Intergenerational trauma: what it is, signs and how to heal

What is intergenerational trauma?

Psychiatrists first described it in the 1960s, in the children of Holocaust survivors^[3]. It is a concept, not a diagnosis, and there is no test for it. People who use “generational” and “intergenerational” trauma usually mean the same thing. The US psychology association’s guideline asks therapists to explore how historical and generational trauma shape a person’s experience of PTSD^[4], and the NHS notes that PTSD can follow events you heard about happening to someone close to you, not only ones you lived through^[5].

How is trauma passed down through generations?

Mostly through relationships. Across 42 studies, the more severe a parent’s PTSD, the more distress their children tended to have^[6]. In refugee families, a review found parents’ war trauma affected children who had no direct exposure through insecure attachment, harsher parenting, less emotional availability, family stress and difficult communication^[7]. In a large study of refugee families in Australia, parents’ PTSD was linked with harsher parenting, which was linked with more emotional and behaviour problems in children^[8].

• Silence and secrets. Some families never talk about what happened; in Cambodian refugee families, that silence passed on a pattern of avoidance^[9].
• Children looking after parents. In one study of Khmer Rouge survivors, mothers’ PTSD predicted daughters’ anxiety, partly through daughters taking on a caring role for their mothers^[10].
• Attachment patterns. Secure and insecure ways of relating tend to repeat across generations^[11].

Research suggests a parent’s PTSD is an important factor in how much children are affected^[13]. As psychiatrist Rachel Yehuda wrote, children may be more vulnerable “as a result of witnessing the extreme suffering of a parent with chronic PTSD rather than because of inherited genes”^[12].

Is trauma passed down in your genes?

Not in any proven way. Scientists are studying whether trauma leaves biological traces, such as chemical “tags” on genes (epigenetics), that pass to children. A few small studies have found differences in stress hormones and gene tags in the children of survivors^[16]. But the clearest evidence of true inheritance comes from animals: in one study, mice trained to fear a smell had offspring that were more sensitive to it^[18]. In people, it is not possible to say yet whether effects come from biology or from growing up with a struggling parent^[3][15].

A mother’s stress during pregnancy can also matter: babies of mothers with PTSD after the 9/11 attacks had lower stress-hormone levels, especially when the mother was exposed late in pregnancy^[17]. The researchers who led much of this work warn against a narrative of “permanent and significant damage” in children^[14]. Biological differences are not a life sentence.

What are examples of intergenerational trauma?

• War and genocide: the children of Holocaust survivors^[3], families who survived the Khmer Rouge in Cambodia^[10], and families of Holodomor survivors in Ukraine, who described living in “survival mode”, including stockpiling and reverence for food^[20].
• Colonisation: in Canada, a family history of residential school attendance is linked with more everyday stress and a stronger effect of stress on wellbeing, with effects that build across generations^[21].
• Slavery is a recognised example of historical trauma^[1].
• Refugees and migrants: conflict, loss and uncertainty can lead to depression, anxiety or PTSD^[22], and children can be affected through family life^[7].

Families who left their country

Many people whose families fled war or moved for a better life carry part of that story. In a study of Kosovar Albanian families after the 1998–99 war, young people whose parents had PTSD were more likely to have PTSD symptoms themselves, although they had also lived through more difficult events of their own^[19]. The same study notes that stigma about seeking psychological help adds to the challenge^[19]. Language and cultural barriers can also make care harder to reach for refugees and migrants^[22].

Which kind of generational trauma is most common? There is no reliable count. The most studied are war and genocide, forced migration, colonisation, slavery, and abuse or neglect within families.

Signs of generational trauma you might notice

Studies of the children of survivors describe more distress, anxiety and trauma symptoms, and relationships shaped by mistrust and holding back emotions^[23]. You might recognise some of these:

In your family

• Nobody talks about what happened, or there are secrets
• A parent’s moods set the tone of the whole house
• Overprotection, or a “survival mode” around food, money or safety
• As a child, you looked after a parent’s feelings

In yourself

• Feeling always on guard, as if something bad is about to happen
• Anxiety or low mood without an obvious reason
• Finding it hard to trust people, or to show what you feel
• Guilt about your own life being easier than your parents’

These are common human reactions, not a diagnosis. If they affect your daily life, it is worth talking to someone.

Is it inevitable?

No. In well-designed studies, children of Holocaust survivors did as well, on average, as other people^[24], and there was no evidence of effects in the grandchildren^[25]. The belief that abused children become abusive parents has been called unfounded in its absolute form^[26], and a 30-year study found parents abused as children did not report more abuse of their own children than others^[27]. Most people who live through trauma do not develop PTSD^[4]. Good experiences in childhood can protect too: in one small study, they predicted fewer PTSD symptoms in pregnant women who had also faced adversity^[28].

How to heal generational trauma

Learn your family’s story

Understanding what happened can help. In one study, children who knew more about their family history had higher self-esteem and less anxiety^[29]. Talking to relatives can help, but only if it is safe: you do not have to confront people who hurt you to heal.

Therapies with the best evidence

No trial has tested a treatment for intergenerational trauma itself. But if family history has left you with trauma symptoms, trauma-focused therapies have the strongest evidence. The 2025 US psychology guideline strongly recommends cognitive processing therapy, prolonged exposure and trauma-focused CBT, and conditionally recommends cognitive therapy, EMDR and narrative exposure therapy^[4]. UK guidance offers trauma-focused CBT, typically over 8 to 12 sessions, or more if someone has experienced multiple traumas^[30], and a review of 114 trials found clear benefits for trauma-focused CBT and EMDR^[31]. US guidelines support delivering validated trauma therapies by secure video^[32]. See our pages on PTSD therapy and EMDR.

Working on relationships and parenting

Because so much passes through relationships, therapy with parent and child together can help: in one trial, child-parent psychotherapy reduced young children’s trauma symptoms^[33], and short programmes that build parents’ sensitivity improve children’s attachment^[34]. A small pilot in Kosovo suggests family therapy may help mothers affected by war^[35]. Noticing old patterns with your own children is part of breaking the cycle.

Culture, language and connection

Therapy adapted to a person’s culture tends to work better^[37], and one large review found therapy in the client’s own language more effective than therapy in English^[36]. The US guideline asks therapists to consider identity, immigration and refugee status, and notes that culture affects how people make sense of trauma^[4]. For some communities, feeling connected to their culture is linked with better wellbeing^[39].

Day-to-day support

Alongside therapy, the NHS suggests talking to someone about how you feel, keeping a diary, breathing exercises and staying active^[5].

How Bliss Therapy can help

On Bliss Therapy you choose a therapist who speaks your language, by video, wherever you live, with no waitlist. 35 psychologists and counsellors list trauma, with sessions from €30 (about £25). Sessions are one to one.

Our therapists are based outside the UK and the US, so they are unlikely to be on UK registers or covered by US health insurance. Ask any therapist about their training, including in trauma-focused therapy, and their registration in the country where they practise.

When to get help

See a GP or a therapist if you think you have symptoms of PTSD^[5], or if distress, low mood or relationship problems are affecting your work or relationships^[38]. Trauma symptoms can start years after the events^[5].