Trauma-induced alterations to cellular function and the expression of genes appear to be long term, impacting brain neurocircuitry, the “repair and defend” process of the immune system, the hypothalamic-pituitary-adrenal (HPA) axis, and, not surprisingly, the “fight-or-flight” sympathetic nervous system (SNS). These diverse biological processes in the body all impact health on their own, but in combination the effects can be multifold over the course of someone’s life.
This idea should make common sense to everyone because it was used before in defining a previous disorder: the notion that a profoundly life-altering experience results in an enduring change — rather than just transient ones — which led to to the definition of post-traumatic stress disorder (PTSD) in 1980.
Conventional medicine’s essential paradigm governing the body’s stress response has only emphasized short-lived responses. Fight-or-flight has been the name of the game, and like a switch, stress has been thought of as something that can be easily turned on and off, and controlled with ease. While all organisms, including people, recover from the initial wave of stress chemicals (called cortisol) after a threat has passed, the conventional system has not considered what can happen if these chemicals linger day in and day out at unsafe levels which shut down the body’s optimal functioning?
What is finally becoming accepted in Western medicine is the long lasting molecular and epigenetic changes which occur inside cells when faced with unrelenting levels of stress linked to prior trauma.
The acceptance of the transformative nature of trauma is a required understanding for better healthcare. This notion allows us to ask better questions, chief among them is whether and to what extent children of trauma survivors are also affected biologically and/or psychologically by trauma exposure in their parents or grandparents. And if future generations are impacted, how does it directly impact the genetic material passed to the offspring in utero and its expression?
Parental trauma can easily persist and be passed on to subsequent generations via epigenetic marks encoded on DNA changing and passed through the germ line (stem cells). Epigenetics is the study of changes in organisms caused by modification of gene expression rather than alteration of the genetic code itself. Although the DNA is left unchanged, the expression of certain genes within DNA is changed, either by activation or deactivation.
Because all of us are affected by trauma, it’s no stretch of the imagination to consider that children are affected by the effects of trauma experienced by their parents.
Intuitively, this makes a lot of sense, but it has been virtually impossible to validate models of potential non-genomic (i.e. epigenetic) heritability, except, in animal models. While this is beginning to change as technologies advance, once again, the medical community’s critical understanding of trauma and stress lags behind by over 15 to 20 years based solely on not being able to simplify this otherwise complicated concept into cause-and-effect associations. It is extremely difficult to investigate the lasting complications over one’s life and their offspring’s life, and so often this fundamental concept has been mostly ignored in clinical practice.
Epigenetics is not something that can be studied over the course of 8 weeks or 12 months, like most published research. True generational epigenetic studies need generational data. This is a mammoth undertaking. Instead of understanding what’s truly going on beneath the surface, it’s been easier to write trauma and chronic stress off and praise one’s resiliency, flexibility, and wisdom of the survivor (and not even think about their offspring).
The evidence for how trauma is passed onto offspring is reported in multiple cultures and societies with collective traumatic exposures. These descriptions are largely in association with experiences that involve subjugation of one people by another, as in racism, war, and genocide (which, again, is still ocurring throughout the world today).
The impact of these collective traumas extends beyond personal experiences of parent-to-offspring influences. This is because the effects of universal atrocities shape the communal experience of an entire generation, unquestionably altering the fabric of society and culture. I believe we are at a point now where the more nuanced reflection is not whether children are affected by parental trauma (which they are!), but which children are more affected and how? If there are global effects of parental trauma on a child, it would be prudent to (1) elucidate the mechanism(s) explaining such effects and (2) identify what can be done to mitigate the potential harm of said trauma on the child’s life.
Our whole life we were told we got our eyes from mom or perhaps our height from granddad, but that’s only the physical. We now have to add what life-changing events the child got from mom and granddad. This may be difficult to tease out, and likely impossible when we don’t fully know our family’s lived experience. Of course, health is a complicated 3D puzzle, and healing people requires operating in 4D — the biological (i.e. what’s going on physically), the psychological (i.e. what’s happening mentally), the social (i.e. what’s your connection to others), and the spiritual (i.e. what’s your connection to self and the world).
Something that might be useful when determining if you have unresolved trauma is to write the story of your life. You can write in a journal or on a piece of paper with a timeline. I like the timeline because it helps you see when certain diseases/symptoms pop up and any associated traumatic events that precede them. But it also helps you look at people in your life who have been challenging for you through those four dimensions of health. We can all do this to better understand some of our automatic stressful reactions, some of which may have nothing to do with the present.
Oftentimes, we carry strategies from when we were a kid which have served us well in dealing with certain stressful and traumatic encounters. But if we don’t continue to learn new strategies along the way to adapt to our ever-evolving lives, these old strategies don’t work when we are older and can instead, cause us a great deal of harm.
In summary, as concrete biological representation of this complex phenomena grows and solidifies in the literature, the societal and medical conversation about the effects of trauma needs to be completely altered in order to understand the root cause of disease. Including this in a patient’s story and addressing it adequately must become the new standard of health care: to lean completely towards integrative functional medicine focused on prevention and personalized treatment that truly heals.
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