Many others have ventured into this territory: among them, mountain men (McClintock, On the Old North Trail), fur trappers (Ewers, ref. Indian Life on the Upper Missouri) (Lewis and Clark, Journals), missionaries (De Smet, Ignatius), and educators (Schultz, Gold).
Personal reasons as well as the forces of western migration impelled these  men to new and unknown (at least to them) and unexplored (at least to them) territories, · domain of the American Indian (who now may prefer to be called Native American.)
Surprisingly often, they wrote accounts of their contacts and adventures and of their considerable physical hardships. scientists came in hopes of recording or preserving the material culture, ethnography, and religion of peoples in a process of rapid change. (Ewers, Wissler, George Bird Grinell, Oscar Lewis) .
Our encounter in the modern day has more in common with the trapper or military man in historical time than with a contemporary anthropologist. We are here  to work.
We are brought here and allowed here by the necessity of our daily business; psychiatric consultation. The welcome of the anthropologist has passed some time ago—-victim of misunderstanding. Residents of reservations  have felt used as informants by the anthropologists need of raw data for science. Clinical necessity brings us here. Local mental health personnel request consultation.  Small hospitals rapidly turn over their doctors, nurses and social workers, to the  distress of their Native American patients. Local schools are concerned with the high dropout rates. The entire community is distressed.
A psychiatrist in these communities is an anomaly: Unknown or only as  humorous figure from movies and television.
text from scan 2 and BEAR
by white medical personnel, medical care takes place in an area of often unsatisfactory cross-cultural contact. One, then, cannot assume an initial positive transference (Freud, ref.), In practice I have found it useful to assume a history of unsatisfactory contacts with white physicians, and to explore with the patient their negative expectation that this contact will  be another like experience. Records chart histories are influenced by the background and experience of the physicians and other health workers. The physicians usually are from far away, as are other mental health professionals. Nurses, and mental health workers and hospital staff are often local and of the same or different tribal backgrounds. Written records may reflect these differences and lack the emotion and gesture of spoken reports. 
   Trauma and habituation trauma  allostatic overload and Merleau ponty  habituation at bodily level PTSD. 
Family history and individual history have a separate life in the community. The family doctor of our culture some generations ago  did not require a family and social history as he already knew it. He had treated his patient's parents and brothers and sisters, and knew of family relationships and genetic trends. A Native American's history is likewise known, as matters are known in a small town: gossip friendly or malicious, public and external events, and shared experience. Why tell these to a stranger? Even if told, can a stranger understand the meaning and significance of these events to his patient? We also usually think of psychoanalytic history as individual history, and analysis is strongly individualistic, while perhaps the Native American culture may be more involved in group processes , (Footnote -- self and object-separations/self and group separations)
Carlos Castenada, in describing his relationship with the Yaqui Indian medicine man, Don Juan, describes an incident in which Don Juan asks him to find his place. Carlos reacts rather literally(and compulsively). This task--to find one's place- -or to be sure it -is another dimension of the profile as it is applied cross-culturally. In the security of my private office, I see my patients from a reasonably consistent vantage point--my chair. I have, literally, sat in this chair for years, and my points of reference are familiar. Against this consistent environmental ground, and applying the