Intergenerational Trauma: The Ghosts of Times Past (4 page)

Native Americans also differ from the Holocaust survivors due to the loss of their culture and the destruction of the family unit in the case of Native Americans. Jewish individuals typically have strong family ties and bonds to their heritage. After World War II, the state of Israel was founded in 1947 which served to mitigate some of the effects of the Holocaust had upon individuals of Jewish heritage. This strengthened the bonds of many Holocaust survivors to their heritage and strengthened the family unit. As a result of strong family units, substance abuse, alcohol abuse, and crime rates among Jewish populations has traditionally been lower than those of non-Jewish populations. The family connections served as a buffer to some of the pronounced effects of PTSD symptoms such as self-treatment of symptoms through substance abuse.

In the case of Native Americans, the family unit was severely impacted by the assimilation efforts that occurred during the board school era. As a result, the family ties and connections to one’s heritage were severed. Instead of creating higher levels of ethical behavior, the board schools did the opposite. As a result, substance abuse, alcohol abuse, and crime rates have been disproportionately higher among Native American populations. As a result of the separation of younger generations from the cultural ties, many individuals have reduced resilience in addition to a predisposition to anxiety-related symptoms. When the younger generations become adults, they are left with minimal coping skills to deal with psychological stressors. In order to manage the stress and the body’s reaction to stress, many individuals will then self-treat through substance abuse and alcohol abuse due to a lack of resources available to them.              

When the younger generation has children, their children will then learn maladaptive coping skills for stress from the parents and will also be genetically more vulnerable to trauma-related symptoms much like the children of Holocaust survivors. In Native Americans, the impacts of intergenerational trauma create a vicious cycle and become imbedded into the culture of the Native American people. This process leads to very pronounced prejudice towards individuals that are outside of their cultural group along with an avoidance to seeking treatment.

In the case of Native Americans, it is easy to see why they would avoid outsiders and treatment when taking into consideration how history is passed along in their culture. Native Americans have traditionally passed their history along in narrative form. Many cultures do this, but it is highly pronounced in Native American culture. Basically, the older generation will tell stories of how things were when they were young to the younger generations. The stories will be passed along from one generation to the next by storytelling. This form of relaying tales across generations has been essential to the development of civilizations, agriculture, science, and people’s general way of life. It is how younger generations learn how to explicitly do things and explicitly learn about the world they may not have been able to observe. It is a way to learn about danger without being exposed to it and to learn about things that benefit them without having to commit trial and error work experiencing losses along the way.

Storytelling also plays a part in the transmission of intergenerational trauma. Researchers have found that silence about the trauma between family members and nostalgia contributed to the effects of the trauma. Nostalgia served to define to the younger generations how life was so drastically changed by the traumatic events of the past. Grandparents tell stories to grandchildren about how much better life was before the traumatic event and reflect that things were never the same after. Since all the children know is what life is like after the trauma, they assume a role of individuals that were directly affected by the traumatic events even though they never personally experienced the events.

Through interviews, researchers have noted that younger generations responded to the older generations when discussing the trauma as if they experienced the events themselves also. The best example was given when one of the children of a survivor answered questions about the survivor asked about events that occurred during the trauma, which happened before the younger individual was born. The traumatic events were discussed among family members rarely. The scarcity of the stories of trauma enriches the stories with a sense of novelty. The elders mentioned the stories only a few times to the younger generation so that the silence between the times that it is discussed strengthens the traumatic events and provides a connection for the younger generation to the events. The younger generation is often referred to as a “hinge” generation that is not yet free from the effects of the trauma but still a step toward making the trauma a notable history of their culture. In the case of Native Americans, there have been several “hinge” generations that have attempted to mitigate the long standing effects of trauma from prior generations.

This research serves to show how storytelling between generations serves to provide a tie between the recent generations and the current generation so that the scars of a specific trauma carry on through history. This shows how that intergenerational transmission serves to display how severe a traumatic occurrence is based upon how relevant the experience feels for proceeding generations. The effect of the trauma can be seen also by the way that younger generations also see the trauma as separating them from the nostalgia of the past that is magnified by silence. 

By looking at the impacts that intergenerational trauma has had on Native Americans, one can note the impacts have been long standing and deeply impacted the entire culture of the people. In more recent generations, attempts have been made to mitigate the impacts of the numerous events that have impacted many prior generations. Even though positive steps have been made in the direction of change through new policies and concessions to make up for the impacts of historically significant trauma, there is still a long ways to go in addressing the issues that have built up over time.

         The treatment of trauma-related disorders has a long history, but the evidence-based treatment of these disorders is a relatively new thing. Post-Traumatic Stress Disorder (PTSD) is nowadays the most commonly and widely known disorder related to trauma. PTSD, however, was not recognized as a diagnosable disorder until 1980 in adults and was not recognized in children until 1987. The treatment of PTSD has had a long and dark history. Over the years, the stigmas and misconceptions have waned over time to give way to more effective treatments, but many of the historical treatments of trauma related disorders tended to cause additional trauma that has led many individuals to be cautious of seeking help. The effects of historical treatments for trauma-related disorders in creating barriers to treatment is often seen as having similarities to how Intergenerational Trauma occurs.

One of the earliest noted treatments for trauma was around 2000 BC when tribes in modern-day Russia ingested poisonous mushrooms to counteract symptoms similar to PTSD-like symptoms. The mushrooms produced a euphoric state with delusions, which replace the fear and dread that is normally experienced during PTSD-related flashbacks. The ancient Greeks told trauma victims to get married to help with their PTSD and anxiety-related symptoms. The Vikings drank deer urine to help cope with symptoms. During the middle ages, Europeans attempt to purge the body of PTSD symptoms by taking laxatives. The Inca of South America were found to chew on Coca leaves to overcome their combat-related anxiety.

During the nineteenth century, a few treatments began to emerge that resembled modern treatments for PTSD and trauma-related disorders. In Japan, Dr. Genyu Imaizumi developed an approach to treating anxiety called persuasion therapy during the 1850s. The approach was fundamentally similar to modern Cognitive Behavior Therapy (CBT) and Rational Emotive Behavioral Therapy (REBT). Rest Therapy was an approach developed during the American Civil War that consisted of bed rest, a milk diet, massage, and electrical shock. Rest therapy, therefore, served as one of the earliest treatment to utilize electricity for the treatment of anxiety. Psychiatric medications, such as Potassium Bromide, were developed to treat individuals suffering from trauma-related disorders and anxiety disorders. Potassium Bromide was the forerunner of Barbital and Phenobarbital. During the late nineteenth century, early forms of psychotherapy emerged in Europe as treatments for PTSD symptoms.

During the early to mid-twentieth century, a variety of treatments for PTSD emerged that could be seen as highly questionable today. The questionable approaches can be seen as stemming from the denial of PTSD as a legitimate condition during those time periods. During World War I, common practices included the use of tranquilizers, placebos, and the surgical implantation of metal balls in the larynx of soldiers. The tranquilizers were used by the Russians and served to make the soldiers functional enough to return to the front lines with little to no resolution to the soldier’s symptoms. The placebos were used to make the soldiers think that they were getting treatment when they were not receiving any
treatment. The metal balls placed in the larynx did nothing more than allow the soldiers to make sounds when they attempted to scream in terror from flashbacks.

During World War II, the stigma of PTSD being experienced only by weak individuals was still present, but the increasing psychological causalities brought attention to the condition as being something more than a symptom of being weak. During the war, several clinicians attempted to treat anxiety using a variety of approaches. Captain Joseph Campbell, a military doctor, treated
patients with an approach including rest, work, and a form of brief psychoanalysis. Meanwhile, others used a mixture of hypnosis, drugs, and cathartic reliving of traumatic experiences.

During the 1950s, several psychotherapeutic interventions were develop to advance the treatment of trauma-related disorders. One of the most notable treatments was Systematic Desensitization. This therapeutic approach is based off of research in the study of learning and behavioral theory. What that basically means is that the approach is based off research in how people learn and how their behavior is driven by learning new things to replace old things. It is fairly simple practice and is at the basis for many PTSD treatments today. Systematic Desensitization allows one to rewire the brain by learning new things.

              This treatment consists of three steps. First, one must identify the item that causes the anxiety. In the case of trauma-related disorders, the items that cause anxiety is referred to as triggers. Individuals who suffer from these disorders typically have multiple triggers. It is important to rank the triggers from least stressful to most stressful when identifying the triggers. The ranking of triggers will serve to help in determining the best approach for treatment in the later steps. Next, the individual learns techniques that are called coping strategies. These coping strategies are incompatible responses to the stress reactions. Examples of coping strategies include deep breathing, muscle relaxation, and various techniques that are typically producing a calming effect. In the final step, the anxiety producing item is then coupled with the coping technique. When coupling the anxiety producing items with the coping technique, it is best to start with the least stressful item and gradually work one’s way up to more stressful items. The process allows the individual to become more aware of how their body is responding to triggers. Overtime, the individual will have less and less pronounced reactions to the triggers until the symptoms are barely noticed. It is important to note that not always will the negative responses to triggers go away completely, but most often, the symptoms will diminish greatly over time thereby improving the individual’s quality of life.

              In most modern Systematic Desensitization programs, the process is broken down into ten steps. This steps are as follows:

1. Initial evaluation. This includes patient history, intake assessment, and explanation of how the therapy works.
   
2. Relaxation technique training. In this phase, the individual is educated on how to perform tasks such as deep breathing, progressive muscle relaxation, and the visualization of a peaceful place.
   
3. Overcoming negative self-talk. In this phase, the individual addresses their overestimations of negative outcomes and explores their ability to cope with stressors in order to develop a better understanding. Additionally, individuals will focus on restructuring negative talk into a more constructive thought process.
   
4. Anxiety coping skills phase. In the step, the individual comes to terms with their symptoms. They address how the symptoms will not completely vanish but that the individual will be better able to cope with symptoms.
   
5. Imagery desensitization. In this stage, individuals begin to couple coping strategies with stimuli by imagining their triggers and stressors while performing relaxation techniques. Mental exposure is typically done in one minute increments and is progressively increased overtime.
   
6. Exposure. During this phase, the individual temporarily enters a trigger-related situation in order to practice the breathing and relaxation techniques.
   

7-9. Exposure Practice phases. In these steps, the individual is exposed to their trigger in several scenarios involving real-life exposure. Initially, they are exposed with a support person, such as therapist, nearby. They will then discuss and address difficulties that may have occurred with the support person. This process is then repeated and continued until the individual is able to manage their triggers without the presence of a support person.

10. Follow-up. In the final step, the therapy is reviewed and summarized for the individual to help in understanding the process. Relapse prevention strategies are developed for the individual to have a plan in the event of a relapse, and the individual discusses closure regarding their treatment.

With regard to System Desensitization, there are several issues that many practitioners and therapist have voiced regarding this treatment. The main concern that most people have with this approach to treatment is that it does not address the underlying issues regarding the trauma. The trauma is effective in addressing the behaviors and manifestations of symptoms, but it does ignore the individual’s feelings and emotions regarding their triggers. In addition to this, Systematic Desensitization requires individuals to do a large amount of homework outside of the therapy sessions. As many therapists have experienced, clients often fail to do homework because it is time consuming, they lose motivation, or a myriad of other reasons. The homework can often be a significant amount of work in the case of many Systematic Desensitization programs. It is important to continually assess the client’s abilities throughout the treatment because pushing a client too hard in this therapy can cause substantial psychological damage and re-traumatization.

During the 1950s and 1960s, several approaches to treatment attempted to address the cognitive piece that was missing from Systematic Desensitization. Two of the most commonly used approaches were Rational Emotive Behavioral Therapy (REBT) and Cognitive Behavioral Therapy (CBT). These two approaches are some of the most commonly used approaches today for treating trauma-related disorders and can be helpful in addressing some of the issues involved with Intergenerational Trauma.

REBT can be easily understood by looking at the ABC model of trauma (activating event, belief, consequence). In addition to the ABC, there is a DEF portion of the model that contains the treatment piece of the model.
D
stands for “disputing or questioning the evidence”,
E
stands for “an effective new philosophy”, and
F
stands for “new feelings and behaviors.” Basically, what occurs in REBT is that a therapist will attempt to change the person’s belief associated with their trigger through presenting evidence and disputing the belief. Through a process of utilizing logic and argument, the individual will be able to tear down the dysfunctional belief system and replace it with a new belief system that produces less anxiety and stress.