Traumas: Bitter inheritance

“The past is never dead. It’s not even past. We separate ourselves from it and treat it like a stranger,” wrote Christa Wolf (1926-2011) in her semi-autobiographical novel Patterns of Childhood, published in 1976. What she is describing, in words partly borrowed from William Faulkner, is the massive injury to the psyche caused by terrible, overwhelming events during wartime and while fleeing conflict – and how this can affect a person their whole life and go on to harm the next generations.

Something heavy weighs down on the family and oppresses even children and children’s children. And for this to be the case, the younger generations do not actually have to know anything about the awful things that happened to their parents or grandparents, who may never have spoken about them. Indeed, they may be suffering because of this silence.

From today’s perspective, it is clear that the novelist is describing the phenomenon of transgenerational trauma. This refers to the transmission of an unprocessed traumatic experience to subsequent generations. Researchers at LMU are studying how this comes about and how the transmission can be broken.

People affected by transgenerational trauma can suffer from inexplicable sadness, full-blown depression, diffuse anxiety, panic attacks, sleeplessness, and physical symptoms. They torment themselves with unwarranted feelings of guilt, shame, and insecurity, or a permanent sense of being lost. In short, they have symptoms of a trauma-related disorder – without themselves having experienced the traumatic event. They have “inherited” the trauma, as it were.

If we want to understand how this can happen, first we need to appreciate how traumatization arises and what it can mean for those affected. An expert on this subject is Professor Thomas Ehring, Chair of Clinical Psychology and Psychological Treatment and Head of the Outpatient Treatment Center at LMU. “When psychologists speak of trauma, we mean an extreme event involving a threat to somebody’s life or injury or sexual violence,” says Ehring.

Such events include war and the attendant atrocities, natural disasters, serious accidents, killing sprees, abuse, cot death, or finding the body of a relative who has committed suicide. Often it involves a massive threat to one’s own life – or watching helplessly as the lives of others are extinguished. For example, helpers in crisis situations can be traumatized by their experiences.

When victims can no longer talk about what happened

Not everyone who experiences traumatic situations suffers long-term damage. In the world’s largest study of trauma-related disorders, 60 percent of US citizens surveyed said they had experienced at least one trauma in their lives. But only eight percent of men and twenty percent of women suffered from post-traumatic stress disorder (PTSD). “However, in the case of massive violence, and especially sexual trauma, the numbers of people who develop PTSD are higher,” adds Ehring.

Studies indicate there are certain genetic risk factors that affect the hormone system, for example, and make people more vulnerable to prolonged stress. “But social factors are also decisive,” says Ehring. “What happens to the victims after a traumatic experience? If they are well integrated socially, that’s a good protective factor. But if they’re left alone or repeatedly exposed to new stressors, this increases the risk of trauma-related disorders.” Another big problem is avoidance behavior – when victims of trauma avoid certain places or refuse to discuss certain topics for fear of being reminded of the terrible event. This also increases the risk of long-term effects.

This complexity is what makes the topic so fascinating for Ehring: “There are many factors, including external ones like social environment and wider society, that determine people’s reaction to traumas and trauma-related disorders. As such, we have many points of attack when it comes to intervention.” This applies to acute crisis intervention and to caring for people after a traumatizing event, both of which can help prevent PTSD from arising. “But we also have well studied and effective therapeutic methods for PTSD that has already developed,” says Ehring.

But for these to be of any use to traumatized people, first they have to recognize that they need help and seek it out. “The problem is that there’s a large number of undetected cases. And these people often get no help – or only once their symptoms have already become chronic and the condition is difficult to treat.”

Ghosts in the nursery

It is precisely here, in suppressed and untreated traumas, that the risk occurs of passing damage on to the next generation. Professor Corinna Reck is Head of the Clinical Psychology of Childhood and Adolescence & Counseling Psychology teaching and research unit and of the University Outpatient Clinic for Babies, Children, Adolescents, and (Expectant) Parents at LMU. She investigates how parents’ mental illnesses affect the mental health of their children. “Various mechanisms, biological and psychological, are at play in the transmission of mental illnesses to the next generation,” says Reck. “Specifically for trauma-related disorders and PTSD, there are numerous studies indicating that epigenetic changes play a role.”

These are chemical modifications which regulate whether and to what extent a certain gene is read. These changes then affect things like how the body responds to stress hormones. “We’re interested in the psychological view – that is to say, how the behavior of sufferers affects their descendants, because that is something we can positively influence,” says Reck. She is convinced that the first months of life are particularly important for the transgenerational transmission of traumatic experiences.

The reason for this is the behavior of the traumatized parents, which affects the development of the child. In this regard, the psychoanalyst Selma Fraiberg (1918-1981) spoke of “Ghosts in the Nursery.” An extreme case might be a traumatized father who was abused by his own father and then passes down this behavior by beating his children.

Often, though, the ghosts that torment the parents are much subtler, such as when a traumatized parent adopts an emotional or actual distance in order to protect the child. The trouble here is that babies need contact with their attachment figures. And they respond sensitively when they cannot establish it – when parents are emotionally unavailable, say, due to their traumatic past.

This was demonstrated by an experiment conducted by researchers in the United States in the 1970s. Babies seek contact via the animated facial expressions of mother and father. If a parent freezes these expressions for just a few minutes, healthy infants become irritated. They begin to protest until contact has been re-established – or failing this, they move their gaze away from the inaccessible person. These frozen facial gestures are common in people with trauma-related disorders, and their babies take the reduced contact quality to be the normal state of affairs.

Connecting with one’s own emotions

People with trauma-related disorders often find it hard to feel and express their own emotions. Moreover, they find it difficult and stressful to read the emotions of others. This affects their interactions with their children – and does so from day one, as parents cannot appropriately address the child’s needs. They can act in an impulsive or even hostile manner, for example, because they perceive the baby’s screaming as an attack on their own person. Or because the physical closeness the infant demands feels threatening to the traumatized parent. Temporary interruptions in human contact repeatedly occur. As a result, the baby’s ability to form healthy interpersonal connections can be impaired from the beginning.

“With some children, we observe behavioral indicators from an early age,” says Reck. “Even in one-year-old babies, we can see they’re suffering from stress.” The children are hypersensitive to the moods of their attachment figures and therefore cannot explore their environment in the same carefree and playful manner as their peers.

Promoting the parent-child relationship

But how can this vicious cycle be broken? Corinna Reck and her team work with affected parents and their babies in the University Outpatient Clinic. Often, young families come to the clinic because the mother, for example, is diagnosed with postnatal depression. Or because they feel completely overwhelmed. “Usually, impaired attachment behavior, as is common in people with trauma-related disorders, can still be functional within the couple’s relationship,” says Reck. Oftentimes, this is because people with similar, often avoidant, attachment styles tend to pair up. “But as soon as a baby, with its natural need for closeness, comes on the scene, the system becomes unstable.”

To support the parent-child relationship, Reck employs an integrative approach with body-therapy elements. Based on the work of the American psychologist George Downing, this approach is built on the idea that experiences are saved not only as words or images in the brain, but also as body memories. When therapeutic work integrates the body level, it gives better access not only to the problems, but also the resources of the patients.

Overwriting the experience

For example, Reck gets a mother who feels threatened by physical contact to carry her child in her arms. How does it feel? She then prompts the mother – first, without the child – to picture herself in a situation in which she feels well and relaxed. Reck encourages her to feel exactly where and how this sense of security manifests in her body. The mother tries to imagine this sensation in her body, and then picks up her child again. This method, Reck’s research demonstrates, makes the mother more aware of her own tension and better able to regulate it, which in turn facilitates more sensitively attuned interactions with her baby.

The best protection for the next generation, however, is to not let things come to this pass in the first place. Unprocessed traumas in particular can manifest in trauma-related disorders and can be passed down unfiltered to the next generation. The best way of protecting one’s offspring is therefore to break the silence and get treatment for an existing trauma. “In therapy, there’s no way around confronting the memory of the trauma, as unpleasant and stressful as this is for patients,” says Thomas Ehring. After all, a trauma-related disorder arises when the brain is unable to process what the person has experienced. To integrate the event, the story has to be relived in the person’s memory and placed in a new context – “I’m safe now.”

Ehring and his team carry out therapy research to further improve the available methods. Among other things, he is interested in how “rescripting” – the conscious overwriting of the experience – can help people process trauma. “This involves retrieving the memory and then, instead of just repeating it as in confrontational therapy, the script is changed and the patient experiences in their imagination that somebody arrives to help them, overpowers the perpetrator, and protects and cares for the child,” says Ehring. In his studies, he has shown that this method can help not only strengthen the perceived self-efficacy of patients, but also dismantle feelings of shame. “What we don’t yet know, however, is whether and to what extent rescripting can interfere with the memory of the facts of the event,” says Ehring. This would be problematic, say, if a violent act is to be prosecuted in court. Ehring and his team are currently investigating this question.

But whether a victim is trying to obtain some measure of justice in court, or processing their trauma for their mental health, confronting the trauma is essential to resolve it. In Christa Wolf’s novel, this process plays out as follows: Her protagonist returns to the place of her childhood, where memories are awakened. This breaks the silence – the self-imposed one and the one expected by society – and thus effects a decisive step toward healing.

Prof. Dr. Corinna Reck is Head of the Clinical Psychology of Childhood and Adolescence & Counseling Psychology teaching and research unit and of the University Outpatient Clinic for Babies, Children, Adolescents, and (Expectant) Parents at LMU. Born in 1964, Reck studied psychology at Philipps University Marburg and completed her doctorate at Heidelberg University. She worked as a research associate, and later as senior psychologist, at Heidelberg University Hospital, where she also obtained her habilitation degree. In 2013, she took up an appointment at LMU. In addition, she undertook training to become a psychological psychotherapist at the Center for Psychological Psychotherapy (ZPP) in Heidelberg, obtaining her license in 2019. She also completed training in fields such as body-oriented psychotherapy and video intervention therapy according to the methods of George Downing.

Prof. Dr. Thomas Ehring is Chair of Clinical Psychology and Psychological Treatment and Head of the Outpatient Treatment Center at LMU. Born in 1973, Ehring studied psychology at the Universities of Mainz and Hamburg. Subsequently, he completed his doctorate at King’s College London and worked as a research assistant at Bielefeld University. After that, he was Assistant Professor at the University of Amsterdam. In the meantime, he trained to become a psychological psychotherapist at the Institute for Psychological Psychotherapy Training at the University of Münster, obtaining the corresponding license. Ehring was Professor of Clinical Psychology at the University of Münster before coming to LMU in 2015.

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