Health survivance: Decolonizing resilience for indigenous peoples in psychology

Behavioral health inequity for American Indians and Alaska Natives (AI/ANs), stemming distally from histories of colonization and continual subjugation, is a challenge that has largely evaded mainstream psychological solutions. Eurocentric psychology conceptualizes the contemporary AI/AN behavioral health environment in terms of compounded trauma balanced at times by remarkable instances of resilience. Decolonized approaches to psychology require a paradigm shift away from approaches that uphold Eurocentric ideals of behavioral health. Resilience, despite its use by minoritized populations globally, remains rooted in hierarchical and comparative systems historically used to dehumanize and disenfranchise non-White communities. Instead, addressing AI/AN behavioral health inequity must center Indigenous ways of knowing, emphasizing continued presence achieved through active resistance. We contend that the concept of health survivance better meets the needs of AI/AN communities. In this article, we interrogate the foundations, utility, and bounds of health survivance through critical comparison with the established construct of resilience. We propose that health survivance differs from conventional resilience in four key ways: (a) resistance to unjust societal arrangements versus adaptation to the status quo; (b) recognition of a temporal arc inclusive of the past, present, and future versus focusing on individual lifespan; (c) persistence of community and culture versus personal adaptation and well-being; and (d) refusal of identities of victimization versus accentuating adversity and trauma. Incorporating health survivance into research and interventions to address existing behavioral health inequities enables a shift from Eurocentric approaches to health toward Indigenous agency in promoting well-being through resistance to the status quo, celebrating the recognition that we are still here. (PsycInfo Database Record (c) 2025 APA, all rights reserved).