Getting Older Veterans Proper Care

In an era of ongoing armed conflict, the impact of posttraumatic stress disorder (PTSD) is more widely recognized than it was 40 years ago when veterans were knee-deep in the atrocities of the Vietnam War. In fact, PTSD wasn’t even recognized as a mental illness until 1980.

While the disorder is more visible today, we usually only see young, male veterans representing all veterans experiencing PTSD. But there’s still a large population of Vietnam veterans who have been struggling with PTSD symptoms for over four decades, often with little support.

recent article by The Family Institute at Northwestern University highlighted the ongoing impact of PTSD in older veterans, and how we can ensure they receive the unique types of support and interventions they need.

What Older Veterans Need

Diagnosis has typically been delayed in older veterans, which means some have been struggling for decades. These heroes face age-related events that could trigger an exacerbation of symptoms—like retirement, the loss of a loved one or changes in health.

Due to their unique needs, some experts suggest older veterans might benefit from a counseling approach that integrates the following:

  • An approach that embraces the veteran’s story and affirms their feelings
  • Technology that increases access and decreases isolation (such as telehealth)
  • An affirmation of the realities of both the trauma and the resulting symptoms of PTSD
  • Peer support

Encouraging older veterans to embrace the benefits of therapy and counseling can be a challenge, so they may prefer to work with professionals who were/are also a member of the military in order to feel a sense of camaraderie.

Delayed-Onset PTSD In Older Veterans

About 31% of male American veterans who served in Vietnam experienced PTSD at some point in their lifetime, according to the National Vietnam Veterans Readjustment Study. A 2013 study on the long-term effects of the conflict found that approximately 1 in 10 veterans who served in Vietnam experienced PTSD 40 years later.

This is called delayed-onset PTSD. Although most people experience symptoms of PTSD within a few months after a traumatic event, sometimes it can be years before someone experiences the full spectrum of their symptoms.

Dr. Dawn M. Wirick, daughter of a Vietnam veteran and a veteran herself, counsels older combat veterans and has seen the effects of delayed trauma: “What they end up telling me is down the road, when they retire, once they aren’t so busy, they start having recurring nightmares.”

There are a variety of complex factors that can lead to delayed-onset PTSD. Some of the main reasons why it was so prevalent among Vietnam veterans were:

  • They were drafted
  • The conflict itself was highly unpopular (so they were reluctant to talk about it)
  • The troops were often treated poorly when they returned home

Additionally, as is the case for most men, they were told to “man up” and be strong, so expressing sadness was viewed as a sign of weakness. In result, many veterans repressed their feelings. This created more complex psychological reactions to their time in combat, andrepressed feelings often find their way to the surface much later.

Older veterans need proper treatment to overcome these long-term effects of living with PTSD. Coming to terms with events that occurred decades ago is no easy task, but access to effective counseling can help validate what they are feeling, eliminate the sense of isolation and begin the healing process. Coming to terms with events that occurred decades ago is no easy task, but access to effective counseling can help validate what they are feeling, eliminate the sense of isolation and begin the healing process.

 

If you are a veteran in need of help or are concerned about a veteran in your life, visit the Veterans Crisis Line website or call their 24/7 hotline at 1-800-273-8255.

 

Colleen O’Day is a Digital PR Manager and supports community outreach for 2U Inc.’s social work, mental health, and speech pathology programs. Find her on Twitter @ColleenMODay.

https://www.nami.org/Blogs/NAMI-Blog/November-2018/Getting-Older-Veterans-Proper-Care

PTSD And Trauma: Not Just For Veterans

When we think about posttraumatic stress disorder (PTSD), it’s typically in the context of active duty service members and veterans—for good reason. Dangerous and potentially traumatic situations are common occurrences in the context of military service. However, it’s important to note that PTSD is not exclusive to this type of trauma.

In the U.S., about eight million people experience PTSD. While any traumatic experience can lead to PTSD, there are a few types of trauma that are the most common. Examples include sexual assault/abuse, natural disasters, accidents/injuries to self or other, or being in a life-threatening situation. When you consider these examples, it’s understandable why people would associate PTSD most frequently with military service members. However, this assumption can be problematic.

If people believe that only service members and veterans can develop PTSD, the recognition of symptoms and treatment can be delayed. The fact is: Anyone can develop PTSD when they experience or witness a traumatic event—adult or child, man or woman. Anyone.

How Do You Know If You Have PTSD?

About 50% of all people will go through at least one traumatic experience in their lifetime. But not everyone will develop PTSD. In fact, the majority won’t. However, it can be difficult to distinguish between the typical symptoms that follow a traumatic event and when it has reached the point that a condition like PTSD has developed.

It’s common for people who experience trauma to have nightmares or flashbacks for a few weeks and then gradually improve. It’s when those symptoms don’t improve and begin to interfere with a person’s life that a mental health evaluation should be considered. A person who experiences the following intense symptoms for more than a month may have PTSD:

  • At least one “re-experiencing” symptom (flashbacks, bad dreams, frightening thoughts)
  • At least one avoidance symptom (avoiding thoughts, feeling, places, objects or events related to the traumatic experience)
  • At least two arousal and reactivity symptoms (easily startled, feeling tense, difficulty sleeping, outbursts of anger)
  • At least two cognition and mood symptoms (difficulty remembering details of the traumatic experience, negative thoughts, distorted feelings, loss of interest)

It’s important to note that PTSD-related symptoms may not occur immediately after the traumatic event; they may not surface until weeks or months afterwards. Another major, key difference between typical reactions and PTSD is that while most will remember the fear they felt during trauma, PTSD can cause a person to actually feel as if they are reliving that fear.

What Should You Do After Trauma?

If a person feels supported by friends and family after a traumatic event, it can reduce the risk of developing symptoms of PTSD. It can also be helpful for a person to join a support group, so they can share their thoughts, fears and questions with other people who have also experienced trauma. Using healthy, positive coping strategies—such as exercise, mediation or playing an instrument—can also be helpful.

If symptoms persist, it’s essential to seek treatment. Those with PTSD typically respond better to structured therapies such as:

  • Cognitive behavioral therapy (CBT) – helps a person replace their negative thoughts and behaviors with positive ones
  • Eye movement desensitization and reprocessing (EDMR) – exposes a person to traumatic memories with varying stimuli, such as eye movements
  • Exposure therapy – helps a person safely face their fears so they can learn to cope with them
  • Imagery rehearsal therapy (IRT) – is a new treatment for reducing the intensity and frequency of nightmares

If you or someone you know is having a difficult time coping with trauma, these interventions can make a huge difference. PTSD is treatable. It’s more effective if treated early, but it’s never too late to get treatment no matter how long ago the trauma occurred.

Trauma is a part of life—it affects most people at some point. But that doesn’t mean it’s a mundane experience that can be ignored or brushed off. The key is to check-in on symptoms and seek care from a mental health professional if they persist.

Whether you’re a military service member, veteran, salesperson or elementary school student, PTSD has the potential to develop in any of us. And if it does, please know that help is available. No one should face PTSD alone.

Laura Greenstein is communications coordinator.

https://www.nami.org/Blogs/NAMI-Blog/November-2017/PTSD-and-Trauma-Not-Just-for-Veterans

Loving a Trauma Survivor: Understanding Childhood Trauma’s Impact On Relationships

Survivors of childhood trauma deserve all the peace and security that a loving relationship can provide. But a history of abuse or neglect can make trusting another person feel terrifying. Trying to form an intimate relationship may lead to frightening missteps and confusion.

How can we better understand the impact of trauma, and help survivors find the love, friendship and support they and their partner deserve?

How People Cope With Unresolved Trauma

Whether the trauma was physical, sexual, or emotional, the impact can show up in a host of relationship issues. Survivors often believe deep down that no one can really be trusted, that intimacy is dangerous, and for them, a real loving attachment is an impossible dream. Many tell themselves they are flawed, not good enough and unworthy of love. Thoughts like these can wreak havoc in relationships throughout life.

When early childhood relationships are sources of overwhelming fear, or when absent, insecure or disorganized attachment leaves a person feeling helpless and alone, the mind needs some way to cope. A child may latch onto thoughts like

  • Don’t trust, it’s not safe!
  • Don’t reach out, don’t be a burden to anyone!
  • Don’t dwell on how you feel, just move along!

These ideas may help a person cope when they hurt so badly every day and just need to survive. But they do not help the emerging adult make sense of their inner world or learn how to grow and relate to others. Even if the survivor finds a safe, loving partner later in life, the self-limiting scripts stay with them. They cannot just easily toss them and start over. These life lessons are all they have (so far) to survive the best way they know how.

Noticing Trauma’s Impact On Behavior and Mood

Many times, trauma survivors re-live childhood experiences with an unresponsive or abusive partner (an important topic for another article). This often happens without the ability to see the reasons why they feel compelled to pursue unhealthy relationships. Beneath awareness is a drive to revisit unresolved trauma, and finally make things right. Of course, childhood wounds cannot be repaired this way unless there are two willing partners working on changing those cycles. But if these forces remain unnoticed, survivors can get caught in a cycle of abuse.

Even with a safe partner, a trauma survivor may

  • Experience depression
  • Develop compulsive behavior, an eating disorder, or substance dependence to try and regulate their emotions
  • Have flashbacks or panic attacks
  • Feel persistent self-doubt
  • Have suicidal thoughts
  • Seek or carry out the adverse behavior they experienced as a child

Partners of trauma survivors may want desperately to help. But partners need to “be clear that it is not your problem to fix and you don’t have the power to change another human being,” says Lisa Ferentz, LCSW in a post for partners of trauma survivors. Rather, know that both of you deserve to connect with resources to help you find comfort and healing.

Seeing Trauma’s Impact On Relationships

It is important to recognize unhealed trauma as a dynamic force in an intimate relationship. It can super-charge emotions, escalate issues, and make it seem impossible to communicate effectively. Issues become complicated by:

  • Heightened reactions to common relationship issues
  • Emotionally fueled disagreements
  • Withdrawal or distant, unresponsive behavior
  • Aversion to conflict and inability to talk through issues
  • Assumptions that the partner is against them when it is not the case
  • Lingering doubt about a partner’s love and faithfulness
  • Difficulty accepting love, despite repeated reassurance

In a relationship, a history of trauma is not simply one person’s problem to solve. Anything that affects one partner impacts the other and the relationship. With guidance from therapy, partners begin to see how to untangle the issues.

Many people do not even realize that they have had traumatic experiences. Trauma-informed therapy works by helping couples begin to see how they experienced traumatic abuse or neglect, and how it still affects them, and impacts their current relationships. This approach enables the therapist to provide specific insights to help couples separate past issues from present ones. Progress often comes more readily through a combination of individual sessions and work as a couple.

Trauma-informed therapy helps partners give each other the gift of what I and other therapists call psychoeducation – learning to understand each individual’s story, how it impacts their relationship, and how to process thoughts and emotions in healthier ways.

The Importance of Self-Care For Trauma Survivors and Their Partners

Trauma survivors and their partners have different needs for support. How can one respond when the other is grappling with mental health issues? How do you calm things down when overwhelming emotions get triggered?

It takes therapy for couples to find answers that are most healing for them. But some general tips for trauma survivors and their partners that can help are:

  • Have a really good support system for each of you and the relationship. Make time for family and friends who are positive about your relationship and respect you and your loved one.
  • Find a trauma-informed therapist to guide you as a couple or as individuals in your effort to better understand yourselves and each other.
  • Find resources outside of therapy such as support groups or other similar activities
  • Take time for psychoeducation. Learn about the nature of trauma, self-care and healing techniques like mindfulness. For example, one helpful model is Stan Taktin’s “couple bubble.” This is a visual aid to help partners see how to become a more secure, well-functioning couple. Surrounding yourself and your partner with an imaginary bubble “means that the couple is aware in public and in private they protect each other at all times. They don’t allow either of them to be the third wheel for very long, at least not without repair. In this way, everybody actually fares much better.” See More Helpful Resources below.

Communication Tips for Partners of Trauma Survivors

Building a healthy bond with a trauma survivor means working a lot on communication. Grappling with relationship issues can heighten fear and may trigger flashbacks for someone with a history of trauma.

Learning how to manage communication helps couples restore calm and provide comfort as their understanding of trauma grows. For example, couples can:

  • Use self-observation to recognize when to slow down or step back as feelings escalate
  • Practice mindfulness to raise awareness and recognize triggers for each of you
  • Develop some phrases to help you stay grounded in the present and re-direct your dialog, such as:
    • “I wonder if we can slow this down.
    • “It seems like we’re getting triggered. Can we figure out what’s going on with us?”
    • “I wonder if we are heading into old territory.”
    • “I’m thinking this could be something we should talk about in therapy.”
    • “I wonder if we could try and stay grounded in what is going on for us – is that possible?”

Communication can also help a partner comfort a loved one during a flashback. Techniques include:

  • Reminding the person that he or she is safe.
  • Calling attention to the here and now (referencing the present date, location and other immediate sights and sounds).
  • Offering a glass of water, which can help stop a flashback surprisingly well. (It activates the salivary glands, which in turn stimulates the behavior-regulating prefrontal cortex.)

Healing childhood wounds takes careful, hard work. But it is possible to replace old rules bit by bit. Finding a therapist who can recognize and acknowledge the hurt, which the survivor has carried alone for so long, is key to repairing deep wounds.

Partners may decide to work individually with their own trauma-informed therapist, while working with another as a couple, to provide the resources they need. When a survivor of early trauma can finally find comforting connection with a therapist, and then with their partner, the relationship between the couple can begin to support deep healing as well.

The more we understand about the impact of trauma, the more we can help those touched by it to go beyond surviving, and find the healing security of healthier loving relationships.

More Helpful Resources

Articles and Websites

Helping a Partner Who Engages in Self-Destructive Behaviors” by Lisa Ferentz, LCSW

Trauma-Informed Care; Understanding the Many Challenges of Toxic Stress” by Robyn Brickel, M.A., LMFT

Sidran Institute (resources for traumatic stress education and advocacy)

Books

Wired for Love: How Understanding Your Partner’s Brain and Attachment Style Can Help You Defuse Conflict and Build a Secure Relationship by Stan Tatkin, PsyD, MFT

Allies in Healing: When the Person You Love Was Sexually Abused As a Child by Laura Davis

Trust After Trauma: A Guide to Relationships for Survivors and Those Who Love Them by Aphrodite Matsakis

Mindsight: The New Science of Personal Transformation by Daniel Siegel

http://brickelandassociates.com/trauma-survivor-relationships/

10 Things That Changed Me After the Death of a Parent

ALEXANDERNOVIKOV VIA GETTY IMAGES

I don’t think there is anything that can prepare you to lose a parent. It is a larger blow in adulthood I believe, because you are at the point where you are actually friends with your mother or father. Their wisdom has finally sunk in and you know that all of the shit you rolled your eyes at as a teenager really was done out of love and probably saved your life a time or two.

I lost both of mine two years apart; my mother much unexpected and my father rather quickly after a cancer diagnosis. My mom was the one person who could see into my soul and could call me out in the most effective way. She taught me what humanity, empathy and generosity means. My father was the sarcastic realist in the house and one of the most forgiving people I have ever met. If you wanted it straight, with zero bullshit; just go ask my dad.

Grief runs its course and it comes in stages, but I was not prepared for it to never fully go away.

  1. My phone is never more than 1 foot away from me at bedtime, because the last time I did that I missed the call that my mother died.
  2. The very thought of my mother’s death, at times, made me physically ill for about six months after she died. I literally vomited.
  3. Their deaths have at times ripped the remainder of our family apart. I did my best to honor their wishes and sometimes that made me the bad guy. The burden of that was immense, but I understood why I was chosen. It made me stronger as a person, so for that I am grateful.
  4. I’m pissed that my son didn’t get to experience them as grandparents. I watched it five times before his birth and I feel robbed. He would have adored them and they him.
  5. I would not trade my time with them for anything, but sometimes I think it would have been easier had you died when I was very young. The memories would be less.
  6. Don’t bitch about your parents in front of me. You will get an earful about gratitude and appreciation. As a “Dead Parents Club” member, I would take your place in a heartbeat, so shut your mouth. Get some perspective on how truly fleeting life is.
  7. It’s like being a widow — a “club” you never wanted to join. Where do I return this unwanted membership, please?
  8. Other club members are really the only people who can truly understand what it does to a person. They just get it. There is no other way to explain it.
  9. Life does go on, but there will be times even years later, you will still break down like it happened yesterday.
  10. When you see your friends or even strangers with their mom or dad, you will sometimes be jealous. Envious of the lunch date they have. Downright pissed that your mom can’t plan your baby shower. Big life events are never ever the same again.

Here I sit eight and ten years later and there are still times that I reach for the phone when something exciting happens. Then it hits me; shit, I can’t call them.

Their deaths have forever changed me and how I look at the world. In an odd way it has made me a better parent. I am always acutely aware of what memories can mean to my son and how I will impact his life while I am on this earth. He deserves to know how much he is loved and when I am gone, what I teach and instill in him now, will be my legacy.

http://www.huffingtonpost.com/lisa-schmidt/10-things-that-changed-me-after-the-death-of-a-parent_b_7925406.html

Help Protect Your Child from Sexual Abuse

You can help to protect your child from sexual abuse by teaching the following crucial Body Safety Rules.

1. From an early age, teach your child that their body is their body and it belongs to them. Explain that they have the right to say “no” if they don’t want to be kissed or hugged by someone.

In a greeting situation, encourage your child to offer the person a high-five or a handshake (or, with people they know well they could blow them a kiss instead). Other adults may be offended by your family’s stance on this issue, but the best option is to explain your family’s reasons behind this practice.

Keep in mind it is our job as parents and carers to empower our children and not to pacify the occasional disapproving adult and/or relative.

2. Help your child to create a Safety Network. A Safety Network is made up of three to five adults that your child trusts. These are adults your child could tell anything to and they would be believed. The people who have the honor of being on your child’s Safety Network should be adults who will listen to your child’s concerns, who will always believe them, and who are accessible. Remember, it is your child’s choice who they place in their Safety Network.

3. Talk to your child about their Early Warning Signs. Explain that if they feel worried or unsafe, their body will let them know. Their Early Warning Signs may include feeling sick in the stomach, feeling shaky, their heart racing, etc. Explain to your child that if they feel any of their Early Warning Signs, they must tell an adult on their Safety Network straightaway.

4. Always call your child’s private parts by their correct names. Explain that no child, teenager or adult can touch their private parts, that they should never touch another person’s private parts even when asked, and that they should not view images of private parts.

Explain that if any of these things happen, they have the right to say, “no” or “stop,” and then they must tell an adult on their Safety Network straightaway. If that person is not available, they will need to tell another person on their Safety Network. Reinforce that your child needs to keep telling until they are believed.

5. Discourage secrets. Explain that your family has “happy surprises” instead of secrets because happy surprises will always be told. Explain that if someone does ask them to keep a secret, they should tell that person that they don’t keep secrets. Reinforce that if someone does ask them to keep a secret that makes them feel unsafe or uncomfortable, they must tell an adult on their Safety Network straightaway.

A few final hints!

1. Decide on a “family word.” For example, “pickles.” So if your child is somewhere without you or in a situation where they can’t speak up, and they feel unsafe, they can call or shout out “pickles.” This will alert you to the fact that they feel unsafe and need to be removed from the situation immediately.

2. Educate yourself in Body Safety; this includes signs of child sexual abuse and the grooming process. Remember, sexual predators groom both parents and children.

3. Encourage your child’s school to teach Body Safety! And if they don’t, please ask why not.

http://www.huffingtonpost.com/entry/help-protect-your-child-from-sexual-abuse_us_5878261be4b03e071c14fbc8

It Didn’t Start With You: How Inherited Family Trauma Shapes Who We Are

Trigger Warning: Self Harm, Suicide

A well-documented feature of trauma, one familiar to many, is our inability to articulate what happens to us. We not only lose our words, but something happens with our memory as well. During a traumatic incident, our thought processes become scattered and disorganized in such a way that we no longer recognize the memories as belonging to the original event. Instead, fragments of memory, dispersed as images, body sensations, and words, are stored in our unconscious and can become activated later by anything even remotely reminiscent of the original experience. Once they are triggered, it is as if an invisible rewind button has been pressed, causing us to reenact aspects of the original trauma in our day-to-day lives. Unconsciously, we could find ourselves reacting to certain people, events, or situations in old, familiar ways that echo the past.

Sigmund Freud identified this pattern more than one hundred years ago. Traumatic reenactment, or “repetition compulsion,” as Freud coined it, is an attempt of the unconscious to replay what’s unresolved, so we can “get it right.” This unconscious drive to relive past events could be one of the mechanisms at work when families repeat unresolved traumas in future generations.

Freud’s contemporary Carl Jung also believed that what remains unconscious does not dissolve, but rather resurfaces in our lives as fate or fortune. “Whatever does not emerge as Consciousness,” he said, “returns as Destiny.” In other words, we’re likely to keep repeating our unconscious patterns until we bring them into the light of awareness. Both Jung and Freud noted that whatever is too difficult to process does not fade away on its own, but rather is stored in our unconscious.

Freud and Jung each observed how fragments of previously blocked, suppressed, or repressed life experience would show up in the words, gestures, and behaviors of their patients. For decades to follow, therapists would see clues such as slips of the tongue, accident patterns, or dream images as messengers shining a light into the unspeakable and unthinkable regions of their clients’ lives.

Recent advances in imaging technology have allowed researchers to unravel the brain and bodily functions that “misfire” or break down during overwhelming episodes. Bessel van der Kolk is a Dutch psychiatrist known for his research on post-traumatic stress. He explains that during a trauma, the speech center shuts down, as does the medial prefrontal cortex, the part of the brain responsible for experiencing the present moment. He describes the “speechless terror” of trauma as the experience of being at a “loss for words”, a common occurrence when brain pathways of remembering are hindered during periods of threat or danger. “When people relive their traumatic experiences,” he says, “the frontal lobes become impaired and, as result, they have trouble thinking and speaking. They are no longer capable of communicating to either themselves or to others precisely what’s going on.”

Still, all is not silent: words, images, and impulses that fragment following a traumatic event reemerge to form a secret language of our suffering we carry with us. Nothing is lost. The pieces have just been rerouted.

Emerging trends in psychotherapy are now beginning to point beyond the traumas of the individual to include traumatic events in the family and social history as a part of the whole picture. Tragedies varying in type and intensity—such as abandonment, suicide and war, or the early death of a child, parent, or sibling—can send shock waves of distress cascading from one generation to the next. Recent developments in the fields of cellular biology, neurobiology, epigenetics, and developmental psychology underscore the importance of exploring at least three generations of family history in order to understand the mechanism behind patterns of trauma and suffering that repeat.

The following story offers a vivid example. When I first met Jesse, he hadn’t had a full night’s sleep in more than a year. His insomnia was evident in the dark shadows around his eyes, but the blankness of his stare suggested a deeper story. Though only twenty, Jesse looked at least ten years older. He sank onto my sofa as if his legs could no longer bear his weight.

Jesse explained that he had been a star athlete and a straight-A student, but that his persistent insomnia had initiated a downward spiral of depression and despair. As a result, he dropped out of college and had to forfeit the baseball scholarship he’d worked so hard to win. He desperately sought help to get his life back on track. Over the past year, he’d been to three doctors, two psychologists, a sleep clinic, and a naturopathic physician. Not one of them, he related in a monotone, was able to offer any real insight or help. Jesse, gazing mostly at the floor as he shared his story, told me he was at the end of his rope.

When I asked whether he had any ideas about what might have triggered his insomnia, he shook his head. Sleep had always come easily for Jesse. Then, one night just after his nineteenth birthday, he woke suddenly at 3:30 a.m. He was freezing, shivering, unable to get warm no matter what he tried. Three hours and several blankets later, Jesse was still wide awake. Not only was he cold and tired, he was seized by a strange fear he had never experienced before, a fear that something awful could happen if he let himself fall back to sleep. If I go to sleep, I’ll never wake up. Every time he felt himself drifting off, the fear would jolt him back into wakefulness. The pattern repeated itself the next night, and the night after that. Soon insomnia became a nightly ordeal. Jesse knew his fear was irrational, yet he felt helpless to put an end to it.

I listened closely as Jesse spoke. What stood out for me was one unusual detail—he’d been extremely cold, “freezing” he said, just prior to the first episode. I began to explore this with Jesse, and asked him if anyone on either side of the family suffered a trauma that involved being “cold,” or being “asleep,” or being “nineteen.”

Jesse revealed that his mother had only recently told him about the tragic death of his father’s older brother—an uncle he never knew he had. Uncle Colin was only nineteen when he froze to death checking power lines in a storm just north of Yellowknife in the Northwest Territories of Canada. Tracks in the snow revealed that he had been struggling to hang on. Eventually, he was found facedown in a blizzard, having lost consciousness from hypothermia. His death was such a tragic loss that the family never spoke his name again. Now, three decades later, Jesse was unconsciously reliving aspects of Colin’s death—specifically, the terror of letting go into unconsciousness. For Colin, letting go meant death. For Jesse, falling asleep must have felt the same.

Making the connection was a turning point for Jesse. Once he grasped that his insomnia had its origin in an event that occurred thirty years earlier, he finally had an explanation for his fear of falling asleep. The process of healing could now begin. With tools Jesse learned in our work together, which will be detailed later in this book, he was able to disentangle himself from the trauma endured by an uncle he’d never met, but whose terror he had unconsciously taken on as his own. Not only did Jesse feel freed from the heavy fog of insomnia, he gained a deeper sense of connection to his family, present and past.

In an attempt to explain stories such as Jesse’s, scientists are now able to identify biological markers— evidence that traumas can and do pass down from one generation to the next. Rachel Yehuda, professor of psychiatry and neuroscience at Mount Sinai School of Medicine in New York, is one of the world’s leading experts in post-traumatic stress, a true pioneer in this field. In numerous studies, Yehuda has examined the neurobiology of PTSD in Holocaust survivors and their children. Her research on cortisol in particular (the stress hormone that helps our body return to normal after we experience a trauma) and its effects on brain function has revolutionized the understanding and treatment of PTSD worldwide. (People with PTSD relive feelings and sensations associated with a trauma despite the fact that the trauma occurred in the past. Symptoms include depression, anxiety, numbness, insomnia, nightmares, frightening thoughts, and being easily startled or “on edge.”)

Yehuda and her team found that children of Holocaust survivors who had PTSD were born with low cortisol levels similar to their parents, predisposing them to relive the PTSD symptoms of the previous generation. Her discovery of low cortisol levels in people who experience an acute traumatic event has been controversial, going against the long-held notion that stress is associated with high cortisol levels. Specifically, in cases of chronic PTSD, cortisol production can become suppressed, contributing to the low levels measured in both survivors and their children.

Yehuda discovered similar low cortisol levels in war veterans, as well as in pregnant mothers who developed PTSD after being exposed to the World Trade Center attacks, and in their children. Not only did she find that the survivors in her study produced less cortisol, a characteristic they can pass on to their children, she notes that several stress-related psychiatric disorders, including PTSD, chronic pain syndrome, and chronic fatigue syndrome, are associated with low blood levels of cortisol. Interestingly, 50 to 70 percent of PTSD patients also meet the diagnostic criteria for major depression or another mood or anxiety disorder.

Yehuda’s research demonstrates that you and I are three times more likely to experience symptoms of PTSD if one of our parents had PTSD, and as a result, we’re likely to suffer from depression or anxiety. She believes that this type of generational PTSD is inherited rather than occurring from our being exposed to our parents’ stories of their ordeals. Yehuda was one of the first researchers to show how descendants of trauma survivors carry the physical and emotional symptoms of traumas they do not directly experience.

That was the case with Gretchen. After years of taking antidepressants, attending talk and group therapy sessions, and trying various cognitive approaches for mitigating the effects of stress, her symptoms of depression and anxiety remained unchanged.

Gretchen told me she no longer wanted to live. For as long as she could remember, she had struggled with emotions so intense she could barely contain the surges in her body. Gretchen had been admitted several times to a psychiatric hospital where she was diagnosed as bipolar with a severe anxiety disorder. Medication brought her slight relief, but never touched the powerful suicidal urges that lived inside her. As a teenager, she would self-injure by burning herself with the lit end of a cigarette. Now, at thirty-nine, Gretchen had had enough. Her depression and anxiety, she said, had prevented her from ever marrying and having children. In a surprisingly matter-of-fact tone of voice, she told me that she was planning to commit suicide before her next birthday.

Listening to Gretchen, I had the strong sense that there must be significant trauma in her family history. In such cases, I find it’s essential to pay close attention to the words being spoken for clues to the traumatic event underlying a client’s symptoms.

When I asked her how she planned to kill herself, Gretchen said that she was going to vaporize herself. As incomprehensible as it might sound to most of us, her plan was literally to leap into a vat of molten steel at the mill where her brother worked. “My body will incinerate in seconds,” she said, staring directly into my eyes, “even before it reaches the bottom.”

I was struck by her lack of emotion as she spoke. Whatever feeling lay beneath appeared to have been vaulted deep inside. At the same time, the words vaporize and incinerate rattled inside me. Having worked with many children and grandchildren whose families were affected by the Holocaust, I’ve learned to let their words lead me. I wanted Gretchen to tell me more.

I asked if anyone in her family was Jewish or had been involved in the Holocaust. Gretchen started to say no, but then stopped herself and recalled a story about her grandmother. She had been born into a Jewish family in Poland, but converted to Catholicism when she came to the United States in 1946 and married Gretchen’s grandfather. Two years earlier, her grandmother’s entire family had perished in the ovens at Auschwitz. They had literally been gassed—engulfed in poisonous vapors—and incinerated. No one in Gretchen’s immediate family ever spoke to her grandmother about the war, or about the fate of her siblings or her parents. Instead, as is often the case with such extreme trauma, they avoided the subject entirely.

Gretchen knew the basic facts of her family history, but had never connected it to her own anxiety and depression. It was clear to me that the words she used and the feelings she described didn’t originate with her, but had in fact originated with her grandmother and the family members who lost their lives.

As I explained the connection, Gretchen listened intently. Her eyes widened and color rose in her cheeks. I could tell that what I said was resonating. For the first time, Gretchen had an explanation for her suffering that made sense to her.

To help her deepen her new understanding, I invited her to imagine standing in her grandmother’s shoes, represented by a pair of foam rubber footprints that I placed on the carpet in the center of my office. I asked her to imagine feeling what her grandmother might have felt after having lost all her loved ones. Taking it even a step further, I asked her if she could literally stand on the footprints as her grandmother, and feel her grandmother’s feelings in her own body. Gretchen reported sensations of overwhelming loss and grief, aloneness and isolation. She also experienced the profound sense of guilt that many survivors feel, the sense of remaining alive while loved ones have been killed.

In order to process trauma, it’s often helpful for clients to have a direct experience of the feelings and sensations that have been submerged in the body. When Gretchen was able to access these sensations, she realized that her wish to annihilate herself was deeply entwined with her lost family members. She also realized that she had taken on some element of her grandmother’s desire to die. As Gretchen absorbed this understanding, seeing the family story in a new light, her body began to soften, as if something inside her that had long been coiled up could now relax.

As with Jesse, Gretchen’s recognition that her trauma lay buried in her family’s unspoken history was merely the first step in her healing process. An intellectual understanding by itself is rarely enough for a lasting shift to occur. Often, the awareness needs to be accompanied by a deeply felt visceral experience. We’ll explore further the ways in which healing becomes fully integrated so that the wounds of previous generations can finally be released.

An Unexpected Family Inheritance

A boy may have his grandpa’s long legs and a girl may have her mother’s nose, but Jesse had inherited his uncle’s fear of never waking, and Gretchen carried the family’s Holocaust history in her depression. Sleeping inside each of them were fragments of traumas too great to be resolved in one generation.

When those in our family have experienced unbearable traumas or have suffered with immense guilt or grief, the feelings can be overwhelming and can escalate beyond what they can manage or resolve. It’s human nature; when pain is too great, people tend to avoid it. Yet when we block the feelings, we unknowingly stunt the necessary healing process that can lead us to a natural release.

Sometimes pain submerges until it can find a pathway for expression or resolution. That expression is often found in the generations that follow and can resurface as symptoms that are difficult to explain. For Jesse, the unrelenting cold and shivering did not appear until he reached the age that his Uncle Colin was when he froze to death. For Gretchen, her grandmother’s anxious despair and suicidal urges had been with her for as long as she could remember. These feelings became so much a part of her life that no one ever thought to consider that the feelings didn’t originate with her.

Currently, our society does not provide many options to help people like Jesse and Gretchen who carry remnants of inherited family trauma. Typically they might consult a doctor, psychologist, or psychiatrist and receive medications, therapy, or some combination of both. But although these avenues might bring some relief, generally they don’t provide a complete solution.

Not all of us have traumas as dramatic as Gretchen’s or Jesse’s in our family history. However, events such as the death of an infant, a child given away, the loss of one’s home, or even the withdrawal of a mother’s attention can all have the effect of collapsing the walls of support and restricting the flow of love in our family. With the origin of these traumas in view, long-standing family patterns can finally be laid to rest. It’s important to note that not all effects of trauma are negative. In the next chapter we’ll learn about epigenetic changes—the chemical modifications that occur in our cells as a result of a traumatic event.

According to Rachel Yehuda, the purpose of an epigenetic change is to expand the range of ways we respond in stressful situations, which she says is a positive thing. “Who would you rather be in a war zone with?” she asks. “Somebody that’s had previous adversity [and] knows how to defend themselves? Or somebody that has never had to fight for anything?” Once we understand what biologic changes from stress and trauma are meant to do, she says, “We can develop a better way of explaining to ourselves what our true capabilities and potentials are.”

Viewed in this way, the traumas we inherit or experience firsthand not only can create a legacy of distress, but also can forge a legacy of strength and resilience that can be felt for generations to come.

https://www.scienceandnonduality.com/an-excerpt-from-it-didnt-start-with-you-how-inherited-family-trauma-shapes-who-we-are-and-how-to-end-the-cycle-viking-april-2016-by-mark-wolynn/