Wednesday 13 April 2016

Transgenerational Trauma: A Northern Ireland Perspective

  

The child is born into a family which is the product of the operations of human beings already in this world.  It is a system mediated through sight, sound, taste, smell, touch, pain and pleasure, heat and cold, an ocean in which the child quickly learns to swim.
(R D Laing, 1971, p.11)


 
This essay will critically evaluate the mechanisms involved in the passing of trauma from parent to child using the various theories of the transmission of trauma: with a focus on the Northern Ireland perspective (concentrating on the impact of the ‘Troubles’); as well as international experiences (mainly, the long term effects of the Holocaust). 

Trauma, as a concept, is multicomplex and thus its impact can be experienced in various ways by individuals, by families, by communities, and by societies.  Summerfield (2000, p.232) posits that, ‘[t]here is no such thing as a universal response to highly stressful events’; while Douglass and Vogler (2003, p.10) assert that ‘[…] the pathogenic traumatic experience of one person is an interpretive construct that may not be shared in another, even in identical situations’. 

Herman (2001, p.33) characterises trauma as an affliction of the powerless in which the victim is rendered helpless by an overwhelming force: fundamentally altering the ‘systems of care that give people a sense of control, connection and meaning’.  Auerhahn and Laub (1998, p.22) describe how a ‘massive psychic trauma [can] shape the internal representations of reality’.  This is supported by Van der Kolk and McFarlane (1996, p.6) who state that, ‘[...] the core issue of trauma is reality’ and that the ‘meaning [attached] to the [trauma] is as fundamental as the trauma itself: leading to an inability to ‘integrate the reality’, resulting in a ‘repetitive replaying of the trauma’.  Douglass and Vogler (2003, p.42) summarised Freud’s speculation that in cases where the traumatic event is so extreme one does not in fact experience it - i.e. it is ‘not integrated mentally and emotionally into one’s sense of being’.

There may be positive effects after trauma, such as Post Traumatic Growth, but the majority of trauma literature focuses on the negative (Tedeschi and Calhoun, 1996).  This essay will concentrate on the negative effects and psychopathology of traumatic experiences and how these effects may potentially be ‘passed’ to the offspring of those who were initially affected (Weingarten, 2004, p.45).  There are multiple models put forward to explain transmission but due to space this essay will analyse the psychodynamic, sociocultural and family systems theories.

Research into the sequelae of the Holocaust brought the conceptual framework of Transgenerational Trauma (TGT) transmission to the fore.  Weingarten (2004, p.49) posits that the offspring of traumatised people act as witnesses to their parents experiences while stating that it is not the trauma itself that is passed, but ‘its impact’; or as Lev-Wiesel (2007, p.76) puts it: ‘its contagion’.  Herman (2001, p.2) states that, ‘[w]itnesses as well as victims are subject to the dialectic of trauma’.  The DSM-V-TR (American Psychological Association, 2013, p.271) criteria categorises repeated or extreme indirect exposure to ‘aversive details of the event[s] [as a stressor for PTSD diagnosis, usually in the course of professional duties]’This criterion omits offspring, begging the question: Why?  Why are children, who face similar exposure, around the clock, not considered to be affected in the same way as professionals?

Kellerman (2001, p.257), who concentrated on the long term effects of the Holocaust, presents an integrative model to demonstrate how trauma is transmitted and characterises the ‘process’ as a ‘functional relationship’.  This ‘content’ of this relationship can manifest itself in a way that has an adverse pathological effect on the offspring of survivors (Ibid., p.257).  The child is liable to experience problems with: (1) ‘Self’, which would impair ‘self-esteem’ and ‘identity’ development; (2) ‘Cognition’, promoting ‘[c]atastrophic expectancy and ‘stress upon exposure’ [to disturbing] ‘stimuli’; (3) ‘Affectivity’, ‘[a]nnihilation, anxiety, nightmares’ [and] ‘unresolved conflicts around anger complicated by guilt’; and (4) ‘Interpersonal functioning’, involving ‘[e]xaggerated family attachments and dependency or exaggerated independence’ [which may hamper] ‘intimate relationships and the ‘handling [of] interpersonal conflicts’ (Ibid., p.259).  McKenna (2015, p.40) postulates ‘that the children of victims are at an increased risk of experiencing toxic stress’: which has been defined by Shonkoff et al. (2009, p.360) as the ‘strong, frequent, and/or prolonged activation of the body’s stress response’.

Kellerman (2001) puts forward four major theoretical models for the transmission of TGT: Psychodynamic; Sociocultural; Family Systems; and Biological.  Downes et al. (2012, pp. 584-586), who researched families bereaved during the conflict in Northern Ireland, summarise similar approaches including: stress-vulnerability models (in which ‘increased vulnerability to develop psychopathology is [...] transmitted’ [emphasis in the original]); transmission of psychopathology (whereby ‘the parental trauma in itself is not transmitted, but rather that the parental psychopathology is the factor that influences the children’ [emphasis in the original]); genetic and physiological explanations (which posits that the stressor is ‘transmitted physiologically’ to the offspring); social psychological/parenting perspectives (which focuses on ‘social learning and effects on parenting’); psychodynamic theories (through transposition; overidentification; role reversal; and attachment problems); and family system approaches (with a focus on ‘particular interpersonal patterns present in families’).  Hanna et al. (2012) encapsulate a phenomenon of poor psychological functioning in children which may stem from the impact of trauma experienced by their caregivers, leading to a deficit in optimal interactions.

While some of these models may be discrete, others are more intertwined and connected.  Kellerman (2001) argues that any or all of the manifestations of trauma transmission can be determinants.  Weingarten (2004, p.49) echoes this line stating that ‘no mechanism alone is the answer to how trauma passes; none is incontrovertible; and none can be easily separated from the others’ [emphasis in the original].

The psychodynamic model of transmission, according to Kellerman (2001, p. 260), comes from the psychoanalytic tradition where ‘repressed, [unresolved], and insufficiently dealt with’ emotions within the primary victims are passed over to the next generation through unconscious ‘absorption’: which Hesse and Van IJzendoorn (1998, p.304) purport as having the potential to lead to ‘substantial alterations in consciousness’.  According to Volkan (1997, in Kellerman, 2001, p.260) the elder ‘unconsciously externalizes his traumatized self onto the developing child’s personality’: an influence that the child cannot repel; thus it becomes the child’s ‘task, [to] mourn, to reverse the humiliation [and shame]’ [emphasis added].  Lev-Wiesel (2007, p.90) also recognises this dynamic, in that, the 2nd generation were expected to repay a ‘debt […] for the suffering of the 1st generation [Holocaust survivors]’: it became their life’s ‘mission’.  A recent full page advertisement from a local victim-centred NGO in one of the main newspapers in Northern Ireland (The Irish News) echoes this mission mentality being placed upon subsequent generations, to perpetually seek truth and justice for human rights violations, by stating that, ‘[The UK] Government is waiting for us to die off but our families will not go away’ (News Letter, 2015).

Rowland-Klein and Dunlop’s (1997, p. 366-367) Holocaust research identifies this ‘intimate, intrapsychic, and unconscious’ process in the form of ‘projective identification’: in which the parents attempt to self-heal through the children, who reciprocate ‘despite the cost to themselves’; and ‘whereby the parent splits off the unwanted part of the self, which is projected into the child, and internalised by it; becoming [Kleinian] ‘containers’ for the parent [emphasis added].  DeGraaf (1998, in Downes et al., 2012, p. 585) describes a ’bad child’ within the parent being externalised through ‘anger, rage, sadness disappointment and grief onto their child’ [emphasis added].  Themes that arose in Rowland-Klein and Dunlop’s (1997, pp. 366-367) research included ‘overidentification’ and ‘re-enactment’ which involved the child placing itself in an analogous situation to the parent where they would try to find meaning and ‘share the suffering’, in a process of ‘introjection’ and ‘transposition’. 

Overidentification and overprotectiveness are evident when children display similar traits to the parents such as hypervigilance and a pervasive mistrust of others; in which the world is a dangerous place and the family is the only safe haven (Danieli, 1985).  Rowland-Klein and Dunlop, (1997, p.367) posit that this can compromise the child’s ‘own sense of security’.  This observation is corroborated by Black’s (2004, p.104) research into the children of police officers in Northern Ireland, in which ‘[the children] may develop anxiety regarding their parent’s or their own safety’.  The child becomes enmeshed in the reality of the parent in a ‘symbiotic’ relationship; boundaries are blurred; role reversal occurs (‘parental child [vs] adult child’); potentially leaving the child with problems around ‘separation’, ‘individuation’ and ‘autonomy’ (Freyberg, 1980, p.90; Rowland-Klein and Dunlop, 1997, p.366; Downes et al., 2012, p.593).  This type of relationship can be detrimental to both parent and child as they may become entwined in what Karpman (1968) has described as ‘The Drama Triangle’.

Kellerman (2001, p.261) shone a light on the ‘sociocultural and socialization models of transmission’ in which it is postulated that social norms and beliefs are passed down from ‘generation to generation’; whereby children ‘form their own images through their parents’ childrearing behaviour’.  This contrasts with psychodynamic theories of the unconscious to more direct and conscious learning.  In Holocaust literature, according to Kellerman (2001, p.261) survivor parents have been described as ‘inadequate’: as their extreme suffering was ‘assumed to create child-rearing problems around both attachment and detachment’.  Difficulties with attachment have been posited as a prominent conceptual framework for the transmission of TGT (Liotti, 1992; Bar-on et al., 1998; Kellerman, 2001; Downes et al., 2012; McKenna, 2015).  Attachment is a psychological model which describes the bonds and interactions between a young child and its primary caregiver and it is believed to be an important determinant of the child’s successful social and emotional development (Commission for Victims and Survivors, 2015, p.23).  Bowlby (1982) describes how we are born with a strong tendency to seek care, help, and comfort in times of danger or when suffering from physical or emotional stress.  Bar-on et al. (1998, p.318) assert that ‘[...] a primary function of attachment relationships is to serve as a source of security [...] in situations that induce fear or anxiety’.  Ideally, in an optimal relationship, the caregiver gives a positive response to the child: problems arise when a negative response is offered.  These problems may manifest in children as ‘disorganised’ or ‘insecure-ambivalent and preoccupied attachment strateg[ies]’, which could lead to an increased vulnerability to ‘dissociative disorders’ (Liotti, 1992, p.196; Bar-on et al., 1998, p.330).

McKenna (2015, p.37) asserts that ‘parental trauma exposures interfere with interaction patterns within families’.  Bar-on et al. (1998, p.319) postulate that ‘parents who are unable to monitor their discourse and thoughts [around traumatic experiences] appear to have children who show a lack of consistent attachment strategy’; adding that it is the ‘lack of successful coping, rather than the loss/trauma per se that contributed to this relation’.  Main and Hesse (1990, in Bar-on et al., 1998, p.320) propose that this ‘lack of resolution [...] is characterised by parental fear [...] perceived by the child as being either a frightened model or as directly frightening the child’; and that the attachment figure is ‘at once the source and the solution of the infant’s alarm, and this leads to a paradox of fright without solution’. 

McKenna (2015) posits that communication within families can be a detrimental determinant of TGT transmission.  McNally (2014, p.32) asserted that traumatic experiences could lead to the development of ‘unhealthy methods of communication’ within the family: ranging ‘from silence to intrusive attempts to discuss the events and imposing their interpretations [onto their children]’.  This type of communication can be either intentional or unintentional: verbal or non-verbal (McNally, 2014).  Bergman and Jucovy (1982) signal the importance of how the narrative of the trauma is relayed to children, in what spirit, or whether the information is used to educate or employed as a threat. 

Danieli (1985, p.298) highlights this ‘Conspiracy of Silence’ as a major factor in the transmission of TGT.  The problems with a frightening narrative explained above are seen in contrast to how silence around trauma can be even more insidious to the next generation.  Many of the families who survived trauma employed silence as a way of coping with their extreme experiences; and also to protect their children.  Their Holocaust experiences were too horrifying to recount; there were no words; they were dealing with feelings of shame and guilt; and at the same time their audience could not or would not listen to or believe them: which led to problems with intrapsychic integration and healing (Ibid.).  Nevertheless, many of their offspring ‘attested to the constant psychological presence of the Holocaust at home, verbally and nonverbally [and] reported having absorbed the omnipresent experience [...] through osmosis’ (Ibid., p.299). 

However, Bar-on et al., (1998, p.331) stress that the conspiracy of silence ‘cannot be total’.  The offspring may hear partial facts and use their imagination to complete the narrative which may result in a more pervasive interpretation; where the ‘made-up story may be even more frightening than the real one’ (Dekel and Goldblatt, 2008, p.285).  They are left with an emotional story without an actual narrative to make sense of it.  Bar-on (1995, in Bar-on et al., 1998, p.326) asserted that, ‘the “untold story” of the past was [transmitted] with greater intensity [...] than the “told” story’; and that the children became sensitive to their parents’ need to keep silent responding with a “double wall”: [t]he parents did not tell and the children did not ask’. 

Danieli (1985, pp.299-304) described four categories of post-Holocaust survivor families to give a sense of the systems they employed: (1) Victim families (characterised by a victim identity, pervasive depression, worry, mistrust, fear of the outside world, and symbiotic clinging); (2) Fighter families (characterised by an ‘intense drive to build and achieve’, mistrust, overinvolvement and overprotectiveness, contemptuous of dependency on others); (3) Numb families (characterised by ‘pervasive silence and depletion of all emotions’, role reversal, children grew up on their own and taught themselves how to live); an observation supported by Becker and Diaz (1998) who argue that such children had to mature rapidly in order to become protectors of their parents; and (4) Families of ‘those who made it’ (characterised by a ‘desire to make it big’, children were emotionally neglected, denial of impact of Holocaust).  All of these families have a commonality in that the past is ‘taboo, excluded from open discussion, [which] cannot then become [an integrated] history (Becker and Weyermann (2006, p.28).

Downes et al. (2012, pp.590-595) located this theme in their research of families affected by the NI conflict: whereby families hid ‘aspects of the traumatic experiences and engage[d] in cognitive and affective avoidance’; where the ‘unspoken’ was prevalent; and the children ‘invented [their] own explanations; a place where the ‘truth [was] dangerous’; where facts were ‘hidden but not hidden’; where the children attempted to ‘block out their feeling for fear of the consequences; upon which one child developed the ‘propensity to be the “good girl” [in] a conscious attempt to avoid causing her own mother any more stress’.  This echoes Dekel and Goldblatt’s (2008, p.285) observations where ‘sensitive subjects are avoided’ to prevent the intensification of stress. 

In conclusion, it becomes clear from the evidence that there is a case to be made for the existence of mechanisms which may pass trauma from one generation to the next; and in certain cases to subsequent unborn generations. However, they are not mutually exclusive and they may not always pass on pathological consequences.  There can be recovery; missions can be accomplished; and growth can occur. 

The main focus of this essay was concerned with transmission inside families however wider society and political responses can have a profound effect on traumatic sequelae (Becker, 2004; McNally, 2014).  From this comes a view that trauma is a biopsychosocial issue that should not be seen through a purely pathological diagnostic lens; ‘in which the basic focus is not so much on the symptoms […] but on the sequential development of the traumatic situation’ (Becker, 2004, p.6).  This point is echoed by McNally (2014) who argues that TGT should not be given a clear diagnostic criterion as this may steer any responses firmly in the direction of the medical model to the detriment of other treatment modalities, and of the individuals and families themselves.  Until the wider issues, that pervade societies affected by protracted conflict, violence, and trauma, are addressed the chances of seriously dealing with the long term legacy of traumatised families are diminished.

 References

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