When Liz Prager O’Brien was growing up in Rhode Island, the trauma her mother had endured during World War II would sneak up on both of them at unexpected moments.
Her mom was 2 years old when she and her parents fled their small Polish town. They left a comfortable life and spent the next dozen years in dire poverty, struggling to survive.
As a young refugee going from one war-torn country to the next, Prager O’Brien’s mom didn’t have opportunities to develop friendships.
So decades later, when Prager O’Brien was 9 years old and sought advice on how to handle a disagreement between her friends, her mother lashed out.
“‘I never had childhood friends. Why the hell are you asking me?’” Prager O’Brien, who’s now 60, said her mom screamed at her.
This and similar interactions left Prager O’Brien frightened and confused.
“It made me feel like my feelings didn’t matter, my problems didn’t matter,” she said, adding that the harsh responses laid the groundwork for her lifelong anxiety and depression. “I really believed that I didn’t matter.”
As Russia’s invasion of Ukraine stretches into a second month, descendants of survivors of previous conflicts say they fear the war there could leave lasting scars on Ukrainians living through it — as well as on the generations that follow them.
It’s a psychological phenomenon is known as generational trauma. Most widely studied among children of Holocaust survivors, generational trauma, also called intergenerational or transgenerational trauma, refers to the effects of trauma that get passed down a family’s lineage, changing the lives of not just those who experienced a traumatic event but of subsequent generations that never had direct exposure to it.
Like the generation before them, they may live with heightened anxiety, major depression, have difficulty connecting with others and regulating their feelings, and it may negatively affect how they parent their own children.
War is not its only cause. Experts say racism, domestic violence, sexual and other forms of abuse can also set the stage for generational trauma.
“There is a style of attachment that these parents have when they are depressed, when they are trying to keep the secret and not share the horrors that they have experienced, that all comes through in the family,” said Sandra Mattar, a clinical psychologist and assistant professor at Boston University School of Medicine.
“There is a style of attachment that these parents have when they are depressed, when they are trying to keep the secret and not share the horrors that they have experienced.”
The detached parenting style can affect their ability to teach children how to regulate their emotions.
“These children may have trouble self-soothing,” explained Mattar, who also directs training at the Immigrant and Refugee Health Center at Boston Medical Center.
The consequences can extend beyond mental health. People in a constant state of stress produce more of the hormone cortisol, which suppresses their immune system, increasing the risk for colds, viral illnesses and autoimmune diseases.
Mattar said therapy, spirituality and education about the physical and cognitive effects of trauma are key to helping refugees at her clinic.
For anyone with generational trauma in their families, addressing it is a first step, she said.
“It’s important to talk about it, to normalize talking about it and to seek help,” Mattar said. “It becomes this big monster in the family dynamics.”
Jason Tammemagi, 47, an animation producer in Dublin, Ireland, whose paternal grandparents fled Estonia in 1944 when Soviet troops invaded, was determined not to continue that dynamic when he had his own children.
His grandparents stayed in Estonia during the war with their two teenage children for as long as they thought they safely could. When they left, their daughter, who was about 18, had dreams of marrying a soldier and refused to go, Tammemagi said. Their other child, a son who was about 14, became ill and died during their journey across Europe. Eventually, they arrived in the United Kingdom, armed with a photo of their son’s grave and hardly anything else; Tammemagi’s father was born later.
“It’s like a wound he kind of inherited.”
“They had to leave behind an entire life,” Tammemagi said.
What his grandparents went through had ramifications for his father, who Tammemagi said struggled with his emotions while growing up.
“It’s like a wound he kind of inherited,” he said. “You can trace it back through those generations of hurt.”
How generational trauma gets passed down
While conflict and other intensely painful experiences can result in irreplaceable losses and deep harm, experts say it’s not a given that they will lead to generational trauma — or post-traumatic stress disorder.
Despite how common traumas are — about 60 percent of men and 50 percent of women will experience an event that qualifies as traumatic, according to the U.S. Department of Veterans Affairs’ National Center for PTSD — only about 6 percent of people develop PTSD. The mental health condition is characterized by flashbacks, nightmares, severe anxiety and other symptoms that interrupt daily life, and an avoidance of situations that remind a person of the event.
Generational trauma does increase the risk for PTSD, as well as anxiety disorders such as obsessive-compulsive disorder and social phobia, said Dr. Gayani DeSilva, a child and adolescent psychiatrist in Southern California.
This is “partly genetic and it’s partly parenting styles,” she said. While a parent who is clouded by depression or is suspicious of the world around them may not be connecting emotionally with their child, controversial research suggests that generational trauma may potentially affect offspring on an epigenetic level.
That means that while there has been no alteration to a person’s DNA as a result of the trauma, someone could pass down traits induced by the trauma that carry a heightened risk for developing mental health problems, depending on the family dynamics.
But it can be prevented, DeSilva said.
“Parenting plus societal awareness and intervention to decrease further traumas can help,” she said.
‘Break this chain of trauma’
Ukraine’s humanitarian crisis has already left many in need: More than 10 million Ukrainians, or a quarter of the nation’s population, have fled their homes and are now displaced in the country or are among its more than 3 million refugees, according to the United Nations.
Jasmine Chan, 34, who lives in Los Angeles, worries that in addition to physical threats to their safety, Ukrainian refugees will feel severed from their culture.
It’s something that happened to her maternal grandmother, who in her late teens left her village in China. It was during the Japanese occupation of World War II, and there was not enough food at home to sustain their large family, so her grandmother and her grandmother’s brother fled to Hong Kong, where Chan’s grandmother eventually met Chan’s grandfather.
In Hong Kong her grandmother had economic opportunities she would not have had in her rural village. But she never reconnected with the family she left behind.
“Seeing what my grandmother went through, I feel like we have lost not quite the identity, but it’s more the linkages to our family, and knowing who they were,” Chan, a communications director for a consulting firm, said.
Although her grandmother lost her ties to her past, she put a strong emphasis on traditions when Chan was growing up, such as Sunday family gatherings.
Prager O’Brien, who still lives in Rhode Island, in Wakefield, also had special rituals with her grandmother, Tamara Sylman, whom she “could always count on for unconditional love.”
While Sylman rarely talked about the life in Poland that she and her family escaped, she would do everything she could to express how much she cared for her granddaughter. She constantly performed small acts of kindness, said Prager O’Brien, as she recalled how her grandmother sewed for her, or peeled pomegranates for her, giving her the juicy seeds.
It was a bond that Prager O’Brien never had with her mother. When Prager O’Brien had her own children, she used her grandmother as a role model.
“To break this chain of trauma, I have poured my heart and soul into my children,” Prager O’Brien said. “I tell them every time I speak with them, even if it’s by text, that I love them.”