“I don’t live in the past, the past lives in me.” – Olga Horak, Holocaust survivor
I asked my daughter what she thought of the Tree of Life text and the metaphor I described in it. She said that she liked it, but contrary to the metaphor in which the tree represents an individual life that branches in different directions depending on the decisions we make, she liked the one in which the seed grows into a new tree, which symbolizes a breakaway from “unhealthy ingredients” transmitted from one generation to the next. By separating, the new tree “makes a decision” not to repeat the patterns that afflicted the previous generations (trees).
This thought of hers reminded me of theories related to the transgenerational transfer of information in the mental health domain. A classic example is childhood abuse that causes a cycle of abuse and anxiety in future generations. Other types of intergenerational trauma are related to extreme poverty, sudden or violent death of a family member, crime against the family, a parent who fought in the war, and torture of a family member. In addition, there are so-called “collective traumas” that affect many people or even an entire generation such as slavery, genocide, famine, natural disaster, war, terrorism, exile, etc.
I grew up in a family and a country where the traumas of war and other calamities are almost a norm. Grandfathers on both sides of the family were prisoners of war during the First World War. After many years of imprisonment, exposure to terrible conditions, the daily threat of death from starvation or disease, they finally returned home to start families and a new life. My mother’s father became an alcoholic prone to violence. He died early on from the consequences of drinking. My father’s father was better adjusted but he suffered from anxiety and died prematurely from cancer. My parents experienced significant traumas during World War II by fighting in the war (father) and living in exile (mother), respectively. I wonder how these “shadows of the past” affected my parents and were passed to my brother and me, and do they extend their long dark reach to my daughters too? Trauma has a powerful effect in ways that are not always visible. Those affected by it often experience depression and anxiety, unstable or bad relationships, higher mortality rates, and an increased susceptibility to violence and substance abuse. On the other hand, it can lead to resilience and “wounded healer” life direction. I know that I was either born or early on sensitized to be compassionate toward my mother. I remember listening stories about her traumatic childhood due to her father’s alcoholism and death when she was only 9 years old, witnessed the conflictual relationship with her mother and ambivalence toward her older sister. Many decisions my parents made were not fully rational but are remnants, emotional “carry overs” from transgenerational trauma. I am sure that choices I made had a stamp of a different sort related to these patterning. For one thing, a positive effect, is that I chose early on to be in a healing profession and use caring nature for the benefit of others. Negative side of the coin is that I lost a good measure in caring for my own needs and setting appropriate healthy boundaries with others.
Conventional thinking about the transmission of traumatic information is related to the external and internal environment in which children are born and raised. For example, during pregnancy, the mother’s diet, exposure to various toxic substances (from nicotine, alcohol to drugs), psychological stress, and infections affect the development of the fetus. At birth, external environmental factors related to nutrition, the mother’s mental state, the quality of attachment to the child, and early traumatic events determine the child’s health. These effects are indirectly related to familial and transgenerational trauma. More direct factors are learned by observing behavior, listening to family stories, living in the presence of unspoken secrets, being exposed to the “survival messages” based on fear, and reading books related to the family or group with whom they identify with (nation, race, historical events, etc.). The standard approach to this topic is summarized in the words of psychiatrist Volkan: “Transgenerational transmission is when an elderly person unconsciously externalizes his traumatized self to the personality of a developing child. The child then becomes a reservoir for unwanted, problematic parts of the older generation.”
The non-standard approach is related to epigenetics, a science about thirty years old that investigates the influences of environmental factors on the activation or deactivation of genes that do not change the basic DNA sequence of nucleotides. This mechanism is different from a mutation in which gene is changed structurally. To clarify this, I will say that epigenetics deals with the function of genes (as physiology deals with the function of the organism) and genetics with the structure of genes (as anatomy deals with the structural elements of the organism). Or to put it in computer language, the epigenome is the software, and the genome is the hardware of the organism. There is a great excitement among scientists about the potential benefits epigenetics can have in explaining the mechanisms of aging, human development, the origins of cancer, heart disease, mental illness, and other important fundamental processes. But in this text, I will only focus on research about hereditary epigenetic mechanisms related to the transmission of trauma from parents and previous generations to children.
Research shows that our experiences, especially those that are traumatic, violent, or disturbing, can have a profound biological impact by affecting the functioning of genes that regulate stress hormones. There are many studies about PTSD that consistently implicated DNA methylation and gene expression changes in hypothalamic-pituitary-adrenal axis and inflammatory genes. * It is less investigated if these epigenetic changes are transferred to the offspring. I looked for the latest research on the topic and was able to identify a recent review study describing the transmission of stress and anxiety via epigenetic markers in the sperm. ** An older and better-known publication is related to Dr. Rachel Yehuda, director of the Department of Traumatic Stress Studies at the Medical School in New York. It found that children of holocaust survivors with PTSD had lower rates of DNA methylation (the most common type of epigenetic mechanism) at a particular stress-related glucocorticoid receptor than children of survivors without PTSD. *** Based on these and other studies, it is obvious that stress and trauma can leave a chemical mark on the genes of germ cells, which are then passed on to future generations via reproduction. This mark does not cause a genetic mutation, but it does change the mechanism by which the gene is activated. I will let the words of Dr. Yehuda, the pioneer in this field, complete this section. “We are just beginning to realize that being born with a certain set of genes does not mean that we are in a biological prison because of those genes – that the way these genes work can change. The idea is very simple, and you hear it from people all the time. People say that when something cataclysmic happens to them, they are no longer the same person. Epigenetics gives us the language and the science to start unpacking that.”
Epigenetic changes are not permanent so that various therapeutic methods and healthy lifestyles lead either to increased resilience to the effects of trauma or reverse the biological markers of trauma. The most effective therapies are prolonged exposure to trauma through conversation, virtual reality, videos, detailed writing, etc. This method is very demanding and is not popular with patients, although it is very effective. A similar method that is being used more and more due to its ease and acceptance is the EMDR (eye movement desensitization and reprocessing). The material of trauma (images, sounds, affects, sensations of the body, etc.) becomes “stuck” so that the memories are encoded in a disturbing state of excitation. In this condition, the trauma material is easily activated by internal or external stimuli. EMDR protocols and procedures are intended to activate the brain’s information processing system and transform traumatic memories through “reprocessing”. Subsequent integration into adaptive brain networks leads to symptom resolution using bilateral eye movements. Alternative stimulation methods can be audible or tactile. Last but not least is psychedelic-assisted psychotherapy, especially use of methylenedioxymethamphetamine (MDMA), known as ecstasy in the treatment of PTSD. This drug is on the verge of approval by the US Food and Drug Administration (FDA) after a study that resulted in a cure of two thirds of those treated.
A healthy lifestyle enhances strength to offset trauma. Family and community play a dominant role in increasing an individual’s resilience. Basic elements include the promotion of self-esteem and self-efficacy. Music, art, dance, and communication through storytelling about past events reduce anxiety and increase cohesiveness among participants. It has been known for a long time that exercise is associated with various health benefits. It is valuable for regulating reactions to stress, sleep, and negative mood thanks to increased levels of galanin, a neuropeptide associated with the regulation of norepinephrine and other stress hormones. Regular mindful meditation increases awareness of the present moment, self-compassion and strengthens the ability to self-regulate.
In this text, I referred to the importance of understanding transgenerational trauma, especially its transmission by epigenetic mechanisms. Scientific research is becoming numerous and convincing in this regard. I have also outlined the best treatment methods that are effective in relieving the symptoms and biological changes caused by trauma. My writing is informed by scientific literature and clinical practice. This time I did not include theories that are further away from the official science. They include the theory of chaos and fractals, the collective unconscious, the morphogenetic field, the reincarnation, as well as the luminous body described in Shamanism. Writing about them may follow future inspiration.
*Mehta D, Miller O, Bruenig D, David G, Shakespeare-Finch J. A systematic review of DNA methylation and gene expression studies in posttraumatic stress disorder, posttraumatic growth, and resilience. J Trauma Stress. 2020;33(2):171-180
**Xingyun Xu, et al “Epigenetic Mechanisms of Paternal Stress in Offspring Development and Diseases”, International Journal of Genomics, vol. 2021, Article ID 6632719, 10 pages, 2021
*** Rachel Yehuda, et al. “Holocaust Exposure Induced Intergenerational Effects on FKBP5 Methylation”, Biological Psychiatry September 1, 2016; 80: 372–380