1. The ability to regulate emotions, especially negative affect, is key to maintaining an understandable emotional climate for others in the family. Frequent unexplained emotional outbursts are difficult for other family members to understand. For children, it is especially important for them to understand that any emotional dysregulation is not caused by their behavior but by the parent’s experience of prior trauma.
2. The family should have an understanding of the meaning and cause of the traumatic events.
The traumatic events must be symbolized in a way that allows conversation and discussion about the past. The mention of wartime trauma can be phrased in a way that allows for the experience of pain, and then recovery, with hope and resilience as the message. A narrative story is important, with a good ending that the parent has survived, has overcome difficulties, and is here in the present with the child.
3. The parent must have "worked through" the trauma to the extent that he can internally symbolize his experiences enough to be able to talk about them and relay them to his
offspring in a coherent narrative with a positive message.
4. Open communication about the trauma prevents any unsymbolized, unspoken aspects of the trauma from being driven into unconsciousness, where they become dark fearful secrets that haunt the imagination and awaken the children, even as adults, at night.
5. Being able to access public accounts of the traumatic events is helpful to widen the family’s understanding of how others are affected, thus reducing the fearfulness of being alone with the trauma. Families should be encouraged to access these sources in order to understand the global aspects of trauma and the associated suffering and recovery.
6. For many families, having suffered trauma means that they must always be prepared for disaster. This, too, can be framed in a positive way, more like the scout motto of "be prepared," rather than the fearful posture of the survivalist.
7. A family fleeing from trauma might experience displacement through immigration and have no sense of home. This can be modulated by reestablishing and developing a new sense of community, and developing strong social and family rootedness. Sometimes, this involves a religious or spiritual group affiliation.
8. Family members who have suffered trauma often can identify skills that helped them survive. Hope, education, community, art – these values can be transmitted as the positive legacy of trauma. Helping families identify with positive resilient features of surviving trauma does not mean forgetting about the trauma but identifying the aspects that help the family go forward, enabling them to develop a narrative that allows recovery and growth.
9. If the child or other family members develop ongoing secondary PTSD or have enduring feelings of survivor guilt, persecution, and so on that are not resolved by family intervention, individual assessment might be needed.
In conclusion, despite the many illuminating case reports and anecdotes about the intergenerational transmission of trauma (for example, see J. Marital Fam. Ther. 2004;30:45-59), the message to families must be resilience focused. The question for these families becomes: "What did you do to manage the trauma and survive?"
Using a narrative framework, we can help these families identify the factors that can contribute to resilience, and build a future for the family that does not transmit traumatic symptoms but rather transmits the ability to move forward, despite traumatic symptoms.
E-mail Dr. Heru at cpnews@elsevier.com.