagining ourselves as old. Erikson [14] goes on to state, "One could still think in terms of 'elders,' the few wise men and women who quietly lived up to their stage-appropriate assignment and knew how to die with some dignity in cultures where long survival appeared to be a divine gift to and a special obligation for a few" (p. 62). The lifespan of Alaska Native Elders today continues to increase with improvements in health care technology and services, and this longer lifespan may have a direct impact on the recognition and respect of Elders in rural communities [15]. How elders are viewed in society today is vastly different from the past, and our views of the elderly will continue to shift with social and cultural changes. In addition to changes in how society views its

The psychoanalyst Erik Erikson developed a theory of affective, or emotional, development complementary to the developmental theory of Sigmund Freud, who also studied human development. Erikson identified eight stages of development, and this chapter focuses on the seventh one, adulthood, which includes the concept of generativity, or leading the next generation [14]. During this stage of development, the individual is focused on being a contributing member of society and concerned for the wellbeing of future generations. Lerner [16] explained that during this stage of development an individual successfully plays the role society expects of him (role expectation). More specifically, if they are contributing and producing what is expected, they will experience a sense of generativity. Generativity, broadly defined, refers to not only the creation of children, but also to the production of things and ideas through work. Most of Erikson's work, however, focused on the generation of children. Notably, Erikson does not require that individuals have their

own children to achieve, or experience, the benefits of generativity.

*DOI: http://dx.doi.org/10.5772/intechopen.90548*

**2. Definition of AN Elder**

communities is incompatible with problem drinking.

elders, family dynamics are shifting.

**2.1 Generativity**

*Alaska Natives in Recovery and Indigenous Cultural Generativity: Sharing Redemptive… DOI: http://dx.doi.org/10.5772/intechopen.90548*

and guide the development of alcohol intervention approaches built upon strengths found in the redemptive narratives. This need to pass along experiences and stories to serve as examples of recovery is one form of generativity, which Erik Erikson's seventh stage of human development. In particular, it is important to highlight cultural strengths that exist in native communities; these strengths include values based having a desire to pass on their experiences, wisdom, lessons, and cultural values and beliefs [11], specifically those experiences related to their experiences while drinking, their journey to recovery, and how they use those past experiences to help others on their own journey. We will refer to these as generative acts and behaviors.
