Resilience and Transgenerational Trauma
There have been various research studies pertaining to the existence of ancestral exposure to trauma and its effect in second (2G) and third (3G) generations of families as transgenerational trauma (TGT) or resilience to future traumas (Yehuda et al., 2001). Sometimes the silent conspiracy in a family can be passed down through an implicit memory that is felt through many generations (see figure 6). Resiliency has been present when there was open communication, a nurturing environment, freedom for artistic expression, social support, cultural identity, a sense of safety and security with parents, and a sense of belonging and place attachment (Braga et al., 2012). In general, TGT studies showed that a parent's exposure to trauma could affect biology and increase one’s offspring's vulnerability for TGT (Yehuda et al., 2001). Furthermore, research looking into the debate of nature and nurture show’s that both are present, there is a genetic inheritance influence as well as the context of one’s environment, land, and neighborhood (Champagne, 2016).
Looking into the hypothesis that parents with PTSD may transfer trauma symptoms to their offspring more than parents who were exposed to trauma but did not develop the diagnosis, Yehuda et al. (2001) conducted a study with 93 Holocaust survivor offspring. Sixty participants reported having at least one parent with PTSD, and 33% reported having parents without PTSD. Surprisingly, results showed that parental trauma exposure was significantly associated with a lifetime of depression in their offspring, despite not having a parent with a diagnosis of PTSD (x2= 21.73, df =1, p < 0.0005). Yehuda et al. (2001) demonstrated that adult offspring of Holocaust survivors also showed greater prevalence of PTSD, including in this study where PTSD was reflected in offspring, by showing occurrence of PTSD (x2= 10.36, df = 2, p < 0.0006) and depression (x2 = 17.95, df = 2, p < 0.0005), but not anxiety (x2 = 4.2, df = 2, n.s.). Lastly, because depression in the parental survivors was not examined, the study could not analyze if that was a factor. This study alluded to the possibility of a genetic component in these results where the parent’s exposure to trauma, even if not acquiring PTSD diagnosis, was carried on by the child as a vulnerability to depression and PTSD (Yehuda, Halligan, & Bierer, 2001).
The legacy of vulnerability to transgenerational trauma has been balanced by the legacy of resilience. Resilience, in trauma survivors and their offspring, is seen as a capacity to keep going with higher levels of optimism when faced with adversity or stressors by using humor and the arts, creativity, open communication, and flexibility in the face of adversities (Braga et al., 2012). Meanwhile, TGT symptoms include a lifetime of depression and PTSD symptoms, a vulnerability for psychopathology and feeling helpless, as well as the tendency to repeat maladaptive behaviors and traumatic experiences from parents, over-identification, and preoccupation with parents, reversal parenting, and loss of culture and sense of belonging (Bowers & Yehuda, 2016; Braga, 2012).
A qualitative study of TGT found resilience and trauma in the offspring of Holocaust survivors (OHS). Braga et al. (2012) studied how OHS in Brazil felt and made meaning from their parents’ memories and experiences. Through the Brazilian Jewish Institute and snowball sampling, the researchers recruited and individually interviewed 15 OHS (nmales = 7; nfemale = 8), with ages ranging from 40 to 66 years old, and education ranging from 12 to 22 years. Braga et al. (2012) found three main themes for patterns of transgenerational transmission of a traumatic experience or resilient patterns. The first theme was related to the ability or inability of the survivors to work over the collective trauma. This was seen in TGT families through “somatic symptoms and psychopathology disorders,” while resilient families showed “personal narratives, documentary records, and cultural rituals” (p. 11). The second theme was the quality of the communication from survivors to offspring. In families presenting with TGT, there was “indirect communication, fragmented discourse, and secrets,” while in resilient families, there was an “open, loving, humorous interaction” (p. 11). The third theme was repercussions in the lives of the survivor’s offspring. These included the TGT experiences of “guilt, victimization, and submission,” while resilience could be seen in “artistic creation, humor at home, imaginary resources and social support” (p. 11). Further examination of communication patterns and overidentification with parents who were victims of trauma could clarify some of these themes.
As it happens, a year later, Giladi and Bell (2013) used a quantitative method to measure the correlation of enmeshment and lack of open family communication in descendants of Holocaust survivors with symptoms of TGT. A non-random sample of 215 Jewish American/Canadian descendants of World War II immigrants was divided into four groups: 2G (n = 77), 3G (n = 52), and two control groups (n = 50, n = 36, respectively), of similar age, that were immigrants with no Holocaust survivor relatives. Instruments included the Secondary Trauma Scale (STS), Crucible Differentiation Scale (CDS), Family Communication Scale (FCS), and a demographic questionnaire. There were significant differences between 2G and 3G and respective control groups in all scales, but no statistical difference between 2G and 3G scores. Comparing scores of all participants with multiple hierarchical regression, the null hypothesis was rejected, showing that higher CDS and FCS were associated with lower STS, R (2, 186) = .605, R2 = .37, ΔR2 = .326, p < .001. Despite limitations, this study showed that family communication and differentiation were associated with the development of resilience in 2G and 3G survivors of trauma, which would be important to measure in future studies (Giladi & Bell, 2013). Considering communication as an essential part of resilience, the question remains if the act of verbalizing trauma to anyone would be enough to create a resilient outcome or if communication within one’s family and community would be necessary to achieve these results.
Going beyond resilience and looking into post-traumatic growth (PTG), Dekel et al. (2013) sought to understand if TGT and resilience affected PTG by comparing veterans from the Yom Kippur war living in Israel; some had parents who were Holocaust survivors’ parents (n = 43), and others had parents who were not (n = 156). This project was part of a more extensive study that measured participants three times after the war ended (18, 30, and 35 years). This study compared data from the second and third administrations (N = 199, Mage =53.4, SD = 4.4, 100% male) of the Posttraumatic Growth Inventory. A t-test was used to compare PTSD inventory scores with measurements taken about stressors during combat and after. There was no significant difference in levels of PTSD between the 2G or non-2G Holocaust survivors. However, results showed that even 35 years after the war, veterans who had a Holocaust family history showed lower PTG than veterans who did not (Dekel et al., 2013). ANOVA results for PTG between groups were F (1, 133) = 4.39, p = .044, ηp2 = .03. Dekel et al.(2013) suggested that, although seemingly counterintuitive, resilience might block PTG. Dekel et al.(2013) speculated that veterans who were not 2G or 3G survivors of trauma could communicate openly about their trauma, successfully address PTSD in treatment, and show the presence of PTG. Dekel et al. (2013) further suggested that among the reasons for the discrepancy was a “silent conspiracy” surrounding TGT that opposed the “open verbal communication and self-disclosure about their own trauma, a key facilitator of PTG” (p. 532). Nevertheless, 2G or 3G offspring of trauma survivors might not have heard the story verbally and might only register the narrative in their body as implicit memory.
Walkerdine et al. (2013) addressed the fact that TGT is not due to repression, as 2G or 3G might not consciously know “what it is that their body knows and feels” (p. 275). The lack of safety associated with this TGT is instead characterized in terms of “imaginary” and “symbolic” memory. In a case study, these authors analyzed a 5-hr interview conducted with a woman named Angela. Angela reported that she was not cared for or held by her parents, and presently, she had no support and was “repeating a situation where she experienced no emotional holding” (p. 283). The case study described Angela’s childhood, her visit to Jamaica when she was 23 years old, and her difficult relationship with the father of her children (Walkerdine et al., 2013). There were multiple levels of embodied knowledge, and the case study illustrated how broad historical context needed to be acknowledged in treatment in order for Angela to understand her nonverbal memory of the trauma. The authors emphasized that it is not possible to separate history from family relations, as even if a person does not consciously know what happened, it “does not mean that the body does not at some level remember what cannot be spoken” (p. 295).
So even though communication seems crucial to resilience, and implicit memory might sometimes be the only trace of one’s ancestry, collective trauma might allow what happened to public information and, therefore, part of one’s community identity. Bezo and Maggi (2015) wrote that the participants with TGT in their study were eager to speak about what happened even starting the conversation at the door of their homes. However, they reported mistrust in talking about what happened with the community. This was a qualitative study on 15 families of survivors (n=45) of the 1932-1933 Holodomor genocide by interviewing first (Mage = 86.4), second (Mage = 57.6), and third (Mage = 30.3) generation, survivors. In 2010, 45 semi-structured, 53-minute interviews were conducted. The theme for emotions and inner states included categories such as fear it would happen again, mistrust in others, sadness, and shame. Participants also shared states of horror, fear to protest, stress, anxiety, and poor sense of self-worth. The second theme of trauma-based coping strategies included stocking food, an overemphasis on food, accumulation of unneeded things, increased social hostility, and participation in risky behavior. The interviews also revealed that participants felt socially indifferent in the community and that there was a lack of collective healing and identity. Although this study could have had stronger credibility if it had used triangulation, member checking, and made use of an external auditor, it demonstrated evidence of TGT but not the cause. In this study, it seemed that community healing was something that the participants felt was lacking. The 2G and 3G survivors were not supported by the social environment and felt threatened and suspicious of their neighbors (Bezo & Maggi, 2015). It seems that communication is not enough to create resiliency, and trust is essential in one’s community to overcome collective trauma. Furthermore, one could suspect that there is a biological component that is passed down from parents that experienced trauma.
Looking into TGT in a more specific duet of mother and child, Bowers and Yehuda (2016) studied if mothers with PTSD and prenatal stress could affect their babies. The study showed that the offspring of mothers with PTSD and prenatal stress were affected physically and psychologically (Bowers & Yehuda, 2016). Nevertheless, it seems that there is an association between maternal stress and a diminished circulation of cortisol level in offspring, with only 10 to 20% of cortisol of the mother passing to the fetus (Bowers & Yehuda, 2016).
In another study, biological data demonstrated DNA change when there was a separation between mother and infant in humans, rodents, and dogs (Champagne, 2016). During collective trauma and exodus of land, there is often a separation of mother and child, and Champagne exposed the risk of this type of stressor. His studies with animals suggested that when a male was exposed to stress, it influenced the mother’s investment in the offspring. Furthermore, the characteristics of a phenotype due to environment and culture were repeated and propagated across generations. Champagne (2016) advocated continuing to study the influence of the environment on epigenetics when it comes to “resilience and psychiatric risk” (p. 1226). Champagne proposed that there is a bidirectional interaction between an organism and the environment.
Stepping away from TGT studies and their implications and taking into consideration how verbal or artistic expression of trauma seems to help one pass down resilience, a study seems to highlight the long-term effects of collective trauma and the use of arts as a resource for supporting resilience. Diamond and Shrira (2018) conducted a study that investigated engagement in the arts with aging Holocaust survivors. The participants were a convenience sample of 154 elders from a community in Israel (Mage = 81.67) with relatively good health, high economic status, and education. Diamond and Shrira theorized that the creative process could provide an opportunity to “find meaning, to mourn, to bring order into emotional chaos and to regain a sense of continuity and integration” (p. 6). The researchers defined art as a process of creativity that enhanced well-being, coping strategies, and positive adaptation in individuals who faced adversities, tolerated ambiguity, and adjusted easily to new ideas and experiences—characteristics consistent with resilience. The art-making used by the sample included visual art (32.7%), music (15.4%), writing (15.4%), dance (11.5%), drama (1.9%), and other types of art (23%). Self-report questionnaires were used to ascertain participants’ exposure to the Holocaust, engagement with art, PTSD symptoms (PTSD Checklist), psychological stress (18-item Brief Symptom Inventory), resilience (Connor-Davidson Resilience Scale), and subjective perception of age (Attitude to Aging questionnaire). Diamond and Shrira (2018) reported that adversity and creativity had a moderate statistically significant correlation with resilience and growth but concluded that further study is needed to use a more diverse socioeconomic group and investigation how specifically the artistic process connects to resilience. This study highlighted the possibility that the arts might be a source of resilience, as they might address expression and self-investigation. However, this study did not measure other resilience factors, seen in Braga’s (2012) study, which could have deepened the results (Diamond & Shrira, 2018).
Knowing how collective trauma can become a central organizing event in one’s identity, in a recent study, Greenblatt-Kimron et al. (2021) studied the influence of event centrality and secondary traumatization on 2G and 3G. The authors stated that the repercussions of parental PTSD included psychobiological vulnerability, internalizing and behavioral problems as well as compromised hypothalamic-pituitary-adrenal function. Greenblatt-Kimron et al. (2021) were coming from the premise that although transmission of trauma related to the holocaust to other generations has been debated it also has been shown to affect offspring cortisol levels which could affect one’s vulnerability when coping with life-threatening situations. In this study, Greenblatt-Kimron et al. attempted to understand if the collective trauma of Holocaust survivors was integrated into one’s identity and life story as an event centrality due to transgenerational trauma. Also, another point of interest was secondary trauma, defined as being affected by the trauma of another person without direct exposure, which was present in 2G and 3G. According to previous studies, there was a general vulnerability to 2G due to one’s biology and also due to nonverbal communication and having a parent that was numb or emotionally detached. Coming from these premises, the study sampled 92 Holocaust G1-G2 and G3 triads and 67 comparison groups, which came from countries not occupied by the Nazi regime but were of Western European descent (Greenblatt-Kimron et al. 2021). All participants could speak Hebrew and live in Israel. For this study, background measurement was taken, including medical conditions. A two-item difficult life event was asked only to G1, which included the event and second a small description. PTSD Checklist for DSM-5 and a short version of the centrality of event scale was used for all participants, and an 18-item measure assessment symptoms from DSM-4 of secondary traumatization due to exposure was conducted to G2 and G3. Results showed a direct effect from G1 to G3 on the Holocaust survivor sample versus the comparison group. It is also important to state that Holocaust G1 showed higher PTSD than the G1 comparison sample. Furthermore, there was higher secondary traumatization to Holocaust G2 and both higher secondary traumatization and event centrality on G3. Greenblatt-Kimron et al. speculated that the higher event centrality on G3 has to do with the collective experience of the social climate at the time which had to do with events that created a pride of being part of collective memory and Israeli identity, versus shame and silence that 2G experienced. Furthermore, medical conditions seem to be repeated on G2 and therefore less successful aging among Holocaust G2. This study concluded that TGT created the identity to the event centrality and not vice-versa.
In summary, parents who survived trauma can affect children in a resilient way or, due to biological and environmental stressors, in a way that makes them vulnerable to PTSD, psychopathology, and a lifetime of depression (Braga, 2012). In TGT, there is often a lack of communication about history alongside the development of mistrust in the community, which yields feelings of guilt, fear, poor self-esteem, victimization, and submission within the family (Bezo & Maggi, 2015; Giladi & Bell, 2013). Resilience, on the other hand, shows up in humor, use of art, pride, and social support (Braga et al., 2012; Diamond et al. 2018). Lastly, it seems that just the sheer exposure to traumatic events could cause TGT in 2G and 3G (Yehuda & Halligan, 2001). Greenblatt-Kimron et al.’s (2021) study proposed that the time of the generation and what is happening to that population might affect how TGT manifests on each generation, where event centrality and identity is reinforced. Nevertheless, there is a controversy if TGT studies reliability as it could be the issue of early attachment style (Bar-On et al., 1998).