Transgenerational trauma

Transgenerational trauma is trauma that is transferred from the first generation of trauma survivors to the second and further generations of offspring of the survivors via complex post-traumatic stress disorder mechanisms.

History

Soon after descriptions of concentration camp syndrome (also known as survivor syndrome) appeared, clinicians observed in 1966 that large numbers of children of Holocaust survivors were seeking treatment in clinics in Canada. The grandchildren of Holocaust survivors were overrepresented by 300% among the referrals to a child psychiatry clinic in comparison with their representation in the general population.

The phenomenon of children of traumatized parents being affected directly or indirectly by their parents' post-traumatic symptoms has been described by some authors as secondary traumatisation (in reference to the second generation). To include the third generation, as well, the term intergenerational transmission of trauma was introduced.

Symptoms of transgenerational trauma have in recent years been identified among Black Americans, in relation to the effects of slavery and racial discrimination. This passing of trauma can be rooted from the family unit itself, or found in society via current discrimination and oppression. The traumatic event does not need to be individually experienced by all members of a family; the lasting effects can still remain and impact descendants from external factors. For example, Black children's internalization of others' reactions to their skin color manifests as a form of lasting trauma originally experienced by their ancestors. This reaction to Black skin stems from similar attitudes that led to the traumatizing conditions and enslavement of slaves. Black children and youth are more susceptible to racial trauma because they have not yet acquired the knowledge to have a full understanding of racism and its effects. However, these traumatizing behaviors experienced at such a young age are a reflection of a child's parenting. A White child may learn racist behaviors from their environment, but on the same token a Black child can learn to assert their blackness and how to respond to racist remarks and actions from their parents. Traces of trauma have an impact on Black and other minority children's success in an educational context.

Instances of transgenerational trauma where the trauma affects a large population of people and their role in society can be identified as cultural trauma. This form of trauma results in a greater loss of identity and meaning, which in turn affects generations upon generations as the trauma is ingrained into society. This passing of psychological and emotional trauma from slavery has also been identified as Post Traumatic Slave Syndrome (PTSS). According to Dr. Joy DeGruy Leary, PTSS is when a population experiences intergenerational trauma from centuries of psychological and emotional enslavement and continues to face institutionalized oppression and racism. Black Americans who are descendants of former slaves when faced with racism and oppression have reactions that mirror that of PTSD.DeGruy theorizes that PTSS is directly responsible for other dangers and origins of harm in the Black community. The internalized harm caused by PTSS becomes external, allowing the rest of society to use the effects and symptoms of PTSS as stereotypes against Black people, thus exacerbating the racial-trauma and moving forward the cycle.

Building upon the clinical observations by Selma Fraiberg, child trauma researchers such as Byron Egeland, Inge Bretherton, and Daniel Schechter have empirically identified psychological mechanisms that favor intergenerational transmission, including dissociation in the context of attachment, and "communication" of prior traumatic experience as an effect of parental efforts to maintain self-regulation in the context of post-traumatic stress disorder and related alterations in social cognitive processes.

Symptoms and treatment

Unresolved grief and/or trauma often times accompanies Human Trauma Response (HTR), which can be passed from one generation to the next along with its symptoms. HTR's symptoms include depression, self-destructive behavior, suicidal thoughts and actions, anxiety, low self-esteem, anger, or substance abuse. However, the treatment and identification of these symptoms differ based on the affected group. A feeling of hopelessness or worthlessness is also an effect of race-based trauma. These symptoms come from the reminder that many of the traumatic events were at one point or still are protected by law. Slavery, Jim Crow, and other forms of violence and oppression against Black Americans were a part of the law. Even today, there remain opportunities for the disenfranchisement of Black Americans that remain protected by law. This systemic disadvantage adds as a level of distress and exacerbates the traumatic effect.

Both survivors and immediate witnesses of traumatic events in family history have traditionally been treated by family therapists. The first-generation experiences of combat veterans, hostages, prisoners of war, and the civil population who was victimized at the hands of war criminals from genocidal organizations such as the German Nazi Party, Italian Fascist party, and similar organizations and their (para-)military arms, have been dealt with within the confines of political arena and international law, however the descendants of both immediate witnesses and victims of genocide, colonial suppression, slavery, political totalitarian control, clerical abuse in religious organizations, and many survivors of terrorism had to deal with the victimization symptoms themselves, without the transfer of original trauma being recognized and help offered.

In general, Black Americans who suffer from any mental illness are resistant to receiving treatment due to stigma, negative conceptions, and fear of discrimination. This reduces the number of those affected to seek help. Not seeking treatment allows the symptoms to compound and further internalization of distress continues, worsening the mental health of the individual. Those affected by race-based trauma oftentimes do not seek treatment not only because of stigma but because of fear the medical professional will not understand their perspective as a disenfranchised minority. Due to the recent identification and research of transgenerational trauma affecting Black Americans and other racial minorities combined with the existing stigma of mental health, there is a lack of research and consequently treatment. However, lack of treatment can also be attributed to the misdiagnosis of the aforementioned symptoms. Signs of trauma exhibited in Black children are labeled as behavioral or educational disabilities, allowing the trauma to go untreated. While trauma symptoms often manifest as other mental illnesses such as depression and anxiety, the larger diagnosis often goes untreated. Additionally, there is disproportionate access to treatment for Black Americans, whether it be financially, geographically, or because of a lack of transportation. However, academics such as Dr. Joy DeGruy Leary provide treatment and services to Black Americans experiencing symptoms of race-based trauma and have made the connection between current problems facing Black American families and the centuries of enslavement.

Enslavement and slavery, civil and domestic violence, sexual abuse, and extreme poverty are also sources of trauma that can be transferred to subsequent generations. For instance, survivors of child sexual abuse may negatively influence future generations due to past untreated or unresolved trauma which can increase feelings of mistrust, isolation, and loneliness. Descendents of slaves when faced with racism-motivated violence, microaggressions, or outward racism, react as if they were faced with the original trauma that was generationally transmitted to them. There are a variety of stressors in one's life that lead to this PTSD-like reaction such as varying racist experiences, daily microstressors, major race-related life events, or collective racism or traumas. This also presents itself in parenting styles. Parents who not only receive the trauma genetically but also experience triggers frequently in their environment can create a home environment that deflects the stress they experience, adding on to the inherent stress of the child. Goodman and West-Olatunji proposed potential transgenerational trauma in the aftermath of natural disasters. In a post-Hurricane Katrina New Orleans, residents have seen a dramatic increase in interpersonal violence with higher mortality rates.

This phenomenon has been reported in the descendants of students at American Indian boarding schools, who were removed from their parents and extended family and lacked models for parenting as a result. Being punished for speaking their native language and forbidden from practicing traditional rituals had a traumatic effect on many students, and child abuse was rampant in the schools as well.

Transmission

Epigenetic Transmission

Previous research assumed that trauma was mainly transmitted by the parents' child-rearing behavior. However, it may also be epigenetically transferred. Epigenetics studies how cellular function is influenced by the regulation of gene expression. An epigenetics study published in 2015 suggested that a parent's experience of trauma may change a child's stress hormone profiles. Many experts have since pointed out flaws in the study's methodology, which had a very small sample size, studied only a tiny number of genes, and didn't control for social factors. One blog, published by the Center for Epigenomics at the Albert Einstein College of Medicine in New York, called this research the "over-interpreted epigenetics study of the week."

The theory of trauma transmission via epigenetics has been researched by other parties. Trauma can be transferred when a child is raised in the same environment as their ancestors, which triggers the reformation of a gene in each generation; this is the most indirect form of epigenetic imprinting. One's environment and external experiences impact cellular activity and epigenetic processes, making it possible for victims of trauma to pass their symptoms and effects to their children and so on, especially if the environment does not change.

The epigenome may also be passed through the gametes. For this to occur, the epigenome must be present in the germline. However, the epigenome is extensively reprogrammed during germ cell differentiation and after fertilization to create totipotent cells, erasing many changes that occur during an individual's lifetime. Therefore the best candidates for heritable epigenetic marks are located at repeat/transposable sequences or regulatory elements that are resistant to reprogramming.

Non-coding RNA is currently one of the most investigated epigenetic mechanisms in the study of transgenerational trauma. Small ncRNAs guide DNA/ histone methylation and post-transcriptionally regulate mRNA. In C. elegans, starvation-induced stress triggered the expression of small RNAs that cause gene silencing and persist for several generations. These generational effects have been correlated with behavioral phenotypes in some studies. When microRNA (miRNA) from the sperm of these C. elegans was injected into fertilized oocytes, the offspring exhibited similar phenotypes. Although the mechanism of this transmission is complex, one hypothesis is that piwi-interacting RNA (piRNA) and exogenous RNAi are involved in a pathway with secondary small RNAs and chromatin regulatory complexes that results in stable transgenerational inheritance.

DNA methylation is another mechanism studied for transgenerational epigenetic inheritance. 5-methylcytosine (5mC) is the form of methylated DNA linked to gene repression in mammals, and N6-Methyladenosineis linked to promotion of gene activity. Various empirical studies have shown that trauma alters methylation patterns in the offspring of survivors, predominantly at the glucocorticoid receptor (NR3C1) gene. For DNA methylation to be inherited, it has to be stable enough to undergo mitosis and meiosis, and it must escape the aforementioned epigenetic reprogramming. 5mc at repeat sequences and rare regulatory elements are resistant to reprogramming. However, it has been hard to find methylated regions that are stable over multiple generations, and there has been a lot of discrepancies across studies. These discrepancies may be due to method of methylation analysis used or due to variations in the epigenome between individuals.

Recent evidence suggests that histone modifications may also be inherited across generations. Histones tend to be preserved at housekeeping sites and developmentally regulated genes in sperm and are preserved everywhere in oocytes. Although it isn’t confirmed, if changes in the histone modification machinery were to cause phenotypic changes, a second epigenetic mechanism may be involved.

Transmission during Pregnancy

Another major way that stress can be transmitted across generations biologically is through the uterine environment. The gestational stage is a developmentally sensitive stage in an individual’s lifespan. Exposure to harmful stimuli during this stage can have long-lasting, detrimental effects. The uterine environment with its unique blend of the mother’s cellular secretions and proteins is a major source of stimuli. Empirical evidence has shown that trauma experienced by a mother during pregnancy can affect offspring’s physiology and psychology. One possible method of transmission is through transport vesicles transferring amino acids and microRNA from the uterine fluid to the fetus. These molecules may then alter gene expression in a way that affects the developmental trajectory of the fetus. Most biological research on transgenerational trauma has focused on the hypothalamic-pituitary-adrenal (HPA) axis, which is the center of the body’s stress response system. One way the HPA axis responds to stress is by triggering the production of glucocorticoids, primarily cortisol. Cortisol triggers “fight-or-flight” physiological symptoms like increased blood pressure and heart rate. In animal models, maternal stress and trauma during pregnancy has been shown to reduce the expression of placental enzyme 11B-hydroxysteroid dehydrogenase type 2 (11 β-HSD2), which converts the mother’s cortisol to inactive cortisone. This leads to increased fetal exposure to the mother’s glucocorticoids, which affects the development of glucocorticoid-sensitive systems like the HPA axis. In some studies, abnormal cortisol levels compared to controls and alterations in DNA methylation were observed in infants of mothers who endured trauma while pregnant, particularly in the NR3C1 glucocorticoid receptor gene.

Nurture: The Psychological and Social Aspects of Transgenerational Trauma

There are many current transgenerational studies that have been done on adults that have experienced natural disasters or adversities. One study revealed that the children of Australian Vietnam War-Veterans are more likely to suffer from family dysfunctionality, lower self-esteem, and symptoms resembling the disorders (most commonly PTSD) of their parents. Another study done on the offspring of torture victims was performed. The study found that they showed more symptoms of anxiety, depression, post‐traumatic stress, attention deficits and behavioral disorders compared with the comparison group of those who had not experienced the specific trauma. A qualitative study was done on the Brazilian children of Holocaust survivors. This study was particularly interesting because it was able to propose not only a supported model of the transgenerational transmission of traumatic experiences, but one also of resilience patterns that can be transmitted in between generations and developed within generations. Researchers Cowan, Callaghan, & Richardson studied the impact of early-life adversities on individuals and their descendants. Their research was also consistent with the transmission theory, in which their findings revealed that the stress phenotype that was expressed in individuals who experienced the adversity was also observed in children and even grandchildren.

The famous study of Harlow’s monkeys also revealed that the adversity of a maternal variable which would create stress in the individual was also witnessed in their offspring although not having experienced the adversity. One last study displayed that if children were exposed to high postnatal maternal licking/grooming and arched-back nursing then they were likely to do the same to their offspring. Vice versa, if children experienced low LG-ABN mothers, then they were likely to provide the same to their offspring. Consequently, this causes a decrease in serotonin and expression, and an increase in methylation. Ultimately, a more stressed pup is created, causing this phenotype to be passed on through experience and genes.

Theses studies allude to the fact that often times adversity, especially early on and for longer periods of time, can impact development in individuals and their offspring.

The chains of oppression that blacks experienced through slavery and repackaged racism are observed to have a psychological impact on how they view achievement and even the striving of it. The work of decolonizing the mental chains of slavery is now done by profound black researchers. In terms of the social aspects of this, the repackaged forms of racism seem to make it difficult for blacks to surpass a certain SES threshold, to escape a certain neighborhood, to move beyond a certain lifestyle or status, or to exist without first acknowledging their setback: being black. Unless psychologically and socially diminished, this trauma, coupled with the current pattern observed in the livelihood of black people, may perpetuate this transfer for generations to come.

The “Trail of Tears” still affect the Native Americans today. The act of taking their lands from them and displacing them is still one that is practiced today and therefore is still one that affects them many generations later. The social enforcement of their ostracization causes them to be generally removed from society, to be powerless and uninvited in government, and to be left to fend for themselves. This trauma unless socially altered will continue to exist and continue to cause Natives to become used to insignificant existence.

See also

• American Indian boarding schools
• Collective trauma
• Dispossession, oppression and depression
• Historical trauma
• Intergenerationality
• National memory
• Post Traumatic Slave Syndrome

Further reading

• Coffey, R. (1998). Unspeakable truths and happy endings. Sidran Press. ISBN 1-886968-05-5
• Danieli, Y. (Ed.) (1998). International handbook of multigenerational legacies of trauma. New York: Plenum.
• Daud, A., Skoglund, E. & Rydelius, P. (2005). Children in families of torture victims: transgenerational transmission of parents’ traumatic experiences to their children. International Journal of Social Welfare, 14, 23-32.
• Degruy, J. (2005). Post Traumatic Slave Syndrome: America's Legacy of Enduring Injury and Healing, . Uptone Press ISBN 978-0963401120
• Graff, Gilda. “The Intergenerational Trauma of Slavery and Its Aftereffects: The Question of Reparations.” Journal of Psychohistory, vol. 44, no. 4, Spring 2017, pp. 256–268.
• Fossion, P., Rejas, M., Servais, L., Pelc, I. & Hirsch, S. (2003). Family approach with grandchildren of Holocaust survivors. American Journal of Psychotherapy, 57(4), 519-527.
• Herman, JL (1997). Trauma and recovery: The aftermath of violence from domestic abuse to political terror. New York: Basic Books.
• Schwab, G. (2010). Haunting Legacies: Violent Histories and Transgenerational Trauma. Columbia University Press.
• Sibrava, Nicholas J., et al. “Posttraumatic Stress Disorder in African American and Latinx Adults: Clinical Course and the Role of Racial and Ethnic Discrimination.” American Psychologist, vol. 74, no. 1, Jan. 2019, pp. 101–116.
• van der Kolk, B.A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola, J. (2005). "Disorders of extreme stress: the empirical foundation of a complex adaptation to trauma". Journal of Traumatic Stress 18, 389-399.
• Plaskon, Kyril D. (2015). Silent Heroes of the Cold War. ISBN 1507884664

External links

• Video by Leila Levinson, child of an American witness of concentration camp and author of Gated Grief.
• An article by a supervisor of Master's and Doctoral students specialising in trauma counselling, Wentzel Coetzer.
• Healing Collective Trauma, a website with resources on collective, historical, and transgenerational trauma.
• Maria Yellow Horse Brave Heart on intergenerational trauma in Native Americans
• Master's thesis – Tim Haslett's NYU Master's Thesis on Transgenerational Haunting in African Diasporic Lifeworlds