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Résumé
L’approche à double perspective :
un cadre pour comprendre les approches
autochtones et non autochtones
à la recherche en santé autochtone
Debbie H. Martin
Cet article présente l’approche à double perspective (two-eyed seeing) en tant que
cadre théorique englobant les apports des modes de connaissances (visions
du monde) autochtones et occidentaux. Il présente les caractéristiques et les
principes clés de ces différentes perspectives et suggère des façons dont elles
pourraient être utilisées conjointement pour répondre à nos questions les plus
pressantes sur la santé des Autochtones et leurs collectivités. Contenant une cri-
tique du positivisme, qui a dans le passé miné ou rejeté les modes de connais-
sances autochtones jugés non scientifiques, l’article traite des or igines des
approches occidentales et autochtones en matière de compréhension de la santé;
de l’importance d’accorder la même attention aux diverses visions du monde
occidentales et autochtones de manière à ce que l’une d’elles ne domine pas ou
ne sape pas les apports de l’autre; et de la manière dont un examen équilibré des
apports des diverses visions du monde, effectué dans un cadre fondé sur une
double perspective, peut reformuler les questions que nous posons dans le
domaine de la recherche en santé autochtone.
Mots clés : Autochtones, santé, recherche en santé, visions du monde, double
perspective
CJNR 2012, Vol. 44 No 2, 20–42
20
Two-Eyed Seeing:
A Framework for Understanding
Indigenous and Non-Indigenous
Approaches to Indigenous
Health Research
Debbie H. Martin
This article presents two-eyed seeing as a theoretical framework that embraces
the contributions of both Indigenous and Western “ways of knowing” (world-
views). It presents key characteristics and principles of these different perspectives
and suggests ways in which they might be used together to answer our most
pressing questions about the health of Indigenous people and communities.
Presenting a critique of positivism, which has historically undermined and/or
dismissed Indigenous ways of knowing as “unscientific,” it discusses the origins
of both Western and Indigenous approaches to understanding health; the impor-
tance of giving equal consideration to diverse Indigenous and non-Indigenous
worldviews such that one worldview does not dominate or undermine the
contributions of others; and how balanced consideration of contributions from
diverse worldviews, embraced within a two-eyed seeing framework, can reshape
the nature of the questions we ask in the realm of Indigenous health research.
Keywords: Indigenous peoples, Aboriginal peoples, health, health research,
theory, worldviews, two-eyed seeing
Introduction
Two-Eyed Seeing adamantly, respectfully, and passionately asks that we
bring together our different ways of knowing to motivate people,
Aboriginal and non-Aboriginal alike, to use all our understandings so
that we can leave the world a better place and not compromise the
opportunities for our youth (in the sense of Seven Generations) through
our own inaction. (Bartlett, Marshall, Marshall, & Iwama, in press, p. 11)
There are many ways of seeing and understanding the world. How health
is understood within our academic and health-care institutions is pre-
dominantly shaped by conventional scientific approaches, but there are
other, equally valuable, ways to understand health. Discussions about the
importance of alternative ways of knowing, such as those encompassed
CJNR 2012, Vol. 44 No 2, 20–42
© McGill University School of Nursing 21
by Indigenous1perspectives, are often absent from research generally
(Smith, 1999) and health research specifically. Through an uncritical
reliance upon only conventional scientific, or Western, understandings of
health (Denzin & Lincoln, 2008), we disregard other avenues that may
hold key insights into the health and well-being of populations. This
article presents and builds upon a framework called two-eyed seeing pro-
posed by Mi’kmaw Elders Albert and Murdena Marshall as a means to
bridge Western science and Indigenous knowledge (Bartlett et al., in
press). This article argues that two-eyed seeing offers a way in which
diverse perspectives might work together to answer our most pressing
questions about the health of Indigenous people and communities.
Epidemiological data suggest that in many Indigenous communities
the burden of chronic disease is worsening and that health disparities
between Indigenous and non-Indigenous populations are widening
(Gracey & King, 2009; Loppie-Reading & Wien, 2009). The significant
health inequities between Indigenous and non-Indigenous populations
can largely be explained by inequitable access to many of the social
determinants of health (King, Smith, & Gracey, 2009; Loppie-Reading &
Wien, 2009; Richmond & Ross, 2009). In Canada, for example, a
country consistently ranked in the top 10% of the world’s most devel-
oped nations according to the United Nations Development Index, one
need look no further than Indigenous communities to find living con-
ditions more reminiscent of developing countries than other parts of
Canada — communities that are characterized by unemployment, poor
sanitation, overcrowded housing, and often desperate poverty (Adelson,
2005). Given these social and living conditions, it is not surprising that
members of Indigenous communities experience poor health compared
to non-Indigenous Canadians (Adelson, 2005; King et al., 2009; Waldram,
Herring, & Young, 2006). Researchers who study Indigenous health are
in agreement that the causes and consequences of ill health within
Indigenous communities are multi-faceted, complex, and predominantly
social in origin; health issues are so intertwined with social, political, eco-
Debbie H. Martin
CJNR 2012, Vol. 44 No 2 22
1 No set definition of the term “Indigenous peoples” exists, although certain characteris-
tics are deemed to be common among collectives who identify themselves as Indigenous
peoples, including the claim that they are the original inhabitants of a particular territory
(United Nations, 2004, 2006). This term, rather than “Aboriginal people,” is specifically
chosen for this article, because although “Aboriginal peoples” is more commonly used
to describe the Indigenous inhabitants of Canada (Royal Commission on Aboriginal
Peoples), it is politically charged and includes specific collectives (i.e., those who are
identified by the Government of Canada as either First Nation, Inuit, or Métis). This
article chooses to avoid these political distinctions, as there are Indigenous peoples in
Canada who identify as Indigenous to a particular location or territory, despite a lack of
recognition by the Government of Canada.
nomic, and environmental issues that one cannot hope to address them
without a thorough understanding of the context within which health is
situated (King et al., 2009).
The prevention and treatment of a variety of chronic and non-
chronic illnesses can be directly attributed to scientific advances in the
fields of public health, medicine, nursing, and other health disciplines
(Wilkinson & Marmot, 2003). Undeniably, research conducted within
these disciplines and the application of research findings in health pro-
grams, policies, and services have positively influenced the overall health
and longevity of populations, including Indigenous communities
(Loppie, 2007). Despite these advances, however, there continues to be a
noticeable gap between the health of Indigenous populations and that of
their non-Indigenous counterparts (Gracey & King, 2009). Taking into
account even the most diligent efforts by health disciplines, research find-
ings do not appear to be translating into better health for Indigenous
communities.
With growing recognition of the complex nature of the causes and
consequences of ill health in Indigenous communities, it is not enough
to simply define and describe the health issues being experienced. To
address the significant health disparities between Indigenous and non-
Indigenous peoples, Indigenous health researchers and communities are
calling for health research that is participatory, community-based, and
action-oriented; they are also calling for research processes and method-
ologies that reflect the needs, issues, and concerns of community
members themselves (Bull, 2010; Kovach, 2009; Minkler, 2005). For far
too long, Indigenous peoples have been subjected to research in its
various forms without receiving its benefits (Marker, 2003; Smith, 1999).
There is a groundswell of support for research that is driven by the needs
of the community and that can recommend solutions to some of the
health crises being experienced.
Just as important as the engagement and involvement of Indigenous
peoples in research, though less clearly understood, is the need for
research involvement to go beyond participation, to include thinking
carefully about how knowledge gets created (Kovach, 2009; Smith, 1999).
The means through which Indigenous health issues are identified,
defined, and addressed must uphold Indigenous worldviews. Otherwise,
simply put, even well-intentioned research within Indigenous commu-
nities may at best be less than useful and at worst perpetuate harm by
adding to the scepticism and trepidation that many Indigenous peoples
feel towards research (Kovach, 2009; Smith, 1999). The term “world-
views” is used here to elucidate the ways in which diverse groups of
people create knowledge about the world around them and principles for
engaging with it. In upholding Indigenous worldviews, the motive is not
Two-Eyed Seeing
CJNR 2012, Vol. 44 No 2 23
to diminish or dismiss the important work of Western health research
but, rather, to critically examine the lens through which health research
is interpreted and understood and to offer, in place of this dominant
view, an alternative lens through which health research can embed
Indigenous perspectives and realities. The lens proposed here is one that
has been developed and proposed by Mi’kmaw Elders Albert and
Murdena Marshall, called two-eyed seeing. Two-eyed seeing holds that
there are diverse understandings of the world and that by acknowledging
and respecting a diversity of perspectives (without perpetuating the dom-
inance of one over another) we can build an understanding of health that
lends itself to dealing with some of the most pressing health issues facing
Indigenous peoples and communities (Bartlett et al., in press; Iwama,
Marshall, Marshall, & Bartlett, 2009).
This article will explore the origins of Western thought and the
Indigenous origins of many of the ideas often assumed to have emerged
from Western science. It will re-imagine a health framework that does
not position one “way of knowing” above another. Finally, it will offer
two-eyed seeing as a theoretical framework that honours and accepts
diverse ways of knowing.
Origins of Western Scientific Understandings of Health
Health research as we know it today has been almost exclusively under-
stood from the perspective of Western science. With few exceptions,
major advances in health research have occurred as a result of Western
scientific methods of inquiry, with little attention paid to alternative,
much less Indigenous, ways of knowing (Denzin & Lincoln, 2008). The
many Indigenous origins of Western scientific thought and the health
advances that have resulted have received scant attention (Iaccarino,
2003). With its roots firmly established in positivism, the scientific tradi-
tion has become a pervasive (although contested) means of inquiry in the
Western world, which has failed to acknowledge the existence of per-
spectives that might question or contradict some of its fundamental
assumptions (Denzin & Lincoln, 2008; Varadharajan, 2000). The domi-
nance of positivism in the Western world can be seen in Canada’s educa-
tion system, which has been noted to teach a colonial version of history
that largely overlooks the key roles played by Indigenous peoples in the
settlement of what is now known as Canada (Truth and Reconciliation
Commission of Canada [TRC], 2012). Consequently, Canada’s education
system has established a “truth” about its past that fundamentally ignores
Indigenous perspectives (Marker, 2004). It has been claimed that this
absence of Indigenous history in curricula across Canada contributes to
Debbie H. Martin
CJNR 2012, Vol. 44 No 2 24
the ignorance and lack of respect for Indigenous experiences, knowl-
edge(s), and perspectives (Bartlett, 2011; TRC, 2012).
With its claims to “truth,” scientific method, or what has been called
“positivist science” or “positivism,” assumes that there is only one reality
“out there,” which can be discovered through scientific procedure
(Iaccarino, 2003). The ultimate goal of science conducted in a positivist
paradigm is to make claims about reality by offering proof of its existence
through scientific inquiry. According to this logic, value can be placed
only on knowledge that meets the acceptable standards of objectivity as
defined by positivist, scientific research. No other forms or ways of
knowing about the world hold legitimacy. Anything that falls outside of
scientific reasoning is disregarded as inconclusive and ideological
(Marker, 2003; Mills, 1997; Petch, 2000). Thus, studies that cannot be
replicated, that use tools or methods that have not been standardized or
verified, or that reach conclusions that veer away from the questions
asked are dismissed as unscientific and lacking in credibility. Yet even
though positivism and post-positivism remain a dominant and pervasive
means of inquiry, it continues to be contested, even among researchers
who conduct scientific research in its most basic, conventional form
(Pohl, 2011), suggesting that its established dominance should not be
taken as an indication that it is the only correct way of thinking about
science or scientific methodologies. Within health research specifically,
certain “types” and styles of research are viewed as having more credibil-
ity than others (e.g., the randomized controlled trial continues to be the
gold standard of Western health research, whereas storytelling may be
interpreted as anecdotal and lacking in evidence) (Denzin & Lincoln,
2008; Marker, 2003).
It is interesting to note that some of the greatest health-research con-
tributions of our time (e.g., the importance of hand-washing in disease
prevention) have not emerged as a result of these strict research standards
(Wilkinson, 1996) but have come from methods that might bear more
resemblance to Indigenous ways of knowing than to positivist research.
Indeed, if we look closely at the origins of Western science we learn that
there has never been one, pure definition of science or one “best” way to
make scientific discoveries or health research advances, since science has
stemmed from a variety of decidedly non-Western locations (Turnbull,
1997; van Eijck, 2007). As van Eijck (2007) points out, “the very founda-
tion of European science is itself the result of a mélange of many peoples
from the empire of Alexander the Great, including from then-current
countries like Persia, Anatolia, Syr ia, Phoenicia, Judea, Gaza, Egypt,
Bactria, Mesopotamia and even Punjab” (p. 609). Thus, “Western science”
is not purely Western or even European; rather, it is a social and cultural
construct with global, and often Indigenous, origins.
Two-Eyed Seeing
CJNR 2012, Vol. 44 No 2 25
The word “science” comes from the Greek scientia, and its roots can
be traced back to 15th-century Britain, where there was a growing
demand for empirical evidence to replace the authority of the Church
and the Crown as an alternative knowledge system (Aikenhead &
Ogawa, 2007). Originally, “science” was referred to as “natural philoso-
phy,” and in 1661 the Royal Society of Natural Philosophers emerged to
represent the interests of those who wished to advance empirically based
knowledge. Although natural philosophy recognized that knowledge
about the world could be gained through experience and circumstance,
its intent was to divorce itself from the spiritual or divine elements of
knowing that were considered the purview of the Church. The Society’s
success and influence grew throughout the Industrial Revolution and
“the name science was chosen to replace natural philosophy in 1831, with
the birth of the British Association for the Advancement of Science
(BAAS)” (Aikenhead & Ogawa, 2007, p. 554). The founding of BAAS sit-
uated “the word science squarely in a political arena of elite social privi-
lege,” giving rise to science as a “professionalized philosophy” that is asso-
ciated only with Eurocentric, or Western, knowledge (Aikenhead &
Ogawa, 2007, p. 554). With the professionalization of this knowledge
through BAAS (concurrent with the growing importance of social class
in Britain), the global origins of science were forgotten and science
became redefined as only that which was taught in university. Only those
who were university-trained, with ties to institutions and funding bodies,
could contribute to this version of science, and the experience and cir-
cumstance that had originally played an important role in natural philos-
ophy were replaced with strict standards of objectivity (Aikenhead &
Ogawa, 2007). Science became narrowly associated with that which
could be verified within the academy; the Indigenous origins of scientific
inquiry were all but forgotten.
It is not only the Indigenous origins of science that are ignored, but
also, frequently, the Indigenous origins of particular scientific “discover-
ies.” Within the positivist paradigm, Indigenous knowledge is used to
inform and uphold many of the claims made within positivist science, but
without the consent of the Indigenous holders of that knowledge (Posey,
2004). Fragments of Indigenous knowledge have been appropriated for
scientific use, which can be observed in everything from forestry-man-
agement practices to the identification and use of certain pharmaceuti-
cals, such as digoxin (Little Bear, 2000; Posey, 2004). This contributes to
the colonization of Indigenous ways of knowing, because knowledge is
abstracted from its source as well as from its originators, in order to meet the
strict confines of the positivist approach. Thus the social and cultural
context in which knowledge is situated is lost or ignored. The very
success of positivism lies in its ability to take knowledge(s) from many
Debbie H. Martin
CJNR 2012, Vol. 44 No 2 26
diverse sources and claim them as discoveries within positivism (Michell,
Vizina, Augustus, & Sawyer, 2008). For example, important scientific
advances in the fields of medicine, pharmacy, forestry, engineering, and
many other disciplines can be attributed to the knowledge generated by
diverse Indigenous cultures:
Traditional Native knowledge about the natural world is often extremely
sophisticated and of considerable practical value . . . Traditional Bolivian
healers use some six hundred different medicinal herbs, and their coun-
terparts in Southeast Asia may use up to sixty-five hundred kinds of
plants for their medical concoctions. In addition, more than seventy-five
percent of the 121 prescription drugs used around the world that are
derived from plants are said to have been discovered on the basis of
initial clues found in traditional indigenous medical practices. (Knudtson
& Suzuki, 1992, p. 12)
Despite the clear Indigenous origins of many pharmaceuticals, Indigen -
ous knowledge has been used by pharmaceutical companies for monetary
gain, without crediting or compensating Indigenous peoples (Posey, 2004).
It is important to point out that positivist research is not always asso-
ciated with a particular method or methods of conducting scientific
research. It is the perspective with which certain methods are employed
that is the most troubling, not the methods themselves (Denzin &
Lincoln, 2008; Marker 2003). This means simply that positivist science
can be either quantitative or qualitative, and, alternatively, a decolonized
research agenda may include either quantitative or qualitative methods
(Denzin & Lincoln, 2008). This distinction is important, since a research
agenda that attempts to move towards a decolonized approach to research
(an approach that positions Indigenous knowledge as a veritable source
of knowledge generation) is not about carte blanche advocating or dismiss-
ing certain methods over others but, instead, critically interrogating the
way in which those methods are applied.
Diversity of Thought Within Western Science
While Indigenous peoples have perhaps been the group most under-
mined and ignored through the proliferation of positivist thought, many
others have also railed against the narrow conceptualizations of the world
advocated by positivism. Substantial Western-derived schools of thought,
including constructivism, critical theories, feminist theories, and queer
theories, all stem from a well-established critique of positivism, question-
ing the notion that it offers the only correct way to acquire knowledge
about our world (Denzin & Lincoln, 2008). Critics of positivism are
deeply troubled by its domination over other forms of knowledge.
Two-Eyed Seeing
CJNR 2012, Vol. 44 No 2 27
Within the critiques of positivism, alternative methods of thinking about
and seeing the world are reflected upon, compared, and constantly
changing. It is from these alternative places of theorizing that people of
diverse races, sexualities, abilities, and religions have expressed their per-
spectives on how knowledge is produced, re-produced, understood, and
accepted or rejected within various social locations.
Unlike non-positivist scientific approaches to research, such as critical
theories or feminist theories, Indigenous ways of knowing have not
emerged from a critique of positivism, nor have they always been
required to use positivism as a benchmark for articulating the emergence
of Indigenous thought. Indigenous worldviews, as far as we know, have
existed since time immemorial, which suggests that positivism is in fact
“newer.” Since Indigenous worldviews do not emerge from within a cri-
tique of positivism and yet are required to navigate within a colonized
world, Indigenous knowledges are distinct from Western theories that
have emerged as a response to positivism. Nevertheless, alternative
Western perspectives can and do assume various forms of imperialism,
domination, and colonization through junctures of sexuality, age,
dis/ability, religion, and/or race, which can be attributed to the dominat-
ing effects of positivist science and thought. Since these positions are
marginalized within the borders of Western science, they offer a different
lens through which to understand the imperialistic tendencies of posi-
tivist science and thought. In this sense, these alternative perspectives
stand not only to inform but also to benefit from Indigenous ways of
knowing.
Respect for diversity of thought has been inherent to Indigenous sci-
ences and philosophies, since this is what allows one’s own perspectives
and experiences to respond to changes and fluctuations in the world
(Loppie, 2007). Sharing diverse perspectives has been integral to all cul-
tures, even those in the Western world, since learning about and under-
standing the perspectives of others is essential to cultural survival
(Turnbull, 1997). It has long been recognized by Indigenous peoples that
the health of Mother Earth is directly linked to the health of people: If
we do not pay attention to the knowledge that exists among diverse cul-
tures regarding how to take care of local ecologies, we risk abandoning
the very solutions that we seek with respect to the world’s most pressing
health and ecological crises (Davis, 2000). The scholar and anthropologist
Wade Davis (2000) argues that the diversity of thought that results from
cultural diversity is at least as important for the protection and preserva-
tion of Mother Earth as biodiversity. Without cultural diversity and,
perhaps more importantly, the recognition and acceptance of diverse ways
of knowing that accompany cultural diversity, the very health and well-
being of Mother Earth is jeopardized.
Debbie H. Martin
CJNR 2012, Vol. 44 No 2 28
If we accept the notion that diverse ways of knowing are integral to
the promotion and protection of the health of people and Mother Earth,
then we must reject positivism and positivist thought altogether, as posi-
tivism and Indigenous worldviews cannot co-exist. Although rejecting
positivism might seem contradictory to the acceptance of diverse per-
spectives, positivist thought does not allow or acknowledge alternative
expressions of knowing, and so rejecting positivism is an exception to the
general principles of acceptance in Indigenous cultures. It is not the
lending or borrowing of knowledge that is problematic for Indigenous
cultures; indeed, lending and borrowing knowledge is a characteristic of
many Indigenous worldviews (Loppie, 2007). It is when Indigenous
knowledge is undermined through appropriation that Indigenous peoples
risk further colonization. In fact, the need to appropriate knowledge and
then claim that the origins of that knowledge are positivist is precisely
what supports the existence and proliferation of positivism. An important
aspect of a decolonized research agenda is avoidance of re-inscribing a
colonial agenda in Indigenous research (Smith, 1999). This does not mean
isolating Indigenous knowledge(s) from Western sciences; indeed, this
would undermine the pluralistic nature of Indigenous knowledge
(Loppie, 2007). Rather, a decolonized research agenda requires careful
reflection on the role that colonization plays in the articulation of
Indigenous knowledges today and on how Indigenous knowledges are
shaped by experiences of colonization. Thus, decolonized Indigenous
scholarship does not assume that a state of pre-colonization can ever be
achieved, but in the process of reflecting on how Indigenous knowledge
has been shaped by colonization we can begin to identify colonial prac-
tices and move beyond the boundaries created by colonization, rejecting
forms of knowledge that perpetuate a colonial agenda.
The concept of two-eyed seeing offers a framework from which to
explain not only how different types of knowing can be brought
together, but why they are important. Identifying Western theories that
are closely aligned with Indigenous thought might, at first glance, appear
to reinforce the idea that the similarities between Western theories and
Indigenous thought are so great that there is no need for both perspec-
tives to exist. However, as Bartlett, Marshall, and Marshall (2007) point
out, diverse perspectives always have roots that emerge from very differ-
ent places — even though they may be similar in many ways, they have
been created to respond to the needs and desires of a particular group of
people. Just as Indigenous sciences and philosophies have emerged from
a direct and intimate relationship with local ecologies, creating an unend-
ing diversity of perspectives, languages, understandings, and knowledge(s)
of the world and how to live in it, Western theories emerged as a means
to convey different perspectives within Western sciences. We must be
Two-Eyed Seeing
CJNR 2012, Vol. 44 No 2 29
attentive to the strengths and insights of each perspective, and must rec-
ognize the diverse places from which they have come and the diverse
purposes for which they were intended (Bartlett et al., 2007).
Re-imagining the Landscape of Indigenous Health Research
The previous section argued that conventional Western scientific
approaches to health research often ignore or undermine alternative ways
of knowing, preferring to focus on the pursuit of objective, detached
research that can uncover the “truth” about a particular topic (Denzin &
Lincoln, 2008; Marker, 2003; Petch, 2000). As a direct result of the colo-
nization, appropriation, and suppression of Indigenous knowledge,
Indigenous health researchers and their allies strive towards a decolonized
approach to research. A decolonized approach asks whether conventional
scientific research contributes to the oppression and colonization of
Indigenous peoples worldwide (Smith, 1999). As Denzin and Lincoln
(2008) argue, “Indigenous knowledge systems are too frequently made
into objects of study, treated as if they were instances of quaint folk
theory held by the members of a primitive culture. The decolonizing
project reverses this equation, making Western systems of knowledge the
object of critique and inquiry” (p. 6).
A decolonized approach to research requires that all stages of research
critically reflect on how questions are asked, why they are being asked and
by whom (Smith, 1999). Through the process of reflecting on the entire
research process, the purpose of research becomes more than just the pro-
duction of new knowledge; it upholds the pedagogical, political, moral,
and ethical principles that resist oppression and contribute to strategies
that reposition research to reflect the unique knowledge, beliefs, and
values of Indigenous communities. Thus, it creates research that always
“begins with the concerns of Indigenous people. It is assessed in terms of
the benefits it creates for them” (Denzin & Lincoln, 2008, p. 2). In doing
so, it offers a means for Indigenous peoples to address the political and
social conditions that perpetuate ill health, poverty, and lack of educa-
tional opportunities in their communities (Smith, 1999).
If Indigenous struggles for autonomy and freedom from oppression
begin at the level of epistemology (Kovach, 2009), and if the health
inequities experienced within Indigenous communities stem from the
greatest of all oppressors, colonization, whose intent is to silence
Indigenous voices, then a decolonized approach to research means that
Indigenous worldviews must be included in discussions that influence
their health and well-being. This means that for Indigenous communities
to witness health improvements, the solutions to health and social crises
must include Indigenous perspectives and understandings about health
Debbie H. Martin
CJNR 2012, Vol. 44 No 2 30
and social issues. We need a framework that positions Indigenous knowl-
edge as an integral source of information about health and well-being.
Such a framework, however, must also recognize the important and
undeniable contributions that non-Indigenous, or more specifically
Western scientific, understandings of health have made to Indigenous
health and well-being. It must tease apart the contributions of Western
science that maintain and perpetuate colonization from those that make
space for Indigenous perspectives to inform and shape the health and
well-being of not only Indigenous peoples, but also Mother Earth and all
of her inhabitants.
The Origins of Two-Eyed Seeing
Two-eyed seeing is a concept introduced to the world of research by
Mi’kmaw Elders Albert and Murdena Marshall from Eskasoni, a First
Nation in Cape Breton, Nova Scotia. It has gained renown for its role in
the development of the Integrative Science Program at Cape Breton
University (led by Canada Research Chair Cheryl Bartlett and Elders
Murdena and Albert Marshall). Here, Indigenous knowledge and Western
sciences interact in a science program that offers Mi’kmaq and non-
Mi’kmaq students the opportunity to learn about diverse ways of under-
standing our world. Two-eyed seeing acts as “an important guiding prin-
ciple for one’s journey while here on Mother Earth” (Bartlett et al.,
2007, p. 13). It stems from the belief that there are many ways of under-
standing the world, some of which are represented by European-derived
(Western) sciences and others by various Indigenous knowledge systems
and sciences. Albert Marshall contends that aspects of both Western and
Indigenous ways of knowing about the world are important for
Indigenous communities. If we learn to appreciate multiple perspectives,
we can draw on what is useful and relevant to inform and build upon
our existing knowledge. Essentially, we can learn to “see through both
eyes.” Two-eyed seeing stresses the importance of being mindful of alter-
native ways of knowing (multiple epistemologies) in order to constantly
question and reflect on the partiality of one’s perspective. It values differ-
ence and contradiction over the integration or melding of diverse per-
spectives, which can result in the domination of one perspective over the
others. As a result, one “eye” is never subsumed or dominated by the
other; rather, each eye represents a way to see the world that is always
partial. When both eyes are used together, this does not mean that our
view is now “complete and whole,” but a new way of seeing the world
has been created — one that respects the differences that each can offer.
An important aspect of two-eyed seeing is that it responds to the idea
that our perspectives of the world are never static but are constantly shift-
Two-Eyed Seeing
CJNR 2012, Vol. 44 No 2 31
ing and changing in response to the changing world around us. Local
ecosystems are composed of interdependent parts that are in a state of
constant flux. No one part can be altered or changed without causing
changes to all the other parts. Each part of the ecosystem has a responsi-
bility to the whole, such that if for some reason one part does not fulfil
its role the entire ecosystem is affected (Henderson, 2000; Knudtson &
Suzuki, 1992). Albert Marshall likens this interdependence to the roots of
trees beneath a forest floor, where trees of different types — birch, pine,
fir — are all “holding hands” (Bartlett et al., in press). Indigenous philoso-
phies recognize interconnections and relationships, rather than narrowly
seeing them as discrete elements unrelated to the whole. Human beings
represent one part of this web of life and are connected to all things
living and non-living. Thus, like all other parts of the ecosystem, human-
ity has a responsibility to contribute to the whole in a way that ensures
“interactive harmony” (Henderson, 2000). Interactive harmony means
that we must accept the strengths, beauty, and limits of our ecology. In
many Indigenous societies, this way of being is constantly reinforced
through prayers, rituals, songs, and dances that are tailored to specific
localities and the corresponding needs and desires of their people (Little
Bear, 2000).
What we are able to know is shaped not only by our physical sur-
roundings, but also by our social surroundings. The social construction of
knowledge with which two-eyed seeing is imbued recognizes that we are
social beings and in order for knowledge to be produced anew “we all
need one another” (Marshall, n.d.). The fluid nature of two eyes that can
look back and forth and assist one another to attain a more complete
picture of the world indicates that Indigenous knowledge merits a place
in the world both broadly and in the realm of health research, and that
this place is not “greater or lesser than” the place held by Western scien-
tific understandings of health but is, simply, different. It also recognizes
that, through the acceptance of diverse perspectives, those solutions that
appear to be the most beneficial for addressing a particular set of circum-
stances or situations, whether they are Western or Indigenous in origin,
or even if they are some variation of the two, can be employed. The
intent is to share knowledge with the understanding that it will be used
for the greater good.
As a concept that values both Western and Indigenous ways of think-
ing, two-eyed seeing embraces diverse understandings of reality. Beyond
recognizing and accepting the existence of diverse perspectives, two-eyed
seeing suggests that different perspectives must be reflexively considered.
The concept of reflexivity is one that has us reflect on our firmly estab-
lished beliefs and assumptions and constantly question them through the
incorporation of new ideas and experiences (Tomaselli, Dyll, & Francis,
Debbie H. Martin
CJNR 2012, Vol. 44 No 2 32
2008). An exceedingly important aspect of reflexivity in research is what
Bartlett et al. (in press) call “co-learning,” whereby the relationship
between researchers and communities develops in such a way that differ-
ent epistemologies and ontologies are shared and form the basis for
working together in a manner that “involves learning from each other,
learning together, learning our commonalities and differences, and learn-
ing to see how to weave back and forth between our cultures’ actions,
values and knowledge as circumstances require” (p. 5).
In addition to the importance of understanding the physical and
social elements of our world, reflexivity in two-eyed seeing challenges us
to include the wisdom of the spiritual and the humility of the emotional
in our quest to conduct health research and improve the lives of
Indigenous peoples (Bartlett, Marshall, & Marshall, 2012). In this perspec-
tive, the spiritual and emotional dimensions of human understanding are
not positioned as more important than the physical or social, but each
dimension is necessary for a complete understanding of our world. This
permits us to ask what value can be added to our understanding of the
world if we incorporate these human dimensions into all varieties of
health research, Indigenous and non-Indigenous alike.
Reflexivity also requires us to do more than simply look at ourselves,
to also consider how different beliefs and values inform and shape how
others see the world (Tomaselli et al., 2008). Marker (2003) argues that
reflexivity calls for researchers to question the structures (social, political,
economic, etc.) that serve to perpetuate the issues that are being
researched. This entails using a “mirror” to reflect on the role of the
researcher in conducting research, whereas research has tended to use
only a “microscope” to understand populations of interest. For health
researchers specifically, it suggests a responsibility to go beyond what
might be viewed as the “expertise” of the research (which might,
for example, be related to virology, prenatal health, or diabetes), to look
at how the lenses through which Indigenous and Western scientific
knowledge gets interpreted have dislocated Indigenous peoples from the
traditional methods of healing and living that have contributed to and
ultimately “caused” the health issues being experienced.
Indigenous Knowledge Generation
The ability to learn, express, and convey Indigenous knowledge is closely
related to health (Bartlett et al., 2012; Chandler & Lalonde, 2008). Within
our conventional health and social systems, Indigenous knowledge
remains at the margins of knowledge generation, through a process
referred to as “cognitive imperialism” (Battiste, 2000). Cognitive imperi-
alism positions positivism as the only correct way of understanding the
Two-Eyed Seeing
CJNR 2012, Vol. 44 No 2 33
world. It does so by denying the existence of alternatives in order to
support its own legitimacy. In the context of health inequities experi-
enced within Indigenous communities, the success of cognitive imperi-
alism does not lie, as many would suggest, in the failure of existing health
systems to treat the health problems of Indigenous peoples, although
this is certainly part of the issue. Rather, it lies in the concerted effort
to dismiss, under mine, or ignore the very existence of Indigenous
approaches to health and healing, and in the failure to acknowledge the
fact that Indigenous communities have thrived for many, many millennia
using medicines and healing techniques developed according to their
own forms of knowledge generation, without the need for Western
medical intervention. In working towards the dismissal of cognitive
imperialism and towards a space where Indigenous knowledge can be
embraced, the means by which knowledge is generated in Indigenous
communities must be viewed as veritable in its own right. Such a process
requires opportunities for respect, reflexivity, and co-learning.
Among Indigenous peoples, the generation and application of knowl-
edge tend to be participatory, communal, experiential, and reflective of
localized geography (Loppie, 2007; Smylie et al., 2004). This means that
more value is placed on the traditions, laws, customs, and philosophy of
the group than on the successes and achievements of individuals. It also
means that a diversity of perspectives and opinions is valued, since it is
believed that no one perspective is right or wrong; all views are seen to
contribute something unique and important; diversity is also respected in
that individuals often need to know a little bit about a great number of
things.
The collective nature of Indigenous knowledge rests on stories
derived from practical experience. The oral tradition of storytelling pro-
vides the foundation for local knowledge by helping people to connect
their own experiences with those from the past. By sharing their personal
experiences and learning about the experiences of others through stories,
individuals develop wisdom, which is then passed on to the younger gen-
erations (Battiste, 2000; Cruickshank, 1998; King, 2003). A unique feature
of Indigenous stories is that contradictory perceptions of the same event
are often accepted, because they are seen as specific to the individual
(Henderson, 2000). No perspective is dismissed, since all perspectives
offer something important. For example, if particular phenomena cannot
be fully explained through certain versions of a story, those versions are
put aside, rather than forgotten, so that if new information arises it can
be used to complement what is already known. This collective process of
knowledge-building ensures that very little is forgotten and that all per-
spectives, even those that are contradictory, are given value.
Debbie H. Martin
CJNR 2012, Vol. 44 No 2 34
An additional feature of Indigenous knowledge-generation is the
integral importance of historical knowledge (Knudtson & Suzuki, 1992).
Since stories have their roots in thousands and thousands of years of
history, they are a means of reminding us where we have been and the
issues and problems that others have faced — as well as how they reacted
and responded to various issues and crises. Essentially, history not only
tells us where we have been, but also helps us to understand the future.
Paying careful attention to the lessons learned and the experiences of the
past ensures that present generations are able to learn from the successes
and failures of their ancestors and Elders and do not have to constantly
generate new solutions to modern-day problems. Building on historical
knowledge in this way means that new information is continually used
to augment existing knowledge, in order to achieve a deeper understand-
ing of a particular phenomenon.
Embracing Two-Eyed Seeing
Science is part of culture, and . . . how science is done largely depends
on the culture in which it is practiced. (Iaccarino, 2003, p. 220)
Often, diverse perspectives of reality, and thus approaches to health
research, are seen as on a continuum, with Western scientific understand-
ings of health at one end and Indigenous knowledge(s) about health at
the other. In this conceptualization, overlapping, blending, or blurring
will occur at some point on the continuum. Brandt (2007) and
Aikenhead and Ogawa (2007) argue that conceiving of knowledge in this
way reinforces dichotomies that are not aligned with Indigenous per -
spectives. Brandt proposes that if knowledge is considered from a both/
and rather than an either/or position, one can begin to “challenge the
fixed notion of the binary to reveal positions that were previously erased
and ignored simply because they did not fit into normative categories”
(p. 602). If, as Brandt suggests, knowledge is not a dichotomy between
Indigenous knowledge(s) and Wester n sciences and there is, in fact,
overlap between the two systems, then we need to re-conceptualize how
we think about the production of knowledge that does not reinforce this
dichotomy.
According to Turnbull (1997), one way of thinking about the produc-
tion of knowledge is through a conceptual framework where “all knowl-
edge systems can be equitably compared” (p. 557) and where differences
are recognized and embraced. Turnbull argues that there is no “great
divide” between many Western sciences and Indigenous knowledge(s),
but that the two systems operate within “different knowledge spaces with
different devices and strategies for assembling and moving the knowl-
Two-Eyed Seeing
CJNR 2012, Vol. 44 No 2 35
edge” (p. 557). He proposes a “thirdspace,” where knowledge systems can
be reframed and re-negotiated.
The notion of thirdspace as proposed by Turnbull (1997) entails two
overlapping concentric circles, with the shared space between them being
the thirdspace. Brandt (2007) argues that thirdspace, while useful to the
extent that it moves beyond the either/or continuum separating Western
and Indigenous knowledge, it still implies that many aspects of diverse
knowledge systems are “out of reach” of one another, since the only
point at which knowledge is shared is that where they converge. Brandt
envisages an expansion of this shared space, proposing that it be thought
of as “common ground,” where diverse knowledge systems co-exist, each
informing and building upon the knowledge of the other, to varying
degrees, depending on the context, so that one type of knowledge is
never subsumed by the other.
In her research with students from linguistically and culturally diverse
backgrounds attending university in a Western setting, Brandt (2007) was
constantly searching for a “border” between Indigenous knowledge and
Western science. She realized that by making such a distinction she was
reinforcing rather than questioning the very dichotomies she was trying
to avoid. Brandt found that the “bridge” linking Indigenous and Western
knowledge systems was illusive, so she began to look at the ways in
which her research participants were simultaneously embracing multiple
epistemologies. Her research participants “held firm to their traditional
worldviews” (p. 602) but added certain aspects of Western epistemology
that served to expand and diversify their traditional worldviews. For
example, one participant “held multiple epistemologies where she refer-
ences her Indigenous Navajo worldview, beliefs through the Native
American Church, teachings from her education in the Catholic school,
oral traditions within her family, and Eurocentric science” (p. 602). For
Brandt, “common ground implies that one does not have to relinquish
either position, but . . . can simultaneously embrace elements of
Eurocentric societies and Indigenous knowledge” (p. 603), depending on
the circumstances.
Brandt’s (2007) “common ground” approach aligns with the concep-
tualization that Marshall, Marshall, and Bartlett (2011) use to describe the
“bringing together” of cosmologies, philosophies, stories, and worldviews
contained within two-eyed seeing. They propose that if we envisage these
two versions of knowing (Western and Indigenous) as two people sitting
around a campfire sharing knowledge, suspending judgements and opin-
ions and simply listening to what the other has to say — then we have
the essence of two-eyed seeing. Moreover, they suggest that if such topics
as the health of communities were to be tackled during such “campfire
Debbie H. Martin
CJNR 2012, Vol. 44 No 2 36
discussions,” the same conclusions about health and healing would be
reached, but through very different approaches and channels.
Moving beyond the Indigenous knowledge/Western science contin-
uum also presents an opportunity to reflect upon which elements of
Indigenous and Western sciences are best suited to addressing the issue at
hand — be it a health crisis, a chronic health problem, or a systemic issue
that contributes to ill health. Of integral importance are the critical contri-
butions that Western sciences have offered Indigenous peoples, and vice-
versa. This is not to suggest that Western sciences have not also been the
source of much harm, or that such harm should be ignored, but it is
important to distinguish among the various epistemologies that inform
diverse Western sciences. Too often, criticism of non-Indigenous sciences
is rooted in the idea that they are all attached to positivism, at least to
some degree. This ignores the myriad holistic approaches to research that
are commonly found in the social sciences, as well as those within the
natural sciences that embrace the existence of multiple realities (van
Eijck, 2007). Reducing Western sciences to those forms that are rooted
in positivist or reductionist approaches is incongruent with both current
and past Indigenous approaches to knowledge-making and knowledge
generation. Aikenhead and Ogawa (2007) argue that criticizing Western
science without regard for its diversity not only reduces science to that
which is understood through positivist approaches to science, but also
under-values the important contributions that Indigenous knowledge has
made to science. This contributes to, and one might argue enhances, the
very reductionist, narrowly conceived arguments that are born of posi-
tivist thought.
Two-eyed seeing is not about nursing, specifically, nor even about
health singularly. It is intended to apply to life itself. It does not offer
new methodologies, nor does it offer ideas about the types of knowledge
that it might generate. Rather, it challenges us (Indigenous and non-
Indigenous peoples alike) to understand the larger dimensions (physical,
social, emotional, spiritual) of our knowledge systems and the limitations
and challenges that accompany any single approach to viewing the world.
The ultimate challenge is to find new and better ways of doing research
in order to create a healthier place for our children and our children’s
children, for Seven Generations forward. The implications of doing so
may not be immediately evident, but, as Albert Marshall points out, even
though an ash tree drops its seeds on the ground at the end of each
season, if the conditions are not right it may take many seasons for the
seed to decide to germinate (Bartlett et al., in press). The same is true
when we attempt to “measure” the benefits of approaching health issues
using two-eyed seeing; it takes time for Indigenous approaches to health
and healing to translate into reduced health inequities, but we must
Two-Eyed Seeing
CJNR 2012, Vol. 44 No 2 37
believe that the process we are following will result in a healthier Mother
Earth — which will ultimately create a healthier place for us all.
Conclusion
This article has offered a way to re-think how the production of knowl-
edge about Indigenous health is understood. It is by no means conclusive,
as learning is a dynamic process. Two-eyed seeing presents both
Indigenous and Western perspectives as distinct knowledge systems unto
themselves, but as knowledge systems that can offer only a “partial” per-
spective on reality. When these partial perspectives are viewed together,
the result is not a “complete” view of the world but one that is different
and that can perhaps offer a new way of thinking about how knowledge
is produced, one that could not emerge if we looked through “one eye”
only. Thus, it presents a conceptualization of knowledge production that
does not rely upon dyadic or dualistic thinking, since each “eye” must
continually weave back and forth between its own understandings and
those of others, which hold new understandings and opportunities. The
“new” perspective gained by seeing through two eyes provides clarity and
insight that might help us to understand the health crises experienced by
many Indigenous communities.
Two-eyed seeing is a way of drawing upon Indigenous knowledge
and non-positivist Western sciences that addresses the needs of the com-
munity while not pitting one view against another or favouring one per-
spective over another. It moves beyond the simple dichotomies of
Western sciences and Indigenous knowledges. Through the analogy of
two eyes, we learn that no one perspective is ever complete and whole,
and that the very creation of dichotomies and dualisms assumes that
borders can be drawn between one type of knowledge and another.
By embracing non-positivistic Western perspectives we are upholding
one of the guiding principles of two-eyed seeing — that all things are
related and share similar issues and concerns, even human beings whose
differences may appear vast. As Elder Albert Marshall suggests, we human
beings would do well to enact our humility in dealing with the problems
and concerns that face us.
Only when we come to realize that everything we do to the water, the
air and the earth, we also ultimately do to ourselves . . . will we treat our
environment and ourselves with equal reverence . . . and only with the
understanding that all must be maintained and that all must be equal, will
we be healthy. This is the path that will lead us to good health and well-
ness — for humans and all others in our environment and the Earth
itself. (Bartlett et al., in press, p. 7)
Debbie H. Martin
CJNR 2012, Vol. 44 No 2 38
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Acknowledgements
I would like to thank Mi’kmaq Elders Murdena and Albert Marshall and
Dr. Cheryl Bartlett for introducing me to the concept of two-eyed
seeing. I would also like to thank my doctoral supervisory committee,
and especially my primary supervisor, Dr. Lois Jackson, for providing
feedback and support, as well as the anonymous reviewers for providing
feedback.
This article is adapted from my doctoral dissertation. My doctoral
research was funded by the Atlantic Health Promotion Research Centre
and the Nova Scotia Health Research Foundation.
Financial disclosure and conflict of interest: No financial disclosure or
conflict of interest to report.
Debbie H. Martin, PhD, MA, BRec, is Assistant Professor, Faculty of Health
Professions, Dalhousie University, Halifax, Nova Scotia, Canada.
Debbie H. Martin
CJNR 2012, Vol. 44 No 2 42
