Why therapists need to know about intergenerational trauma

intergenerational trauma
Therapists need to know about intergenerational trauma

In April (2019) I presented for a half-day on The Therapeutic Use of Metaphor in EMDR at the EMDR Canada conference in Vancouver, BC. Being in Canada got me thinking about intergenerational trauma and I’ll tell you how. A big shout out to my Canadian friends and colleagues – they run an excellent EMDR conference and are a wonderful group of people! You can learn more about the therapeutic use of metaphor in EMDR therapy here.

Before the conference, I was able to spend a few days exploring Vancouver itself. I was very struck by what I learned about the First Nations people and the Unceded Territories. Particularly moving was my visit to UBC’s Museum of Anthropology. This was full of powerful images, incredible history, and great learning. In the gift shop, I bought a card which has the image you see here – Laurence Paul Yuxweluptun’s Portrait of a Residential School Girl.

Yuxweluptun, who was also in the residential school system, honors the child with his painting. The young girl shows the “enforced conformity” of residential schools, through her white blouse and clipped back hair European hair. In contrast, her face has spiritual markings of strength and protection. A halo, which is also covered in Indigenous designs, is behind her head. The central message intended is that no matter how hard European settlers try to eradicate and conform Indigenous peoples, this will never be possible to successfully achieve. It is a very striking image.

More than 80 residential schools existed across Canada – starting in the 1870s and lasting until the 1960s and 1970s. Parents were forced, after 1920, to enroll their children or face prison. The purpose of the residential school system was to “kill the Indian in the child,”, by breaking children’s linguistic, spiritual and cultural attachment to their traditional cultures. It is also clear that sexual abuse, sexual assault, rape and child neglect, as well as the trauma of loss and separation from family and community were consistently rife issues in this system. By 2015, over 30,000 students claims submitted to receive compensation for sexual abuse “as part of the Independent Assessment Process, set up under the Settlement Agreement” had been concluded, with a further 6,000 in the process (Truth and Reconciliation Commission of Canada)

Naturally, this got me thinking about intergenerational trauma – in Canada, Australia and back home in Northern Ireland. As Francine Shapiro said, “The past affects the present even without our being aware of it.”

As therapists, we need to be aware of intergenerational trauma, what it is and how to work with it. We need to take detailed trauma histories of both our clients and their own origins.

The intergenerational transmission of trauma is known through old wisdom. The presence of such a phenomenon has long been known to First Nations peoples as “blood memory” and “soul wound”.

What is intergenerational trauma?

Why therapists need to know about intergenerational trauma

This animation was launched at The Healing Foundation’s #OurFuture Youth Webinar on 24 July 18. It has been created as a new education resource that explains where Intergenerational Trauma comes from and how it impacts young Aboriginal and Torres Strait Islanders (https://healingfoundation.org.au/intergenerational-trauma/). I think it explains it quite well.

At its simplest, the best way to define intergenerational trauma is to take the words of Yehuda and Lehmer (2018) :

“On the simplest level, the concept of intergenerational trauma acknowledges that exposure to extremely adverse events impacts individuals to such a great extent that their offspring find themselves grappling with their parents’ post‐traumatic state. A more recent and provocative claim is that the experience of trauma – or more accurately the effect of that experience – is “passed” somehow from one generation to the next through non‐genomic, possibly epigenetic mechanisms affecting DNA function or gene transcription”

So, according to Yehuda and Lehmer, intergenerational trauma has two parts

  1. people who have been through traumatic experiences can then have an impact on their children (for example, this could mean that the children may develop PTSD without having been exposed to a traumatic event). Yehuda’s work on the children of holocaust survivors’ points to this.
  2. the effect of the trauma that the parent has experienced is passed on through epigenetic means (essentially, part of the parental DNA changes and this is then passed on to the children and can be identified in the DNA of the children). The word used here is ‘provocative‘ because there is some disagreement about this.

It is worthwhile to hear this explained by Rachel Yehuda directly.

Why therapists need to know about intergenerational trauma – Rachel Yehuda

This explanation, covering both the environment and genetics, is convincing. This is similar to the familiar nature/nurture debate.

intergenerational trauma
Why therapists need to know about intergenerational trauma – nature/nurture

Dr. Yehuda remains in the role of the scientist, following the evidence rigorously, and not getting overly excited. However, there are alternative views on epigenetics and some criticism with regard to these findings.

Not Everyone Agrees

The research carried out by Dr. Yehuda et al. (2015) is certainly an interesting read and not the only research on epigenetics. It claims that

“This is the first demonstration of an association of preconception parental trauma with epigenetic alterations that is evident in both exposed parent and offspring, providing potential insight into how severe psychophysiological trauma can have intergenerational effects.”

However, the sample size (n=22) is very small and cannot be generalized to a wider population. It is also necessary to conduct a more longitudinal study to examine the impact and transmission of intergenerational trauma across more than one generation. This is acknowledged by Yehuda et al.

“It is also necessary to investigate multiple generations to differentiate among exposure effects, epigenetic inheritance, and social transmission”

Josie Glausiusz, a participant in the Yehuda et al study (2015), has asked

“How does one separate the impact of horrific stories heard in childhood from the influence of epigenetics?”

Glausiusz quotes both John Greally (Professor of Genetics and Pediatrics at the Center for Epigenomics at Albert Einstein College of Medicine in the Bronx, New York), and Rafael Irizarry (Professor of Applied Statistics at Harvard and the Dana Farber Cancer Institute) who raise questions and doubts about what they view as inconsistencies in the design and method of Dr. Yehuda et al.’s research.

Yehuda et al. responded and in a paper published in 2018, state the following :

“There has been great interest in the possibility that effects of trauma might be passed from parent to offspring through epigenetic mechanisms. This topic has stimulated discussion and controversy in the scientific literature, the popular press, and culture at large. This article describes the initial observations that have led to recent examinations of epigenetic mechanisms in association with effects of parental trauma exposure on offspring. Epigenetic research in animals has provided models for how such effects might be transmitted. However, the attribution of any specific epigenetic mechanisms in human studies of offspring of trauma survivors is premature at this time.

The article describes some of the ways in which initial epigenetic findings in the offspring of trauma survivors have been represented in the popular media. Reports have ranged from overly simplistic and sensationalistic claims to global dismissals. The authors discuss the importance of clarity in language when describing epigenetic findings for lay audiences, the need to emphasize the limitations as well as the promise of research on intergenerational transmission of trauma effects, and the importance of countering popular interpretations that imply a reductionist biological determinism. Scientists have an obligation to assist in translating important research findings and nascent avenues of research to the public. It is important to recognize the ways in which this research may unintentionally be received as supporting a narrative of permanent and significant damage in offspring, rather than contributing to discussions of potential resilience, adaptability, and mutability in biological systems affected by stress.”

intergenerational trauma
Why therapists need to know about intergenerational trauma – key points

The key points to note here are that:

  1. Previous research pointed to initial observations regarding epigenetic mechanisms related to the effects of parental trauma exposure on their children.
  2. Epigenetic research relating to animals shows possible transmission models but it is premature to state that epigenetic transmission happens in humans
  3. Reporting of the original findings have been simplistic and sensationalist and have lost accuracy despite the fact that this is essential to maintain.
  4. There are limitations as well as potential promise in the research on intergenerational transmission of trauma from parents to their children
  5. It is vital that research findings in this area are not misinterpreted in a way that is reductionist or limiting so that children of trauma survivors are not seen as being permanently and significantly damaged.
  6. The discussion needs to uphold a narrative of resilience, adaptability, and mutability in biological systems affected by stress.

So, what does it mean for therapists?

As therapists, we are in the business of helping people to heal from trauma.

Therapists must uphold a narrative of resilience, adapatibility, and mutability in biological systems affected by stress.

This is a central guiding principle behind the work that we do. However, we need to be well informed so as to provide the best therapeutic interventions possible.

So, how should we proceed? Here are some suggestions.

  1. We do not need to get caught up in the debate about epigenetics – that will become clearer in time. However, it is clear that intergenerational trauma does exist. Clients can have adverse experiences by virtue of being exposed to a traumatic family environment. Intergenerational trauma describes the transgenerational transmission of parents’ traumatic experiences to their children and even grandchildren.
  2. Clearly this is not about blame, but it is about recognizing that a traumatic family environment can have a devastating impact on those who grow up within it. The devastating impact of traumatic experiences, including war, genocide, and ongoing oppression, can alter a person’s capacity for being attentive and present, having an ability to love, to form attachments, or parent well.
  3. As therapists, we need to ‘unpack’ this family history and make sense of it – both for our own work as therapists and how we might proceed (think of the trauma minefield) and for our clients deciphering their own history.
  4. A simple practical but powerful way to do this is by the use of a genogram. This invites both discussions and can greatly aid clarity given its visual nature. Therapists need to be aware of how to work with genograms and the different forms of notation used in these. This work should be done slowly as part of a gradual unpacking and to notice new patterns of insights that emerge. Find out exactly how to take a trauma history in this post.
  5. We need to actively listen to the stories that get told that the stories that a family has ‘created and lived by’. As Dan P. Mc Adams has said “People tailor their life stories for particular audiences. The recipient or audience for a story may crucially influence the stories form.” Stories are constructed in particular ways and clients can become ‘prisoners’ of particular family narratives. We need to gently help them unpick the locks of the chains that bind them into what seems like the perceived truths of certain stories. We need to look out for what may have become a dominant narrative in a family system and one that has been passed down. This may not accord with the client’s current experience or reality or future wishes. This is where resilience and adaptability come in.
  6. As stories are told, we need to watch and listen for emotional tone and somatic reactions in the client. Where do they become upset, frozen, tearful or caught in words? What metaphors do they use in their language that tells us that metaphor is necessary because it is the only way to express the inexpressible? We need also to be able to use various mediums to enable a story to be told, and not just words.
  7. We need to be trauma-informed as therapists and to be able to help clients stay within a window of tolerance. We need to be able to moderate and modulate the pace of the sessions and to help clients self-soothe. We need to navigate slowly through the trauma minefield.
  8. We need to have an awareness of human developmental stages and what ages the client is telling their story from. How a six-year-old will understand recount an event is different from that of a sixteen-year-old.
  9. The therapeutic work needs to be collaborative. It needs to rely on and work with the wisdom, input, and suggestions from the client throughout the therapeutic process, coupled with the professional knowledge and expertise of the therapist.
  10. Finally, the therapist needs to have a clear plan which entails working to an ending from the first session, and not engaging in a lengthy process that will re-traumatize the client or that will involve being in therapy for years? The process is about resolution and healing.

Some therapists like to keep points like this in a journal or pin them to a noticeboard.