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PTSD Questions & Answers
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Joyce Boaz & Dr. Frank Ochberg, M.D.

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Relationships: Preventing Intergenerational PTSD

Q: Dear Frank, What can parents do to help prevent intergenerational PTSD? If a parent is suffering with PTSD symptoms how can they prevent their suffering from being visited upon their children......so that their children do not grow up feeling beaten, bleak, depressed. No parent (If the parent was victimized, traumatized by an accident, abuse, domestic violence) wants this to happen but if you are suffering yourself what would you suggest?

A: Dear Joyce, Thank you for speaking up for the millions of parents with PTSD. Let's say you are the mom of a 5 year old and you have periods in which you become anxious, startled, perhaps angry, and you feel very much alone. You may know that these feelings stem from being traumatized. In fact, your mind takes you back to the past when you were helpless and terrified.

You don't want your young child to be afraid of you or afraid for you. Your child depends upon you to feel loved, protected and to have a sense of personal optimism - that he or she will grow up and be happy and healthy. And also that you are a person who can handle difficult situations. But you also want your child to avoid strangers who may be dangerous, to know that running into traffic can cause great harm, and to have a sense of reality that is appropriate for a youngster.

Your child is definitely too young to hear all about your trauma.

So you do your best to communicate a few age-appropriate messages. These might be-

1. Yes, you did see Mommy being upset, but I'm not upset with you. I love you and I'm OK. This is the most important message to impart.

2. I was reminded of something.... (this part gets difficult and not everyone will agree). You can tell a "white lie" -that the reminder came from a TV show, not from your own life; or that the reminder was of an event from your past, but it is over and you don't want to bring it up or explain it; or that it was like a bad dream, and you had it in the daytime rather than at night. Often, young children are not that interested in details. Being emotionally upset can be like being physically upset and the child is satisfied to know that you had an ache and you are getting better.

3. You talk about recovering from feeling badly. This message is best delivered once you really have recovered your emotional balance. Depending on circumstances, including the age of your child and the confidence you feel in tackling the subject, you can explore the way both of you go from "sad to glad" or from fear to feeling calm and confident. Remember the song, "I whistle a happy tune..." ? There is Kipling's poem, "If." There is Maya Angelou's "And Still I Rise." Therapists who work with traumatized children engage in play therapy, not to teach them how adults cope with tragedy, but to offer a calm, consistent presence as the child expresses his or her anxieties and then, gradually, expresses more positive and confident outcomes. A parent with PTSD can communicate recovery, resilience and confidence. I can't think of a formula for this, but I think you get the general idea.

So - you admit you were upset. You reinforce your love and your trust in a good future. You explain as much as you have to explain, realizing that children are often too young to grasp the whole picture or to care about learning details. You eventually help your child learn to regulate emotion - to go from feeling down or anxious to feeling joyful and confident.

What if your child is older, wiser and able to understand all you have encountered in a life that was no bed of roses? Let's say you are a dad who saw combat and you have PTSD, including nightmares and numbing of positive emotion. Your daughter is in her twenties and she wants to hear all about it. This is the case of Christal Presley - http://www.christalpresley.com who wrote 30 Days With My Father. You could be that father -or a mother with a different story, but with a daughter or son who is searching for the real you and who deserves the truth.

You don't want to be "triggered" into an episode that will frighten your adult child and will be intolerable for you. But you may be ready to admit your condition and to explain some traumatic events. Would it be easier to do this with a friend from the military present? Or with a therapist in the room? Or on a walk? In a private or a public place? Think about the setting that helps both of you feel safe.

Do you want to explain what happened "over there" or would you rather explain how PTSD affects you? You could do either or both. Some traumas, such as sexual attacks, are not easy to talk about or to receive as a listener. But a perceptive adult child will have a sense of what happened and a candid explanation could relieve that son or daughter's anxiety. You might benefit from a conversation with someone you trust, a friend or a professional, about whether to reveal details --and if so, just how detailed to be.

As a therapist, I do not have a preconceived idea of how to do this. I usually listen and provide a sounding board as my patient figures out what he or she will do.

It comes up a lot. My patient is in her 40s or 50s and her sons are 17 and 25. Or my veteran patient is 60 and he has a blended family with a half-dozen kids, some who have seen combat themselves.

Since, by definition, my patient is in therapy, I can coach him or her on how to demonstrate progress in contending with PTSD - rather than dwelling on the trauma that caused the condition or the symptoms. Then the adult child becomes an ally in the struggle to survive and to cope and to overcome hardship.

Way too often, PTSD is a source of shame and therefore of self-imposed distance. The child can be confused, can assume the parent doesn't love or respect them, and can become pessimistic about life in general. Adolescent kids can "act out" - rebelling against a parent they regard as harsh or aloof. Seldom, in my experience, do parents with PTSD transfer their PTSD to their children. But they often withdraw from their children in subtle ways and give the wrong message by doing that.

So the bottom line, for preventing transmission of any form of emotional disability from parent to child is to consciously and continuously remind your children that they are loved and that you are overcoming something painful. WE SHALL OVERCOME -that is a message worth passing on.

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