Abstract
Posttrauma symptoms can have a profound effect on the manner in which a trauma survivor relates to others, including, perhaps most significantly, family members. Survivors are markedly changed by their experiences. The psychological impact of trauma is well established in a variety of survivor populations (e.g., Burgess & Holmstrom, 1974; Davis & Friedman, 1985; Figley, 1978; Foa, Rothbaum, Riggs, & Murdock, 1992; Kilpatrick, Veronen, & Best, 1985; Koopman, Classen, &Spiegel, 1994; Laufer, Frey-Wouters, & Gallops, 1985; Titchner, Kapp, & Winget, 1976). These posttrauma symptoms include (1) experiencing the trauma through flashbacks, nightmares, and persistent thoughts; (2) cognitive and phobic avoidance of trauma-related stimuli; (3) hyperarousal symptoms of irritability, startle response, and sleep disturbance (American Psychiatric Association, 1994). It is easy to understand how survivors’ numbing of responsiveness, social withdrawal, and irritability, with episodic outbursts of rage, can make it difficult for them to maintain interpersonal relationships. In turn, children of traumatized patients may be affected directly or indirectly by their parents’ posttrauma symptoms. For example, Rosenheck and Nathan (1985) described a child of a combat veteran with post-traumatic stress disorder (PTSD) as having insomnia; headaches; tearfulness; feelings of helplessness; fears of being kidnapped, shot, or killed; attention problems at school; and fantasies similar to his father’s flashbacks. These authors coined the term secondary traumatization to describe this phenomenon. Others have referred to this as transgenerational transmission of trauma (Harkness, 1993). Although the terminologies differ, common to these descriptions is the notion that children are affected by their parents’ posttrauma sequelae. Despite a plethora of descriptive information, intergenerational transmission of trauma is a poorly defined empirical construct, and one that is not well understood within the professional community. We do not know the extent to which parental trauma affects the next generation or how many generations may be influenced. One of the best predictors for PTSD is the intensity and duration of exposure to traumatic events (Gleser, Green, & Winget, 1981; van der Kolk, 1988). We can speculate that one of the best predictors for secondary trauma in children may be the intensity and duration of trauma exposure of their parents. Combat veterans are a group that has been exposed to extensive trauma and, therefore, represent a population in which intergenerational transmission is likely. The objectives of this chapter are to describe the legacy of combat trauma on the children of Vietnam veterans and identify the mechanisms through which these cognitive, affective, and behavioral patterns are handed down. In addition, this chapter explores issues of how to determine if, when, and how to intervene.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd edition, rev). Washington, DC: Author.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders ( 4th edition ). Washington, DC: Author.
Ancharoff, M. R. (1994). Intergenerational transmission of trauma: Mechanisms and messages. Unpublished doctoral thesis, Graduate School of Professional Psychology, University of Denver.
Baron, L., Reznikoff, M., & Glenwick, D. S. (1993). Narcissism, interpersonal adjustment, and coping in children of Holocaust survivors. Journal of Psychology, 127(3), 257–269.
Ben-David, A., & Lavee, Y. (1992). Families in the sealed room: Interaction patterns of Israeli families during SCUD missile attacks. Family Process, 31, 35–44.
Bloom, S. (1995). The germ theory of trauma: The impossibility of ethical neutrality. In B. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators (pp. 257–276 ). Lutherville, MD: Sidran.
Burgess, A. W, & Holmstrom, L. L. (1974). Rape trauma syndrome. American Journal of Psychiatry, 131, 981–986. Catherall, D. R. (I 992a). Back from the brink: A family guide to overcoming traumatic stress. New York, Bantam. Catherall, D. R. (1992b). Working with projective identification in couples. Family Process, 31, 355–367.
Chrestman, K. R. (1994). Secondary traumatization in therapists working with survivors of trauma. Unpublished doctoral dissertation, Nova University, Fort Lauderdale, Florida.
Danieli, Y. (1981). Therapists’ difficulties in treating survivors of the Nazi Holocaust and their children. Dissertation Abstracts International, 42, 4947-B.
Danieli, Y. (1984). Psychotherapists’ participation in the conspiracy of silence about the Holocaust. Psychoanalytic Psychology, 1(1), 23–42.
Danieli, Y. (1985). The treatment and prevention of long-term effects and intergenerational transmission of victimization: A lesson from Holocaust survivors and their children. In C. R. Figley (Ed.), Trauma and its wake: The study and treatment of post-traumatic stress disorder (pp. 295–313 ). New York: Brunner/Mazel.
Danieli, Y. (1988a). Confronting the unimaginable: Psychotherapists’ reactions to victims of the Nazi Holocaust. In J. P. Wilson, Z. Harel, & B. Kahana (Eds.), Human adaptation to extreme stress: From the Holocaust to Vietnam (pp. 219–238 ). New York: Plenum Press.
Danieli, Y. (1988b). Treating survivors and children of survivors of the Nazi Holocaust. In E Ochberg (Ed.), Post-traumatic therapy and victims of violence (pp. 278–294 ). New York: Brunner/Mazel.
Danieli, Y. (1993). Diagnostic and therapeutic use of the multigenerational family tree in working with survivors and children of survivors of the Nazi Holocaust. In J. P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes (pp. 889–898 ). New York: Plenum Press.
Davidson, J., Smith, R., & Kudler, H. (1989). Familial psychiatric illness in chronic post-traumatic stress disorder. Comprehensive Psychiatry, 30 (4), 339–345.
Davis, R. C., & Friedman, L. N. (1985). The emotional aftermath of crime and violence. In C. R. Figley (Ed.), Trauma and its wake: The study and treatment of post-traumatic stress disorder (pp. 90–112 ). New York: Brunner/Mazel.
DeFazio, V. J., & Pascucci, N. J. (1984). Return to Ithaca: A perspective on marriage and love in posttraumatic stress disorder. Journal of Contemporary Psychotherapy, 14(1), 76–89.
Doreleijers, T. A. H., and Donovan, D. (1990). Transgenerational traumatization in children of parents interned in Japanese civil internment camps in the Dutch East Indies during World War II. Journal of Psychohistory, 17 (4), 435–447.
Epstein, H. (1979). Children of the Holocaust: Conversations with sons and daughters of survivors. New York: Pengu in Books.
Eth, S., & Pynoos, R. S. (Eds.). (1985). Post-traumatic stress disorder in children. Washington, DC: American Psychiatric Association Press.
Figley, C. R. (Ed.) (1978). Stress disorders among Vietnam veterans: Theory, research, and treatment. New York: Brunner/Mazel.
Figley, C. R. (1985). From victim to survivor: Social responsibility in the wake of catastrophe. In C. R. Figley (Ed.), Trauma and it’s wake: the study and treatment of post-traumatic stress disorder (pp. 398–415 ). New York: Brunner/Mazel.
Figley, C. R. (1988). A five-phase treatment of post-traumatic stress disorder in families. Journal of Traumatic Stress, 1 (1), 127–141.
Figley, C. R. (1989). Helping traumatized families. San Francisco: Jossey-Bass.
Foa, E. B., Rothbaum, B. O., Riggs, D. S., & Murdock, T. (1992). A prospective examination of post-traumatic stress disorder in rape victims. Journal of Traumatic Stress, 5(3), 455–475.
Freyberg, J. T. (1980). Difficulties in separation-individuation as experienced by offspring of Nazi Holocaust survivors. American Journal of Orthopsychiatry, 50 (1), 87–95.
Gallagher, R. E., Flye, B. L., Hurt, S. W, Stone, M. H., & Hull, J. W. (1992). Retrospective assessment of traumatic experiences (RATE). Journal of Personality Disorders, 6, 99–108.
Gizynski, M. N. (1983). The effects of maternal depression on children. Clinical Social Work, 11, 339–350.
Gleser, G. C., Green, B. L., & Winget, C. (1981). Prolonged psychological effects of disaster: A study of Buffalo Creek. New York: Academic Press.
Goodwin, J. (1988). Post-traumatic symptoms in abused children. Journal of Traumatic Stress, 1 (4), 475–488.
Green, B. L. (1993). Identifying survivors at risk: Trauma and stressors across events. In J. P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes (pp. 135–144 ). New York: Plenum Press.
Greenfield, S. F., Swartz, M. S., Landerman, L. R., & George, L. K. (1993). Long-term psychosocial effects of childhood exposure to parental problem drinking. American Journal of Psychiatry, 150(4), 608–613.
Halik, V., Rosenthal, D. A., & Pattison, P. E. (1990). Intergenerational effects of the Holocaust: Patterns of engagement in the mother-daughter relationship. Family Process, 29, 325–339.
Harkness, L. (1991). The effect of combat-related PTSD on children. National Center, for Post-Traumatic Stress Disorder Clinical Newsletter, 2 (1), 12–13.
Harkness, L. (1993). Transgenerational transmission of war-related trauma. In J. P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes (pp. 635–643 ). New York: Plenum Press.
Holaday, M., Armsworth, M. W, Swank, P. R., & Vincent, K. R. (1992). Rorschach responding in traumatized children and adolescents. Journal of Traumatic Stress, 5(1), 119–129.
Jacobsen, L. K., Sweeney, C. G., & Racusin, G. R. (1993). Group psychotherapy for children of fathers with PTSD: Evidence of psychopathology emerging in the group process. Journal of Child and Adolescent Group Therapy, 3 (2), 103–120.
Janoff-Bulman, R. (1992). Shattered assumptions: Towards a new psychology. New York: Macmillan.
Jordan, B. K., Maarmar, C. R., Fairbank, J. A., & Schlenger, W. E. (1992). Problems in families of male Vietnam vet-erans with postraumatic stress disorder. Journal of Consulting and Clinical Psychology, 60(6), 916–926.
Jurich, A. P. (1983). The Saigon of the family’s mind: Family therapy with families of Vietnam veterans. Journal of Marital and Family Therapy, 9 (4), 355–363.
Keinan, G., Mikulincer, M., & Rybricki, A. (1988). Perception of self and parents by second generation Holocaust survivors. Behavioral Medicine, 14, 6–12.
Kestenberg, J. S. (1983). Psychoanalyses of children of survivors from the Holocaust: Case presentation and assessment. Journal of the American Psychoanalytic Association, 28, 775–804.
Kilpatrick, D. G., Veronen, L. J., & Best, C. L. (1985). Factors predicting psychological distress among rape victims. In C. R. Figley (Ed.), Trauma and its wake: The study and treatment of post-traumatic stress disorder (pp. 113–141 ). New York: Brunner/Mazel.
Klein, H. (1971). Families of Holocaust survivors in the kibbutz: Psychological studies. International Psychiatry Clinics, 8, 67–92.
Koopman, C., Classen, C., & Spiegel, D. (1994). Predictors of post-traumatic stress symptoms among survivors of the Oakland/Berkeley, California, firestorm. American Journal of Psychiatry, 151 (6), 888–894.
Krell, R. (1982). Family therapy with children of concentration camp survivors. American Journal of Psychotherapy, 36(4), 513–522.
Krinsley, K. E., & Weathers, F. W. (1995). The assessment of trauma in adults. PTSD Research Quarterly, 6, 1–6. Krystal, H., & Niederland, W. G. (1968). Clinical observations on the survivor syndrome. In H. Krystal (Ed.), Massive psychic trauma (pp. 327–348 ). New York: International Universities Press.
Krystal, H., & Niederland, W. G. (Eds.). (1971). Psychic traumatization: Aftereffects in individuals and communities. New York: Little, Brown.
Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., & Weiss, D. S. (1990). The National Vietnam Veterans Readjustment Study: Tables of findings and technical appendices. New York: Brunner/Mazel.
Laufer, R., Frey-Wouters, E., & Gallops, M. S. (1985). Traumatic stressors in the Vietnam war and post-traumatic stress disorder. In C. R. Figley (Ed.), Trauma and it’s wake: The study and treatment of post-traumatic stress disorder (pp. 73–89 ). New York: Brunner/Mazel.
Leon, G., Butcher, J., Kleinman, M., Goldburg, A., & Almagor, M. (1981). Survivors of the Holocaust and their children: Current status and adjustment. Journal of Personality and Social Psychology, 4, 503–516.
Lichtman, J. (1984). Parental communication of Holocaust experiences and personality characteristics among second-generation survivors. Journal of Clinical Psychology, 40, 914–924.
Link, N., Victor, B., & Binder, R. L. (1985). Psychosis in children of Holocaust survivors: Influence of the Holocaust in the choice of themes in their psychoses. Journal of Nervous and Mental Disease, 173 (2), 115–117.
Maloney, L. J. (1988). Posttraumatic stresses on women partners of Vietnam veterans. Smith College Studies School of Social Work, 58 (2), 122–143.
Mason, P. (1990). Recovering from the war. New York: Viking Penguin.
Matsakis, A. (1988). Vietnam wives. Kensington, MD: Woodbine House.
McCann, I. L., & Pearlman, L. A. (1990a). Psychological trauma and the adult survivor: Theory, therapy, and transformation. New York: Brunner/Mazel.
McCann, I. L., & Pearlman, L. A. (1990b). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3 (1), 131–149.
McLeer, S. V, Deblinger, E., Atkins, M. S., Foa, E. B., & Ralphe, D. L. (1988). Post-traumatic stress disorder in sexually abused children. Journal of the American Academy of Child and Adolescent Psychiatry, 27(5), 650–654.
McNally, R. S. (1996). Assessment of post-traumatic stress disorder in children and adolescents. Journal of School Psychology, 0, 000–000.
Moos, R. H., & Moos, B. S. (1986). Family environment manual scale. Palo Alto, CA: Consulting Psychologists Press. Munroe, J. E (1991). Therapist traumatization from exposure to clients with combat related post-traumatic stress disorder: Implications for administration and supervision. Dissertation Abstracts International, 52–03B, 1731.
Munroe J., Shay, J., Fisher, L., Makary, C., Rapperport, K., & Zimering, R. (1995). Preventing compassion fatigue: A team treatment model. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 209–231 ). New York: Brunner/Mazel.
Munroe, J., Shay, J., Fisher, L., Zimering, R., & Ancharoff, M. (1993). Preventing traumatized therapists: Coping with survivor engagement patterns. Workshop conducted at the 9th Annual Meeting of the International Society for Traumatic Stress Studies, San Antonio, TX.
Nadler, A., Kav-Vanaki, S., & Gleaitman, B. (1985). Transgenerational effects of the Holocaust: Externalization of aggression in second generation of Holocaust survivors. Journal of Consulting and Clinical Psychology, 53 (3), 365–369.
Nagata, D. K. (1991). Transgenerational impact of the Japanese-American internment: Clinical issues in working with children of former internees. Psychotherapy, 28(1), 121–128.
Ogata, S. N., Silk, K. R., Goodrich, S., Lohr, N. E., Westen, D., & Hill, E. M. (1990). Childhood sexual and physical abuse in adult patients with borderline personality disorder. American Journal of Psychiatry, 147, 1008–1013.
Parsons, J., Kehle, T. J., & Owen, S. V. (1990). Incidence of behavior problems among children of Vietnam war veterans. School Psychology International, 11(4), 253–259.
Prince, R. M. (1985). Second generation effects of historical trauma. Psychoanalytic Review, 72 (1), 9–29.
Pynoos, R. S., & Eth, S. (1988). Witness to violence: The child interview. In S. Chess, A. Thomas, & M. Hertzig (Eds.). Annual progress in child psychiatry and child development, 1987 (pp. 299–326 ). New York: Brunner/Mazel.
Pynoos, R. S., Nader, K., Black, D., Kaplan, T., Hendriks, J. H., Gordon, R., Wraith, R., Green, A., & Herman, J. L. (1993). The impact of trauma on children and adolescents. In J. P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes (pp. 535–657 ). New York: Plenum Press.
Pynoos, R. S., Steinberg, A. M., & Wriath, R. (1995). A developmental model of childhood traumatic stress. In D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology: Vol 2. Risk, disorder, and adaptation (pp. 72–95 ). New York: Wiley.
Rakoff, V. (1966). A long-term effect of the concentration camp experience. Viewpoints, 1, 17–22.
Rakoff, V, Sigal, J., & Epstein, N. (1966). Children and families of concentration camp survivors. Canada’s Mental Health, 14, 24–26.
Rodin, R. G., & Rodin, M. M. (1982). Children of Holocaust survivors. Adolescent Psychiatry, 10, 66–72.
Rose, S., & Garske, J. (1987). Family environment, adjustment, and coping among children of Holocaust survivors: A comparative investigation. American Journal of Orthopsychiatry, 57, 332–344.
Rosenheck, R., & Nathan, P. (1985). Secondary traumatization in children of Vietnam veterans. Hospital and Community Psychiatry, 36 (5), 538–539.
Schauben, L. J., & Frazier, P. A. (1995). Vicarious trauma: The effects on female counselors of working with sexual violence survivors. Psychology of Women Quarterly, 19, 49–54.
Sigal, J., & Rakoff, V. (1971). Concentration camp survival: A pilot study of effects on the second generation. Canadian Psychiatric Association Journal, 16, 393–397.
Solomon, Z. (1988). The effect of combat-related posttraumatic stress disorder on the family. Psychiatry, 51 (3), 323–329.
Solomon, Z. (1990). From front line to home front: Wives of PTSD veterans. Paper presented at the 6th Annual Meeting of the Society for Traumatic Stress Studies, New Orleans, LA.
Solomon, Z., Kotler, M., & Mikulincer, M. (1988). Combat-related post-traumatic stress disorder among second-generation Holocaust survivors: Preliminary findings. American Journal of Psychiatry, 145(7), 865–868.
Solomon, Z., Waysman, M., Avitzur, E., & Enoch, D. (1991). Psychiatric symptomatology among wives of soldiers following combat stress reaction: The role of the social network and marital relations. Anxiety Research, 4 (3), 213–223.
Terr, L. C. (1979). Children of Chowchilla: A study of psychs trauma. Psychoanalytic Study of the Child, 34, 552–623.
Terr, L. C. (1983). Chowchilla revisited: The effects of psychic trauma four years after a school-bus kidnapping. American Journal of Psychiatry, 140, 1543–1550.
Terr, L. C. (1985). Children traumatized in small groups. In S. Eth & R. S. Pynoos (Eds.), Post-traumatic stress disorder in children (pp. 45–70 ). Washington, DC: American Psychiatric Association Press.
Terr, L. C. (1990). Too scared to cry: Psychic trauma in childhood. Grand Rapids, MI: Harper & Row.
Terr, L. C. (1991). Childhood traumas: An outline and overview. American Journal of Psychiatry, 148(1), 10–20.
Titchener, J. L., Kapp, F. T., & Winget, C. (1976). The Buffalo Creek syndrome: Symptoms and character change after a major disaster. In H. J. Parad, H. L. P. Resnick, & L. G. Parad (Eds.), Emergency and disaster management (pp. 283–294 ). Bowie, MD: Charles Press.
Trossman, B. (1968). Adolescent children of concentration camp survivors. Journal of the Canadian Psychiatric Association, 13, 121–123.
Verbosky, S. J., & Ryan, D. A. (1988). Female partner of Vietnam veterans: Stress by proximity. Issues in Mental Health Nursing, 9 (1), 95–104.
Wardi, D. (1992). Memorial candles: Children of the Holocaust. London: Tavistock/Routledge.
van der Kolk, B. A. (1988). The trauma spectrum: The interaction of biological and social events in the genesis of the trauma response. Journal of Traumatic Stress, 1(3), 273–290.
Weiss, E., O’Connell, A. N., & Siites, R. (1986). Comparisons of second generation Holocaust survivors, immigrants, and non-immigrants on measures of mental health. Journal of Personality and Social Psychology, 50, 828–831.
Williams, C. (1980). The veteran system with a focus on women partners: Theoretical considerations, problems and treatment strategies. In T. Williams (Ed.), Post-traumatic stress disorders of the Vietnam veteran (pp. 169–192 ). Cincinnati, OH: Disabled American Veterans.
Wilson, J. R, & Lindy, J. D. (Eds.). (1994). Countertransference in the treatment of PTSD. New York: Guilford.
Zerling, I., Podietz, K., Belmont, H., Shapiro, M., Ficher, I., Eisenstein, T., & Levick, M. (1984). Engagement in families of Holocaust survivors. Journal of Marital and Family Therapy, 10(1), 43–51.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer Science+Business Media New York
About this chapter
Cite this chapter
Ancharoff, M.R., Munroe, J.F., Fisher, L.M. (1998). The Legacy of Combat Trauma. In: Danieli, Y. (eds) International Handbook of Multigenerational Legacies of Trauma. The Plenum Series on Stress and Coping. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-5567-1_17
Download citation
DOI: https://doi.org/10.1007/978-1-4757-5567-1_17
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4419-3287-7
Online ISBN: 978-1-4757-5567-1
eBook Packages: Springer Book Archive