Tap to Call

Generational Trauma, Attachment, and Spiritual/Religious Interventions



Authors: Marilyn Doucet a;Martin Rovers of Capital Choice Counselling Group b

Affiliations: a Private Practice, Ottawa, Ontario, Canada
b Faculty of Human Sciences, St. Paul University, Ottawa, Ontario, Canada

DOI: 10.1080/15325020903373078

Publication Frequency: 6 issues per year

Published in: Journal of Loss and Trauma, Volume 15, Issue 2 March 2010 , pages 93 – 105

Previously published as: Journal of Personal and Interpersonal Loss (1081-1443) until 2001

Also incorporating: Stress, Trauma, and Crisis
To cite this Article: Doucet, Marilyn andRovers, Martin ‘Generational Trauma, Attachment, and Spiritual/Religious Interventions’, Journal of Loss and Trauma, 15:2, 93 – 105

Abstract

A heightened interest in posttraumatic stress disorder has arisen in the light of current world events, such as 9/11, the ongoing war against terrorism, and violent acts of ethnic cleansing. However, the effect of traumatic stress upon the next generation has not been steadily addressed. The phenomenon of generational trauma as a secondary form of trauma that may be passed down to subsequent generations through various means of psychological transference is reviewed by means of attachment theory. Spiritual/religious forms of interventions may be of help in mitigating the harmful consequences of severe trauma in the lives of trauma survivors and its generational effects in the lives of their offspring.

We are, more than ever, encompassed by the effects of multitudinous forms of trauma. The carnage of the Holocaust, and of other acts of continued genocide, no longer represents isolated events that somehow can be held at bay or kept in distant memory. This article will explore the psychological effects of such disturbing acts of violence upon survivors of trauma and their secondary consequences upon future generations. The transmission of this type of trauma will be examined from an attachment theory perspective. The positive impact of religion and spirituality in mitigating the effects of traumatic exposure will be examined to identify how religion and spirituality may serve to aid the trauma victim.

TRAUMA

Psychological trauma may be defined and comprehended as the effects of overwhelming and extraordinary experiences that leave their victims in a state of helplessness and thereby undermine their sense of personal efficacy, their relational capacity, and their ability to psychologically integrate the upheavals of life in meaningful ways (Hermann, 1992; Weingarten, 2003). Weingarten (2003) defines a trauma response in terms of its effects upon traditional understandings of personal identity and social reality. Traumatic experiences typically upset our common perceptions about life, and may significantly shatter our view of the world (Janoff-Bulman, 1992). It creates a sense of alarm, fear, and dread that can linger well beyond the actual lived experience of a traumatic event (Weingarten, 2003).

The psychological outcomes of traumatic experiences may encompass a range of pathological symptoms that typically include emotional numbing, sadness, shame, anger, aggression, helplessness, depression, panic, and acute symptoms of anxiety (Hermann, 1992; van der Kolk, 2003) or dissociation, psychotic disorders, and substance abuse (Gold, 2004). Biologically, responses to traumatic events typically activate high levels of physiological arousal, which may lead to a fight-or-flight response (van der Kolk, 2003) or freezing, resulting in limpness physically and the numbing of one’s mental processes (Weingarten, 2003).

Tomb (1994) noted that the diagnosis of posttraumatic stress disorder (PTSD) continues to rest upon three core groupings of symptoms: (a) the continued reexperiencing of a traumatic event through intrusive thoughts, dreams, or feelings; (b) the determined avoidance of environmental triggers connected with the trauma, coupled with a sense of emotional numbing; and (c) ongoing symptoms of physiological arousal, such as difficulty sleeping and a heightened startle response.

GENERATIONAL TRAUMA

Generational trauma may be defined as a secondary form of trauma that results from the transfer of traumatic experiences from parents to their children (Davidson & Mellor, 2001; Motta et al., 1997). This form of trauma is also referred to as intergenerational, transgenerational, or secondary trauma. Generational trauma can result from any number of different types of disturbing incidents or experiences. Danieli (1998) provides evidence that this form of trauma may be derived from such tragic events as atrocities of war and domestic violence, and more recently the discovery of the existence of psychological manifestations of Holocaust experiences in the lives of survivor offspring.

Discrepancies exist between empirical and clinical studies on the existence and nature of generational trauma (Rousseau, 2005; Suedfeld, 2000). Suedfeld (2000) noted that up until the late 1990s most of the clinically oriented research on Holocaust survivors and their children focused on the pathological outcomes of Holocaust experiences, primarily identified as PTSD. However, he also observed that empirical work has sometimes yielded contrary findings, which he attributed to variations in levels of resilience and styles of coping in the lives of individual survivors and their offspring. Danieli (1981, 1985) specifically identified four distinct styles of adaptation among survivors of trauma: those who were “numb,” “victims,” “fighters,” and “those who made it.” Those who responded as either “victims” or as “persons having been numbed” by their experiences were observed to be fearful and emotionally withdrawn, whereas those who reacted as “fighters” tended to be obstinate. “Those who made it,” on the other hand, were survivors who had somehow been able to separate themselves from the trauma of their past and advance on a socioeconomic level.

Some empirical studies have substantiated the existence of generational trauma (Beckham et al., 1997; Bernstein, 1998). These investigations have demonstrated that the postwar effects of war-related trauma in the lives of combat veterans and prisoners of war have had a negative impact on family well-being due to a disruption in familial patterns of interaction engendered by postwar traumatic symptoms in the lives of survivor fathers. Yehuda et al. (1998) found that Holocaust offspring exhibited a greater level of vulnerability to PTSD and other psychiatric disorders in comparison with a demographically similar control group. These authors observed that children of Holocaust survivors were less able to externalize aggression than persons in a control group whose parents had not endured the Holocaust.

Williams-Keeler et al. (1998) provided evidence for the existence of the transmission of PTSD across generational boundaries in Holocaust families. They found that parents’ communication of their traumatic past (e.g., either the excessive disclosure of their Holocaust experience or exclusive silence about the same) is a primary means by which the effects of Holocaust trauma have been transmitted to survivor offspring. Fossion et al. (2003) have noted that the telling of war-related experiences by survivor grandparents to their grandchildren, particularly when presented in conjunction with descriptions of their own prewar existence, has helped to (a) promote an understanding of the silent legacy of Holocaust trauma within families and (b) foster a sense of family history that is characterized by both survival and a positive note of victory.

GENERATIONAL TRANSMISSION OF TRAUMA

A primary focus in the study of generational trauma has been to discover the processes by which parental trauma may be passed on to the next generation. Four basic psychological pathways of trauma transmission may be categorized as follows: (a) the vicarious identification of children with their parents’ suffering at similar stages of chronological development, (b) the intuitive responsibility assumed by children to compensate in various ways for their parents suffering, (c) the particular patterns of parenting demonstrated by survivors toward their offspring, and (d) the styles of communication between parents and their children concerning traumatic experiences the parents had endured (Adelman, 1995; Bar-On et al., 1998; Zeanah & Zeanah, 1989).

The first two of these pathways of transference have been identified as being direct modes by which parental trauma may be passed on from parents to their children, via unconscious channels of intrapsychic influence and styles of familial communication (Fonagy, 1999; Weiss & Weiss, 2000). The latter two have been conceptualized as being indirect channels by which parental trauma may be transmitted, either through distinct styles of parenting or suboptimal patterns of family interaction (Daud et al., 2005).

ATTACHMENT THEORY AND THE TRANSMISSION OF TRAUMA

Attachment theory (Bowlby, 1969, 1988) provides a common conceptual framework by which types of trauma transmission may be comprehended. An attachment theory perspective, which can accommodate both psychodynamic and family systems perspectives, offers an appropriate framework from which to examine the phenomenon of generational trauma. Bowlby’s theory of attachment proposes that internal representations of oneself and of others develop into well-organized intrapsychic constructs. Disruptions in attachment security result from unexpected separations from figures of attachment. Such separations create a sense of intense anxiety and personal loss. Feelings of sorrow, mourning and grief normally follow this response (Bowlby, 1988). Bowlby (1969, 1988) and Ainsworth et al. (1978) observed three patterns of infant attachment to caregivers: (a) secure attachment, (b) anxious-avoidant attachment, and (c) anxious-ambivalent or preoccupied attachment. Main and Solomon (1990) developed a fourth type of attachment, known as disorganized or unresolved attachment, in which infants demonstrated disorientation of movement and expression and signs of fearfulness when confronted with inconsistencies in parental behavior.

Zeanah and Zeanah (1989) focused on the generational transmission of maltreatment of children from an attachment theory perspective. They noted that the internal working models of individuals constitute the mediating factor in the generational transmission of relational patterns. Their research showed that adults classified as preoccupied seemed to be incapable of organizing their relational experiences in a coherent manner and also less able to resolve issues of personal grief, creating a situation that could inhibit the development of healthy, secure patterns of parent-child interaction. Adults who were classified as unresolved seemed to remain perplexed and disoriented with regard to personal traumatic losses and their attending psychological effects. Unresolved parental trauma may elicit frightening parenting responses toward children, triggered by traumatic memories.

The phenomenon of generational trauma may actually be the result of parental disorders of attachment that encompass and fluctuate between insecure/preoccupied and insecure/disorganized patterns of attachment (Bar-On et al., 1998). Inconsistencies in parenting by survivor parents may serve to generationally transpose patterns of disorganized attachment in their offspring. A lack of resolution of parents’ traumatic losses may prevent them from sharing in a consistent manner their horrific experiences, leading to confusion and disorganization in the process of bonding between themselves and their children.

Furthermore, patterns of parental dependency in survivors toward their children may have arisen out of their ongoing sense of personal inefficacy, as derived from their traumatic past. Parents may be unable to care for the emotional needs of their offspring (Bar-On et al., 1998). Children, on the other hand, are often required to carry the unresolved emotional burdens of their parents, leading to their parentification. It may have been required of survivor offspring to assume a level of responsibility beyond their developmental capacity to manage, leading to the formation of unhealthy patterns of insecure/preoccupied/disorganized attachment between their parents and themselves.

Lev-Wiesel (2007) has extended research efforts in this realm of study to also include third-generation survivors. She has found that the transmission of war trauma, as experienced by Holocaust survivors, appears to have encompassed four subordinate themes that describe second- and even third-generational effects: (a) a heightened awareness of parents’ or grandparents’ Holocaust survivor status, (b) parenting style, (c) overidentification with parents’ or grandparents’ experiences, and (d) general fear and mistrust of people. The latter three of these themes could be the result of attachment disorders generated by traumatic experiences.

Bar-On et al. (1998) suggest that the inability of Holocaust survivors to resolve their traumatic past may be understood as a function of a number of difficulties they encountered in their postwar existence. The trauma of losing significant others, coupled with horrific experiences of incarceration and death in concentration camps, was exacerbated by postwar sequential traumatization, which arose as survivors were continually faced with resolving the terror that lay behind them (Keilson, 1992). It would have been very difficult for child survivors who had witnessed the slaying of their parents to express their anger over having been abandoned by a close attachment figure.

Externally, social circumstances faced by survivors are not conducive to the telling of the horrors that they endured, a situation leading to the formation of a “conspiracy of silence” concerning their Holocaust experience (Bar-On et al., 1998). Their ability to mourn and process their losses has become obscured by their new and demanding social realities. The unconscious transmission of their traumatic past onto their children may have become their only means of coping with internal feelings of suppressed grief.

Bar-On et al. concluded that their primary therapeutic task in working with members of the third generation was to build a bridge of communication between them and their grandparents in order to restore a sense of family history. Grandchildren were thus able to comprehend and find relief from the fearfulness of their family’s silent legacy. They could now begin to view the Holocaust as a story of their grandparents’ survival. By also gaining an awareness of their grandparents’ prewar identities, grandchildren were able to identify with happier times in the lives of their grandparents, which opened the way for more life-affirming perspectives on the Holocaust experiences they suffered.

COPING WITH GENERATIONAL TRAUMA: RESILIENCE AND RECOVERY

There are numerous coping strategies by which traumatized persons have been able to manage and recover from shocking and disturbing incidents. The work of Danieli (1998) indicates that Holocaust survivors who were successful in terms of socioeconomic level were those who had been able to separate themselves from past traumas. According to Klein (1973), survivor offspring who were successful employed a coping strategy of intellectualization, or cognitive restructuring, in order to distance themselves from parental trauma.

In a more recent example of war-related trauma, Redekop (2008) has provided a model of postgenocidal justice by which healing and reconciliation might have occurred in the wake of the Rwandan genocide of 1994. In his “justice of blessing” model, Redekop has mapped a process for the healing of trauma in which he emphasizes that the use of cognitive reframing and the application of spiritual disciplines and practices on both individual and collective levels are most significant to traumatic recovery. He has indicated that victims need to construct a new level of reality in order to experience a renewed sense of personal and communal agency. He has suggested that by attaining higher levels of consciousness, which he believes can be evoked through spiritual experience and ritualistic disciplines, the victimized can be empowered to reestablish their lives in meaningful ways to foster a renewed sense of security. His model suggests that resilience from traumatic experience may be understood as partially being a function of spiritual renewal and transformation.

Agaibi and Wilson (2005) have discerned that resilience is related to the ability to harness and mobilize available resources, such as socioeconomic and personal support systems. They have concluded that at least five categories of variables appear to facilitate resilience in the wake of traumatic exposure: personality, affect regulation, coping, ego defenses, and the utilization and mobilization of protective factors and resources. They have postulated that resilience from posttraumatic stress is a function of complex behavioral tendencies and personality traits such as assertiveness, hardiness, a sense of humor, and the ability to regulate emotion, cognitively restructure negative experiences, and detach from stress through various forms of transcendence. In all of the above studies, an interesting finding emerges: The ability of trauma survivors to harness available personal, social, and community resources to help transform their traumatic experience appears to be a significant factor by which a sense of meaning and order can be restored in the midst of their posttraumatic existence.

SPIRITUAL AND RELIGIOUS COPING AND TRAUMA

Religion can be defined as a “system of beliefs in a divine or superhuman power, and practices of worship or other rituals directed towards such a power” (Argyle & Beit-Hallahmi, 1975, p. 23). Spirituality, on the other hand, can be defined as “the presence of a relationship with a Higher Power that affects the way in which one operates in the world” (Armstrong, 1995, p. 23). Current research indicates that spiritual interventions have proven to be helpful in facilitating healing among those who suffer from various forms of trauma (Koenig, 2005). Koenig has noted that religious and spiritual interventions in these populations have minimized the onset of progressive symptoms and have enhanced coping skills. Religious and spiritual resources may also serve as protective factors that can help to mitigate and potentially transform the consequences of severe trauma, as particularly experienced by Holocaust survivors and their offspring.

Kirkpatrick and Shaver (1990) found that a connection appears to exist between attachment styles and levels of personal religiosity. Children who were attached in an avoidant manner to their mothers later showed a higher level of religiosity in their adult life, and the role of God and religion was of a compensatory nature for such individuals. Kirkpatrick (1999) envisions God as a being a substitute figure of attachment whose personal presence may compensate for the lack of healthy attachments in early childhood. From an attachment perspective, religious resources thus serve to mitigate the effects of attachment disorders that have carried over into adulthood.

Grame et al. (1999) report that trauma survivors often struggle with spiritual matters related to the meaning of life, suffering, guilt, forgiveness, and issues of cosmic justice. They emphasize that the spiritual and religious lives of trauma survivors need to be therapeutically considered as possible resources by which traumatic life events may be meaningfully processed. Pargament (1997) has identified a number of helpful forms of religious coping: (a) spiritual support and collaborative religious coping in which God’s guidance, emotional reassurance, and close personal connectedness enable better adjustment to critical life events; (b) congregational support from which the sense of a surrogate family can be derived to assist members experiencing severe stress; and (c) the application of a benevolent religious perspective by which negative events and personal losses may be reframed through the eyes of a loving God who remains in control, in spite of life’s hardships.

Granqvist (1998) and Granqvist and Hagekull (1999) have defined a two-level correspondence hypothesis that proposes that parental religiosity is transmitted to children through learning processes in correspondence with secure internal models of relational representation between parents and their offspring. In securely attached families, a positive model of self and of others has been formulated, and correspondingly of God (Granqvist & Hagekull, 1999). However, it has been found that positive attachments to God engendered by secure patterns of attachment do not necessarily function as a supportive resource in times of distress.

These authors thus concluded that religious coping is best understood according to a compensation hypothesis that links insecure patterns of attachment with religious development (Granqvist & Hagekull, 2001). Persons who are insecurely attached may seek from religious life compensation for emotional loss and distress. They may unpredictably convert or become seriously involved in their faith community in order to find resources to help them regulate their emotional needs and acquire a sense of felt security. Is the influence of religion and spirituality in this population a helpful resource in the management of the effects of survivor trauma?

Peres et al. (2007) have noted that PTSD patients can encounter particular difficulty in integrating traumatic events into a sensible narrative. They have found that religion and spirituality can offer ways to positively reconstruct personal narratives by providing a sense of order, purpose, and meaning in the midst of a shattered existence. Shaw et al. (2005) have found that religious and spiritual beliefs can indeed be helpful in facilitating recovery from traumatic experiences, as well as in providing opportunities for personal growth and development following traumatic incidents.

Marcus and Rosenberg (1989) have specifically reviewed the healing impact of the Judaic religion and spirituality in the lives of Holocaust survivors and their families. Two perspectives are presented: (a) a consideration of what types of pastoral care may be the most beneficial to survivors and their families in synagogue communities and (b) a query into the significance of rabbinic interventions in the lives of survivors seeking to find resolution of the horror of their disturbing past. Skolnik (1989) has pointed out that survivors need to be afforded a very special status within synagogue congregations, both on grounds of compassion and due to the historical import of their first-hand experiences of the horrors of the Holocaust.

In summary, it is postulated that there are spiritual and religious resources that can facilitate the healing of posttraumatic experiences (see Table 1). These forms of spiritual and religious interventions may enable survivors and their families to rebuild their shattered worlds through offering means whereby disorganized/unresolved patterns of attachment may be transformed into secure and coherent patterns within which the turmoil of survivors’ guilt and unrelenting grief can be resolved and genuinely alleviated. Restoration, as well as opportunities for continued personal growth, may thus be facilitated. Koenig (2005) has provided a comprehensive summary of how religion and spirituality can be integrated into the mental health professions to reduce client stress and improve coping skills by (a) promoting a positive worldview, (b) helping to make sense of difficult situations, (c) providing purpose and meaning, (d) discouraging maladaptive coping, (e) enhancing social support, (f) promoting other-directedness, (g) reducing the need for personal control, (h) providing and encouraging forgiveness, (i) encouraging thankfulness, and (j) providing a sense of hope for the future.

TABLE 1 Spiritual and Religious Interventions in Coping With Trauma.

Religious resource

Spiritual function

Healing influence

Pastoral care • Intensive listening• Deep empathy with suffering • Restores a sense of self-respect• Provides comfort and solace

• Engenders a sense of secure attachment to God and religious figures of authority

Congregational involvement • Communal worship• Social identification/ connection • Provides a sense of belonging• Replaces familial losses and/or mitigates relational distress
Priestly ministry of religious and spiritual direction • Absolution and forgiveness of perceived relational guilt • Emotional relief from feelings of inner torment• Promotes resolution of grief and mourning
Theological interpretation of suffering • Spiritual instruction and encouragement • Provides a means for survivors to spiritually and cognitively reappraise/reframe traumatic events and experiences

Various other forms of spiritual and religious interventions can potentially enable trauma survivors and their offspring to develop and/or restore a positive sense of self and personal identity through an awareness of being connected with a benevolent deity who may be trusted to facilitate a process of healing and restore hope and meaning to their lives in the midst of overwhelming tragedy. By placing personal trust in a loving Supreme Being to justly work out all things in his way and time, the untold grief of the horrors endured by survivors and their future generations, both inwardly and on a social level, can be mitigated and eventually even reconciled.

The value of incorporating spiritual and religious interventions and strategies in the healing process of trauma survivors is becoming increasingly recognized within professional circles. People of faith might feel that spiritual and religious coping can provide hope and promise for a yet prosperous future. The reframing of traumatic histories can be facilitated through the optimistic perspectives offered by spiritual predictions and interpretations.

CONCLUSION

The significance of spiritual and religious interventions in therapeutic work with persons of faith needs to be seriously considered to ensure that clients’ spirituality is encompassed and addressed. The positive influence of religious and spiritual resources in the lives of trauma victims and their offspring might prove to a catalytic ingredient in therapeutic work to open the floodgates through which healing waters may flow. The phenomenon of generational trauma can be more deeply and efficaciously resolved through the added use of spiritual resources and interventions in the healing work of psychotherapeutic interaction.

Continued research into the existence and nature of generational trauma, and the role of religious and spiritual resources in mitigating its attendant effects, could help to identify further ways in which therapeutic and spiritual communities could provide more customized care for the needs of trauma survivors and their offspring. Koenig (2005) concludes that the role of pastoral counseling in the treatment of PTSD patients needs to be further explored as a means of addressing spiritual issues in trauma survivors, particularly those who have been exposed to severe traumatic events and stresses. He also suggests that the role of religion and spirituality as coping resources for persons suffering with severe mental illnesses such as schizophrenia and psychosis is an important avenue for research to help uncover the possible influence of these resources on a number of important therapeutic factors (e.g., etiology and treatment). As well, the possibility of integrative treatment with pastoral figures (such as chaplains and ministers) alongside mental health professionals remains an ongoing field of study through which the use of spiritual resources for traumatized populations and their offspring could be significantly enhanced.

REFERENCES

  • 1. Adelman, A. (1995) Traumatic memory and the intergenerational transmission of Holocaust narratives. Psychoanalytic Study of the Child 50 , pp. 343-367.
  • 2. Agaibi, C. E. andWilson, J. P. (2005) Trauma, PTSD, and resilience: A review of the literature. Trauma, Violence, and Abuse 6 , pp. 195-216.
  • 3. Ainsworth, M. , Blehar, M. C. , Waters, E. andWall, S. (1978) Patterns of attachment: A psychological study of the strange situation Erlbaum , Hillsdale, NJ
  • 4. Argyle, M. andBeit-Hallahmi, B. (1975) The social psychology of religion Routledge , London
  • 5. Armstrong, T. D. (1995) Exploring spirituality: The development of the Armstrong Measure of Spirituality — Paper presented at the annual convention of the American Psychological Association, New York.
  • 6. Bar-On, D. , Eland, J. , Kleber, R. J. , Krell, R. , Moore, Y.Sagi, A. et al. (1998) Multigenerational perspectives on coping with Holocaust experience: An attachment perspective for understanding the developmental sequelae of trauma across generations. International Journal of Behavioural Development 22 , pp. 315-338.
  • 7. Beckham, J. C. , Braxton, L. E. , Kudler, H. S. , Feldman, M. E. , Lytle, B. L. andPalmer, S. (1997) Minnesota Multiphasic Personality Inventory profiles of Vietnam combat veterans with posttraumatic stress disorder and their children. Journal of Clinical Psychology 53 , pp. 847-852.
  • 8. Bernstein, M. Danieli, Y. (ed) (1998) Conflicts in adjustment: World War II prisoners of war and their families. International handbook of multigenerational legacies of trauma pp. 119-124. Plenum Press , New York
  • 9. Bowlby, J. (1969) Attachment and loss: Vol. 1. Attachment Hogarth Press , London
  • 10. Bowlby, J. (1988) A secure base: Parent-child attachment and healthy human development Basic Books , New York
  • 11. Danieli, Y. (1981) Differing adaptational styles in families of survivors of the Nazi Holocaust: Some implications for treatment. Children Today 10 , pp. 6-10.
  • 12. Danieli, Y. Figley, C. R. (ed) (1985) The treatment and prevention of long-term effects and intergenerational transmission of victimization: A lesson from Holocaust survivors and their children. Trauma and its wake: The study and treatment of post-traumatic stress disorder pp. 295-313. Brunner/Mazel , New York
  • 13. Danieli, Y. Danieli, Y. (ed) (1998) Introduction: History and conceptual foundations. International handbook of multigenerational legacies of trauma pp. 1-17. Plenum Press , New York
  • 14. Daud, A. , Skoglund, E. andRydelius, P. (2005) Children in families of torture victims: Transgenerational transmission of parents’ traumatic experiences to their children. International Journal of Social Welfare 14 , pp. 23-32.
  • 15. Davidson, A. C. andMellor, D. J. (2001) The adjustment of children of Australian Vietnam veterans: Is there evidence for the transgenerational transmission of the effects of war-related trauma?. Australian and New Zealand Journal of Psychiatry 35 , pp. 345-351. [informaworld]
  • 16. Fonagy, P. (1999) The transgenerational transmission of Holocaust trauma: Lessons learned from the analysis of an adolescent with obsessive-compulsive disorder. Attachment and Human Development 1 , pp. 92-114. [informaworld]
  • 17. Fossion, P. , Rejas, M. , Servais, L. , Pelc, I. andHirsch, S. (2003) Family approach with grandchildren of Holocaust survivors. American Journal of Psychotherapy 57 , pp. 519-527.
  • 18. Gold, S. N. (2004) The relevance of trauma to general clinical practice. Psychotherapy: Theory, Research, Practice, Training 41 , pp. 363-373.
  • 19. Grame, C. J. , Tortorici, J. S. , Healey, B. J. , Dillingham, J. H. andWinkelbaur, P. (1999) Addressing spiritual and religious issues of clients with a history of psychological trauma. Bulletin of the Menninger Clinic 63 , pp. 223-240.
  • 20. Granqvist, P. (1998) Religiousness and perceived childhood attachment: On the question of compensation or correspondence. Journal for the Scientific Study of Religion 37 , pp. 350-367.
  • 21. Granqvist, P. andHagekull, B. (1999) Religiousness and perceived childhood attachment: Profiling socialized correspondence and emotional compensation. Journal for the Scientific Study of Religion 38 , pp. 254-273.
  • 22. Granqvist, P. andHagekull, B. (2001) Seeking security in the new age: On attachment and emotional compensation. Journal for the Scientific Study of Religion 40:3 , pp. 527-545.
  • 23. Hermann, J. (1992) Trauma and recovery: The aftermath of violence—From domestic abuse to political terror Basic Books , New York
  • 24. Janoff-Bulman, R. (1992) Shattered assumptions: Towards a new psychology of trauma Maxwell Macmillan , Toronto
  • 25. Keilson, H. (1992) Sequential traumatization among Jewish orphans Magnes , Jerusalem
  • 26. Kirkpatrick, L. A. (1999) Toward an evolutionary psychology of religion and personality. Journal of Personality 67 , pp. 921-952.
  • 27. Kirkpatrick, L. A. andShaver, P. R. (1990) Attachment theory and religion: Childhood attachments, religious beliefs, and conversion. Journal for the Scientific Study of Religion 29 , pp. 315-334.
  • 28. Klein, H. Anthony, E. andKoupernick, C. (eds) (1973) Children of the Holocaust: Mourning and bereavement. The child and his family: The impact of disease and death Wiley , New York
  • 29. Koenig, H. G. (2005) Faith and mental health: Religious resources for healing Templeton Foundation Press , Philadelphia
  • 30. Lev-Weisel, R. (2007) Intergenerational transmission of trauma across three generations: A preliminary study. Qualitative Social Work 6 , pp. 75-94.
  • 31. Main, M. andSolomon, J. Greenberg, M. T. , Cicchetti, D. andCummings, E. M. (eds) (1990) Procedures for identifying infants as disorganized/disoriented during the Ainsworth strange situation. Attachment in preschool years: Theory, research, and intervention pp. 121-160. University of Chicago Press , Chicago
  • 32. Marcus, P. andRosenberg, A. (1989) Healing their wounds: Psychotherapy with Holocaust survivors and their families Praeger , New York
  • 33. Motta, R. W. , Joseph, J. M. , Rose, R. D. , Suozzi, J. M. andLeiderman, L. J. (1997) Secondary trauma: Assessing inter-generational transmission of war experiences with a modified Stroop procedure. Journal of Clinical Psychology 53 , pp. 895-903.
  • 34. Pargament, K. I. (1997) The psychology of religion and coping: Theory, research, and practice Guilford Press , New York
  • 35. Peres, J. F. P. , Moreira-Almeida, A. , Nasello, A. G. andKoenig, H. G. (2007) Spirituality and resilience in trauma victims. Journal of Religious Health 46 , pp. 343-350.
  • 36. Redekop, V. Hart, B. (ed) (2008) A post-genocidal justice of blessing as an alternative to a justice of violence: The case of Rwanda. Peacebuilding in traumatized societies pp. 205-238. MD: University Press of America , Lanham
  • 37. Rousseau, C. (2005) Diving into complexity: John Sigal’s work on the long-term consequences of the Holocaust. Clinical Child Psychology and Psychiatry 10 , pp. 262-265.
  • 38. Shaw, A. , Joseph, S. andLinley, P. A. (2005) Religion, spirituality, and posttraumatic growth: A systematic review. Mental Health, Religion and Culture 8 , pp. 1-11. [informaworld]
  • 39. Skolnik, G. L. Marcus, P. andRosenberg, A. (eds) (1989) The Holocaust survivor in the synagogue community: Issues and perspectives on pastoral care. Healing their wounds: Psychotherapy with Holocaust survivors and their families pp. 155-166. Praeger , New York
  • 40. Suedfeld, P. (2000) Reverberations of the Holocaust fifty years later: Psychology’s contributions of understanding persecution and genocide. Canadian Psychology 41 , pp. 1-9.
  • 41. Tomb, D. A. (1994) The phenomenology of post-traumatic stress disorder. Psychiatric Clinics of North America 17 , pp. 237-250.
  • 42. van der Kolk, B. Solomon, M. F. andSiegel, D. J. (eds) (2003) Posttraumatic stress disorder and the nature of trauma. Healing trauma: Attachment, mind, body, and brain pp. 168-195. Norton , New York
  • 43. Weingarten, K. (2003) Common shock (Witnessing violence every day: How we are harmed, how we can heal) Dutton , New York
  • 44. Weiss, M. andWeiss, S. (2000) Second generation to Holocaust survivors: Enhanced differentiation of trauma transmission. American Journal of Psychotherapy 54 , pp. 372-385.
  • 45. Williams-Keeler, L. , McCarrey, M. , Baranowsky, A. B. , Young, M. andJohnson-Douglas, S. (1998) PTSD transmission: A review of secondary traumatization in Holocaust survivor families. Canadian Psychology 39 , pp. 247-258.
  • 46. Yehuda, R. , Schmeidler, J. , Wainberg, M. , Binder-Brynes, K. andDuvdevani, T. (1998) Vulnerability to posttraumatic stress disorder in adult offspring of Holocaust survivors. American Journal of Psychiatry 155 , pp. 1163-1171.
  • 47. Zeanah, C. H. andZeanah, P. D. (1989) Intergenerational transmission of maltreatment: Insights from attachment theory and research. Psychiatry 52 , pp. 177-196.