The first essay and namesake of the book, "A Mind Spread Out on the Ground" opens with an exasperated therapist asking the author, Alicia Elliott, what the cause of her depression is. The author reflects on what it means to be depressed and the suffocation and unbearable weight of mental illness. She draws parallels to the intergenerational trauma of colonialism that is passed down through her Haudenosaunee ancestors. Ultimately, she asserts that both colonial trauma and depression manifest as numbness to the pain of living with said burden. While never returning to the moment of the therapist’s question, Elliott traces mental illness and suicidality in her life, in the lifelines of her First Nations heritage, and in the life of her mother, who Elliott characterizes as ravaged by mental instability. She describes the mechanisms with which Europeans oppressed and violated the basic human dignities of Indigenous Americans and First Nations Canadians, erasing their histories and literally demonizing them as a means to justify European greed. In doing so, she builds tangible connections between her own experience of depression and the trauma her Indigenous ancestors endured, stating that a checklist to measure the intensity of her own depression: