Study: PTSD Survivors Children May Have Genetic Scars – TIME.
The above article by Jeffrey Kluger over at Time.com talks about research that suggests that the transgenerational transmission of trauma may leave a genetic trace. The researchers thought that this finding was rather important because it may shed light on the mechanism that apparently has allowed trauma experienced by first generation Holocaust survivors to be passed on to their kids and even their grandkids. The researchers used mice as a part of their experimental design, which would have pleased Bowlby no end because of his keen interest in ethology (e.g., animal studies). Bowlby was also very interested in how trauma—especially relational trauma—was passed on from one generation to the next. What Bowlby found (as have subsequent attachment researchers) is that the transgenerational transmission of trauma often leaves a psychological trace in the form of a particular attachment pattern, whether insecure anxious, insecure ambivalent, or even disorganized. Kluger mentions that up until recently, the only theory that was widely used to explain the transgenerational transmission of trauma was learning theory. Consider this passage from Kluger’s article:
Over the years, a large body of work has been devoted to studying PTSD [post traumatic stress disorder] symptoms in second-generation [Holocaust] survivors, and it has found signs of the condition in their behavior and even their blood—with higher levels of the stress hormone cortisol, for example. The assumption—a perfectly reasonable one—was always that these symptoms were essentially learned. Grow up with parents afflicted with the mood swings, irritability, jumpiness and hypervigilance typical of PTSD and you’re likely to wind up stressed and high-strung yourself.
I agree with Kluger that learning theory would be a reasonable way to go as far as explaining the transgenerational transmission of trauma. I also agree that there may be a genetic component associated with this process. But what troubles me is no mention of the work that has been done in this area that uses Bowlby’s attachment theory as a backdrop. (I’d be remiss if I did not mention that elevated cortisol levels have been linked to insecure patterns of attachment.) Allow me to try to rectify this oversight.
I was fortunate enough to attend a two-day attachment conference held in Salt Lake, Utah February 8–9 2006 at the Salt Lake Public Library. The conference was sponsored by The Children’s Center of Utah. I wrote an executive summary of this conference for the Foundation’s board and staff. Here’s an excerpt from that summary:
— begin excerpt —
Dr. Abraham Sagi-Schwartz got things rolling with a presentation entitled Holocaust Child Survivors and their Offspring: Vulnerability and Resilience. Dr. Sagi-Schwartz started his presentation by pointing out that Holocaust research is very difficult because of the nature of the material being studied. He said that it is imperative that such studies be carried out in a collaborative environment with much support from family, friends, and colleagues. Dr. Sagi-Schwartz and his colleagues looked at three generations of Holocaust survivors. The main focus of the study was to assess whether trauma could be transmitted from survivors to their offspring.
I won’t go into all the design features of the study. I will, however, mention that the study was designed to look at trauma along dimensions such as:
- direct exposure to murder of both parents
- terrifying methods of parental death
- no burial of loved ones
- survivor’s guilt for staying alive
- radical reversal of norms & values (e.g., children should not outlive parents)
- enduring anger for being left alone
- experiences perceived to be against the “natural laws of nature”
The researchers made telephone calls to 30,000 women living in Israel. They were looking for a study population that was of European origin, born between 1926 and 1937 (so that they would have been two and 13 years old during the war years of 1939 to 1945), has a daughter, and that daughter must have had a grandchild. The researchers were able to find 48 grandmothers, 48 mothers, and 48 grandchildren. Each of these groups was paired with a control group of equal size.
Dr. Sagi-Schwartz talked to us about the trauma dimension of “experiences perceived to be against the ‘natural laws of nature.’ ” The theme that trauma could result from experiences perceived to be against the natural laws of nature or against the natural order of things, popped up several times during the course of the conference. The study revealed that Holocaust survivors experienced their first major loss (the loss of both parents) at around the age of 10. The control group began experiencing their first major loss around age 40 to 45. Dr. Sagi-Schwartz pointed out that the control group experienced loss that is “normal for the cycle of life.” In contrast, Holocaust survivors experienced trauma that is abnormal for the cycle of life. Again, a child should not experience his or her parent’s death.
The study revealed that Holocaust survivors became less religious compared to the control group. Dr. Sagi-Schwartz explained this trend by telling us that the Holocaust survivors lost their belief in God because their tragedies were perceived to be against the natural order of things, the order God creates and maintains. Even though the study found elevated traumatic stress in the Grandmothers (60% “lack of resolution with respect to loss” (as revealed by the AAI or Adult Attachment Interview) as compared to 10% in the control group), the study found results that were startling:
- Grandmothers did well in their marital lives
- Grandmothers did well in caring for their offspring
- Grandmothers reported feeling good about their own wellbeing
When the researchers looked at the second generation, they found 25% “lack of resolution with respect to loss” as compared to 10% in the control group. By the third generation there was no discernable difference between the study group and the control group. In essence the study found that there was not appreciable levels of intergenerational transmission of trauma within this population of Holocaust survivors.
The researchers were a bit startled by the results of their study. So, they decided to do a meta-analysis of all the Holocaust studies that the researchers could find that used quantitative measures and a control group. The results of this meta-analysis did show modest intergenerational transmission of trauma within populations of Holocaust survivors. The researchers were a bit perplexed by the results until they began speculating on the types of life experiences that may have provided resilience and, ultimately, buffered the potentially destructive psychological effects of the traumatic events. The researchers arrived at the following list to explain the resilience and buffering that they discovered:
- social support
- genetic factors (e.g., children of Holocaust survivors may have inherited genes that protect against trauma reactions such as Post Traumatic Stress Disorder or PTSD)
- secure emotional infrastructure prior to the Holocaust
- trauma was perceived to be “external” (e.g., not inflicted on the children by parents or other trusted attachment figures, but, in fact, by anonymous and destructive social forces)
- a sense of strong collective national identity that resulted from being in Israel, a feeling of being in a place that is free of anti-Semitism
- search for meaning was encouraged (i.e., the work of Viktor Frankl)
- ability to form bonds with fellow survivors and construct collective story or narrative
- access to public Holocaust memorials
- continued strong bond with deceased parents, parents perceived to provide continuing spiritual support
Dr. Sagi-Schwartz told us that, in his opinion, it makes a big difference whether trauma comes from nature, say, an earthquake or flood, or from man as in a “manquake.” He continued by saying that the trauma events associated with the Holocaust produced a state of mind with respect to the “manquake of war.”
In talking about possible design flaws, Dr. Sagi-Schwartz pointed out that only people with families (multiple generations) were included in the study. He stated the obvious by telling us that you cannot easily assess transgenerational transmission of trauma in people who do not have offspring. Dr. Sagi-Schwartz said that family life in and of itself might provide a protective factor against the potentially destructive psychological effects of traumatic events. Dr. Sagi-Schwartz pointed out that attachment theory is a relational theory and not a trait theory. Dr. Sagi-Schwartz told us, “If you are exposed to a relationship that is more secure, it can change your Inner Working Model (IWM) of attachment.” He continued by stating that to use a relational theory one must consider ecological factors like family support, social support, national support, and even genetic factors (which could play a role in how we react to the environment).
At this point in his presentation Dr. Sagi-Schwartz took this question from the audience: “Why does transgenerational transmission of trauma seem to plague many Native American groups?” Dr. Sagi-Schwartz answered by suggesting that Native American groups may not have access to such ecological support systems like strong national identity, ability to openly tell their stories, memorials, feeling safe from persecution, and freedom from having to hide any reminders of historical oppression. The “conspiracy of silence” that often surrounds “manquake” trauma can have devastating psychological effects. This ties to Bowlby’s idea that family secrets can have a similar destructive psychological effect. Dr. Sagi-Schwartz said that in his opinion, the most important protective factor is the parent’s commitment to the child. The child is constantly asking the attachment question, “Is my parent or caregiver committed to me?” Family or social secrets tend to send the child the message that being committed to preserving the “conspiracy of silence” is more important than a commitment to the child.
— end excerpt —
To sum up, the transgenerational transmission of trauma can be looked at from a number of theoretical perspectives, such as learning theory, epigentics (e.g., “how genes change as a result of environmental factors,” quoting Kluger), and attachment theory. Depending on the theory used, interpretations and even therapeutic treatments may vary, often in dichotomous directions. As an example, the team of neurobiologists at the University of Zurich (who conducted the study Kluger talks about) view the genetic traces they discovered as playing a role in the transmission of trauma from one generation to the next. The theoretical implication here is that if these gene traces could be properly identified and changed, the transmission process could be disrupted. However, Dr. Sagi-Schwartz suggests that these genetic traces may actually play a role in providing protection “against trauma reactions such as Post Traumatic Stress Disorder or PTSD” (quoting Dr. Sagi-Schwartz from above). All this to say that theoretical models are themselves filters that allow us to entertain certain forms of information while blinding us to others. It appeared that the reductionistic theoretical model Kluger talked about—namely biological psychiatry—carried with it the potential to turn a blind eye toward the relational theoretical model of attachment and its focus on ecological factors like family support, social support, national support, and, yes, even genetic factors.
