Just Like Nana

Dr. Irit Felsen

• Amie Penny Sayler • Episode 22

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In this episode of Just Like Nana, host Amie (Elizabeth) Penny Sayler is joined by Dr. Irit Felsen, a clinical psychologist who specializes in trauma and traumatic loss, where they discuss the impact of significant familial trauma through the lens of Holocaust survivors and their families.


Together, they explore how to navigate family dynamics that result from trauma, and the importance of separating the love from the trauma.


About Dr. Irit Felsen

Irit Felsen, PhD is a clinical psychologist specializing in trauma and traumatic loss, whose clinical work and research have been focused on Holocaust survivors and their families. Dr. Felsen is an Adjunct Professor at Columbia University and was previously an Assistant Professor at Ferkauf Graduate School of Psychology, Yeshiva University for 14 years. Dr. Felsen is a Fellow of the APA Trauma division (Division 56) and a member of the American Academy of Experts in Traumatic Stress. She is the chair of the Trauma Working Group at the NGO Committee on Mental Health in Consultative Relationship to the United Nations.  


During the Covid-19 pandemic, Dr. Felsen was the chair of the Working Group focused on the needs of Vibrant Older Adults in the APA Interdivision Covid-19 Task Force, and when she resided in NJ,  she was a board member of the Holocaust Council of MetroWest.  


Dr. Felsen’s papers have been published in peer-reviewed professional journals, and she authored multiple book chapters. Her research was the basis for the book “Psychoanalysis and Holocaust Testimony: Memories of Unwanted Social Trauma.” 


Dr. Felsen is sought-after speaker presenting nationally and internationally about the long-term effects of trauma on survivors and about the intergenerational transmission of trauma and resilience to the descendants of survivors. She is in private practice in Englewood, NJ.



In This Episode, You’ll Learn:

  • Learn to distinguish between your parents' true core personality—what they actually wished and wanted for you—and the restrictive, anxious behaviors caused by post-traumatic stress.
  • Gain a clearer psychological perspective on why trauma survivors sometimes struggle with boundary-setting and letting their children separate, removing the blame and introducing deep compassion into the relationship.
  • Reclaim your family narrative by honoring the immense resilience it took for your lineage to survive, turning that historical strength into fuel for your own personal growth and success.



Resources Mentioned


Connect with Dr. Irit Felsen



Connect with the Show

  • Website: justlikenana.com
  • Share Your Story: If you have a family story or trauma you’re exploring, reach out via our website for a chance to be interviewed.

Connect with Just Like Nana's Website.

A proud member of the Feminist Podcasters Collective.

Theme music by Carter Penny.

Understanding the Blueprint of Trauma: Separation, Love, and Intergenerational Healing with Dr. Irit Felsen

Amie Penny Sayler

Welcome to Just Like Nana. I am your host, Amie Penny Sayler, and I have to admit that while I am recording this, I am watching my 120-pound dog groom my about 8-pound cat who is the absolute boss of him. I do want to let you know that today's episode is very heavy. We will be talking about the Holocaust. My guest today is Dr. Irit Felsen. She is absolutely incredible, intelligent, compassionate, and her parents survived the Holocaust. So please take care of yourself if that sounds like too much for you today. Dr. Irit Felsen is a clinical psychologist specializing in trauma and traumatic loss. Her clinical work and research have been focused on Holocaust survivors and their families. Dr. Felsen is an adjunct professor at Columbia University and was previously an assistant professor at Ferkauf Graduate School of Psychology, Yeshiva University, for 14 years. Dr. Felsen is a fellow of the APA Traumatic Division, Division 56, and a member of the American Academy of Experts in Traumatic Stress. She is the chair of the Trauma Working Group at the NGO Committee on Mental Health in Consultative Relationship to the United Nations. During the COVID-19 pandemic, Dr. Felsen was the chair of the working group focused on the needs of vibrant older adults in the APA Interdivision COVID-19 task force. And when she resided in New Jersey, she was a member of the Holocaust Council of Metro West. Dr. Felsen's papers have been published in peer-reviewed professional journals, and she has authored multiple book chapters. Her research was the basis for a book entitled Psychoanalysis and Holocaust Testimony: Memories of Unwanted Social Trauma. Dr. Felsen is a sought-after speaker, presenting nationally and internationally about the long-term effects of trauma on survivors and about the intergenerational transmission of trauma and resilience to the descendants of survivors. She is in private practice in Englewood, New Jersey. So in case it's not abundantly clear, Dr. Felsen has a lot to share with us on the topic of ancestral and intergenerational trauma.

Dr. Irit Felsen

Thank you so much for being here today, Dr. Felsen. Well, thank you very much for the invitation. It's my pleasure, my honor to be here.

Amie Penny Sayler

We like to start if you have a story that you'd like to share with a story or a powerful memory of a grandma, including what you called her.

Dr. Irit Felsen

Well, Amie, I was born

Dr. Felsen's Personal Story and Connection to Her Work

Dr. Irit Felsen

a long time after, or not so long now when I'm an adult. It doesn't seem like such a long time. But I was born 12 years after my parents survived the Holocaust, and none of their parents and many of their siblings did not survive the Holocaust. So I don't have a personal memory of a Nana or a grandma or a Safta as I would have called her. And I have the memory from a very early age on of not having one, and knowing that other people do have. And uh the beautiful thing, I am named after my mother's mother. So my middle name is Vita. I'm named after her. She was a very real presence in my life and in my way of seeing myself and understanding my mother and the way that my mother described her. She's very much with me. My father's mother, a little bit less than that. My father did not very often talk about his parents.

Amie Penny Sayler

Do you think it was just too painful for your father?

Dr. Irit Felsen

I'm sure it was.

Amie Penny Sayler

Do you feel that you still have a relationship with Vita today?

Dr. Irit Felsen

Absolutely. I will always have it. She's in me.

Amie Penny Sayler

This is Amie interjecting after the interview. Dr. Felsen and I continued to exchange emails, and she told me a bit more about her grandmother Vita, and was willing to have me share that with all of you. I am honored to do so. Part of what Just Like Nana is trying to accomplish is to save stories and tell stories of all of our family members and particularly the women. Women's voices do get lost to history more often than men's voices do. I don't want that to happen to Dr. Felsen's grandmother Vita. And so I'm honored to share what she learned from her mother about her grandmother Vita. So now I'm gonna read to you Dr. Felsen's words about her grandmother Vita. My grandmother Vita was widowed at a very young age while she was already pregnant with my mother, who was her first child. My grandfather was a medic in the Austro-Hungarian army during World War I and was killed on the battlefield. His sword, yes, a sword, and gold ring were brought back and kept for my mother. Despite being a young widow with a baby, my grandmother Vita seems to have managed to remain very vital and positive, and was the person others would come to for advice and for help. My mother described how she would be called to her sisters to help them resolve marital and other issues. From everything I have heard, my grandmother was a very strong, very competent, wise, positive, and empathetic person who was a natural helper, a natural therapist.

Dr. Felsen's Early Awareness of Trauma

Amie Penny Sayler

I have found her story incredibly inspiring. Her resilience in the face of tragedy, and later my mother's unbelievable resilience under the worst circumstances during the Holocaust have fueled my interest in intergenerational transmission of resilience and strengths. And not only the transmission of effects related to trauma, my strong identification with my grandmother, whom I have never met, has also manifested to me the power of the stories that come down the generations as a mechanism to transmit these multi-generational strengths and resiliencies, even from those ancestors whom we never met. It will be abundantly plain to you all as you listen to Dr. Felsen that her grandmother's characteristics and gifts of being competent, wise, positive, and empathetic have been transmitted to her granddaughter, just as Dr. Felsen's research shows happens through family lines. One other note about Dr. Felsen's grandmother Vita, at times, if guests have photographs that they would like to share of their grandmothers, Just Like Nana is able to turn those photographs into the episode art. In this case, I had a suspicion that Dr. Felsen likely did not have a photograph of her grandmother Vita because of the Holocaust, but I did ask. And I'd like to share again with Dr. Felsen's permission the response that she gave me that shows just a glimpse of some of what her mother endured. Now Dr. Felsen is talking about her mother, and I'm going to use again Dr. Felsen's words. In addition to having lost her six siblings and both parents, there was not a single photograph of any of them that survived after they were all taken to their death. When my mother returned to her home after the end of the war, the apartment they lived in was taken up by a Polish man who used to be the super in the building. When he saw my mother, he picked up a wooden log from the fireplace and threatened that if she ever came back, he would kill her. All the contents of the apartment were there, but my mother had not a single photograph. The pain of her trauma was so great, and power of defensive dissociation was such that she was unable to conjure up the faces of her loved ones in her waking time. She was occasionally able to see them in sleep in her dreams. You talked about that feeling of knowing I don't have grandparents and other people do. Part of what I want to ask you is sort of how you came to your work, studying and intergenerational or ancestral trauma. How were you drawn to your work? Absolutely.

Dr. Irit Felsen

I sometimes say when I lecture that I became a trauma specialist a long time before I got my psychology degree. And I remember as a very, very young child thinking about the fact that my parents lost their parents and it would bring tears to my eyes. And I don't know, I mean, I was very, very young when I'm remembering those moments. As I said before, you know, when I was growing up, it seemed like the Holocaust had taken place so much earlier before I was such a long time before I was born. Now as an adult, I understand that it was only some 12 years or so, and uh it's not at all a long time, but apparently my parents managed to create enough of a happy buffer that it seemed like it was so long ago. My parents, like many other survivors, created a very close-knit circle of friendships, which became our substitute family. And one of them, one of them, had a mother who survived. And so she was Oma for all of us, and we called her Oma, and I had a very close relationship with her growing up.

Amie Penny Sayler

But, Doctor, your story is just so and your history is so powerful. So I just want to take a moment to acknowledge that.

Dr. Irit Felsen

Thank you.

Amie Penny Sayler

Can you talk about when you think of intergenerational or ancestral trauma, how do you define that in your work?

Dr. Irit Felsen

I define it as all kinds of ways in which children who did not live through the same experiences

Defining Intergenerational Trauma

Dr. Irit Felsen

that their parents or grandparents or even further ancestors lived through, absorb all kinds of contents and respond to these contents in their own way. So it is very, very important to acknowledge what wide variety or variability there is even in the first generation of trauma survivors. If it's the Holocaust, in the case of uh my family and people from my background, the Holocaust impacted so many different people in so many different countries, so many different types of lives, you know, rural and urban, and higher education, and no education, and every possible factor that creates differences between people existed before the war. And then there were tremendous uh differences in people's experiences during the war, even within the same concentration camp or in the same situation, there were differences. And then there were tremendous differences in the conditions that people encountered after the end of their trauma. And we know now from studies in much more recent trauma survivors or trauma-exposed populations, that the kind of conditions that people find after the end of the trauma is also incredibly impactful. So there was enormous variability in the survivor generation, and there is enormous variability in the second generation, so-called second generation, that's my generation, the children of survivors, and we see the same in other populations as well. Yet there are certain things that we can talk about which seem to be very characteristic mechanisms of transmission and types of effects that we see in many people. And uh, as one of my co-second generation peers said, I will not uh quote him precisely as he said it, but it's uh something like no one who didn't grow in such a home can understand it, and everybody who grew in such a home understands it despite all the differences. That's uh Bukiet in his book Nothing Makes You Free. So I think that it's very important to fully acknowledge the great variance and at the same time acknowledge certain things that seem to impact children of survivors and further descendants because of the way that we absorb all kinds of mini interactions and mini responses, whether they are verbal or non-verbal, through the ongoing sort of interactions in the daily life of the family and in our interaction with these people that we are so close to. Absolutely.

Amie Penny Sayler

You know, when you mentioned everyone who's lived it understands, and no one who hasn't lived it can understand. I mean, I'm paraphrasing you, and he said it much more eloquently. You know, that's when you're telling your story about growing up, and as you talk, there is just this profound understanding and gulf between what you say and what is even possible for me to say in response or how to ask the next question, because there's that gap of I don't understand and can never understand. So thank you for taking time to talk with all of us to help us start to see some aspects of how it's passed on.

Dr. Irit Felsen

Yeah, you know, Amie, I appreciate very much what you just said. And at the same time, the work with Holocaust survivors and their families brought forth these issues of intergenerational transmission, which today seems so obvious to us that there is such a thing, but it took the mental health professions many years to accept it and to acknowledge it. Perhaps it was too difficult to acknowledge that terrible traumas don't end when they just end, they keep having waves and waves of impact, even on people who didn't live through the original trauma. So it took many, many years. And the amazing benefit of it is that the research and the clinical observations about Holocaust survivors and their families and their descendants opened the gate to research in many other trauma-exposed groups and many other types of families where intergenerational trauma is transmitted, and so we can help people much quicker and much more meaningfully.

Amie Penny Sayler

Yeah, just to see that transmission is occurring.

Dr. Irit Felsen

That it's a real thing, and understand that it is very important in the presentation of individuals. Sometimes they don't even recognize it themselves, and it's not like we impose that structure or that construct on the patient, but it is very important to have it in the back of our minds that this person comes from this family, and uh this is what happened to their parents or to their grandparents or to their ancestors. And yeah, you know, Bowen, who was the father of uh family therapy, said we have to look at at least three generations to understand multi-generational processes. And it's so important to keep that in mind because people can come to you with all kinds of symptoms and all kinds of issues and have no clue that it might be related to that, to the fact that this is what their parents went through who didn't maybe talk about it, or their grandparents for sure. The second generation, my generation, at least had the benefit, if you like, of growing up with the survivors and gaining glimpses this way or that way to all kinds of fragments of their experiences during the war, but also before the war. Who they were, who their parents were, what their homes were like, what their friends were like. The third generation and the fourth generation have a much, much less sort of um vivid kind of reservoir of uh memories that were passed down and fragments of stories and of uh real situations and all kinds of things like that. So it's much harder for them to establish a connection between something that they're experiencing and the story behind in previous generations. For them, the issue sometimes is less the pain that was transmitted in some ways, and more a different pain, the pain of the absence of generational connection and chains and understandings.

Amie Penny Sayler

Can you talk about that transmission? How you see that transmission occurring both you know through your experience and your research?

Dr. Irit Felsen

Sure. The transmission occurs basically in every possible aspect of

Mechanisms of Transmission

Dr. Irit Felsen

our interaction with the people that raise us from the very beginning and throughout our lives. So, you know, it occurs through explicit verbal channels, and it occurs also very powerfully in uh other channels which are not verbal, and are body language and facial expressions and tone of voice, and when does the parent all of a sudden seem to kind of stiffen up for a second and uh and look somewhere else or look look lost or looks like there is a certain expression on their face and all kinds of responses that seem disproportionate or out of place. So in the entire range of what is said and what is not said, and what is uh disproportionately experienced as uh why are they so upset about what I just did? It's like it's almost nothing, what and a sort of a gap, to use your word from before, between what seems to be happening in the reality of the here and now and the powerful reaction that a child observes the parent to have, and also in silence, in silence that feels very pregnant and very meaningful. Yeah. So I give the example sometimes, you know, there's a movie called Fugitive Pieces, and there's a moment there where the child, sort of eight or nine-year-old child, is eating an apple, and then he sort of puts the apple down and he wants to go play with his whatever. He's getting bored with the adults, and his father, who starved for years in the concentration camp, has a very disproportionately upset response to the wasting of a half an apple. That's an example of a that kind of a disproportionate response that is like, what, what, why, what did I do? What is this? Then the lack of ability to understand it. And then, as I said, there's the whole range from this to under-reactivity and under-response to good things or to exciting moments in the life of the child. And that is a very wide range of responses that go through, as I said, even tiny little facial expressions, body orientation. My colleague Beatrice Beebe from Columbia University has an amazing body of work that she did on micro kinda interactions between infants and mothers. She shows in video very clearly how sensitive infants are to tiny little, you know, the orientation of the body, the orientation of the face coming in, going out, going still for a minute when mom is uh infants and children and all of us are very sensitive to all of that, and it speaks volumes.

Amie Penny Sayler

Can you talk about that silence? Because there's so much in what is not explicitly stated, and perhaps it's not explicitly stated because it's not known, it's too painful. I mean, I'm sure there are myriad reasons why it's not explicitly stated, but we do take that in as children and even adults. And how do we then process? Is that now we're looking at ourselves to think about well, it wasn't that person, it must have been me. So what did I do when we're internalizing that? Or what happens in those silent interactions where we we don't have a story we can assign?

Dr. Irit Felsen

Well, there are many, many degrees of degrees and kinds of silence and types of silence. So we can't speak about one kind, what silence does. It depends. And I think that it's a it's a very, very important question. You know, what does it do to us? And it does a lot of different things, again, depending on the degrees and the type. It's very, I think, clear by now that the most wounded people often spoke either not at all or incessantly, and in a way that did not take into account whether the child is ready for it, what is the developmental capacity of the child, is this the right time? Is this not the right time? They either were in silence that felt very, very dark and threatening, or they spoke incessantly in a flooding way. The people who are least wounded, who were able to regain their well sort of regulated self, spoke about it in a way that was not too little and not too much, at a time that was appropriate and not at other times, taking into account the developmental level of the child and the level of interest that the child could sustain at a given moment and all of that. I was very fortunate because my parents were like that. But I see a lot of people who were not quite as fortunate, who belong to the other kinds of parents, and when it's either too much or too little, you ask me about the silence, and I can speak about that, but the too much is also very, very damaging. It creates a flooding, intrusive presence inside the child that barely leaves room for their own experiences, for their own small, so to speak, normative struggles, pains, uh disappointments. Everything is pushed aside by the magnitude of those terrible things. And when the silence is there, it creates a great, great vulnerability or a sense of vulnerability of the other, how careful you have to be not to touch, not to push, not to intrude, not to do something, because this silence is clearly protecting something very, very painful. And so what does that do? It like everything else in intergenerational trauma, and that's what I said in the beginning, everybody responds in their own way to these similar mechanisms and issues. A lot of people develop this inordinate sensitivity and awareness to their parents' suffering, to their parents' vulnerability, real or perceived, but even if you just perceive it, and oftentimes you don't just perceive it, oftentimes it's the reality, you have to become very, very consciously and non-consciously constantly oriented to the state of the other person. How are they feeling? Did I say too much? Did I say this? Can I tell them this? Should I not tell them that? Should I do this? Should I not do this? Should I bring up this issue right now, or is it gonna be too much? Is it gonna be this? Is it gonna be that? And that again also leaves very little room for a child to be free to feel their own experience and to be in their own experience and to share that experience more freely and more mutually.

Amie Penny Sayler

I can see how for the child, the child is so focused on the caregiver or the parent or whoever it is that they're not able to probably hear their own voice as clearly and respond to their own sort of reactions.

Dr. Irit Felsen

You're so right, Amie. You know, I think you picked up on something that is very, very central to intergenerational transmission of trauma, and that is just like you said, it interferes with the children's ability or the child's ability to hear and to develop their own voice, their own capacity to be attuned to what they want, what they need, what they feel, which goes along into later life.

Amie Penny Sayler

I know you talk about reclaiming family narratives. Is that part of it that if you can sort of understand this story belongs here, it's not necessarily my story. Do you start

Reclaiming Family Narratives

Amie Penny Sayler

to be able to experience more separation? And I don't mean separation in a negative way, but just understanding that's not me, that's something else. Here's what's inside of me.

Dr. Irit Felsen

Right. So I do. I think that it's very, very important to have the narratives in order to do just that. You know, what we call separation individuation is a very important process by which we sort of uh establish our own differentiated identity as individuals, not at all, as you said, not at all in a negative way, not as a rejection of somebody else, but in fact being individuated within meaningful connections, and finding our own ability to be ourselves in those meaningful connections. And the narrative is a very important part that helps us, even for children who didn't know anything growing up and find out more later as adults, the narrative helps us bring into perspective why we are the way we are, and like you said, that it's not necessarily mine. I absorbed this message or I absorbed this way of feeling or this way of responding way before I could think about it. It's a program, if you like, that was programmed into me as naturally things are when we grow up in a certain context. It's got both thoughts and emotions and behavioral manifestations. It has a cognitive aspect and an emotional aspect, and all of that was sort of absorbed or programmed way before we can consciously think about it. And when we can think about it, which is part, not all, but part of what therapy helps us do, we can understand why it makes sense, why in this context and in that in relation to this kind of a story, we developed this response. Why did our parents did A, B, and C and why did we take it that way or this way? And it helps us be able to have a little more freedom in looking at it one step sort of outside of it, and seeing what of it we would like to keep, and what of it no longer makes sense or enhances our life in the present. And I also would like to add, of course, that intergenerational transmission and the stories and the narrative include also a lot of gifts and a lot of strengths and coping strategies that helped people survive unthinkable difficulties. That's also in us that is also transmitted.

Amie Penny Sayler

How do you encourage people to start to uncover those narratives? I mean, there can be talking with family members, but just what do you recommend?

Dr. Irit Felsen

Whatever is possible, you know, at this point, you know, 25 years ago, I would encourage people, if possible, and it depends on a lot of things, but I would have encouraged people to speak with their parents or with relatives if there were still relatives around. Survivors also were more willing, even those who didn't speak much before, many of them were much more able and willing to speak when they were older. They were further away from the trauma. They have established for the most part, which is an amazing thing about that generation, they for the most part established a very successful second generation. And so it gave them a sense of having really survived and and and succeeded in doing so. And they were not working anymore, they weren't running after the you know daily chores that we all run after when we're younger, they were more able to talk. That was then. Now they are, you know, they are disappearing. So many people no longer have that possibility, but I always carry in mind an example of a patient who came to me knowing nothing almost about her family and their ordeals during the Holocaust. And uh she was able, being very competent with uh searches online and all of that, she was able to find so much information that by now she knows a lot more about her family than I know about mine. So I think there are many ways these days to try to find important pieces of the narrative. And if you can't find anything at all about your own family, one can always try to at least understand and get information about what similar families in some similar sense, you know, the similar area, the similar geography, the similar time, what happened to them.

Amie Penny Sayler

Yeah, part of the genesis of this podcast is that I'm writing stories about grandmas going back generations. And that is part of the reason for it is that through different reasons, whether it's death, divorce, adoption, there are stoppages in family lines where there's no longer kind of access to that piece of the family. And so I do just sort of think about, you know, I can find enough about where were they from, where were they born, where did, you know, they end up dying, and trying to understand the world they lived in, and then sort of just being quiet and trying to listen. I I, you know, I don't hear a grandma's voice or anything like that. That would probably be pretty cool, but it hasn't happened. But just kind of having an open heart and observing a silence for them and thinking about whether something wants to come forward and then writing a bit of a story. And it is made up, but it's sort of a way for me as the granddaughter to try to connect to someone that I didn't know and to fill in that family history, hopefully in a way that honors and respects them.

Dr. Irit Felsen

Yeah, in that sense, there's a certain little bit of similarity. You're trying to get to know these grandmas that you never met, and I have these grandmas that I never met. I did hear a little bit more about them than you heard about 45 of them, as I hear you are researching. It's amazing how fast we can lose this information if we don't pass it on.

Amie Penny Sayler

Well, I have just a couple more questions for you before we close. One is you had mentioned back at the beginning where experiences of trauma can have similar threads that run through them and also be very different depending on the circumstances, the person, all of that. And you had talked in there about it can also be affected by what happens after the traumatic event has ended. What is helpful after the traumatic event has ended to kind of help people start on a process of integrating and healing?

Dr. Irit Felsen

So these things are, of course, very complex processes, but think about the difference, for example, between people who survived the genocide of the, I mean the massacre of the Khmer Rouge in Cambodia and stayed living in the same village with some of the perpetrators and people related to the perpetrators or similar situations,

Impact of Post-Traumatic Conditions

Dr. Irit Felsen

as opposed to someone who actually leaves and starts life in a completely new place. There are so many factors involved already, just in that little comparison, right? On one hand, you're still in your own culture, you're still in your own home, you still know how to do things, you still have the skills that allowed you to make a living before, you can still use them and make a living now, and so forth. Your children are growing up within your own culture. It's an important sense of continuity that you have and fam and understanding your own kids. The people who move, let's say, like Holocaust survivors or like survivors of the Cambodian Khmer Rouge to the United States or anywhere else, Canada, Sweden, came here with no language, some of them with skills that were transferable and some of them not. Some of them had no relatives or people to help them, so there is no home that's ready, there's no somebody that you can turn to and so forth. So all of those things make a very big difference. And their children grew up in a, in many ways, in a in a culture that's foreign. The children are bicultural. To some extent, there is uh understanding between the generations, to some extent there isn't. All of those things are factors in how well the survivors then uh integrate into the new environment and how they feel about it, and how they feel about their children integrating and so forth. When Holocaust survivors went specifically to another country, but that country was Israel, some of the studies show that, for example, that was easier in many ways psychologically, emotionally than other countries because they felt that they were part of building something very, very important for their people, and that that was in some way a positive thing that they could do so that something like the Holocaust would not happen again. They felt part of the culture, they felt their children, they could trust their children to this culture because it's the culture continued, the culture of the family which they lost. So all of these factors, where do you go? What kind of skills do you have? If you come from a very rural, let's say, village in Africa, and you immigrate to the United States right now, you might come here with very, very few skills that are transferable to allow you to immediately feel that you can support yourself and your family. All of those things are part of what makes the mosaic of integration into a new place and how well it will go or how difficult it will be. And what we know from, as I said, studies in recent, more recent immigration studies and refugee populations is that sometimes people come out of the very, very traumatic situations that they fled without post-traumatic symptomatology. But when the situation that they meet after the end of the trauma is very difficult and there is no support, there is an onset of what we call late onset PTSD or late onset of depression and anxiety because they were hoping for better, they were hoping for success, they were hoping for support, and when that doesn't come, that's when the symptomatology sets in. So it's very important for people to have a context that supports them, of course, that doesn't shame them for whatever they went through, and that allows them immediately to gain the skills that they need to feel capable of supporting themselves and their loved ones in the new place.

Amie Penny Sayler

What's the one key insight you would like a listener to leave the episode with?

Dr. Irit Felsen

I think that it's very important to remember that sometimes growing up with parents who went through trauma is not easy. What are the symptoms? We talk about hyper-arousal, so people were very easily triggered by a lot of things, high levels

Key Insights for Listeners

Dr. Irit Felsen

of anxiety, people don't sleep well often, and we know how well we each function when we don't get good sleep and when we have a short night full of nightmares. We talk about avoidance of certain things because we don't want those things to trigger us. We talk about intrusive phenomena, you know, bad things, images and things that come in. Living with someone who suffers from all of that can be not simple. It often also causes people, even though rage and anger are not part of the definition of post-traumatic symptoms, they often appear in the context of people who have suffered a lot of trauma. So it can be very difficult. And like I said before, there is so much, or you said, the gap between what actually happened to people and what can be understood by anybody who didn't, that sometimes kids take it very personally. They feel that it's because of them or because of the parent. The parent is so difficult, the parent is disappointed with them, the parent doesn't want them to go to the college far away or to wherever it is, they don't let them. And I think it's very important to understand that a lot of it is because of the trauma. It's not that the parent is necessarily narcissistic or toxic, words that are being thrown very easily these days. It's not necessarily that it can be the impact of the trauma, which really sometimes needs to be understood as, if you like, as a graft that sits on top of the real personality of the parent, who he really is or she is, what they really would like for their children. So I often say to children of trauma survivors, try not to focus on all of these behaviors that seem to curtail your autonomy and seem to be this or that. And just ask yourself: do you believe that your parent loves you? Do you believe that they would like you to be happy? If so, it is your responsibility to find out. Find your voice and to find how you can be happy, they may not be able to guide you in the best way because of the impact of the post-traumatic stuff on them. It's your responsibility to find the voice. It's also at some point in life, our perhaps uh how shall I call it, our job for our own sake and for our parents to understand what I just said. That there is a difference between what they would have liked, what they would have wanted, what they would have wished for their children and for themselves sometimes, and what was possible because of the impact of trauma and to separate these things. So just like that's the question that I would like to send off people with. Do you believe they love you? Do you believe they want you to be happy? And if you do, then follow that thought and find your way towards it. And not all of these other behaviors that seem to indicate that they don't care what you want and they don't want you to leave, and all the don't those are the post traumatic grafts.

Amie Penny Sayler

Thank you for that, Doctor. Really appreciate your time.

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Dr. Irit Felsen

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