Intergenerational Trauma

What is intergenerational trauma? The term ‘intergenerational’ is defined by Merriam-Webster Dictionary as “existing or occurring between generations.” (1) Trauma is defined by the Center for Health Care Strategies as “results from exposure to an incident or series of events that are emotionally disturbing or life-threatening with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, and/or spiritual well-being.” (1). However, the term ‘intergenerational trauma’ refers to the lasting emotional, mental, and sometimes physical impact that trauma has across multiple generations. Intergenerational trauma can be anything from a repeated cycle of abuse or neglect to the effects on health and wellness caused by genocide or war. Intergenerational trauma ranges from person to person and family to family in the severity and type of effects it has on day-to-day life, physical health, and emotional wellbeing. What causes intergenerational trauma? There are as many forms of intergenerational trauma as there are human beings that carry that burden, but it usually has three root causes:

• The initial trauma.

• Lack of support and ability to cope with the trauma

• Repeated trauma that turns into a cycle.

The initial trauma, such as abuse, neglect, living through a war or living through a genocide, has impacts of its own on the individual who survived it, however in this article we are addressing the impact of trauma across generations. Yet, a lack of support or ability to cope with this trauma can make the survivor more likely to pass down the trauma, either in the form of being emotionally absent, having unhealthy boundaries, or by repeating the cycle if it’s abuse or neglect. However, cycles of systematic oppression or historical-level violence can also cause intergenerational trauma. Addressing the historical trauma that her family experienced through massacre, dispossession, slavery, rape and violence on missions, an Indigenous woman from the Kimberley in Western Australia explains: “How can anyone forget that? And why should we forget? We pass it on to our kids just like my parents passed it onto me. It stays with you ’til you die. I’ve seen pain all my life… Us old ones can’t forget our memories. How do we expect the little ones to forgive and forget? What those little ones are going through is adding to the bad memories we’ve given them from our stories.” [5]. The causation of intergenerational trauma in particular is the repeated lack of support and change that carries on the pain through multiple generations. What is the impact of intergenerational trauma? The impact of intergenerational trauma can manifest in many ways. There are psychological effects of intergenerational trauma, for example members of the Stolen Generation of Aboriginal Australians are found to be 1.5 times more likely to have mental health problems, such as anxiety or mood disorders, compared to Aboriginal and Torres Strait Islander people not descended from the Stolen Generation. Descendants of the Stolen Generation are 1.3 times more likely to report mental health problems than Aboriginal and Torres Strait Islander people not descended from the Stolen Generation according to the Healing Foundation. There are other increased life risks that result from intergenerational trauma; according to the Australian Institute of Health and Welfare, there is “a higher likelihood of: being incarcerated in the last five years (3.3 times), being formally charged by police in their lifetime (2.2 times), having government payments as their main income source (1.8 times), not being a home owner (1.7 times) and being more likely to have poor general health based on a composite measure (1.6 times).” (5). There is also an increased risk for substance use, and serious chronic health conditions or disabilities such as cancer, diabetes, and heart disease. There is even some evidence of a genetic predisposition to developing PTSD or having poorer general mental health in descendants of those who experienced major trauma. In a study published under the name “Intergenerational Transmission of Trauma Effects: Putative Role of Epigenetic Mechanisms,” by the World Psychiatric Association, there had been “...findings of low cortisol and increased glucocorticoid receptor (GR) sensitivity in Holocaust survivors and other trauma exposed individuals with PTSD, suggesting that the experience of trauma might leave long‐lasting biological signatures in stress‐related biology that could be a catalyst for longer‐term adaptations.” (21). It was also noted that “One the most provocative observations regarding Holocaust offspring was the report that Yom Kippur war veterans were more likely to develop post‐traumatic stress disorder (PTSD) in response to combat if they had a Holocaust survivor parent.” How can we be more conscious of intergenerational trauma in healthcare? A way that healthcare workers and doctors can be more conscious of intergenerational trauma is to understand a patient’s family background and the risks that they are more likely to have based on traumatic experiences. It is important to be aware that there can be serious health effects as a result of social and emotional aspects of a patient's life outside their medical history. Trauma-informed care can be helpful for patients with intergenerational trauma because it helps healthcare workers be conscious of the widespread impact of trauma and understand possible paths for recovery, recognize the signs and symptoms of trauma in patients, families, and staff, make policies, procedures, and practices more conscious of trauma and actively avoid re-traumatization of the patient. As healthcare workers it is our job to fully understand our patients and their medical background, both psychiatric and physical, to give them the care that they need. What can help manage intergenerational trauma? Intergenerational trauma cannot be changed, as the past cannot be undone, however one of the ways that people learn to cope with and move past their intergenerational trauma involves understanding the trauma itself, any cycle it may create, and the fears and emotions that come from that. This can be done with the help of psychotherapy. What makes psychotherapy so effective for intergenerational trauma is that it creates a safe space to express the effects of intergenerational trauma without making the full weight of it their child’s responsibility. Psychotherapists are also trained professionals who can help an individual understand why they have certain reactions to triggers of that trauma, and to help them react logically to something that otherwise may cause them to panic or shut down. Psychotherapists monitor patients’ progress, are aware of a client's characteristics in context, and have an acceptable and adaptive explanation of the client's condition. All of these characteristics mean that a psychotherapist can be an ally and an advocate for people suffering from intergenerational trauma, while also helping on an individual level. There are also therapists who specialize in trauma or in familial relationships. One other thing that can help intergenerational trauma is change within a community or family to break the cycle and prevent the trauma from repeatedly happening in the first place. 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