As a director of behavioral health for a hospital in the heart of the Navajo Nation, doctoral student Michelle Kahn-John, MS ’00, has seen first-hand the health challenges endemic to this Native American population.
And it is why Kahn-John has chosen to base her practice with adolescent and adult psychiatric patients on the Navajo, or Diné, philosophy of Hózhó—what she calls “a way of living in the world.”
Hózhó is a philosophy of beauty, balance, peace, wellness, and harmony. It encompasses discipline with every aspect of life, says Kahn-John, who is Diné and whose mother was a medicine woman.
As Kahn-John was beginning her work as a College of Nursing online doctoral student in Fort Defiance, Ariz., in 2005, one of her most significant accomplishments was to launch the state of Arizona’s first inpatient psychiatric clinic for Native American teens. Her traditional Diné upbringing has enabled her to integrate Hózhó into her practice.
In the Navajo way of life, Kahn-John wrote in a paper published in Advances in Nursing Science (2010), illness occurs when “one is disconnected from the ways of Hózhó”: Harmony is replaced by dissonance; life is out of balance. Kahn-John believes this disconnect from traditional wellness philosophies contributes to the health problems in the younger Dine’ population: post-traumatic stress disorder, depression and substance abuse.
“Through my exploration of the concept of Hózhó, I'm interpreting that living a way of life in the spirit of Hózhó requires behaving and acting with constant mindfulness of all its attributes,” Kahn-John says: discipline, respect, reciprocity, relationships, spirituality and thinking.
Whether this wellness philosophy is known to Kahn-John’s patients “depends on how immersed they are in their traditional culture. There are ranges of cultural knowledge,” she says. The younger generation may not always be as aware of the traditional ways.
“Our Navajo elders are our greatest example of Hózhó,” says Kahn-John. “Those who have lived a traditional Navajo life have lived long healthy lives. It's important for our younger generation to remember the teachings of our elders and apply the attributes of Hózhó in our own lives.”
The attributes of Hózhó are subtle and complex. To fully understand Hózhó requires an extensive understanding of the traditional Navajo way of living. Kahn-John hopes to discover attributes of Hózhó through a qualitative inquiry on the lived experience of Hózhó among the Diné.
The way Kahn-John sees it, those who embrace the philosophy of Hózhó reap its rewards in the way of physical, emotional, mental, social and environmental health.