Mental(izing) Health
Newsletter, #43
The intergenerational transmission of trauma is an intriguing but enigmatic construct. Originally, evidence for its existence came from Holocaust studies, although diversified studies now continue to add support.[i] It is not included in the DSM. Much remains unresolved about understanding precisely how the neurobiology of transmission works (Jovanovic et al., 2023; Yehuda & Lehrner, 2018).[ii] On the face of it, there is something radically strange and disturbing about how a person can be so profoundly affected by the experiences from the life of another person, without any conscious intentionality to pass the experiences on by the second person. To help us make sense of the construct, I would like to discuss two remarkable but quite different memoirs: Tastes Like War by Grace M. Cho (2021) and The Absent Moon (2023) by Luiz Schwarz.[iii]
Grace Cho defines herself in relation to her family in her memoir, her white American father, a merchant marine and former farmer, and her Korean born mother who survived the occupation of Korea by Japan and the Korean war, and her brother. Cho grew up in Chehalis, Washington, her father’s hometown, that was white and conservative—a place where the John Birch society thrived. Cho’s parents had a tumultuous (and occasionally violent) relationship, and end up getting divorced, re-married and then divorced. She has a contentious relationship with her father, exacerbated at one point by finding a letter from David Duke, the white supremacist politician, thanking him for his donation.
At the center of the memoir is the complex relationship Cho has with her mother. She suggests that she had three mothers, the first from birth up to her teenage years, the second as an adolescent to young adulthood when her mother became psychotic and was diagnosed as schizophrenic, and the third during her adult years when she learns more about her mother’s history and comes to understand her mother’s schizophrenia as produced from her war trauma (from the Japanese occupation of Korea and the Korean war). There is a final twist in what she learns about her mother’s history that I will not reveal in case readers are inspired to read this memoir, which I heartily recommend.
The notion of having different experiences with the same mother is worth noting, as it rings so true, and corresponds to a clinical sensibility that discerns how parenting is not a unitary function and can vary at different stages of life. We do not hear much about Cho’s early years, besides the immense and rocky transition from living in Korea to moving to small town America as a child. Cho describes her mother’s evolution to being a vivacious host, and finding a direction with work, selling blackberries, blackberry pies, and later mushrooms. Her mother is not willing to talk about her past.
During the second, disturbing stage, Cho’s mother begins to be grandiose and paranoid. She withdraws from social life (“socially dead”), as she becomes floridly psychotic. Cho and her mother have screaming fights, one of which led Cho’s mother to slap her, so Cho calls the police, who take her mother, not to a psychiatric ER, but to jail. Cho is largely on her own in trying to find a way for her mother to get help and is terrified of losing her. Cho is forced to negotiate assimilation on her own, too, and becomes a model student. She leaves the west coast to go to Brown for college and then moves to New York for graduate school at CUNY in sociology. The subject of her dissertation is her mother, as she “wants to write her back into existence” (p. 7).
The third stage represent something of a rapprochement. Cho’s mother comes to live with her and her boyfriend in Queens, but then moves to Princeton to live near her brother and his family. All is not well, though, and she makes a few suicide attempts during this period. What distinguishes this stage is that Cho begins to take care of her mother. She encourages her mother to tell her more about her history and learns that her family was transported as slave labor to live in Osaka, Japan, during the occupation of Korea. Two out of four siblings die, as well as her father. She declines to reveal more about how she survived during the Korean war. She meets her American husband when he served as a soldier in that war.
Cho also begins to cook for her mother—Korean dishes, but also beloved cheeseburgers. This is highly symbolic in that Cho’s mother never wanted her to learn to cook because she desired for her daughter to have the education that she lacked. Cho chooses to challenge the either/or alternative: she trains to be a pastry chef as well as pursuing higher education. She begins to make her mother Korean dishes like a pollack stew with radishes and garlic and red pepper, which her mother had not tasted for 40 years. Sometimes her mother would stand nearby, delivering instructions about the quantity of ingredients, like for sogogi soup, made with a clear aromatic broth with beef and radishes. Cho recalls saentae jihae as the dish which made her realize that eating it helped her mother to be able to release the past. In toto, Cho learns to make 15 Korean dishes from her mother. The medium of food serves as a brilliant intervention: a way to encourage Cho’s mother to connect to and let go of the past, rather than brushing it aside. The memoir includes the saga of Cho’s mother death, just after they make plans to eat cheeseburgers together, the final words of the memoir.
Not much is divulged about any treatment Cho’s mother received for her suffering. There is one nightmare story, where Cho’s father is brought to see the therapist her mother had been seeing for couples therapy, and apparently, an affair ensued between the therapist and her father. Cho comments that this turned her mother off from therapy, which is certainly understandable. But is this therapist still practicing? Yikes!
There are deeper issues to consider about the diagnosis and treatment of Cho’s mother. Her mother understands her suffering in the Korean terms, having “a pained spirit,” not as a mental disorder (p. 128). Furthermore, Cho is strongly invested in the notion that the disorder has a social dimension, in this case, caused by the trauma of overwhelming hardship, trauma, and violence. Cho introduces the Korean word, han, which means anger about injustice, as something that affects both her mother and her (p. 147). From Cho’s perspective, her mother decompensated because she was not able to digest the horrible, overwhelming experiences from her earlier life, which were intensified by the unhappiness of her marriage and the incommensurate conditions of life in the US. It is unclear whether Cho believes that her mother might have benefitted from better quality mental healthcare.
Cho’s life is dramatically affected by her mother’s life and history. She does not disclose much about her feelings, and we do not know if she would consider the construct of the intergenerational transmission of trauma as useful. Cho’s is self-conscious about her life being easier than her mother’s; but it is also true that her mother’s history has an ongoing impact on her own. Writing her memoir must be understood as an effort to work out aspects of her relationship with her mother, accomplishing some distance and finding a path back to connect with her. By feeding her mother, Cho served as a kind of therapist, inspiring memories that had been lost, and helping her mother feel contained. As I read this memoir, I kept wondering, perhaps as a wish, if Cho had a therapist for herself.
Luiz Schwarcz’s memoir is like Cho’s in contending with a same-sex, traumatized parent and engaging with the struggle to come to terms with experiences that happened to that person but somehow affect you. Schwarcz’s tale has its source in the Holocaust: his family were Hungarian Jews, and his paternal grandfather (Lajos) was renowned for holding services in his private home after they had been publicly banned, until the family ended up being transported to the concentration camp, Bergen-Belsen. En route, Lajos’ boldness leads him to throw his son (André, Schwarcz’s father) off the train, which allowed him to survive. André lived but was traumatized by his father’s sacrifice. After the war, André finds his way to Brazil; marries, and has one child (Luiz, same name as Lajos), the author of this memoir. Schwarcz is explicit in essaying that the effect of war trauma lasts for several generations.
From the time that Schwarcz was a little boy, he noticed sadness in his father’s green eyes. He also overheard the sound of his father’s rolling around in bed, kicking his feet, unable to sleep. This caused a sense of terror, and eventually depression. Schwarcz felt the responsibility (a word that repeats itself throughout the memoir) to heal his father, an impossible task. There was friction in his parents’ marriage, and at one point, they separate, only to get back together after Schwarcz punches his mother, and she thereby decides to return to her husband.
Although the family drama is always present in the background, Schwarcz acknowledges having a white, upper class, Jewish experience growing up—playing soccer and being exposed to art, literature, and especially music. As a late adolescent, his father takes him to a prostitute, an experience he does not enjoy and feels was traumatic for him. Schwarcz reflects on how he did not reveal his feelings while growing up, especially not to his own family. Given his father’s suffering, he did not feel that his own emotions deserve recognition, which is strikingly like how Cho feels about herself in relation to her mother.
We learn more about Schwarcz’s father in the course of the memoir: that he had met Raoul Wallenberg; that after the war, he donned a Nazi uniform as an extra in the film, Roma: Open City, as refugees from the camps were housed in Cinecittà, the film studio; that in Brazil, after getting married, he joined the prosperous business of his wife’s family; and that he remained religious. Although Schwarcz tells us that he is not religious, he maintains that he adheres to “Jewish values” and notes after his father’s death, he found consolation during services at the synagogue. As his father was in the hospital dying, Schwarcz recalled how frightened his father was and remained haunted by this experience. Why was this so traumatic? Because of dread about mortality? Perhaps because it represented his ultimate inability to heal his father?
A major theme of Schwarcz’s memoir is his own history of depression. Like Cho, he is inclined to understand his suffering as a result of his traumatic family history. There is a twist, however, as he comes to terms with receiving a diagnosis of bi-polar disorder. He struggles to make sense of what this means. Would he have been bipolar, regardless of his father’s history? Or did the father’s history trigger the disorder into existence? No answers are provided to these questions. Schwarcz does make it obvious that being bipolar has made life difficult for him. As he mordantly puts it, “I am not part of any bipolar pride group” (p. 215).
Schwarcz accepts that his mood fluctuations justify the need for medication, but he maintains that it was psychoanalysis which helped him to be able to cope with having this disorder. According to Schwarcz, he would not have written this memoir without having been analyzed. He also reflects on how he would not have created the successful publishing house that he was able to do without the help of his psychoanalysis, which in total lasted 13 years. He stopped the work with his first analyst because he was so busy with the publishing business, but then began another analysis, as his depression increased along with his success. Schwarcz tells us that “Psychoanalysis was one of the most important experiences of my life” (p. 175) and adds that “Without analysis, I would not have had the tools to grapple with the chemical effects of my depression” (p. 176). This latter point is fascinating, as it challenges an exclusively psychopharmacological treatment for bipolar disorder and emphasizes that there is a valuable role for therapy in dealing with how medication interacts with one’s emotions and life.
There are upbeat moments in Schwarcz’ memoir: his success as both a publisher and author. Indeed, there is one beautiful moment, where his father tells him that seeing his son’s book about his childhood and family was “the best thing that ever happened to him, that it had provoked such powerful emotions that he hadn’t been able to call (pp. 159-160). This moment turns bittersweet, though, as Schwarcz became aware that in writing the book, he was motivated by the fantasy of bringing his parents together, which was unrealistic and did not occur.
Nevertheless, by the end of the memoir, Schwarcz seems less at war with himself, accepting that people comment on how he looks like Andre, and revealing that he rolls around, slamming his legs, just like his father (He also ends up seeing the same psychiatrist after his father died). Schwarcz seems to find some degree of happiness, surrounded by his family and dogs. He appreciates how his daughters confront him when he acts out. In the Acknowledgements, he lovingly mentions his two granddaughters. So, he has had a full life, even if he has battled against depression, and has had to endure the intergenerational transmission of trauma.
What have we learned from these two memoirs? There is a common theme of intergenerational transmission of trauma, where the child of a traumatized parent, in a family under stress, is profoundly affected and has the overwhelming desire to heal the parent. There is a parentified element in how they are pulled in the direction of worrying about their parent, especially insofar as the parent might not be able to care for them. It is reasonable to speculate that unconscious processes are at work, like projective identification, which serves to fill the child with disavowed emotions from the parent, as well as introjection of the parent by the child in order to sustain attachment (Rowland-Klein, et al., 1996).[iv]
Another related theme is how the wish to care for a parent becomes a conflict, as caring for her/himself easily creates guilt because the child’s concerns will never seem equal to those of the traumatized parent. The conflict, then, is that if you only care about the parent, you are failing yourself, but if you care about yourself, you are failing the parent. A final theme in these two memoirs is that the project of writing a memoir is an effort to resolve or reduce the conflict, that is, to mentalize their relationship, to commemorate the life of the parent, to mourn for them, and to embrace a life for themselves. Writing their stories, it seems, promotes post-traumatic growth, insofar as that is relevant to vicarious experience.
There are differences to note between the memoirs that have to do with gender and culture. Cho’s memoir features her actual caregiving to her mother with food, which presumably they shared together. Schwarcz’s memoir is more about his own struggle with depression and the ample treatment he experienced (We do learn that his father consistently sought psychiatric help for his suffering; at one point even receiving ECT). Cho is also less direct in the way she reflects on herself, revealing more about her work than her personal life. To some degree, these differences reflect cultural preferences on the part of both memoirists.
Both of these memoirs offer compelling accounts of the phenomenon of the intergenerational transmission of trauma, and the very specifics of their stories provide insight for mental health professionals, helping to clarify and deepen our understanding.
[i] A summary of recent research is found in an article by T. Angelis: https://www.apa.org/monitor/2019/02/legacy-trauma.
[ii]T. Jovanovic, A. Roberts, & A. Huels (2023);. Intergenerational transmission of trauma: A biological perspective. Journal of Traumatic Stress, 00, 1– 3. https://doi.org/10.1002/jts.22938; R. Yehuda and A. Lehrner (2018), Intergenerational Transmission of Trauma Effects: Putative Role of Epigenetic Mechanisms. World Psychiatry, 17: 243-257. https://doi.org/10.1002/wps.20568
[iii] G. Cho (2021). Tastes Like War. New York: The Feminist Press; L. Schwarcz (2023). The Absent Moon. New York: Penguin.
[iv] D. Rowland-Klein and R. Dunlop R (1998). The Transmission of Trauma across Generations: Identification with Parental Trauma in Children of Holocaust Survivors. Australian & New Zealand Journal of Psychiatry. 32(3):358-369. doi:10.3109/00048679809065528