How Awareness of Epigenetics and Generational Trauma Can Inform Therapy

The pandemic has become a source of collective trauma for many, leaving some wondering what the long-term impact may be even after it's over. The study of epigenetics may have the answer, as history shows that oppressed groups, for example, may pass down the impact of such trauma in their genes.

Epigenetics—in highly simplified terms—is the study of how genes may be affected by the experiences people have, which can then be passed down to future generations.

While it may be challenging to consider how bigotry continues to harm groups of people to the extent that its impact transcends generational lines, it is crucial to understand the issue better if it is to be addressed.

What the Research Tells Us

While the research is still evolving, there is a growing scientific consensus that trauma has the ability to impact the genes of future generations.

A 2019 study explored how psychological interventions may have the potential to be personally tailored to meet the needs of clients in terms of epigenetic processes in the future. Kumsta offered that switching people from competitive motivational systems into caring motivational systems with compassion-focused therapy could target different gene processes.

A 2021 study reviewed how systemic racism may continue to harm future generations at the level of their genes, as the author argued for urgent changes to the status quo of white supremacy. Mulligan's work focuses on the plight of African Americans but she notes that racism-associated epigenetic marks may apply to any racially oppressed population.

Although it will take time before epigenetics is weaved into therapeutic best practices, this evolving research can still help to understand the far-reaching implications of generational trauma.

Epigenetic Changes May Increase Mental Health Risks

Deidra Thompson, DNP, FNP-C, PMHNP-BC, faculty member in Walden University’s MSN Psychiatric-Mental Health Nurse Practitioner program says, "Epigenetic changes can affect one’s mental health."

Thompson explains, "An individual’s environment and behaviors, including nutrition, exposure to chemicals, exercise, adversity, smoking and stress, can affect gene expression. This expression of genes affects development and disease and can make one more susceptible to mental illness."

Since raising awareness of this can influence treatment planning in mental health care, Thompson notes that providers can partner with patients and other members of the health care team to develop a holistic plan of care that will address mind, body and spirit, with an understanding of past trauma.

Thompson highlights, "This will likely include a collaboration with professionals in various disciplines to ensure that each patient receives an effective plan that minimizes negative behaviors and environments while emphasizing positive behaviors and environments. Psychotherapy also plays a role in gene expression, so it may be a part of the treatment plan."

Given that epigenetic changes do not change the underlying DNA sequence, Thompson notes that some of the changes may be reversible. "Stopping the negative behavior or removing one from a negative environment can reverse the effects. Early intervention can improve outcomes." she says.

While a healthy diet and exercise, as well as stress relief measures such as meditation and mindfulness can prove beneficial, Thompson highlights that each person, along with their condition, is unique. "There are several factors that play a role in the development of disease including genetics, finances, trauma, and social and physical influences," she says.

Thompson recommends, "Those who suffer symptoms of a mental illness should seek evaluation and treatment from a professional. Patients often respond well to an individualized plan of care that includes both pharmacological and non-pharmacological measures."

Patients should be active participants in the treatment planning process and willing to invest in themselves, as Thompson notes that it often takes time and discipline to make lifestyle changes, stop negative behaviors, etc.

Thompson explains that patients should work closely with their service providers to develop an intervention that meets their needs. "Patients should also advocate for themselves and ask their providers about services and referrals from which they believe they can benefit," she says.

Environmental Adversity Shapes Mental Health

Mental health equity research, clinical psychologist, and director of medical affairs at Big Health, Juliette McClendon, PhD, says, "These studies highlight the impact of environmental experiences on health via biological changes, a phenomenon that can impact both mental and physical health."

McClendon highlights, "I am glad that there is more attention being brought to understanding how one’s environment and life experiences impact mental health via biological mediators."

In psychological care, McClendon notes that they have been aware of that biological and brain mediators shape mental health, but there has not been as much focus on how and why those biological mediators develop.

McClendon explains, "Bringing an epigenetics perspective to the forefront can allow us to better integrate the roles of genes, biological processes, and environmental adversity in shaping mental health and developing effective treatment approaches."

By understanding that mental health conditions can develop from chronic experiences of adversity that shape the brain and biological functioning, McClendon notes that health inequities can be addressed. "Epigenetics is closely aligned with social determinants of health," she says.

McClendon highlights, "We know where one lives, works, plays and prays is a significant predictor of our long-term health and well-being, both physically and mentally. Communities of color and LGBTQ+ communities experience higher stress burdens, which in turn can lead to higher rates of chronic psychological and physical illnesses among these populations."

In her own research, McClendon notes work on a 2021 study published in Psychoneuroendocrinology, which examined whether stress, health behaviors, social isolation and inflammation were associated with racial inequities in self-reported physical health.

McClendon explains, "Specifically, Black Americans were exposed to greater cumulative stress, which was associated with reduced engagement in preventative health behaviors, which as a result, was associated with greater inflammation and reduced physical health."

Since the study highlights disproportionate chronic stress in the development of biological dysfunction among Black adults, McClendon notes, "More studies that integrate stress, biology, and health will allow us to identify more effective interventions for ending health inequities."

In her experience as a therapist, McClendon explains how patients who experienced chronic stress and adverse events at a young age are more likely to have chronic health conditions in adulthood. "What happens from birth (and even before) through young adulthood can shape an individual’s risk for health problems throughout their life," she says.

McClendon explains, "Mental health continues to be stigmatized, but opening up the conversation about how trauma affects one’s health is important so that the public can understand that if they are struggling, it is not because there is something inherently wrong with them."

By grasping how stressful experiences can affect biology in a way that increases the risk of mental and physical health struggles, McClendon highlights, "This work can also alert psychologists and other mental health providers that the environment is just as important to address in psychotherapy as internal thoughts, feelings and behaviors."

McClendon explains, "The pandemic is a collective trauma. Generations of children and adolescents may already be experiencing biological changes due to the level of stress and uncertainty they are experiencing."