SELECTED POSTS

Treating Intergenerational Trauma: Hope for the Future
Janet Woznica, Ph.D.

A 55-year-old woman presents with terrifying nightmares and flashbacks of being in a concentration camp. She is plagued by vivid images of death and destruction and the horrific sound of blood-curdling screams of dying infants. She feels tormented by the smell of crematorium ashes. She speaks of ongoing feelings of panic and fears of losing family members.

This woman sounds like a Holocaust survivor experiencing symptoms of post-traumatic stress disorder. Yet she was born almost a decade after the Holocaust.  Her parents were concentration camp survivors, but she herself grew up in an upper-middle class neighborhood in Los Angeles. So how could she be experiencing the traumatic effects of the Holocaust as if she herself had suffered the horrors of the concentration camps?

Such is the nature of intergenerational trauma. We are well aware of the powerful effects of trauma, ranging from mild anxiety to extreme symptoms of post-traumatic stress disorder. Yet often traumatic experiences affect not only the individual who has been directly traumatized, but rather have reverberating effects on family members, friends, and society.

Perhaps the most potent and insidious of these reverberating effects is the intergenerational transmission of trauma. In this process, the effects of traumatic experiences are transmitted unconsciously from parent to child, from generation to generation. As illustrated by the patient described above, trauma can be passed on like emotional DNA.

It is important that we as therapists understand the nature and dynamics of intergenerational trauma in order to provide optimal treatment. We must be attuned to its effects on children and even grandchildren of survivors of the Holocaust, 9/11, wars, rape and incest, physical and sexual abuse, violent crimes, and an array of natural disasters and other traumas. We must be prepared to work effectively with an influx of family members of active military service members and veterans who are experiencing the effects of primary or transmitted trauma.

Traumas overwhelm our psyche, manifesting in a wide range of feelings and behaviors that permeate our very being and may be absorbed by or projected onto those to whom we are emotionally connected. Many parents who have experienced traumas care deeply for their children, yet the effects of their own traumas may well permeate the parent-child bond.

In many cases, symptoms of post-traumatic stress are normal responses to trauma that may attenuate over time. For it is often not trauma per se but rather the unresolved nature of repressed, dissociated, or unprocessed trauma that creates particular vulnerability to intergenerational transmission. Unresolved traumas tend to permeate the emotional environment and the parent-child relationship in a particularly insidious manner. Even the most well intentioned parents may convey trauma-induced feelings or reactions to their children through their very essence, which the children may then internalize as their own.

Over time, trauma may also be conveyed through verbal messages. The Holocaust survivor who is plagued by conscious or unconscious memories of concentration camp experiences, the soldier who screams in terror upon hearing a loud noise because it evokes memories of bombings, unwittingly creates an emotional ambience that affects other family members.

Yet there is great hope for the future. There is much that we as therapists can to do to help those experiencing transmitted trauma and promote their healthy development. Survivors of trauma and transmitted trauma are often amazingly resilient, and with effective psychotherapy often adapt in ways that transform the effects of trauma into strength and perseverance.

The nature and quality of the patient-therapist relationship and process is critical in this regard. A therapeutic relationship in which the therapist is empathically attuned, calm, and thoughtful promotes the development of a secure attachment and sense of trust, security, and inner well-being. The patient internalizes the therapist’s very essence.

We as therapists must be able to immerse ourselves in our patients’ emotional experiences while maintaining a sense of our own perspective.  Within this relationship, it is important to address the verbal as well as nonverbal forms through which trauma may have been transmitted. We can explore with our patients the effects of trauma they may have absorbed from their parents, who they may have represented to their parents, the process through which they may have internalized their parents’ traumas, and the meaning of these traumas in their lives.

We must continue to develop our own awareness and understanding of the dynamics of intergenerational trauma. Sometimes we know that a patient is the child of a traumatized parent, while other times we are in the dark, faced only with the inexplicable sense that the patient seems like someone who was traumatized but has not identified any known trauma per se.

We must pay attention to our own internal reactions to our patients, as there may be communication between our patients and us that provides valuable insights regarding transmitted trauma.  At times patients may reenact traumas in the therapeutic relationship, providing rich insights into their emotional experience. Through mutual exploration, emotional attunement, and interpretation of family dynamics we can help our patients better identify, understand, and eventually modify the effects of transmitted trauma.

We must also strive to be aware of our own emotional states and work through our own unresolved traumas. If we ourselves are experiencing the effects of unresolved or transmitted traumas, we may inadvertently co-create with our patients the very type of emotional environment that led to their internalization of parental traumas. It is our personal and professional responsibility to address these issues in our own therapy and/or supervision in order to provide an optimal therapeutic environment for our patients.

While we cannot erase transmitted trauma, we can help mitigate its power over patients’ feelings, attitudes, and behaviors.  In so doing, we can help our patients transform intergenerational trauma into a deeper sense of self-understanding, perspective, and internal security.