North American Indigenous Medicine Ways

A Note on Approach

The spiritual traditions of North American indigenous peoples are not historical artifacts. They are living practices belonging to living peoples who have endured centuries of genocide, forced assimilation, and cultural suppression. Many of these traditions are considered sacred and not intended for public sharing. What follows draws on publicly available information, particularly teachings that indigenous scholars and elders have chosen to share with wider audiences. The intention is educational and respectful — to honor these traditions for what they are, not to appropriate them for personal use outside of their cultural context.

The diversity of indigenous North American spiritual practice is immense — hundreds of distinct nations, each with their own language, cosmology, and ceremonial life. This article focuses primarily on traditions of the Plains peoples, particularly the Lakota (Sioux), while acknowledging that these represent only one stream within a vast river.

The Medicine Wheel: A Map of Wholeness

The Medicine Wheel is one of the most widely recognized symbols of indigenous North American spirituality, yet its meaning is far deeper and more multidimensional than most people realize. It is not a single, fixed teaching but a framework — a way of understanding the relationships between all things, organized according to the four cardinal directions.

Physical medicine wheels — stone arrangements laid out in circular patterns with spokes radiating from a central cairn — exist across the Great Plains and Rocky Mountain regions. The Bighorn Medicine Wheel in Wyoming, situated at nearly ten thousand feet elevation, is among the most famous and is considered a sacred site by multiple tribal nations. These physical structures served as ceremonial sites, astronomical observatories, and places of prayer and vision-seeking.

The conceptual Medicine Wheel maps the four directions, each associated with specific qualities, elements, seasons, stages of life, and aspects of human experience. While different nations assign different correspondences, a common framework associates:

East with spring, new beginnings, birth, the element of fire, the color yellow, and the eagle or hawk. East is the direction of illumination, of spiritual vision, of seeing clearly.

South with summer, youth, growth, the element of water, the color red, and the mouse or coyote. South is the direction of innocence, trust, emotional learning, and close-to-the-earth perception.

West with autumn, adulthood, introspection, the element of earth, the color black, and the bear. West is the direction of looking within, of facing one’s shadow, of the thunder beings and transformative power.

North with winter, elderhood, wisdom, the element of air or wind, the color white, and the buffalo. North is the direction of gratitude, of knowledge earned through experience, of the ancestors and the capacity to see the whole picture.

Movement around the Medicine Wheel follows a clockwise or “sun-wise” direction, aligning with the forces of nature — the path of the sun from east to south to west to north. This circular movement is fundamental to indigenous ceremony and reflects a cosmology in which all things are connected, all things return, and wholeness is achieved through honoring every direction, every season, every aspect of existence.

The Medicine Wheel teaches that health — physical, emotional, mental, and spiritual — comes from balance. When any direction is neglected or overemphasized, the wheel falls out of balance, and illness or disharmony follows. The work of healing is the work of restoring this balance.

The Seven Sacred Rites of the Lakota

According to the tradition recorded by the holy man Black Elk, seven sacred rites were given to the Lakota people by White Buffalo Calf Woman (Ptesan Wi) — a supernatural being who appeared to the people in a time of great need, bringing the sacred pipe and the ceremonies that would sustain them.

Inipi — The Sweat Lodge (Purification Rite): The Inipi is the foundational ceremony of purification. The word means “to live again,” and the ceremony represents a symbolic death and rebirth. A domed structure is built from bent willow saplings and covered with blankets or hides, creating a dark, womb-like enclosure. Heated stones — called “Stone People” or Tunkasilas (Grandfathers) — are placed in a central pit, and water is poured over them to create intense steam.

The ceremony unfolds in four rounds, called “doors,” each associated with one of the four directions. Participants pray, sing sacred songs, and endure the heat as a form of purification — releasing physical toxins through sweat, but more importantly, releasing spiritual and emotional burdens. The darkness, the heat, the steam, the sound of prayer — all combine to create a powerful altered state in which visions may come and healing occurs.

The door is opened between rounds to allow participants to breathe and to bring in additional heated stones. Each opening represents a passage between worlds — from the darkness of the lodge (symbolic of the womb or the spirit world) to the light of day (the ordinary world). Participants emerge from the final round reborn, cleansed, ready to face what comes next.

Hanbleceya — Crying for a Vision (Vision Quest): The Hanbleceya is the practice of seeking direct communication with the spirit world through solitary fasting and prayer in an isolated natural setting. The word means “crying for a vision” — it is understood as an act of radical humility, a desperate plea from the human heart to the Great Mystery for guidance, purpose, and power.

Before the quest begins, the seeker undergoes purification in the sweat lodge and is guided to a remote location by a holy man (wicasa wakan). There, the seeker remains alone — typically for one to four days and nights — without food, water, or shelter, praying continuously for a vision.

The isolation, fasting, and exposure to the elements create conditions in which the boundary between ordinary consciousness and the spirit world becomes thin. Visions may come in dreams or waking states. Animals may appear as messengers. Natural phenomena — a shift in wind, a sudden thunderstorm, the cry of an eagle — are read as communications from the spirits.

The visions received during Hanbleceya often shape the entire course of a person’s life. They may reveal one’s purpose, one’s medicine, one’s relationship with specific animal spirits, or one’s responsibility to the community. The vision quest is not undertaken lightly; it is one of the most demanding and transformative practices in North American indigenous spirituality.

Wi Wanyang Wacipi — The Sun Dance: The Sun Dance is widely recognized as the most sacred and demanding ceremony of the Plains peoples. Traditionally lasting seven days (with four days of preparation and three of the actual dance), it is a ceremony of sacrifice, renewal, and communion with Wakan Tanka — the Great Mystery, the sacred power that permeates all things.

The ceremony centers on the Sundance Tree — a cottonwood pole that represents the World Tree, the axis connecting earth and sky. Dancers circle the tree for extended periods, fasting from food and water, gazing at the sun, and praying for the health of the people, the renewal of the earth, and the continuation of life.

In the most intensive form of the ceremony, dancers undergo piercing — wooden pegs are inserted through the skin of the chest or back and attached by rope to the Sundance Tree or to buffalo skulls. The dancer then moves away from the tree until the pegs tear free, offering their flesh and blood as a sacrifice. This is not masochism; it is understood as the highest form of prayer — giving of one’s own body so that the people may live.

The Sun Dance was banned by the United States government from the 1880s until the American Indian Religious Freedom Act of 1978 — nearly a century of suppression that speaks to how threatening these practices were to colonial power structures, and how deeply devoted practitioners were to maintaining them despite the risk.

The Sacred Pipe (Chanunpa): The Sacred Pipe, brought by White Buffalo Calf Woman, is central to Lakota spiritual life. It is not “smoked” in the recreational sense — it is used to carry prayers. When the pipe is loaded with tobacco (canshasha) and lit, the rising smoke carries the prayers of the people upward to Wakan Tanka and outward to the four directions.

The pipe is offered to each of the four directions, to Father Sky, and to Mother Earth before being shared among participants. Every element of the pipe carries meaning — the bowl represents the earth and the feminine, the stem represents all growing things and the masculine, and when they are joined together, they represent the union of all things.

Animal Medicine and Totems

In many North American indigenous traditions, animals are understood as carriers of specific spiritual qualities — what is sometimes called “animal medicine.” This is not the same as the European concept of a “mascot” or “spirit animal” in the casual sense. It refers to a deep, reciprocal relationship between a human being and an animal spirit that offers its particular wisdom and power.

During vision quests, encounters with animal spirits are among the most common and significant experiences. The animal that appears becomes a lifelong ally — offering protection, guidance, and the specific quality of consciousness that animal embodies. Eagle medicine brings clarity and connection to the divine. Bear medicine brings introspection and healing power. Coyote medicine brings trickster wisdom — the ability to see through illusion and laugh at the absurd. Buffalo medicine brings abundance, gratitude, and prayer.

These relationships are earned, not chosen. One does not pick an animal totem from a list; the animal chooses the person, and the relationship carries responsibilities as well as gifts.

The Medicine Person

The role of the medicine person (wicasa wakan or winyan wakan) in indigenous North American societies is distinct from both the priest and the doctor of Western culture, though it shares elements of both. The medicine person is a healer, a visionary, a ceremonial leader, a counselor, and a keeper of sacred knowledge.

The calling to this role typically comes through powerful visions, unusual experiences in childhood, or the recognition of natural gifts by existing medicine people. The training is long — years of apprenticeship, fasting, ceremony, and the gradual accumulation of spiritual power and knowledge. The medicine person does not serve themselves; they serve their people. The power they carry is understood as belonging to the community, not to the individual.

Dreamwork and the Living Dream

Dreams hold extraordinary importance in many indigenous North American traditions. They are not understood as random neural firings or subconscious processing, as in the dominant Western view. Dreams are a primary channel of communication between human beings and the spirit world. Visions received in dreams carry the same weight — and sometimes more — as experiences in waking life.

Dream interpretation, prophetic dreaming, and the practice of “dreaming true” (seeking specific information or healing through intentional dream practices) are sophisticated arts cultivated across many nations. The boundary between dreaming and waking is understood as permeable, not absolute — and the capacity to move consciously across that boundary is one of the marks of spiritual maturity.

Living Traditions

These traditions have survived five centuries of deliberate, systematic destruction — forced removal, residential schools that punished children for speaking their languages or practicing their ceremonies, legal prohibition, and cultural erasure. That they survive at all is testimony to their power and to the courage of the people who carried them through the darkest periods of colonial history.

Today, many indigenous communities are engaged in active revitalization of their ceremonial practices. Some have chosen to share certain teachings with wider audiences as a form of cultural bridge-building. Others maintain strict privacy around their most sacred practices. Both responses deserve respect.

What these traditions offer to anyone willing to listen — without appropriating what is not theirs to take — is a reminder that the land beneath our feet is alive and sacred, that all beings are related, that suffering and sacrifice can be pathways to renewal, and that the Great Mystery speaks to those who have the humility and the courage to listen.