Braga et al.

BMC Psychiatry 2012, 12:134

http://www.biomedcentral.com/1471-244X/12/134

RESEARCH ARTICLE Open Access

Transgenerational transmission of trauma and

resilience: a qualitative study with Brazilian
offspring of Holocaust survivors
Luciana Lorens Braga*†, Marcelo Feijó Mello*† and José Paulo Fiks†

Abstract
Background: Over the past five decades, clinicians and researchers have debated the impact of the Holocaust on
the children of its survivors. The transgenerational transmission of trauma has been explored in more than 500
articles, which have failed to reach reliable conclusions that could be generalized. The psychiatric literature shows
mixed findings regarding this subject: many clinical studies reported psychopathological findings related to
transgenerational transmission of trauma and some empirical research has found no evidence of this phenomenon
in offspring of Holocaust survivors.
Method: This qualitative study aims to detect how the second generation perceives transgenerational transmission
of their parents’ experiences in the Holocaust. In-depth individual interviews were conducted with fifteen offspring
of Holocaust survivors and sought to analyze experiences, meanings and subjective processes of the participants. A
Grounded Theory approach was employed, and constant comparative method was used for analysis of textual data.
Results: The development of conceptual categories led to the emergence of distinct patterns of communication
from parents to their descendants. The qualitative methodology also allowed systematization of the different ways
in which offspring can deal with parental trauma, which determine the development of specific mechanisms of
traumatic experience or resilience in the second generation.
Conclusions: The conceptual categories constructed by the Grounded Theory approach were used to present a
possible model of the transgenerational transmission of trauma, showing that not only traumatic experiences, but
also resilience patterns can be transmitted to and developed by the second generation. As in all qualitative studies,
these conclusions cannot be generalized, but the findings can be tested in other contexts.
Keywords: Transgenerational, Transmission, Trauma, Resilience, Offspring, Holocaust, PTSD

Background This phenomenon has importance beyond the study of

More than 50 years after the liberation of Nazi concen- OHS. Many studies suggest that genocides in Rwanda,
tration camps, researchers and clinicians are still Nigeria, Cambodia, Armenia, and former Yugoslavia
devoted to studying the long-lasting consequences of the brought about distinct psychopathological symptoms in
traumatic experiences endured by Holocaust survivors offspring of survivors [2]. Depression, posttraumatic
and their descendants. This is probably the most com- stress disorder (PTSD), attention deficits, and behavior
prehensively researched case of transgenerational trans- disorders were more pronounced in children of tortured
mission of trauma [1]. Despite this, there are no parents, as compared to controls [3].
published studies conducted with Brazilian offspring of In the medical literature, the first study concerning the
Holocaust Survivors (OHS). transgenerational effects of trauma in OHS was pub-
lished in 1966. The author, Dr. Vivian Rakoff, was re-
searcher at the Jewish General Hospital in Montreal, a
* Correspondence: [email protected]; [email protected] city where thousands of Holocaust survivors had settled
†
Equal contributors
Department of Psychiatry, São Paulo School of Medicine, Federal University
[4]. Then, other psychiatrists and psychologists who
of São Paulo, Rua Botucatu 431, 04023-061 São Paulo, SP, Brazil were also treating OHS published case reports of their
© 2012 Braga et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
Braga et al. BMC Psychiatry 2012, 12:134 Page 2 of 11
http://www.biomedcentral.com/1471-244X/12/134

own [5-7], proposing that the psychiatric disorders of the availability of protective factors, including internal
these patients were the result of a “survivor syndrome” assets and external resources that may be associated
[8] perpetuated from one generation to the next [9]. with counteracting the effects of risk factors, and (iii)
The idea that a parental traumatic experience could the achievement of positive adaptation despite experi-
reach the second generation soon gained consistency. ences of significant adversity” [30].
Clinical studies [10-13] reported a wide range of The review of the literature suggests that current stud-
affective and emotional symptoms transmitted over gen- ies on transgenerational transmission of trauma to OHS
erations: distrust of the world, impaired parental func- are not conclusive. There is no consensus between the
tion, chronic sorrow, inability to communicate feelings, clinical observations and empiric research on the exist-
an ever-present fear of danger, pressure for educational ence of long-term psychological effects on Holocaust
achievement, separation anxiety, lack of entitlement, un- survivors and their offspring [31,32]. Whereas case
clear boundaries, and overprotectiveness within a narcis- reports are indicative of transgenerational transmission
sist family system. of trauma [33], systematic studies have found no psycho-
Although clinical data provided evidence of psycho- pathologic manifestations in the children of Holocaust
pathologic effects on OHS, some methodological limita- survivors, except when they were exposed to life-
tions were apparent: predominance of case reports, threatening situations [34,35].
unclear definitions of psychopathology, small sample The objective of qualitative studies [36-38] is to ex-
sizes, sampling biases, absence of control groups, and plore conceptual aspects [39] and understand different
lack of standardized instruments [14]. meanings and nuances of these apparent contradictions
The literature on the “Second Generation” has grown between clinical research and controlled methodologies.
quickly and profusely since the mid-1980s. Controlled The present study aims to detect how Brazilian OHS
studies have confirmed that Holocaust trauma has psy- perceive transgenerational transmission of their parents’
chological impacts on the children of survivors [15], experiences in the Holocaust. We should point out that
such as higher levels of childhood trauma, increased vul- studying specifically this sample is an important data, in
nerability to PTSD and other psychiatric disorders as much as the vast majority of the specific literature is
[16,17]. based on American, European or Israelite population.
Conversely, other studies have pointed out that OHS The immigration of the first generation to Brazil and the
were in no way affected in terms of personal adjustment Brazilian culture itself could play a diverse role in the
[18-20] and that differences between OHS and control experience of being offspring of Holocaust survivors.
groups could suggest a specific character organization
rather than psychopathology [21,22]. Specific types of Method
interpersonal relations were found in OHS, and were Participants
related to the pattern of parental communication regard- The nonclinical sample of this qualitative study were
ing the Holocaust [23,24]. No evidence of personality recruited initially from a Brazilian Jewish Institution, and
disturbances was showed in methodologically sophisti- then, by snowball sampling. The participants and the
cated studies conducted with nonclinical samples of researchers had no former acquaintance. They were
OHS [25,26]. identified by their history of being OHS: they were all
A series of meta-analytical studies conducted with sec- men and women whose parents had survived the Holo-
ond generation [27] and third generation [28] offspring caust. Specifically, the inclusion criterion for our study
found no evidence of transgenerational transmission of was based on the following definition of Holocaust sur-
trauma, except in studies conducted with “selected” vivor: an individual who had lived under Nazi rule or in-
samples. These resilient patterns were widely described fluence and was subject to: 1) forced displacement; 2)
in literature and, for the purpose of this study, we restriction in a ghetto; 3) permanence as a refugee or in
adopted the definition of resilience provided by the hiding places; 4) confinement in forced labor camps or
American Psychological Association: “the process of extermination camps [40]. We avoided recruiting
adapting well in the face of adversity, trauma, tragedy, patients of mental health services, as the research focus
threats, or even significant sources of stress – such as was on the general population.
family and relationship problems, serious health pro- The participants comprised 15 adult OHS (7 males, 8
blems, or workplace and financial stressors. It means females). They ranged in the age from 40 to 66 years
‘bouncing back’ from difficult experience” [29]. and the number of years of education ranged from 12 to
There are three critical conditions in almost all defini- 22 years and they were well adapted to their professional
tions of resilience: “(i) growing up in distressing life con- careers. At the time of the interview, 13 participants had
ditions and demanding societal conditions that are a stable union or civil marriage and two were divorced.
considered significant threats or severe adversities, (ii) Only one didn’t have children and the main number of
Braga et al. BMC Psychiatry 2012, 12:134 Page 3 of 11
http://www.biomedcentral.com/1471-244X/12/134

children was two. They presented good functioning in differences and negative cases [42], what provided the
terms of personal, social and professional lives. Five of means for the realization of the third stage: Codifica-
them have had history of prior anxiety disorders, but tion of categories.
any participants presented psychiatric problems at the The codification process made possible the creation
time of the interview. Concerning the parents, nine par- of categories and subcategories, which were all in-
ticipants were offspring of parents that had survived ductively derived from the content of the interviews.
Nazi concentration camps and six had parents that had “To code, data are broken down, compared, and then
been restricted in ghettos or in hiding places during the placed in a category. Similar data are placed in simi-
Holocaust. lar categories, and different data creates new categor-
ies” [43]. To be created, a category or subcategory
Procedures had to be based in the repetition of the theme in
All eligible individuals were sent an invitation letter, two or more interviews. This process can be better
which was followed by a phone call from the main inves- understood as following:
tigator (first author), who explained the general aims of
the research. Prior to interviews, all participants were a) First of all, a more opened way of coding data
assured that their anonymity would be maintained. enabled the identification of Descriptive Categories,
Then, they completed a demographic questionnaire and by recognizing general and non-selective thematic
provided written informed consent by means of a axes in the interviews.
standardized form approved by the University Research b) Then, the constant questioning of data led to a new
Ethics Committee. The lead investigator conducted all classification of these axes during the phase of axial
interviews at a location chosen by the participant (usu- coding, when data were “put back together in new
ally, at their homes). ways” [44], making new connections and facilitating
Participants were invited to speak freely about the the emergence of few core phenomena and
traumatic experiences of their parents and how these Conceptual Categories.
experiences affected their lives. The in-depth ap- c) Finally, the selective coding reordered the
proach was assured by semi-structured open-ended categories from the perspective of the core
interviews, which prioritized interviewees’ feelings and phenomena, enabling the establishment of
the meanings they assigned to their memories and Theoretical Categories.
experiences. The interviews were conducted in
Portuguese, lasted from one to three hours, were By this systematic procedure, the interpretative work
digitally recorded and transcribed verbatim. The tran- was accomplished through the development of a com-
scripts were compared to the audiotaped interviews prehensive model to understand the phenomenon in
to check for accuracy. The sample was closed when question. An example of data analysis is in Table 1.
theme saturation was achieved. To amplify inter-rater reliability of data analysis pro-
cedure, three investigators performed the thematic con-
Data analysis tent analysis separately. Then, the individual analysis
A qualitative method seeks to understand and interpret were compared and discussed, examining the diverse
the subjective meanings of peoples’ experiences rather categories and the interpretations of findings. The differ-
than to test hypothesis and generalize findings. The ences were discussed and a mutual consent was pursued,
Grounded Theory (GT) methodology [41], chosen as the leading to a high level of agreement between the
theoretical basis for analysis and interpretation of data, researchers.
is a qualitative research method based on a systematic
set of procedures used to develop a model derived in- Results
ductively from the study phenomenon. GT-based analysis of the 15 interviews enabled con-
The data analysis involved a succession of phases for struction of a system of categories related to transge-
its realization. The first stage was actually a Pre-Analysis, nerational transmission of trauma and resilience
in which the investigators established an initial contact between Holocaust survivors and the second gener-
with the texts without prioritizing any specific aspect, so ation (Table 2). Development of conceptual categories
that the content could gain clarity in an overall led to the systematization of patterns of communica-
perspective. tion between the first and second generations, and
The second stage consisted of analyzing each inter- ways in which descendants deal with their parents’
view individually (Within-case analysis) and confront- traumatic experiences, which entails mechanisms of
ing analysis of all cases (Cross-case analysis). This transgenerational transmission of trauma or resilience
procedure enabled discovery of similarities, standards, in the second generation.
Braga et al. BMC Psychiatry 2012, 12:134 Page 4 of 11
http://www.biomedcentral.com/1471-244X/12/134

Table 1 Sample of data analysis: construction of categories

Coded original transcript Descriptive categories Conceptual categories
Participant11: “This secret I carried, c1: Transmission of family secrets c2: Parenting style
I found out that it was their secret (c1). . . between us,
c2: Impaired parental function c1, c3, c4: Transgenerational
there are no relations of love, there are survival relations (c2). . .
It’s this whole strategy for infusing their children with a transmission of trauma
c3: Transmission of fear and of a
manual for surviving a collective disaster. To this day, terrifying world view
I bear a trace of this Holocaust survival handbook (c3). . .
in a way, I was told, you have to recognize the c4: Transmission of mistrust and
signs of a disaster before others do (c4)” anticipation of disasters

Participant 5: “Each day I tell the story of my father, c5: Symbolic dimension of art c5, c6: Pathways of psychical
in this play I am performing in the theatre, work over by offspring
c6: Art as a possibility of
it seems I understand a little more (c5). . .
representing the catastrophe
To tell this story in an artistic way – using music,
dance, the theatre, painting – is also a way of
showing the world what happened (c6)”
Participant 4: “My father shows me the story of a c7: Resilient expressions in parents’ lives c7, c8: Intergenerational
man who lived through all those things and is here, transmission of resilience
right now, moving forward. . . (c7) c8: Pathways of resilience in offspring
this attitude reaches me in a certain way.
I think I grew up with very few fears” (c8)

Communication style spectrum, ranging from open, everyday communication to

The following subcategorization scheme respected the its opposite – silence, secrets and the unsaid. Communi-
relevance of modes of communication between Holocaust cation style has a significant impact on the manner in
survivors and their offspring. These modes cross a broad which members of the second generation integrate their
parents’ traumatic experiences into their lives.
Table 2 Final typology of conceptual categories
Conceptual categories Subcategories Open, loving, everyday communication
1. Communication style 1.1 Open, loving, everyday communication Some participants claimed to have had contact with
1.2 Communication through formal their parents’ experiences through everyday conversa-
records and documents tion. The presence of an open, loving communication
1.3 Indirect communication style enabled creation of symbolization mechanisms,
1.4 Catastrophic, fragmented communication which, in turn, favored resilient outcomes.
1.5 Secrets, silence and the unsaid
My mother would tell us stories of the war ever since I
Experience of trauma 2.1 Terrifying world view: attempts
to anticipate disaster was a child. We’d hear those stories at bedtime. She
didn’t tell us fairy tales, but parts of her own story,
2.2 Psychical deterritorialization: lack of
rootedness and sense of belonging which always had a [message] of hope. [. . .] She
2.3 Presentification of the traumatic parental
managed to stay in this bubble [. . .] sort of like “Life Is
Beautiful”. (Interviewee 01)
2.4 experience
2.5 Experiences of guilt, victimization
and submission The use of linguistic resources, such as jokes and
2.6 Fear of being recognized by comic tirades, enables a peculiar approach to the trau-
external identifiers matic experience: while it makes the issue easier to ad-
2.7 Attempts to explain parental survival and dress, it simultaneously serves to denounce the violence
impact on the second generation experienced. In these cases, humor may be viewed as a
Mechanisms of psychical 3.1 Search for a radical singularity from sort of symbolic displacement, at once allowing the sur-
working over the parental history vivor to present and repudiate the traumatic experience
and resilience
without distancing himself or herself from it, creating
3.2 Visitation of sites related to the something of a cushion to lessen the impact of traumatic
traumatic parental experience
experience:
3.3 Art as a possible means of
representing the catastrophe
We’re even famous for this Jewish brand of humor,
3.4 Sense of belonging to a group:
bonding and social support
which can find the fun even in a major tragedy, but
not in a meaningless way, of course. [. . .] We got to
3.5 Defense of universal, humanistic values
know my father’s history during the war through these
Braga et al. BMC Psychiatry 2012, 12:134 Page 5 of 11
http://www.biomedcentral.com/1471-244X/12/134

ironic, comic outbursts [of his]. [. . .] And then the a negative impact on the lives of their offspring. This
story came. (Interviewee 05) commonly led to silence, secrets and points left unsaid
concerning traumatic experiences. As parents did not
Communication through formal records and documents address their traumatic experiences, the second gener-
Many survivors took part in formal interviews and other ation found it more difficult to achieve psychical and
types of documentary records in an attempt to biographical integration of these events, as indicated by
systematize and order their experience, so their children the following excerpt:
and grandchildren could be aware of their experiences
during the war. Use of this resource by survivors attenu- My parents don’t build any theories and they have
ates possible hurdles to direct communication. Many nothing to tell, because they don’t want to remember,
OHS were only able to find out about their parents’ they’re afraid of remembering, they’re ashamed of
traumatic experiences through access to these records. remembering, because each and every one of their
memories comes wrapped in this shame of having
She never talked about this matter. When she recorded been [who they were] or having lived what they
[her testimony] for Spielberg’s project, she talked two lived. (Interviewee 01)
tapes’ worth. . . and she wouldn’t talk about it before.
[. . .] At all. I only found out about [these] things when Experiences of trauma
I heard the tape. (Interviewee 12) The following subcategories comprise second-generation
experiences that correlate with the disruptive parental
Indirect communication life event. Experience of trauma for OHS may be pre-
Some participants reported that their parents had never sented as a wide range of manifestations, all of which
directly recounted their traumatic experiences. These feature the presence of behaviors, worldviews or experi-
OHS became aware of their parents’ trauma indirectly, ences that follow patterns similar to the traumatization
upon hearing conversations between their parents and suffered by Holocaust survivors.
third parties, perceiving the meaning of nonverbal mani-
festations and feeling the weight of the psychical envir- Terrifying world view: attempts to anticipate disaster
onment during encounters between survivors. The Some participants claimed their parents had failed to
following segments deal with this aspect of parental provide an affective framework of security, stability and
communication. predictability; instead, many survivors transmitted a ter-
rifying view of the world to their children. The offspring
When my mother sat down with her friends, she made of these parents feel the need to always be ready to react
a point of having me stay and listen [. . .] She to imminent catastrophes and potential threats to their
practically forced me to stay. [. . .] It seems she got this survival. The following excerpts provide prime examples
morbid pleasure out of talking about it [. . .] She liked of this scenario:
to talk about the subject, but not to me, not with me.
(Interviewee 07). You have to be successful, have power, clout, [to] be
able to get by in a disaster situation. [. . .] To this day,
Catastrophic, fragmented communication I bear a trace of this Holocaust survival handbook
Some descendents were able to identify a presentifica- [. . .]: if I’m at a meeting with human beings, I’ll never
tion of catastrophic events in their parents’ communica- be among the last to leave. Why? Because, in a way, I
tion patterns, expressed as aggressive or fragmented was told, you have to recognize the signs of a disaster
discourse, conveying a terrifying view of the world. before others do. (Interviewee 11)

We talked of the Nazis at home as we talk of the air Expired passport: not an option. It doesn’t matter if
we breathe. [. . .] The stories were about the Nazis. you’re not going to travel for the next twenty years
There were few stories about what it was like at the [. . .]: you have to renew it, you always have to
village where my father was born, or what it was like have, let’s say, a pair of underwear and a pair of
in the city. [. . .] All the stories were about atrocities socks at hand so you can take off. Always ready.
she’d witnessed. [. . .] We didn’t eat soup at home, we (Interviewee 13)
had blood instead. (Interviewee 11)
Psychical deterritorialization: lack of rootedness and sense
Secrets, silences and the unsaid of belonging
The communication patterns of survivors are often per- This category describes experiences of feeling a lack of
vaded by feelings of guilt and shame or by fear of having rootedness or belonging. Interviewees associated these
Braga et al. BMC Psychiatry 2012, 12:134 Page 6 of 11
http://www.biomedcentral.com/1471-244X/12/134

feelings with a fragmented family history, characterized be externally identifiable as having any sort of
by a large number of deceased relatives, unmet relatives, affiliation. [. . .] That’s an expression of “not wanting to
lost roots, difficult logical nexuses, and a precarious, be seen”. These are typical thoughts of a survivor’s
frayed symbolic fabric. It was reported by many OHS as daughter. (Interviewee 02)
an experience of psychical deterritorialization:
Attempts to explain parental survival and impact on the
My mother would tell us how she hid underneath the second generation
train: on top of the wheels, under the floorboards. Descendents mentioned several elements that could
That’s really the image I was raised in, not inside of have explained or justified the survival of their parents:
anything, no. Outside. Outside, in this implausible chance and luck; contact with powerful, influential indi-
place in which we travel through life, on top of wheels, viduals (social capital); multilingualism (cultural capital);
with no floor. (Interviewee 11) the opportunity of being assigned distinct tasks or pro-
vided a different diet while in concentration camps (ac-
Presentification of parental traumatic experiences cess to privileges); attempts to never stand out (making
OHS related feelings of fear and symptoms of autonomic oneself mediocre and “invisible”); and several others.
hyperreactivity, as if they themselves were experiencing The descendents’ discourse reveals ways in which
their parents’ traumatic events or had lived at the time these signifiers tied to parental survival were passed
in which these events transpired. Some interviewees felt down in the form of a family myth, reactualized in the
as if they were currently living experiences typical of war descendents’ lives:
victims:
The Germans came back and killed everyone who was
I was having a lot of these nightmares about being trying to get food. As my father was very small and
chased. Then I told my mother: “I’m going to therapy, I very weak, he just watched. So, he saw everyone be
must have a problem”. [In the nightmares,] I ran and I killed and he wasn’t killed himself. So, that may have
ran and I saw [Nazi] uniforms, narrow hallways and given me, and perhaps even my brother, something like
doors and people threatening me with guns. this: we never expose ourselves, we never put ourselves
(Interviewee 09) out there. (Interviewee 14)

Experiences of guilt, victimization and submission Mechanisms of psychical working over and resilience
Some descendents related to the victimization of their This category comprises mechanisms used by descen-
own parents and reported feelings of guilt and submis- dents for psychical working over of parental traumatic
sion of their own. experiences. It encompasses a broad spectrum of
mechanisms, ranging from the private to the universal.
What was always very tough was how to relate to this On one pole, descendents can support their own resili-
story, moving through this issue of being a victim, you ence by constructing unique narratives of their parents’
know? Myself, that is. Me, as a victim of this history. I history. On the other, personal involvement in the
have a mother who went through the war and, defense of collective, universal values, transcending the
consequently, I’d be entitled to this host of frailties, particulars of one’s family history, may be identified as a
issues, problems – anyway, the world would have to be means of escaping the traumatic experience.
understanding, right? [. . .] Once, my therapist yelled
at me, in a situation I couldn’t work out: “How long Search for a radical singularity from the parental history
are you going to lick the Nazis’ jackboots?” [. . .] It’s a Faced with the fragmented, enigmatic discourse of their
[feeling of] great helplessness. (Interviewee 01) survivor parents, some interviewees created their own
narratives of parental experiences as a means of taking
Fear of being recognized by external identifiers possession of this past. This may constitute a possible
Several interviews revealed transgenerational transmis- resilience mechanism. Sometimes, the process began in
sion of feelings of persecution, unfounded on concrete childhood:
bases or motivations of OHS’ current lives. These may
occur as fears restricted to self-identification as a Jew or I knew there was something odd about my father when
relative to any type of social identifiability, as the follow- I saw that number tattooed on his arm. When I was a
ing excerpt shows: child, [. . .] I always asked him and my father would
say: “It’s from the war!”. [. . .] Romantically, I used to
People wear crucifixes, Stars of David, they put think: “My father fought in the war! He’s a big hero!”
bumper stickers on their cars. . . I notice I don’t like to (Interviewee 05)
Braga et al. BMC Psychiatry 2012, 12:134 Page 7 of 11
http://www.biomedcentral.com/1471-244X/12/134

This kind of imaginary reconstruction (creation of the existence of peers with whom OSH can share their
epic, heroic, poetic, romanticized narratives) of parental experience.
history had an actual effect on reality, turning a “cursed
inheritance” into a memorable, singular history. We have a family ritual my father used to have [. . .].
Once a year, we visit the graves at the local cemetery.
I think he survived because he’s an only child, and I So, we pay a visit to our dead relatives and I always
think he was raised with a lot of love. That saved him stop by the monument to the Holocaust dead. [. . .] We
and protected him. [. . .]. It’s a private experience. [. . .] used to do this and now I do it and my son goes with
In this sense, war strengthened life. (Interviewee 04) me and he does the same. (Interviewee 02)

Visitation of sites related to the traumatic parental In this sense, Judaism, as a category of belonging to a
experience group, was not reported by participants merely in its re-
Field visits enabled displacement of the traumatic ex- ligious, ethnic, linguistic or cultural dimension, but as an
perience from a distant, enigmatic, cloudy, inappropri- existential issue or legacy that cannot but be
able plane to another, more concrete, accessible and real transmitted.
one. This opened the door to resignification and a sym-
bolic working over of the traumatic parental experience The effects of this loss [referring to her father’s
through visitation of parents’ birthplaces and of concen- trauma] reach me through this search for a Jewish
tration camps. identity, which I ask like so: what is it like to be a
Jew? I have this legacy I can’t lose, and that
I had the opportunity to go back to Poland with my doesn’t mean preaching about the Holocaust, it
father. [. . .] It was a very intense experience, because we doesn’t mean bonding with other Jews and saying
went to the camp where he was held, we paid a visit to “poor us”, it doesn’t mean having a relationship
Auschwitz-Birkenau. [. . .] This trip was a very strong with Israel, it doesn’t mean being religious.
experience, because he told me the story again and he (Interviewee 02)
worked this story over for himself. (Interviewee 02)
Defense of universal, humanist values
Art as a possible means of representing the catastrophe Descendents who defend values such as freedom, toler-
Some reports mentioned the crucial role of art (theatre, ance and respect for differences tend to escape
music, fiction, cinema etc.) in symbolically working over victimization. As they do not constrain themselves to a
traumatic parental experiences. uniform, narrow-minded cultural environment, these
OHS broaden their worldview and begin to take into
I was very shocked by the play. [. . .] The entire second account the history of other peoples that have also
act took place between two survivors who were moving been subjected to traumatic experiences that, from a
stones around. [. . .] I took my father [to see it]. When humanitarian standpoint, are just as relevant as the
he left the theatre, he said: “That’s my story exactly. . . plight of the Jews.
that was my job at the camp”. I didn’t know yet that. I
was fifteen years old. I remember leaving [the theatre] It really pisses me off when someone says something
and writing a short story about that moment, which I discriminatory. Even when a Jew says: “because we, the
kept under lock and key for years. (Interviewee 05) Jews, the chosen people”. . . Who aren’t a chosen
people? Blacks aren’t? [. . .] When we go out into the
Faced with unspeakable trauma, fictional recreation street, we see everyone’s Holocaust. [The homeless] are
and other forms of artistic output and realization were just as imprisoned as if in a [concentration] camp;
privileged means of resilience reported by the second society looks, but doesn’t see. (Interviewee 05)
generation:
By not identifying themselves as heirs of an unique
I asked my father for permission to write his story [of life traumatic history, descendents give themselves more fa-
during the Holocaust]. Each day I tell this story in my vorable conditions for developing resilience.
play, which I have performed for nearly four years, it
seems I can understand a little more. (Interviewee 05) My father never victimized himself. I think he read the
war mainly as a political issue. [. . .] He felt that a
Sense of belonging to a group: bonding and social support fairer world and freedom of thought would avoid that
Opposition to any sort of uniqueness of the parental his- sort of madness [. . .] and that human beings are
tory ensures comfort in one’s identity, social bonds, and entitled to freedom and equality. (Interviewee 04)
Braga et al. BMC Psychiatry 2012, 12:134 Page 8 of 11
http://www.biomedcentral.com/1471-244X/12/134

Discussion consequences of traumatic events are not limited to the

Analysis of interviews revealed multiple and diverse persons immediately exposed to the event, and they often
effects of transgenerational transmission of trauma, a affect significant others in their environment such as
phenomenon that showed to be neither linear nor one- family, friends, and caregivers. Such effects include diffi-
dimensional. This result was in line with a recent finding culties, intrusive imagery, heightened sense of vulnerabil-
in literature, which demonstrated a mixed functional ity, difficulty trusting others, and emotional numbing”.
profile in the midlife of OHS: specific strengths (a higher [46].
sense of well-being) intertwined with specific vulnerabil- Otherwise, survivors find diverse means of working
ities (more physical health problems) [45]. over their disruptive experiences, whether by means of
Using the GT-derived conceptual categories, we personal narratives, documentary records, cultural
sought to present a scheme linking transgenerational rituals and expressions, tapping into collective memory
transmission patterns or resilience patterns to phenom- or defending universal values. These different modes of
ena related to parental trauma. These phenomena were appropriation and historicization of experiences may en-
related to three elements: (i) modes of parental psychic able the transmission of resilience patterns to the second
working over, (ii) ways in which survivors communicate generation. Nevertheless, a recent study demonstrated
the traumatic message to their offspring, and (iii) reper- that “Holocaust survivors can still display posttraumatic
cussions of trauma on second-generation experiences stress symptoms almost 70 years after the trauma,
(Table 3). whereas no intergenerational transmission of trauma
The mode of parental psychical working over concerns was found among the second generation” [47].
survivors’ ability or inability to symbolize disruptive The mode of parental psychical working over is asso-
experiences. The pattern of transgenerational transmis- ciated with the ways in which survivors relay their Holo-
sion or resilience may be regarded as an effect of this caust experiences to their offspring (the parental
phenomenon. When symbolic resources for symbolic communication style). Our current findings are consist-
working over fail or are lacking, trauma and its transge- ent with previous studies, which indicate that the differ-
nerational transmission may lead to several psychopatho- ent roles of affect regulation, narrative cohesion, and
logic disorders and somatization. The phenomenon of symbolic representation, bears the diverse ways in which
secondary traumatization have been described in clinical the parental traumatic experience is appropriated by the
observations and empirical research, showing that “the offspring [48]. Resilience is a recurring outcome among

Table 3 Model for transgenerational transmission: experience of trauma and resilience patterns
Phenomena associated with parental trauma Patterns of transgenerational transmission
Experience of trauma Resilience patterns
1. WORKING OVER (by survivors) Inability to work over: Psychical working over ability intact:
• psychopathological disorders • personal narratives
• somatic symptoms • documentary records
• cultural rituals
• collective memory
• defense of universal values
2. COMMUNICATION • indirect communication • open, loving, everyday communications
(from survivors to their offspring)
• fragmented discourse
• silence, secrets, the unsaid • use of humor as a symbolic resource
3. REPERCUSSIONS •fear of being identified by • imaginary resources
(in the lives of survivors’ offspring) external indicators
• artistic creation
• psychical deterritorialization • appropriation of parental resilience patterns
•experiences of guilt, victimization
and submission
• presentification of parental trauma • field visits and search for knowledge
of the Holocaust
• terrifying worldview • collective bonding and social support
• universal values and social and political activism
Braga et al. BMC Psychiatry 2012, 12:134 Page 9 of 11
http://www.biomedcentral.com/1471-244X/12/134

offspring of families with more open and affectionate As any qualitative study, findings cannot be general-
communication styles, which frequently make use of ized. This kind of research has typically a small scale
humor as a symbolic resource. Conversely, experience of and an exploratory nature. It would be of interest to
trauma is most evident in offspring of survivors that do amplify its domains to other settings, including not
not speak of their traumatic experiences, keep them as a only the descendants of victims of wars, but also vic-
secret or relay them in an indirect, fragmented, cata- tims of natural catastrophes and other disasters. This
strophic manner. was done in a recent research that studied the mental
Some authors prefer the term “echoes of parental trau- health consequences of the 2011 Fukushima natural
matic memory” to describe this kind of phenomenon, disaster in grandchildren of people living in Hiroshima
underscoring that “we are not dealing with the transmis- and Nagasaki during the drop of the atomic bomb
sion of trauma itself, but rather with interpersonal [51]. The description of some specific aspects found in
themes and child-parent dynamics in which these the results can also be explored in further researches,
‘echoes’ of the trauma may play out in the offspring’s with complementary methodologies, like quantitative
recollected relational experiences” [49]. approaches.
The manner in which the traumatic message is As in other studies of retrospective narratives, the
conveyed or silenced by parents can have distinct interviewees may highlight their descriptions of past
repercussions on psychical working over in their off- experiences with the colors of present intentions and
spring. On the one hand, this message may lead OHS feelings, with a high level of motivation to talk about
to associate Holocaust trauma with their parents’ in- their experience that may not be found representative of
ability to adequately carry out their parental func- general population.
tions, compounding potential feelings of psychical Another limitation of this present study is that it did
deterritorialization. Other patterns of traumatic ex- not specify the results in function of the gender of the
perience lived by OHS may be manifested in many offspring. This could be of interest, given that some
ways, such as: fear of being identified by external studies have pointed out gender differences in cases of
signs; experiences of guilt, victimization and submis- transgenerational transmission of trauma.
sion; presentification of parental trauma; and a terri-
fying worldview. Conclusions
On the other hand, the repercussions of traumatic Using a GT approach based on interviews with off-
messages on the lives of OHS may contribute to the de- spring of Holocaust survivors, this study led to the
velopment of resilient patterns, when they are associated emergence of a comprehensive model of transgenera-
with the defense of universal or communal values, social tional transmission of trauma. Analysis of this model –
and political activism, a search for collective bonding which is based on phenomena such as survivors’ ability
and social support networks, attempts to gain greater or inability to symbolically work over traumatic events,
knowledge of the Holocaust, artistic creation and styles of communication between the first and second
realization processes, and exaltation of the radical singu- generations, and the various repercussions of parental
larity of parental history – by means of poetic, epic, trauma on the lives of their offspring – led to the con-
romanticized narratives –, turning a “cursed inheritance” clusion that, just as the traumatic dimensions of a
of sorts into a memorable legacy. traumatic experience can be conveyed transgeneration-
Approaches for the comprehension of transgenera- ally, so can the possibility of overcoming trauma, with
tional transmission of trauma have included psycho- the development of resilience mechanisms by survivors’
dynamic, cognitive, familiar, social and biologic theories offspring.
and models. Although being the topic of much research, As this was a qualitative study, its findings cannot be
only very few studies have considered some cultural generalized to other populations. However, exploration
aspects, like immigration, and their role in the mental of experiences, meanings and subjective processes
health status of OHS. One of these studies postulates enabled construction of a theoretical model, which be-
that personality differences among OHS could be attrib- came a relevant theoretical tool for understanding pos-
uted to their immigrant status rather than to their par- sible mechanisms of transgenerational transmission of
ents’ experiences as Holocaust survivors [50]. Facing the trauma and resilience in the offspring of patients with
challenges of being in a new country, with a different histories of trauma due to catastrophic events. Further
culture, could play an important role not only for the studies on this theme are warranted, including studies
first generation, but also for their offspring, who perform employing complementary or quantitative methods, in
the duty of being a facilitator of communication or even order to confirm or refute the hypotheses generated
a bulkhead between their parents and the local herein and, possibly, to generalize findings to larger
population. populations.
Braga et al. BMC Psychiatry 2012, 12:134 Page 10 of 11
http://www.biomedcentral.com/1471-244X/12/134

Competing interests 23. Lichtman H: Parental communication of Holocaust experiences and

The authors declare they have no competing interests. personality characteristics among second-generation survivors. J Clin
Psychol 1984, 40:914–924.
24. Wiseman H, Barber JP, Raz A, Yam I, Foltz C, Livne-Snir S: Parental
Authors contributions
communication of Holocaust experiences and interpersonal patterns in
LLB conceived the study, performed the design of the research, conducted
offspring of Holocaust survivors. Int J Behav Dev 2002, 26:371–381.
the interviews and data analysis, and drafted the manuscript. MFM
25. Baron L, Reznikoff M, Glenwick DS: Narcisism, interpersonal adjustment
participated in analysis and interpretation of the data and helped to draft
and coping in children of Holocaust survivors. J Psychol 1993,
the manuscript. JPF participated in the design of the study, in analysis and
127:257–269.
interpretation of data and critically revised the manuscript. All authors read
26. Sagi-Schwartz A, van IJzendoorn MH, Grossmann K, Joels T, Grossmann K,
and approved the final manuscript.
Scharf M, Koren-Karie N, Alkalay S: Attachment and traumatic stress in
female Holocaust child survivors and their daughters. Am J Psychiatry
Acknowledgements 2003, 160:1086–1092.
Many thanks are due to all participants of the study. 27. Van IJzendoorn MH, Bakermans-Kranenburg MJ, Sagi-Schwartz A: Are
children of Holocaust survivors less well-adapted? No meta-analytic
Received: 21 February 2011 Accepted: 14 August 2012 evidence for secondary traumatization. J Trauma Stress 2003, 16:459–469.
Published: 3 September 2012 28. Sagi-Schwartz A, van IJzendoorn MH, Bakermans-Kranenburg MJ: Does
intergenerational transmission of trauma skip a generation? No
meta-analytic evidence for tertiary traumatization with the third
References
generation of Holocaust survivors. Attach Hum Dev 2008, 10:105–121.
1. Starman H: Generations of Trauma: Victimhood and the Perpetuation of
29. American Psychological Association: The road to resilience. http://www.apa.
Abuse in Holocaust Survivors. Hist Anthropol 2006, 17(4):327–338.
org/helpcenter/road-resilience.aspx.
2. Danieli Y: Intergenerational handbook of multigenerational legacies of trauma.
30. Lee TY, Cheung CK, Kwong WM: Resilience as a positive youth
New York: Plenum Press; 1998.
development construct: a conceptual review. Sci World J 2012, 390450:9.
3. Daud A, Skoglund DA, Rydelius P-A: Children in families of torture victims:
doi:10.1100/2012/390450.
Transgenerational transmission of parents’ traumatic experiences to
31. Bar-On D, Eland J, Kleber RJ, Krell R, Moore Y, Sagi A, Soriano E, Suedfeld P,
their children. Int J Soc Welf 2005, 14:23–32.
Van der Velden PG, van IJzendoorn MH: Multigenerational perspectives on
4. Epstein H: Children of the Holocaust: conversations with sons and daughters
coping with the holocaust experience: An attachment perspective for
of survivors. New York: Penguin; 1979.
understanding the developmental sequelae of trauma across
5. Rakoff V, Sigal JJ, Epstein NB: Children and families of concentration camp
generations. Int J Behav Dev 1998, 22:315–338.
survivors. Can Ment Health 1967, 14:24–26.
6. Trossman B: Adolescent children of concentration camp survivors. J Can 32. Levav I, Kohn R, Schwartz S: The psychiatric after-effects of the Holocaust
on the second generation [Editorial]. Psychol Med 1998, 28:755–760.
Psychiatr Assoc 1968, 13:121–131.
7. Sigal JJ: Second Generation Effects of Massive Psychic Trauma. Int 33. Phillips RE: Impact of Nazi Holocaust on children of survivors. Am J
Psychiatr Clin 1971, 8:55–65. Psychother 1978, 32:370–378.
8. Niederland WG: Clinical observations on the “Survivor Syndrome”. Int J 34. Baider L, Peretz T, Hadani PE, Perry S, Avramov R, De Nour AK: Transmission
Psychoanal 1968, 49:313–315. of response to trauma? Second-generation Holocaust survivors’ reaction
9. Barocas HA, Barocas CB: Manifestations of concentration camp effects on to cancer. Am J Psychiatry 2000, 157:904–910.
the second generation. Am J Psychiatry 1973, 130:820–821. 35. Solomon Z, Kotler M, Mikulincer M: Combat-related posttraumatic stress
10. Barocas HA, Barocas CB: Wounds of the fathers: The next generation of disorder among 2nd generation Holocaust survivors. Preliminary findings.
holocaust victims. Int Rev Psycho Anal 1979, 6:331–340. Am J Psychiatry 1988, 145:865–868.
11. Freyberg JT: Difficulties in separation – individuation as experienced by 36. Chaitin J: Facing the Holocaust in generations of families of survivors: the
offspring of Nazi Holocaust survivors. Am J Orthopsychiatry 1980, 50:87–95. case of partial relevance and interpersonal values. Contemp Fam Ther
12. Fogelman E, Savran B: Brief group therapy with offspring of Holocaust 2000, 22:289–313.
survivors. Am J Orthopsychiatry 1980, 50:96–108. 37. Chaitin J: Issues and interpersonal values among three generations in
13. Danieli Y: Differing adaptational styles in families of survivors of the Nazi families of Holocaust survivors. J Soc Pers Relat 2002, 19:379–402.
Holocaust: some implications for treatment. Child Today 1981, 38. Lev-Wiesel R: Intergenerational transmission of trauma across three
10(6-10):34–35. generations: a preliminary study. Qual Soc Work 2007, 6:75–94.
14. Solkoff N: Children of survivors of Nazi holocaust: A critical review. Am J 39. Braga LL, Fiks JP, Mari JJ, Mello MF: The importance of the concepts of
Orthopsychiatry 1992, 62:342–358. disaster, catastrophe, violence, trauma and barbarism in defining
15. Sorscher N, Cohen LJ: Trauma in children of Holocaust survivors: posttraumatic stress disorder in clinical practice. BMC Psychiatry 2008,
transgenerational effects. Am J Orthopsychiatry 1997, 67:493–500. 12:68–75.
16. Yehuda R, Schmeidler J, Wainberg M, Binder-Brynes K, Duvdevani T: 40. Landau R, Litwin H: The effects of extreme early stress in very old age.
Vulnerability to posttraumatic stress disorder in adult offspring of J Trauma Stress 2000, 13:473–487.
Holocaust survivors. Am J Psychiatry 1998, 155:1163–1171. 41. Glaser BG, Strauss A: A discovery of Grounded Theory. Sociology Press:
17. Yehuda R, Halligan SL, Grossman R: Childhood trauma and risk for PTSD: Strategies for Qualitative Research; 1967.
Relationship to intergenerational effects of trauma, parental PTSD, and 42. Miles MB, Huberman AM: Qualitative Data Analysis: An expanded sourcebook.
cortisol excretion. Dev Psychopathol 2001, 13:733–753. 2nd edition. London & Thousand Oaks, California: Sage; 1994.
18. Leon GR, Butcher JN, Kleinman M, Goldberg A, Almagor M: Survivors of the 43. Walker D, Myrick F: Grounded Theory: an exploration process and
Holocaust and their children: current status and adjustment. J Pers Soc procedure. Qual Health Res 2006, 16:547–559.
Psychol 1981, 41:502–516. 44. Strauss A, Corbin J: Basics of qualitative research: techniques and procedures
19. Rieck M: The psychological state of Holocaust survivors’ offspring: An for developing Grounded Theory. 2nd edition. Thousand Oaks: Sage
epidemiological and psycho-diagnostic study. Int J Behav Dev 1994, Publications; 1998.
17:649–667. 45. Shrira A, Palgi Y, Ben-Ezra M: Transgerational effects of trauma in
20. Magids DM: Personality comparison between children of hidden midlife: evidence for for resilience and vulnerability in offspring of
Holocaust survivors and American Jewish parents. J Psychol 1998, Holocaust survivors. Psychol Trauma Theory Res Pract Police 2011,
132:245–254. 3(4):394–402.
21. Nadler A, Kav-Venaki S, Gleitman B: Transgenerational effects of the 46. Dekel R, Goldblatt H: Is there transgenerational transmission of trauma?
Holocaust: externalization of aggression in second-generation of The case of combat veteran’s children. Am J Orthopsychiatry 2008,
Holocaust survivors. J Consult Clin Psychol 1985, 53:365–369. 78(3):281–289.
22. Felsen I: Erlich: Identification patterns of offspring of Holocaust survivors 47. Fridman A, Bakermans-Kranenburg MJ, Sagi-Schwartz A, Van IJzendoorn MH:
with their parents. Am J Orthopsychiatry 1990, 60:506–520. Coping in old age with extreme childhood trauma: aging Holocaust
Braga et al. BMC Psychiatry 2012, 12:134 Page 11 of 11
http://www.biomedcentral.com/1471-244X/12/134

survivors and their offspring facing new challenges. Aging Ment Health
2011, 15(2):232–242.
48. Oppenheim-Gluckman H, Oppenheim D: Transmission de l’histoire
familiale et des references identitaires dans les familles qui ont connu
l’exil et la Shoah. L’Evolution Psychiatrique 2008, 73:145–157.
49. Wiseman H: On failed intersubjetivity: recollections of loneliness
experiences in offspring of Holocaust survivors. Am J Orthopsychiatry
2008, 78(3):350–358.
50. Weiss E, O’Connell AG, Siiter R: Comparisons of second-generation
Holocaust survivors, immigrants and nonimmigrants on measures of
mental health. J Pers Soc Psychol 1986, 50:828–831.
51. Ben-Ezra M, Palgi Y, Soffer Y, Shrira A: Mental health consequences of the
2011 Fukushima nuclear disaster: are the grandchildren of people living
in Hiroshima and Nagasaki during the drop of the atomic bomb more
vulnerable? World Psychiatry 2012, 11(2):133.

doi:10.1186/1471-244X-12-134
Cite this article as: Braga et al.: Transgenerational transmission of
trauma and resilience: a qualitative study with Brazilian offspring of
Holocaust survivors. BMC Psychiatry 2012 12:134.

Submit your next manuscript to BioMed Central

and take full advantage of:

• Convenient online submission

• Thorough peer review
• No space constraints or color figure charges
• Immediate publication on acceptance
• Inclusion in PubMed, CAS, Scopus and Google Scholar
• Research which is freely available for redistribution

Submit your manuscript at

www.biomedcentral.com/submit