How today’s trauma can affect future generations – and how to stop it

We are currently living through a confluence of mass trauma events: a global pandemic; oppressive forces of white supremacy; a dangerously partisan political environment; an escalating climate crisis. Mounting evidence suggests that once some of these disasters ebb, the trauma they have inflicted can have lingering effects, even on future generations.

In other words, the current and future offspring of people living through today’s panoply of horrors may well suffer from it even without their own memories of events.

In the United States alone, 23.2 million people have been diagnosed with COVID-19, and more than 385,000 people have died from it, making it the country with the highest number of deaths worldwide, growing daily.

On top of that, the past year has seen multiple killings of Black people by police, leading to historically large and widespread protests against the ongoing legacies of racism in America, generations of racism brought to bear.

Undergirding all this is an ever-escalating climate crisis that wreaked extreme storm damage across the gulf just as COVID made it dangerous to house climate refugees en masse.

The trauma risks to frontline workers, especially healthcare workers during COVID, have already been documented. But the effects 2020 will have on the rest of us are still playing out, and research suggests that those effects may echo far beyond the current generation.

Past studies have indicated an association between parental PTSD and secondary trauma in offspring of refugees, torture victims, and combat veterans, among others.

There is growing recognition in psychology of secondary trauma, where a person experiences post-traumatic stress disorder symptoms via proximity to someone else’s harrowing experience. That is, you don’t need to experience a potentially traumatic event directly to suffer psychological symptoms from it, because learning about terrible things happening to loved ones can trigger reactions akin to experiencing it first-hand. Past studies have indicated an association between parental PTSD and secondary trauma in offspring of refugees (Sangalang & Vang, 2017), torture victims (Daud et al., 2005), and combat veterans (Dekel & Goldblatt, 2008; O’Tool et al., 2016), among others.

In other words, the current and future offspring of people living through today’s panoply of horrors may well suffer from it even without their own memories of events.

A recent research paper published in Traumatology further supports the grim notion that traumas have the potential to affect the children of those who have survived them (Payne & Berle, 2020). The paper is a meta-analysis -- the study of multiple research papers at once, looking for larger trends across data sets -- of prior studies on PTSD in children and grandchildren of Holocaust survivors. The researchers found that children, but not grandchildren, of survivors are more likely than the general population to display trauma symptoms.

It’s unclear how trauma is passed from one generation to the next. Trauma could be hereditary, perhaps through stress hormones, or children may internalize their parents’ trauma through observing behavioral and emotional patterns. Trauma may even be passed down through how parents communicate or interact with their kids. The authors recommend that future studies parse these possibilities further. Regardless, the paper further strengthens the case that if parents suffer from PTSD, their children are more likely to have symptoms, too.

We can’t always stop terrible things from happening to us, but we can, with help, go from strength to strength.

This growing problem has a solution: As we navigate this historically troubling era, we must prioritize  systematic screening for – and increasing access to – trauma treatment, notably for the people of color who have long been shut out of our current system. PTSD is treatable, and no one should have to suffer when there are evidence-based treatments that actually work and can prevent trauma’s passage to survivor offspring.

What’s more, working through trauma has additional benefits -- treatment opens a person up to experiencing posttraumatic growth, an experience of positive psychological change as a result of going through a challenging event. People I’ve worked with who have experienced this talk about having increased resilience, empathy, and improved relationships. We can’t always stop terrible things from happening to us, but we can, with help, go from strength to strength.

About Us

At Center Psychology Group in New York, we specialize in providing compassionate and evidence-based therapy tailored to your unique needs. Whether you’re seeking EMDR therapy, Somatic Experiencing, or integrative trauma-informed psychotherapy, our experienced team is here to support you. Learn more about our services and how we can help you on the path to healing. Ready to take the next step in your healing journey? Book a free 15-minute phone consultation here.

Moral injury and COVID: how to protect our front-line healthcare workers

COVID-19 rates are soaring nationwide, setting new records nearly every day. Recent reports show that doctors have learned a lot about how COVID operates in the past eight months – leading to briefer hospitalizations and fewer deaths. But as hospitals reach and then exceed capacity, doctors, nurses and other healthcare workers are again facing situations where resources are dangerously stretched.

These conditions can lead to moral injury, a form of psychological distress that results when someone’s actions, or inactions, violate their ethical code, or when they feel unprepared to face decisions or situations before them. Moral injury was originally described vis-a-vis the military: think soldiers on the front lines, forced to make decisions that will cause civilian casualties.

Moral injury is not, in itself, a mental illness, but it can contribute to PTSD, depression, or anxiety.

Today, our front line is the healthcare profession, and COVID has forced an ongoing stream of Sophie’s choices, where the options get more dire as the pandemic worsens. Which of two equally sick patients gets the last available ventilator? Who gets admitted first when there aren’t enough beds for everyone? When does saving the life of a milder COVID case trump using resources on a severe one when there aren’t enough supplies to do both? All doctors take an oath to avoid doing harm, and the pandemic’s strain on medical resources has made that vow difficult to uphold.

Moral injury is not, in itself, a mental illness, but it can contribute to PTSD, depression, or anxiety. And since doctors already have a suicide rate twice that of the general population –  one doctor commits suicide every day in the US – it’s vital that hospitals prioritize helping their staffs process pandemic treatment experiences before, during, and after each COVID spike.

Today, our front line is the healthcare profession, and COVID has forced an ongoing stream of Sophie’s choices, where the options get more dire as the pandemic worsens.

According to a recent paper published in the British Medical Journal, psychological support is key for ensuring that what researchers called potentially morally injurious events (PMIEs) become a foundation for increased psychological resilience rather than a risk factor.

A few studies that have come out recently looking at healthcare workers during COVID-19 point to strategies for supporting them through the pandemic, including:

Healthcare workers struggling with the hard emotional fallout of moral injury during COVID have the capacity to eventually experience post-traumatic growth...

It is important to note that most people who endure traumatic events like PMIEs will recover on their own and will not require professional support. Even most healthcare workers struggling with the hard emotional fallout of moral injury during COVID have the capacity to eventually experience “post-traumatic growth,” a strengthening of resilience, self-worth, and values after living through extraordinarily difficult circumstances. But making sure there are supports in place when healthcare workers need them will help ensure that PMIEs won’t contribute to wearing down exhausted front-line workers all the more.

The pandemic has dropped us all in largely uncharted waters, both medically and psychologically. But it’s becoming clear that current conditions, rife with potentially morally injurious events, are putting our healthcare providers at unprecedented risk. What we do know is how to help protect them, and it must become a top national priority.

About Us

At Center Psychology Group in New York, we specialize in providing compassionate and evidence-based therapy tailored to your unique needs. Whether you’re seeking EMDR therapy, Somatic Experiencing, or integrative trauma-informed psychotherapy, our experienced team is here to support you. Learn more about our services and how we can help you on the path to healing. Ready to take the next step in your healing journey? Book a free 15-minute phone consultation here.

5 things moms can do postpartum to support their mental health

(This post was originally published to AfterThird)

The perinatal period – which lasts from pregnancy until a year after childbirth – is a time of great psychological vulnerability, which has only been heightened due to COVID-19.

Approximately one in seven perinatal women will experience depression, anxiety or another significant mood concern. Postpartum depression and anxiety can occur anytime within the first year after the baby is born, but many women who suffer from this condition experience symptoms earlier, during pregnancy. And even before COVID, few of them got help.

“Only 30% of people who should be treated are treated,” said Ann Smith, CNM, the New York City coordinator for Postpartum Support International, which helps parents struggling with perinatal mood and anxiety disorders.

Perinatal mood and anxiety disorders are the most common complication of childbirth in the US, and no one should have to go through it alone.

It’s too early to quantify if more new mothers are experiencing perinatal mood symptoms because of the pandemic, but doctors who work with them say that the increased stressors have taken a toll, even though the movement toward online services has given many of these women easier access to sources of support.

“The biggest anxiety that I’m hearing about from moms is that they know their babies are really fragile when they’re first born and want to make sure they don’t do anything that could expose them to getting COVID-19,” said Priyanka Rao, MD, a board-certified pediatrician and instructor at the C.S. Mott Children’s Hospital in Michigan. In these unprecedented times, we cannot ignore that the psychosocial stressors borne from the COVID-19 pandemic have the potential to heighten the intensity of perinatal mood and anxiety disorders.

While parents adjust to life with a new baby, they are also learning to tolerate uncertainty about the future, the loneliness of social distancing, parenting older children who are attending virtual school, and maintaining partner relationships. Many parents have missed out on the normal rituals after childbirth due to social distancing (like baptisms or brises) and are coping with feelings of loss. It’s normal to feel some level of anxiety about all of this.

But when anxiety becomes excessive, it can interfere with overall wellness and functioning. Some signs that’s happening include:

And no matter how you’re feeling, know that it’s temporary, and that support is available.

When any of these things feel overwhelming, consider seeking professional help, anything from private therapy to support groups that you can now attend from home while maintaining social distancing. PSI, for example, holds support groups every weekday. Or, if those steps feel too overwhelming, talk to your child’s pediatrician, since you’re guaranteed to see them regularly.

“For a lot of families, the only reason they’re leaving the protection and bubble of their home is to come to the pediatric office,” Dr. Rao said. “I’m not a mental health professional or an OB-GYN, but I do know how to help moms connect to resources if I start to notice signs or symptoms that have me concerned.”

Besides reaching out for help, there are things postpartum mothers can do to help stave off depression and anxiety going forward. They include:

And no matter how you’re feeling, know that it’s temporary, and that support is available. Perinatal mood and anxiety disorders are the most common complication of childbirth in the US, and no one should have to go through it alone.

Other resources for new parents include: