Mothering, Addiction, and Attachment: How Intergenerational Trauma Happens

Childhood Adversity, Replaying Old Scripts, and Writing New Ones

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You may have heard the phrase intergenerational trauma. It’s been in the news over the past few years in several different contexts. If you’re familiar with the term – and you’re not a sociologist or mental health professional – you most likely encountered it in news stories or academic articles that discuss specific segments of our population with distinct demographic characteristics.

In the United States, experts identify the effects of intergenerational trauma in indigenous American cultures (Native Americans), African American culture, descendants of Holocaust survivors, descendants of Japanese Americans interned in detention camps during Word War II, and families of Vietnam veterans.

The concept, at first, makes most people furrow their brow and say, “What? Hmmm. Really? That’s interesting.” To be honest, most people are a tad skeptical, at first. However, upon reflection, it’s not a difficult concept to grasp.

Here’s how the American Psychological Association (APA) defines intergenerational trauma:

“…the phenomenon in which the descendants of a person who has experienced a terrifying event show adverse emotional and behavioral reactions to the event that are similar to those of the person himself or herself…the exact mechanisms of the phenomenon remain unknown but are believed to involve effects on relationship skills, personal behavior, and attitudes and beliefs that affect subsequent generations.”

That’s not a farfetched concept at all. In layperson’s terms, what it means is that the pain and suffering of one generation – particularly when that pain and suffering is intense and protracted – can transfer to the next generation and have an adverse effect on their overall wellbeing.

When you think about it, it’s plausible. But as the APA definition states, the exact mechanism of transmission is unknown. That lines up with what most people think when they hear the phrase: it makes logical sense – but how does it happen?

The Effects of Intergenerational Trauma

This article will discuss how it happens in a narrow range of circumstances, compared to the large-scale intergenerational trauma mentioned above. I’ll focus not on entire cultures, but on a specific set of people with whom I’m intimately familiar: new or early mothers with alcohol or substance use disorder who experienced trauma and adversity early in life, who are now at risk of transferring the trauma of their youth to their young children.

Before I get to the mechanisms of transmission – the fancy way of saying how it happens – I’ll first talk about the negative effects of intergenerational trauma, which will explain why it’s an important topic in our culture as a whole, and in addiction treatment specifically.

I’ll quote the APA again. Here are some of the consequences of intergenerational trauma, as identified by trauma experts around the world:

  • Shame
  • Anxiety
  • Guilt
  • Heightened sense of vulnerability
  • Heightened sense of helplessness
  • Low self-esteem
  • Depression
  • Suicidality
  • Alcohol abuse
  • Drug abuse
  • Problems with relationships
  • Difficulty forming meaningful attachments
  • Problems regulating aggression
  • Heightened or extreme reactivity to stress

Those are the effects of intergenerational trauma as observed in a collective – meaning the type of large groups of people I list in the introduction – but recent research into trauma shows that the same set of negative effects may also appear in smaller scale, family-level scenarios, i.e. the mothers with alcohol or substance use disorder and a history of trauma I mention above.

As to how it happens, an article published recently in Frontiers in Psychiatry called “Mothering, Substance Use Disorders and Intergenerational Trauma Transmission: An Attachment-Based Perspective” offers an explanation that makes sense to me – and can help us work to help mothers move past their early trauma and mitigate its effect on their children. The title of the article gives you a preview of the proposed mechanism of transmission of trauma from one generation to the next, and in this context, from a mother who experience trauma to her child: it comes from disrupted attachment patterns.

Early Attachment Experiences Affect Psychological and Emotional Development

The theory presented in the paper proposes that trauma is transmitted through maladaptive and dysfunctional relationships with parents and primary caregivers. Here’s how the study authors describe what happens when an individual experiences early trauma:

“Exposure to trauma within the caregiving system is associated with higher levels of affective/physiological, attentional/behavioral, and self/relational dysregulation in addition to post-traumatic symptoms, affecting individuals’ capacities for emotional understanding and processing significantly. Individuals exposed to early interpersonal trauma also show an atypical combination of anxious and avoidant attachment styles that often result in severe affect dysregulation and psychopathology.”

The idea that early trauma can lead to negative physical, psychological, and emotional outcomes later in life is not news to anyone who works in the field of addiction treatment. That’s the root of the well-documented relationship between adverse childhood experiences (ACEs) and adult dysfunction, which often includes addiction. What this new evidence adds to our knowledge base is that a salient aspect of those ACEs – disrupted relationships with caregivers – affect the ability of the victim of early trauma to form meaningful, rich, and complete relationships throughout their lifespan, and particularly with their children – if and when the victim of early trauma becomes a parent.

Now, let’s back up one step. Decades of evidence confirm that one of the possible outcomes of experiencing early trauma is developing a problem with alcohol or drugs as an adult. Virtually no one with any knowledge on the subject disputes that. Now let’s take one step forward from there and talk about how maternal alcohol or drug addiction/misuse/disordered use can impact children. Keep in mind we’re working towards is an understanding of how trauma may be transmitted across generations.

Here’s what can happen:

  • Chronic, in utero exposure to drugs of abuse, including alcohol, can cause low birth weight, heart problems, lung problems, impair the typical development of the brain and all the major organs, and lead to developmental problems related to memory, learning, cognition, and behavior.
  • Maternal alcohol or substance use disorder (AUD/SUD) can negatively impact parent-child bonding.
  • Maternal AUD/SUD can lead to maladaptive attachment patterns between mother and child
  • Maternal AUD/SUD is associated with co-occurring psychiatric disorders, maladaptive parenting practices – including physical and emotional neglect, maltreatment, and abuse – emotional unavailability, and impaired cognition/reflective ability.
  • Brain imaging studies show that mothers with SUD experience decreased activation in the brain areas associated with responses to their infant’s cues for maternal attention, caregiving, and affection
  • Maternal AUD/SUD can result in a chaotic, unstable child-rearing environment
  • Parental AUD/SUD can result in impaired physical, emotional, cognitive, and behavioral development in infants, toddlers, school-age children, and adolescents

Let’s review and summarize that. A person – for the purpose of this discussion, a woman – experiences trauma as an infant, toddler, child, or adolescent. That woman, as a result of early trauma, develops disrupted attachment patterns, maladaptive relationship patterns, heightened stress reactivity, and an alcohol or substance use disorder. Those psychiatric issues, all related to her PTSD – the relationship patterns, the AUD/SUD, and concordant mental health issues – all have a direct effect on her ability to form a nurturing, positive, healthy attachment to and parenting relationship with her child.

What Happens to the Child?

That child, in turn, experiences the trauma of the disrupted maternal relationship. In the absence of professional support and help processing that trauma, that child has a markedly increased risk of developing patterns of physical, emotional, behavioral, and mental health dysfunction similar to those the mother developed as a result of her early trauma.

That’s the connection, and that’s one logical explanation – according to the study I cite above – of how trauma can be transmitted across generations. At this point, I’d like you to notice a phrase I used a moment ago: in the absence of professional support. The authors of the study make it clear that it’s possible to break this cycle of trauma in the presence of professional support. In the example I use above, the cycle is unbroken, because the trauma the hypothetical mother experienced goes unrecognized, unaddressed, and leads to PTSD, relationship problems, AUD, SUD, or all of the above.

What we know now is that it’s possible to break the cycle of intergenerational trauma. We know because mental health professionals have developed techniques for helping mothers with AUD/SUD and a history of trauma develop healthy attachment patterns, relationship patterns, and learn productive and loving parenting practices.

How to Break the Cycle

The short answer: professional support.

It’s possible for a person with significant early trauma – even if they don’t do it until much later in life – to address, process, and move on from that trauma. They can unlearn maladaptive coping strategies and learn positive, productive ones. They can rebuild their capacity to make genuine emotional connections to others. With the help of licensed psychiatrists, counselors, and therapists, they can heal their old wounds and avoid passing them on to their children.

One effective, evidence-based intervention that helps mothers with trauma/AUD/SUD is called Attachment, Self-Regulation, and Competency, or the ARC Model. An ARC intervention focuses on ten core caregiving skills:

  1. Learning to identify and manage feelings, moods, and emotions
  2. Learning to respond to the emotional needs and moods of others
  3. Understanding the value and importance of consistency in emotional and behavioral responses a caregiving situation
  4. Creating stable routines and rituals
  5. Learning to identify feelings, emotions, and moods
  6. Learning to regulate feelings, emotions, and moods
  7. Learning to expressing underlying feelings, emotions, and moods
  8. Achieving developmental milestones
  9. Improving your child’s executive functions, such as decision making, problem solving, and planning
  10. Teaching a parent how to focus on her child’s self-development

In the case of a mother with a young child – a mother who is the victim of trauma and has an alcohol or drug problem – the ARC model offers a stepwise strategy to unravel past trauma, discover how it affects present emotions and relationships, and learn how to create a healthy, nurturing, maternal relationship. By following these steps and developing these skills, a mother – or a parent of any gender, for that matter – can learn to interrupt the cycle of intergenerational trauma and create a new, healthy, and enduring paradigm for their family that can enrich parent-child relationships for generations to come.

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