Can trauma be handed down from one generation to the next?
“Absolutely chaotic” is the way Dave describes growing up with his emotionally abusive parents — his bank executive father and homemaker mother, the daughter of an alcoholic who rarely drank herself but exhibited many of the disruptive behaviors of this type of addict.
Dave, a man in his 50s, is certain that his traumatic upbringing was a factor in himself becoming an alcoholic — someone who has held high-level jobs but also been homeless.
And he has no doubt that his childhood trauma contributed to his divorce and has affected his two children, now young adults.
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“I was there mentally, I was there physically, but I wasn’t there emotionally,” Dave told The Journal in a recent interview. “You never knew what you were going to get when daddy came home from work. I could be good, or I could just be late — ‘get out of the way,’ you know — or I could be in a bad mood,” which only worsened when he drank.
“There was no emotional stability for them, just as there wasn’t for me,” said Dave, a case manager for a social-services organization who struggled for 12 years as he went into and fell out of recovery but who has been clean and sober since last October. “In recovery, it's common to say that people lied, cheated and stole. I never stole anything [physical], but I stole everybody’s peace of mind.”
In relating his story, Dave includes another relative: his mother’s father, his maternal grandfather, also an alcoholic. When his mother was 11 or 12, Dave said, “he burnt their house down. He was drunk and passed out with a lit cigarette.”
Four generations of trauma, upending a family like a mental-health tsunami.
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Intergenerational trauma Research has its roots in the Holocaust
The clinical term is “intergenerational trauma.” It describes the transmission from one generation to the next of adverse effects rooted in psychologically damaging experiences.
Research into this form of trauma is rooted in studies of people who survived Hitler’s genocide of European Jews.
“From reading the literature, my understanding is that Holocaust survivors went on to have children and some studies have shown that the offspring of those Holocaust survivors had higher rates of different mental health disorders, including PTSD,” said Dr. Lindsay P. Huffhines, a Bradley Hospital research scientist and clinician and assistant professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University.
A similar pattern has been found among survivors of other mass-killing events, including Stalin’s 1930s starvation of Soviet Ukrainians, the Cambodian genocide perpetrated in the 1970s by the Khmer Rouge, the Rwandan genocide, the enslavement of Black people in the United States, and the killings, displacement and detribalization of Native Americans.
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These individuals are a subset of a larger group — Dave and his family, for example — whose numbers are unknown, given that the science is essentially in its infancy. But researchers including Huffhines, a fellow at Brown’s Initiative on Stress, Trauma and Resilience, STAR, are seeking answers as they push for better treatment and effective prevention strategies.
Huffhines conceptualizes intergenerational trauma in terms of two “pathways.”
One, she said, “is the biological pathway, which we're trying to understand.”
Among the key issues: How does trauma shape the developing brain, beginning at or even before birth? Can trauma cause epigenetic changes, which the Centers for Disease Control and Prevention defines as “how your behaviors and environment can cause changes that affect the way your genes work. Unlike genetic changes, epigenetic changes are reversible and do not change your DNA sequence, but they can change how your body reads a DNA sequence.”
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Epigenetic changes have been demonstrated in animal studies, though not yet in humans; such work remains a frontier, as a 2018 paper published in World Psychiatry, the official journal of the World Psychiatric Association, noted.
“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,” wrote the authors, two scientists at the Icahn School of Medicine at Mount Sinai, in New York.
“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.”
The second pathway that Huffhines cites is the behavioral.
“One of the mechanisms that we think is really important is parenting behavior or components like maternal sensitivity and responsivity,” she said.
“How we understand it is that an experience of trauma or adversity may go on to affect how a parent parents their own children. And then that subsequent parenting can result in mental health problems for that kiddo, including things like depression, anxiety, behavioral problems.”
Which in turn could be passed on to these children’s offspring, which would explain what happened in Dave’s family.
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'Constant, constant tension'
The youngest of seven children, Dave said his home environment was perpetually volatile as far back as he can remember.
“Always constant, constant tension, between either one sibling against another sibling or siblings against the parents,” he said.
Little he did, he said, pleased his parents.
“As a result of the chaos, whatever you did — and it might have been a minute thing — you caught the brunt of it,” he said. “I got a C on my report card, and that was a problem, meaning it was magnified. I had to sit down at a desk and write a book and make sure it was neat so I didn't get another C. That was, like, in second grade.”
The family turbulence, Dave said, did not stem from financial difficulties, which can raise stress in families. A bank executive commands a good salary.
“It wasn't because we didn't have enough food and it wasn't because we didn't have enough clothes and it wasn’t because our [physical] needs weren't getting met. It was just chaos. I didn't have June Cleaver coming downstairs saying, ‘How you are doing, honey?’”
Instead, he had a mother he said could be described as a "dry drunk," a term that members of Alcoholics Anonymous use.
"She had the mannerisms of somebody who is an alcoholic who no longer drinks" but has not dealt with the issues underlying their disease, Dave said. "They're bitter and constantly full of anger, frustration, things of that nature."
She was, Dave said, a mother who would “blow everything out of proportion” to her husband when he came home.
And him?
“I was definitely afraid of my father,” Dave said.
Nothing improved when his sisters were old enough to move out.
“That gave me abandonment issues,” he recalled.
Sleeping with vodka under the pillow
Dave began drinking when he was a young teenager. He began smoking marijuana then, too, and a course was set.
“The floodgates opened,” he said. “I was drinking like a fish. I got my first DUI when I was 21.”
He managed, however, to find employment in manufacturing.
"At about age 24, 25, I got an entry-level position in this plant, and within a year and a half, I'm running literally half the plant," he said. "I'm running the production department, the inspection department, and I'm the shipping and receiving manager. So I had some hope. I had some ambition, some skill and talent.
"And I met a girl, she worked there. We ended up getting together. We got married and she got pregnant."
Though still drinking, Dave remained gainfully employed.
"I was making good money. We bought a house — no picket fence, but just shy of that — a nice house, a three-bedroom ranch, on a half-acre lot. We had a garden. We had two brand-new cars."
But alcohol was corroding his relationships. As he and his wife headed toward divorce, Dave said, she left with their two children. Dave responded self-destructively.
"If you thought I drank before, when the rug got pulled out my alcoholism skyrocketed. I went straight to vodka — morning, noon and night, 'round the clock, 24/7. I slept with a pint of vodka under my pillow."
In the years to come, Dave would periodically stop drinking. Armed with insight into addiction and mental health challenges, he found a new career in social services. But relapses interrupted that career, and during one of them, he became homeless.
He also contemplated suicide.
"One night, I sat with a knife at my throat, crying all night long, wanting to push it in," he recalled." I just couldn't do it, because of my kids."
Can trauma during pregnancy affect development of the fetus?
With decades of support from the National Institutes of Health and some 100 published scientific papers, Dr. Laura R. Stroud, director of the COBRE Center for Stress, Trauma, and Resilience and the Center for Behavioral and Preventive Medicine at The Miriam Hospital, Brown Medical School, is a nationally prominent scientist investigating the effects of trauma on the young brain.
"More and more research is showing the absolutely critical importance of early brain development," Stroud told The Journal. And not only from birth through early childhood, she said, but also during adolescence, "another sensitive period when the external environment has an impact."
Stroud said research even suggests that trauma a pregnant woman experiences can affect her unborn baby.
"The mom's environment while pregnant may also influence the child's development," she said, "and obviously the brain is in its very, very formative stages during the fetal period."
Once born, Stroud said, a child is vulnerable to so-called Adverse Childhood Experiences, "potentially traumatic events that occur in childhood (0-17 years)," according to the CDC. "For example: experiencing violence, abuse or neglect; witnessing violence in the home or community; having a family member attempt or die by suicide.
"Also included are aspects of the child’s environment that can undermine their sense of safety, stability and bonding, such as growing up in a household with: substance use problems, mental health problems [or] instability due to parental separation or household members being in jail or prison."
Said Stroud: "Adverse Childhood Experiences have been linked to numerous physical health outcomes — cardiovascular disease, metabolic disease — as well as psychiatric conditions like depression and anxiety. ... Stressors that impact parents may then get transmitted to the child and those can have long-term effects on the child's health."
Therapy can help break the cycle of trauma
But no universal law applies, Bradley Hospital research scientist Lindsay P. Huffhines asserts.
"It's important to understand that not all people who have experienced trauma then go on to have children who also experience trauma or who experience mental or physical health problems down the road," Huffhines said. "Part of the research we do is trying to understand why this happens for some people and not for others, and to help parents who need additional supports in parenting their children.
"A mother who has never experienced warm interpersonal relationships, who does not know what it's like to be paid attention to, to be nurtured, for her feelings to be recognized when she's feeling sad or scared — when she has a baby and is interacting with her infant or toddler or young child, sometimes she doesn't know how to respond when they are experiencing strong emotions.
"Something we see a lot is a toddler who is distressed and is crying or tantruming and the mom might interpret this as the toddler being manipulative, of trying to harm her in some way. Rather than thinking of it as, 'This is a typical thing that toddlers do, they get upset and they cry,' they can read into it as 'The toddler hates me,' or 'It's something I'm doing wrong, it's something they're doing wrong.'"
In cases like this, psychotherapy that Huffhines and other clinicians can provide can help, and the cycle can be broken.
Another approach is "trauma-informed care," according to Stroud, who described it in terms of a holistic understanding of an individual who has experienced trauma. Schools can use this, she said, along with health care professionals — and not just psychiatrists, psychologists and therapists.
"We have a researcher within STAR who's very interested in trauma-informed obstetric care," Stroud said. "If you're a physician of some sort — a cardiologist or whatever — the way that you work with patients can be informed by the possibility that that person has experienced trauma."
The concept is catching on, Stroud said.
"I think there's getting to be realization within different medical specialties about the importance of trauma-informed care in all of the other health-related work that we do."
'The man I was' vs. 'the man I have become'
With the support of Alcoholics Anonymous and colleagues and management at the social-service agency where he works — an agency that prides itself on being what is called a recovery-friendly workplace — Dave is nearing a full year of sobriety.
Recovery takes work, he said, but for many people with trauma histories who became alcoholics like him, it can be the key to a healthy life. Therapy and other interventions such as those described by Stroud and Huffhines, can also prove beneficial, he said.
Today, Dave remains close to his son, who, he said, has his own mental health challenges.
Still carrying the pain of her childhood, his daughter, he said, has not spoken to him in years.
He cannot undo the past, but he can contemplate reconciliation.
"The hope for my children is that they have successful, happy, joyous and full lives, free from addiction and misery," he said.
"I pray and hope that one day my daughter is able to see me for the man I have become and not the man I was. I have done a lot of work on myself to be the man God intended me to be."
Editor's note: Dave agreed to share his story on the condition that his last name would not be used and photography would not identify him. His identity and the essentials of his story have been confirmed by the leadership of the organization that employs him.