There had to be a common link, my cousins and I mused as we discussed the latest diagnosis to befall our family. Our mothers were sisters, three of eight children born to my grandparents. Each had some debilitating condition: lupus, rheumatoid arthritis, myasthenia gravis, multiple sclerosis. And not just them — similar illnesses were present among their own maternal first cousins.
It didn’t make sense. With a few exceptions – my great-uncle Bernard’s death from kidney disease and my grandmother’s diagnosis of stomach cancer, both happening when they were in their thirties – we were a family of people who lived long, vibrant lives. We had the typical hardiness of Southern Black people who, until the 1960s, spent their days doing manual labor. We all expected our life trajectories to be more or less like that of my great-grandmother, whose first hospitalization for illness occurred at 94, just a few weeks before her death.
We all expected our life trajectories to be more or less like that of my great-grandmother, whose first hospitalization for illness occurred at 94, just a few weeks before her death.
When my second cousin was diagnosed with multiple sclerosis in the 1980s, it was an anomaly in our otherwise healthy family. But the diagnoses kept coming. By 2010, every branch of my extended maternal family had at least one person diagnosed with an autoimmune disease or some other disabling condition. As the eldest grandchild and great-grandchild in our matriarchal line, I gained the dubious distinction of being the first in my generation to add my own diagnoses to the list: fibromyalgia, Hashimoto’s hypothyroidism.
Something was clearly going on. The illnesses, while not identical, had a lot in common. Many of them seemed autoimmune in nature, entailing conditions in which the body attacks itself by confusing healthy cells with foreign invaders. These were not lifestyle diseases, that is, those caused by unhealthy eating, smoking, substance use or lack of physical activity. And in our thinking, they were not the types of diseases that Black people got, especially not strong Black women and men like ourselves, descendants of kidnapped and enslaved Africans. That meant there could only be one cause: “It must be that White blood.”
White blood and Black trauma
Over the years, as we tried to figure out the etiology of our familial health struggles, we realized that they traced back to my maternal great-grandfather. Smith W. R. Allen was a carpenter and a pastor in the Central Jurisdiction of the Methodist Church. The Central Jurisdiction was a segregated district created when the Methodist Episcopal Church, the Methodist Episcopal Church South and the Methodist Protestant Church merged in 1939 to form the Methodist Church. Southern Methodists agreed to the merger on the condition that they remain separate from their African American counterparts in the region. Until its abolition in 1968, when the Methodist Church and the Evangelical United Brethren merged to form the United Methodist Church, the Central Jurisdiction was the only jurisdiction organized by racial identity rather than geographic region — the only jurisdiction defined by racial exclusion.
The irony was that my great-grandfather could sometimes be mistaken as White, as could his daughter, my maternal grandmother. His fair skin and fine straight hair have been passed along to many in our family. It’s often what makes us recognizable to each other and to strangers as Allens. Nearly 20 years ago, for example, my mother managed to connect with a branch of his family that we had never met, when she was coordinating our annual reunion. We had no idea what to expect from this group, even though they were descendants of my great-grandfather’s older brother, Curtis. Curtis was a twin to Curlie, who was heavily involved in the Civil Rights Movement in Mississippi. When Curlie was murdered by White supremacists, his body thrown onto their mother’s porch, Curtis fled the state and settled in Cleveland. His descendants were separated from the rest of the family for decades.
The moment when Curtis’s descendants walked into the reunion hotel, we recognized them. “Those are Allens, all right.” Our family has a phenotype that speaks to White ancestry being somewhere in our line. My Ancestry DNA test affirms this, estimating that 14% of my DNA hails from Western Europe. If I scroll back far enough in my DNA matches, White faces began to appear. But no love stories of Black and White people in my family predate the 21st century; there are no illicit romances or marriages between Blacks and Whites in our history.
When we blamed “White blood” for our disease history, what we were blaming was not the presence of White ancestors. Rather, we were clumsily pointing to the most likely way that White ancestry would have entered our familial bloodline, namely the rape of at least one enslaved Black female ancestor by a White male slave owner or overseer. We were pointing to the traumatization of our ancestors and the way their trauma continues to course through our veins, compounding the racial trauma that many of us have experienced directly as we integrated White communities and engaged in antiracist work.
We did not know, however, to call it trauma, in part because these stories are not unusual for Black families. I can tell similar stories about the other lines in my family lineage. On my father’s side, for example, I share a great-great-grandfather with Supreme Court Justice Ketanji Brown Jackson. Our great-grandfathers, Tucker and Sam, were among 10 siblings forced to separate when their brother Jim’s outspokenness about the treatment of Black people led to conflict with White people in Cordele, Georgia. Talk to any Black family in the South, and you’re likely to dig up comparable stories of sexual assault, violence, land theft and terrorism. The stories are so common that we often fail to identify them as trauma or to recognize their impact upon the body.
Trauma and the body
The language of trauma is ubiquitous these days, but it has not always been that way. Before the latter third of the 20th century, the term “trauma” was used primarily by medical doctors to refer to a physical wound or injury that violated the body’s integrity, for example, a deep cut, a broken bone, a concussion from a hit on the head. Only after the Vietnam War was the term increasingly used in a psychological sense, as physicians and psychiatrists struggled to understand what they were seeing in many veterans. “Trauma” gradually became the language for what used to be known as “shellshock” or “battle fatigue.” But it was not until 1980 – when the American Psychiatric Association recognized post-traumatic stress disorder (PTSD) as a psychiatric diagnosis – that researchers began systematically to study trauma and to realize that it was considerably more common than they had believed.
Trauma … is a reaction to an event or situation that poses a real or perceived threat to our lives, including our physical, emotional or spiritual existence.
Trauma is not just something that makes us feel bad. Rather, it is a reaction to an event or situation that poses a real or perceived threat to our lives, including our physical, emotional or spiritual existence. Some traumatic events leave physical scars. More often, however, they leave lasting damage to our self-image, to our view of God, to our sense of safety in the world and to our health.
In the 1990s, researchers at Kaiser Permanente and the Centers for Disease Control and Prevention collaborated on the landmark Adverse Childhood Experiences (ACE) study examining the impact of trauma on health. The study began after Kaiser’s San Diego preventative medicine team realized that many patients diagnosed as morbidly obese had histories of childhood sexual abuse. The original ACE study included data from 17,421 patients who came to the preventative medicine department for annual medical evaluations and who agreed to complete a survey asking whether they had ever experienced seven types of adverse childhood experiences: psychological abuse, physical abuse, sexual abuse, household substance abuse, household mental illness, domestic violence or incarceration of a household member. Using data from the patients’ medical records, the researchers then examined the relationship between traumatic childhood experiences and health.
The ACE study, published in the American Journal of Preventive Medicine in 1998, revealed two things. First, childhood trauma is much more common than believed and occurs across all races, income brackets and educational levels. Second, childhood adversity has devastating consequences for adult physical and mental health. Even among study participants who reported only one category of adverse experiences, the study found a significantly increased risk of poor health behaviors, such as smoking and physical inactivity. Experiencing at least four categories of childhood trauma was found to greatly increase the odds of several health problems in adulthood, including diabetes, chronic bronchitis or emphysema, heart disease, stroke, cancer, sexually transmitted disease, hepatitis or jaundice, severe obesity, depression and suicidality.
In the 30 years since the original ACE study, researchers across the world have documented evidence of trauma’s impact upon a wide range of health conditions, including depression, anxiety, chronic pain, cardiovascular disease, autoimmune disorders, gastrointestinal issues, substance use disorders and sleep problems. As Bessel van der Kolk wrote in his bestselling 2015 book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, “The trauma may be over, but it keeps being replayed in continually recycling memories and in a reorganized nervous system.”
Intergenerational trauma and health
Trauma affects more than the bodies of those who experience it; its impact can extend to subsequent generations. When trauma’s effects are not confined to the individual who directly experienced it but are also passed down to subsequent generations, it is considered intergenerational trauma. With intergenerational trauma, the children or even grandchildren of trauma survivors show patterns of behavioral, emotional and physical symptoms similar to those often seen in trauma survivors. Research on Holocaust survivors, for example, demonstrates that their children exhibit neuroendocrine changes associated with PTSD, regardless of the descendant’s own trauma history. In other words, the brains of Holocaust descendants looked traumatized even if they had not experienced the firsthand trauma. These neuroendocrine changes, in turn, were found to contribute to elevated rates of hypertension, Type 2 diabetes, PTSD, anxiety and depression.
And the impact does not end after one generation. Research indicates that the effects can be transmitted to a third generation. Furthermore, more than cultural or societal trauma can be carried across generations. So can individual trauma such as rape, domestic violence and other forms of violence. Given how widespread we now understand trauma to be, how many of us are suffering from the impact of harm done to our direct forebears?
Intergenerational trauma makes us wrestle with the question of theodicy – why bad things happen to good people – in a different way. On multiple occasions, Scripture speaks to generational curses that punish subsequent generations for their ancestors’ sins. In Exodus, for example, God warns the people of Israel against idolatry: “You shall not bow down to them or serve them, for I the Lord your God am a jealous God, punishing children for the iniquity of parents to the third and the fourth generation of those who reject me but showing steadfast love to the thousandth generation of those who love me and keep my commandments” (Exodus 20:5-6, NSRUE). In Jeremiah, however, the curse is reversed: “In those days they shall no longer say: ‘The parents have eaten sour grapes, and the children’s teeth are set on edge’” (Jeremiah 31:29). Both texts, however, do focus on the perpetrators of sin. What about its victims and their descendants? Are we forgotten? How long, O Lord!
Over the past two decades, as I have struggled with my own health, my soul has uttered the same cry. For the longest time, I couldn’t figure out why I was suffering. I seemed to be more diligent about self-care than anyone that I knew. Meditation, yoga, physical exercise, staying hydrated, eating healthy, getting enough sleep, massage, acupuncture, talk therapy — all were part of my ongoing wellness plan. Yet I couldn’t lose the weight, I couldn’t vanquish the pain and fatigue, and the diagnoses kept coming.
Only recently have I begun to accept that my health is not entirely under my control: that in addition to environmental degradation and chronic stress, my health is a product of a biological inheritance handed down unknowingly by my ancestors. For centuries, as they endured kidnapping, trafficking, assault, torture, family separation, lynching and widespread racial terror, my Africa-descended ancestors’ nervous systems were in constant fight-or-flight mode — circulating stress hormones that enabled them to keep working and living, but also repressing the function of bodily systems deemed less essential when we are under attack, including the digestive, immune, reproductive and urinary systems. These systems are connected to many illnesses that disproportionately affect African Americans: diabetes, chronic kidney disease, hypertension and stroke, some forms of cancer and autoimmune disease — in other words, many of the same conditions that plague my family. Our ancestors were force-fed sour grapes and our teeth have been set on edge.
Caring for myself, then, is not just about relieving the stress and trauma that I have personally endured. It is also about healing the trauma in my bones, the trauma that my enslaved and oppressed ancestors had no opportunity to resolve. I cannot rewrite my family’s history, but perhaps I can teach my body a new story.
Additional readings on trauma and healing
- Thema Bryant, Homecoming: Healing Trauma to Reclaim Your Authentic Self (TarcherPerigee, 2023)
- Stephanie Foo, What My Bones Know: A Memoir of Healing from Complex Trauma (Ballantine, 2023)
- Prentis Hemphill, What It Takes to Heal: How Transforming Ourselves Can Change the World
- Bessel van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (Penguin, 2015)
- Resmaa Menakem, My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies (Central Recovery Press, 2017)
- Mark Wolynn, It Didn’t Start with You: How Inherited Family Trauma Shapes Who We Are and How to End the Cycle (Penguin, 2017)