title: The transgenerational transmission of holocaust trauma. Lessons learned from the analysis of an adolescent with obsessive-compulsive disorder.
abstract: This paper outlines an attachment-theory based model of transgenerational trauma inspired by the successful psychoanalytic treatment of a severely disturbed adolescent with obsessive-compulsive disorder who was the first child of the first daughter of a holocaust survivor. It is proposed that the transmission of specific traumatic ideas across generations may be mediated by a vulnerability to dissociative states established in the infant by frightened or frightening caregiving, which, in its turn, is trauma-related. Disorganized attachment behaviour in infancy may indicate an absence of self-organization, or a dissociative core self. This leaves the child susceptible to the internalization of sets of trauma-related ideation from the attachment figure, which remain unintegrated in the self-structure and cannot be reflected on or thought about. The disturbing effect of these ideas may be relatively easily addressed by a psychotherapeutic treatment approach that emphasizes the importance of mentalization and the role of playful engagement with feelings and beliefs rather than a classical insight-oriented, interpretive approach.
authors.affiliation: Sub-Department of Clinical Health Psychology, University College London, Gower Street, London WC1E 6BT, UK. p.fonagy@ucl.ac.uk
authors.forename: P
authors.initials: P
authors.lastname: Fonagy
mesh_terms: D000293:Adolescent; D003209:Concentration Camps; D004213:Dissociative Disorders / Q000523:psychology / Q000628:therapy; D017767:Holocaust / Q000523:psychology*; D006801:Humans; D007223:Infant; D016901:Intergenerational Relations; D008297:Male; D009034:Mother-Child Relations; D009769:Object Attachment; D009771:Obsessive-Compulsive Disorder / Q000523:psychology* / Q000628:therapy; D010553:Personality Development; D011575:Psychoanalytic Therapy; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy; D017741:Survivors / Q000523:psychology*