Ann McKnight has extensive experience in clinical social work and therapy. Methods and approaches she's learned about and shared to benefit her patients are the Enneagram, Cognitive Behavioral Therapy (CBT), Acceptance Commitment Therapy (ACT), mindfulness, centering prayer, mind-body research including sensory work, and Eye Movement Desensitization and Reprocessing (EMDR). She is certified in Brainspotting and Trauma Studies through Bessie VanderKolk's Trauma Center in Boston. In addition to her private practice, Ann speaks and teaches regarding a variety of topics, including Nonviolent Communications and this TEDx talk on Restorative Circles.
Dr. Barb: Ann McKnight was our guest in a recent episode when we explored the effects of adverse childhood events, or ACEs. In the course of that discussion, we talked about the theory of transgenerational trauma, a topic that deserves more time than we could give it in that podcast. Ann generously agreed to be a guest again so we could learn about transgenerational trauma. She's a therapist who practices here in West Michigan. Welcome back, Ann.
Ann: Thank you, Barb. It's nice to be back.
Dr. Barb: Yeah, so we spent time again talking about the significant impact of adverse childhood events. Let's pivot just a little bit. Can you tell us about transgenerational trauma?
Ann: Yes. It's such a big topic, and I find it a really fascinating one. I think of it in two ways. One is the transgenerational trauma from an epigenetic standpoint—things that are related to our genetics and our DNA that get handed down are impacted from multiple generations back. Then I also think about the emotional and behavioral legacies that can happen from one generation to the next.
Dr. Barb: How do you assess that? Talk about the importance of that, or how do you utilize that?
Ann: One way to think about that is, it's one of the lenses that I will explore with people when they come into my office, if I suspect that there may be something going on. Sometimes if people find themselves behaving in ways that they're not enjoying, it can be really helpful to do what's called a family genogram, which is basically a little simplified family tree, but to look at who else in their family may have had that same behavior issue, problem, generations back.
Another thing that I will ask people about is where did their family come from? What are some of the stories? Most of us here in the U.S. have families who came from somewhere else. What were the circumstances around that? What kind of life experiences did their grandparents, their great grandparents have? [We’re] looking at trauma and how that may be affecting them.
I find this really compelling. It's just a compelling thought. Barb, when your mother was in your grandmother's womb in the second and third trimester of your grandmother's pregnancy, you were there also because your mother had all the eggs that she was ever going to have. Whatever was going on in the environment or in her personal life or in the culture—whether it was stress or war or whatever—was shaping your mother and you were also being shaped by that.
I find that really, really fascinating because I think most of us tend to think of ourselves as, well I'm just here. It doesn't matter what anybody before me was doing. I’m a self-made person. That's not the case.
Dr. Barb: So can you be a little more specific around trauma? What you mean by that? Examples? I think we all can think of some of the big things, but I have a sense there's probably something more subtle in there as well.
Ann: Yeah. Well, trauma basically means when your sub-cortical brain or when the animal brain in you is encountering what it's interpreting to be an inescapable threat, where there's a fear that you will die, or that there's never going to be an end to it. So when we encounter something like that and it stays with us, we continue to carry it around, we continue to carry that level of fear around. That's a definition of trauma.
Dr. Barb: Would you say many of your clients or, say we're with a group of friends—a book club—is this something that you would identify as a fairly common finding?
Ann: I think the way that frightening experiences get metabolized in us is very much part of the human experience. We all have things that didn't get worked through in the way that they might. You can have capital T traumas—like war or famine or something like that—or you can have lowercase t traumas, which might be something that doesn't seem like it should be bothering you as much as it does, but it's hard to get over it. It really is just part of the fabric of being human.
Dr. Barb: It seems like recently I've heard the term resilience used more. Is there a difference in how we move through our existence as our behaviors, our relationships? Does resilience play a role in that?
Ann: Resilience is very interesting language, and I think what it's attempting to refer to as our ability to recover from things, or to get back to normal. I've been playing with this idea about, what's the word? Anti-fragile is a term that comes actually from this book [Antifragile: Things That Gain from Disorder] by a philosopher and economist. The concept is that instead of saying that we're resilient, meaning we're going to go right back to where we were before this thing happened, what about if we actually get to become even stronger, even more capable, having even larger capacity because of this event that happened? I really like that idea, and I actually see that happen for people. Something in their life that actually felt very disempowering at one point can then become something that they're able to feel grateful for in a genuine way, not this fake, “I'm so grateful that happened,” but really, “I can see how that really shaped me and now I've become a better, stronger person because of it, and I feel more confident.” It's really just an interesting thing to talk about.
Dr. Barb: Are there vulnerable times in a person's life where a previous trauma is likely to manifest itself?
Ann: Absolutely, and I bet you know this better than I do because especially for women—around when girls start their period, when women get pregnant, when they have a baby, when they are going through menopause—those are all real hallmarks that I think really give us an opportunity to do some housecleaning, some internal emotional housecleaning. Women often have anxiety come up or some stuckness or relational issues at that time, and it's interesting to see if what's happening is something is wanting to break open in them and become a little more expansive and a little more enjoying of life.
Dr. Barb: Yeah. Interesting and not surprising, but I don't know that I've ever heard it stated quite like that. But I'm nodding as you're speaking about those events in women's lives. So what is the treatment for it, or tell us how you bring people through that? What does that look like?
Ann: With multi-generational trauma, just like with ACEs, I think knowledge is power in and of itself. Just finding out what someone's grandparents were up to. I think pretty much all of us in midlife, our grandparents experienced the depression and World War II, all kinds of things that were real hardships. How did they navigate that?
I like to use this study. They did this study with rats—these poor rats that get studied by psychologists, the poor things—but it's terrible—electric shock paired with the smell of cherries to the first generation and then the second and third generation. So the grandchildren who did not get the shock with the smell of cherries still had an anxious reaction when they smelled cherries. They didn't have the same life experience whatsoever, but their DNA had been impacted and predisposed as an adaptation around that same thing.
In a way it makes a lot of sense. If your grandparents were growing up in a war zone, the DNA wants to make sure that the next generation is going to be able to handle that, and is going to know the dangers, and is going to feel all the threats and be able to survive and be stronger. Sometimes you get, like with people who survived the Holocaust for example, it's very fascinating research on the children and grandchildren of Holocaust survivors who did not experience anything. They grew up in other countries other than Germany, and didn't have any exposure whatsoever to that level of terror, and yet they also had very high levels of PTSD, being predisposed to PTSD, very high rates of anxiety and depression.
Dr. Barb: Fascinating. Wow. I think to some extent, I don't know a lot about my grandparents' very early lives, maybe when they were pregnant with my mother and father for instance. But it is interesting to wonder about that, and I do have some notions about it, and I think their lives were very, very difficult. But they, in the big picture, thrived. So anyway, fascinating.
Ann: It would be interesting to explore that a little bit. What were the things that they must have encountered? I think for sure, most of our grandmothers and definitely our great-grandmothers and great great-grandmothers had lots of loss of pregnancy and of children. I know there's one person in my family who I think they lost five children in the late 1800s. Boy, what impact must that have had on how she felt toward her other children, and how she mothered them, and what did they learn about mothering for the next generation, and fears and anxieties around health.
Dr. Barb: Yeah, and I think it wasn't that unusual for learning something like that much later because it wasn't also spoken about.
Ann: That's such a great point, Barb, because one thing that seems to be common with trauma, whether it's a trauma that's happening to a whole culture or a trauma that's happening to an individual person, there seems to be a period of time where nobody's talking about it. Whether again, within a family or a culture. I've been very interested in the Balkans and in Bosnia. They had some terrible, terrible problems going on there in the 90s and it's really only been within the last five years that there's been much discussion at all from our aged people who were the generation involved in that and their children. Most of those children grew up and didn't have a clue about what happened.
I think about my husband who worked for a German company for a while, and one of his colleagues said that in Germany he grew up learning way more about the French Revolution than he ever learned about 20th century German history. So there seems to be something about needing to just not talk about things, to move forward with life, and then there can be this revisiting at a later point.
Dr. Barb: Do you have any resources you can recommend for listeners who might want to learn more about the topic of transgenerational trauma?
Ann: Yeah, I do. I have a couple things. One is there's a really great interview with a woman named Rachel Yehuda on Krista Tippett's show, On Being. You can find that online very easily. I think it's also a podcast. Rachel talks about some of the research that she is involved in around transgenerational trauma. Then there's an interesting book called It Didn't Start With You: How Inherited Family Trauma Shapes Who We Are And How To End The Cycle, by Mark Wolynn. I think those are both good places to start.
Dr. Barb: I'm curious as to whether or not you feel like this is information that is being transmitted to 14-year-olds, 16-year-olds, 18-year-olds to understand, based on our ACEs discussion and now this, to maybe be healthier and change. It just feels like culturally, I hope we're at a low point with so many children being raised in the presence of some toxicity that obviously, as you said, will have lifelong implications. Even if they move on to climb out of it themselves, the health impact may be there for the rest of their life. I guess I'm just curious if there's reason to have some optimism that we might be able to educate individuals sooner to be more proactive in prevention or early treatment.
Ann: I think you providing a platform here for me to have this conversation is a great way to get started with it. I think there are conversations that are creeping more into the educational world around this. I think there's always reason to hope. I do think that anything that we can do to help people understand themselves better—understand their family histories better, to understand what belongs to them and what doesn't, can be really liberating—and then having some actual concrete tools that help them move forward better, and feel more regulated and more connected and more present. Yeah, all the better.
Dr. Barb: Yeah. Well thank you for your work, and thank you for your time today to help us be more knowledgeable about this. I appreciate you, Ann.
Ann: It's my pleasure, and I really appreciate what you are doing here when you are interviewing people to help all of us women who are in midlife to be able to flourish and enjoy.
Dr. Barb: Well thank you.
Editor’s note: We recorded this interview with Ann just before the crescendo of events, protests, and dialogs about systemic racism. We were sure that Ann would want to add some thoughts given our changed (and, we trust, changing) context. She said, “I am grateful for the chance to add a couple of resources for folks as I continue to learn and grow and have my own eyes opened to systemic racism. Since transgenerational trauma is an emerging field, resources are not as robust as I wish they were but here are a couple of good ones:
- Post Traumatic Slave Syndrome: America's Legacy of Enduring Injury and Healing, by Dr. Joy DeGruy
- Healing Racial Trauma: The Road to Resilience, by Shelia Wise Rowe.
- My Grandmother’s Hand: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies, by Resmaa Menakem
In addition to resources like these, Ann says, “and anger and community and intense love and healing are what is required for transforming transgenerational trauma.”
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.