Transmitting Hypervigilance Through Intergenerational Trauma: Recommendations for Marriage and Family Therapists

This article aims to examine the transmission of hypervigilant behavior in ethnic communities, specifically African American communities, while addressing the distrust between ethnic communities and institutional systems. This article also aims to provide therapeutic initiatives and recommendations for systemic therapists to implement in therapy practices in hopes of helping to decrease chronic hypervigilant behavior in Black and Brown communities.

Empirical evidence shows that people of color, specifically African Americans, display hypervigilant behavior relating to anxiety disorders, post-traumatic stress disorder (PTSD), and racial discrimination (Bryant-Davis, Adams, Alejandre, & Gray, 2017; Range, Gutierrez, Gamboni, Hough, & Wojciak, 2018; Williams, Printz, & DeLapp, 2018), and have a more heightened sense of hyperarousal because of these issues (Phan, So, Thomas, & Gaylord-Harden, 2020).

Hyperarousal is the physiological component of PTSD (Kleshchova, Rieder, Grinband, & Weierich, 2019) where symptoms include irritability, anger, trouble concentrating and being overly cautious and careful (Phan et al., 2020). Hypervigilance is the cognitive, behavioral component of hyperarousal as it alerts the individual to nearby danger in their surroundings and acts as a survival mechanism (Kleschova et al., 2019; Phan et al., 2020), which is also associated with attentional bias, where individuals become more aware, or on the lookout for potential threats (Kimble et al., 2014; Phan et al., 2020).

Hyperarousal and hypervigilance are often associated with PTSD and anxiety disorders (Bryant-Davis et al., 2017; Coleman, Ingram, & Sheerin, 2019; Phan et al., 2020; Williams et al., 2018). However, with lived experiences of trauma, individuals may unknowingly transmit their hypervigilance to their peers and family members. While hypervigilance serves as a protective factor for those who experienced the trauma (Kleshchova et al., 2019), it can impair a person’s quality of life when it becomes chronic, thus categorizing hypervigilance as a maladaptive behavior (Phan et al., 2020), while also increasing hypervigilant behavior in those around them.

Chronic hypervigilance as a maladaptive behavior includes distrust, anger, fear, shame, guilt, isolation, and self-destructive behaviors (Bryant-Davis et al., 2017), which may all lead to misinterpreting or exaggerating non-threatening situations (Kimble, et al., 2014). For instance, young African American males who experienced violent trauma in their community were more likely to overreact to harmless situations (Phan et al., 2020). An example would be a person feeling the need to carry a weapon everywhere, including to places where no threats are present, or becoming excessively aggressive to appear threatening to others perceived as threatening. Thus, chronic hypervigilance may cause a person to be more focused on identifying threats that may not exist, such as profiling certain members of the community as a potential thief or violent person.

Transmission of chronic hypervigilance

Hypervigilance is a byproduct of trauma and hyperarousal (Williams et al., 2018) and while the behaviors are associated with physical and psychological traumas, behaviors deriving from hypervigilance may also play a role in the transmission of trauma, or intergenerational trauma. Intergenerational trauma, or historical trauma, occurs when family members, friends, and members of the community may pass on behaviors, thoughts, and feelings deriving from a traumatic event (Bryant-Davis et al., 2017), such as slavery, the holocaust, the imprisonment of Japanese American citizens, and indigenous genocide, on to their children, peers, friends, and family members through the telling of their personal lived experiences or learned behavior from upbringing (Brave Heart, 2003). For instance, family members and peers in the community may have a distrust of their white counterparts and will behave in ways that will display that distrust, such as seeing any type of behavior from white people as racist, including non-racist behavior. Another example is when a family member relays a personal bad experience with an institution, such as the criminal justice system or hospitals. Listeners may use tactics to avoid the police altogether, including not calling the police for help, or become unnecessarily combative when pulled over by police (e.g., expressing heightened anger when asked for license and insurance). Individuals may also experience heightened body sensations when police are present, such as fear or aggression. In addition to listening to experiences, family members and peers of the community may equip their loved ones and friends with practices to avoid threatening situations (Brunson & Weitzer, 2011). Caregivers may guide, or armor, their youth regarding how to interact with police or face racism, and studies have found that youth who are equipped with this knowledge are less likely to have interactions with the police (Ream et al., 2010). However, this armoring can translate into further hypervigilant behavior.

Media reports and witnessing community violence may contribute to the transmission of hypervigilance (Phan et al., 2020). However, hypervigilant behavior does not begin and end with the police. People may also display hypervigilant behavior towards medical personnel (Powell et al., 2019). When people do not trust doctors, they put themselves at risk, as they will avoid seeking help until the problem is grave. An example would be warning family members and peers not to take a vaccine for fear of something going wrong, or the belief that the vaccine negatively targets people of color. Furthermore, people may not trust research from the science community and opt for home remedies that may or may not work, such as consuming products that claim to boost the immune system to avoid vaccines. Yet, this distrust of the medical community, the criminal justice system, and the science community is not without scrutiny. When examining the historical relationship between these communities and people living in ethnic communities, it is safe to assume that trust has been severed. Centuries of mistreatment and racial discrimination between these institutions and people of color heightens hypervigilant behavior in the form of covert and/or overt aggression (Williams et al., 2018). Therefore, chronic hypervigilant behavior may affect people of color in places where race and racial discrimination intersect.

Recommendations for marriage and family therapists

Racial trauma, race-based trauma, or racist incident-based trauma is defined as the psychological effect oppression has on people of color and people of marginalized groups (Bryant-Davis et al., 2017). This means that when people of color and marginalized groups experience what they perceive to be racism and/or oppression, the traumatic experience can cause anxiety, hypervigilance, and distrust. Additionally, because of the power dynamics that racism and oppression place over people of color, racial trauma can be as psychologically damaging as sexual assault and intimate partner violence (Bryant-Davis, 2017).

When addressing racial trauma in marginalized communities, most research reviews revolve around police interactions and the negative affects those interactions breed (e.g., Brunson & Weitzer, 2011; Bryant-Davis et al., 2017; Range et al., 2018; Williams & Printz, 2018). However, people of color may experience race-based trauma in clinics, hospitals, mental health clinics, social service organizations and other institutions where services are sought (Powell et al., 2019; Pettus-Davis, Renn, Lacasse, & Motley, 2019). Additionally, racial trauma may be perceived within the science community where unethical practices and research targeting people of color and marginalized groups has led to loss of trust by the members of those groups (e.g., Tuskegee Experiment, Henrietta Lacks, surgical experiments practiced on enslaved Africans by J. Marion Sims [Holland, 2018]). Also, the long-term, generational traumatizing effects of slavery is overlooked because some professionals do not seem to think it has profound effects on African Americans today (Wilkins, Whiting, Watson, Russon, & Moncrief, 2013). Therefore, it is imperative that professionals recognize the long-term effects racial trauma has on communities that are marginalized.

Mental health professionals must acknowledge how race plays a present role in the identity of Americans and how that intersects with systemic institutions and may play a role in the dysfunction of hypervigilant behavior in people of color. Professionals must also acknowledge and recognize how people of color cope with racial discrimination and trauma in spaces they perceive to be white-dominated spaces. For instance, Pettus et al. (2019) contend that men who practice traditional beliefs of masculinity (e.g., dominance, aggression, Alpha-male traits) would rather deal with their trauma alone and on their own without seeking professional help. The same observation could apply to communities of color. People of color may rather seek help within themselves, and sometimes with peers within their communities (e.g. neighbors, family members, friends), rather than seek help from therapeutic professionals (Awosan, Sandberg, & Hall, 2011; Wilkins et al., 2013) due to perceived lack of care and compassion for people of color in spaces they perceive to be white-dominated.

For those who do decide to seek help, dealing with health and social services can be re-traumatizing (Bloom & Farragher, 2011; Yatchmenoff, Sundborg, & Davis, 2017) due to perceived microaggressions from white professionals. Because trust has been severed due to historical events, such as slavery (See Davey & Watson, 2008 as cited in Wilkins et al., 2013), people of color may see small acts of behavior as racist whether it is real or imagined, intended or unintended. Yet, people of color have layers upon layers of trauma to unpack, examine, and heal from, that has not been addressed historically or modernly. For instance, Range et al. (2018) point out that maladaptive hypervigilant behavior may lead to aggression, domestic violence, and aggressive parenting practices within families and communities. Therefore, to address chronic hypervigilant behavior in Brown and Black communities, the relationships between systemic institutions and ethnic communities must be repaired by first recognizing the historical trauma systemic institutions caused Black and Brown people, and not be dismissive about it. In addition to recognizing and acknowledging the effects of historical trauma on/in these communities, following are two possible initiatives that may give professionals the tools to rebuild trust between Black and Brown communities and mental health professionals: Implementing the Multi-Phase Model (MPM) and Trauma-Informed Care (TIC) into mental health spaces.

Multi-phase model

The Multi-Phase Model of Psychotherapy, Counseling, Human Rights and Social Justice (MPM) is a model born from working with refugees and rooted in multiculturalism that addresses issues that plague people of color—systemic racism and social injustices—and suggests placing the power back into a people who have lost their power due to systemic racism and oppression (Range et al., 2018). The MPM model also suggests that professionals look within themselves and within Western culture and ideals for biases that are harmful to people of color and to adopt a proactive approach when working with families dealing with personal, familial, systemic, and historical trauma (Range et al., 2018).

An important insight to note is that professionals who are people of color should not take their membership for granted. Professionals who are persons of color could also potentially re-traumatize and lose the trust of individuals seeking help because of the power element minority professionals have over their clients, and that professionals of color may have their own biases towards people of their shared ethnic group. Also, professionals of color must keep in mind that membership in a particular group does not guarantee the professional will have the same knowledge or cultural practices with a client of the same ethnic group. Therefore, professionals of color must also keep abreast of cultural knowledge and differences while acknowledging their own biases whether they are members of the same group or not. Displaying this level of cultural competence may rebuild trust for those who have been overpowered and overlooked by a system that has treated them as such.

Trauma informed care

Trauma informed care (TIC) is an initiative where organizations and companies work to acknowledge the effect trauma has, as well as recognize what trauma looks like behaviorally. It teaches a system of observation, care, and compassion for those who display trauma symptoms (Yatchmenoff et al., 2017). While TIC is not evidence based (Yatchmenoff et al., 2017), it is an initiative worth looking into to break cycles of stigmas and biases, such as implicit and explicit biases about rape victims or stereotypes placed on people with mental illness. TIC is an initiative that can be implemented in large and small spaces, such as companies of more than 500 employees, to an office with a client and therapist. For the family therapist who may see a minority family, the professional must use TIC to not only acknowledge and examine recent trauma, but historical trauma as well, and how it may be embedded within the family structure in behavior and family practices. Recognizing family practices/rituals as protective factors may also help professionals recognize how a family builds resilience in dealing with trauma (Bockneck, 2017). Family rituals provide rules on how to decrease risk and increase strengths for families living in low-income, high-crime areas (Bockneck, 2018). However, there may be family rituals and practices that are maladaptive and set within the family structure.

Range et al. (2018) suggest that with chronic hypervigilance comes maladaptive behaviors, such as criminal activity, aggression, domestic violence and abusive parenting practices, which may produce fear in their children. These practices may stem from one or two things: 1) the idea that parents need to get a handle on their children before the world does (Range et al., 2018), or 2) a learned behavior stemming from 246 years of conditioning practices between enslavers and the enslaved. Whether the reason is one, two, or both, the idea is for professionals to use TIC to understand the internal and external conflicts that plague communities and families of color. For instance, an African American family who may display closed or combative behavior towards their white therapist may come from historical traumas that have taught the family that white people are not to be trusted, for whatever reason. Using TIC and recognizing the historical significance of the current behavior may help the family therapist navigate the session better.

Yatchmenoff et al. (2017) offer principles embedded in practices, policies, and procedures to use when framing TIC in the workplace that may help in therapeutic settings: safety, power, and self-worth. To provide safety is to provide safe spaces for individuals who have experienced trauma, which involves creating safe, physical and emotional spaces through physical safety, trustworthiness, choice, transparency, predictability, and clear and consistent boundaries (Yatchmenoff et al., 2017). For the systemic therapist, providing a safe environment for Black and Brown families could mean to allow families to be candid about their racial experiences and understand the cultural dynamics within the family structure that may have been caused by racial trauma. To provide power is to empower traumatized families by providing choice, strengths perspective, and skill building (Yatchmenoff et al., 2017). This means that therapists can help families build foundational skills lost by experience of racial trauma.

Finally, to build self-worth is to build relationships, respect, compassion, mutuality, collaboration, acceptance and non-judgment. Professionals who are non-white and people of color should understand the dynamics of the power element and their privilege that it presents over people of color. With this understanding, professionals can work to establish a rapport with families and help them decrease maladaptive, hypervigilant behavior within their families, and hopefully, within their communities. Thus, being the first steps to repairing the trust between therapists and people of color.

Future directions

Historical, race-based, community, and personal traumas all have serious effects on people of color that impact them in different ways. Trauma produces PTSD-like symptoms such as fear, aggression, and anger. Trauma can cause maladaptive behaviors such as substance abuse and aggressive parental practices. Trauma may also cause hypervigilance that leads to mistrust towards white professionals. What is important to note is that trust must be repaired and established and to do this, professionals must acknowledge their power dynamics along with familial dynamics structured to serve as a protective factor. Professionals must implement initiatives that may help rebuild that trust, such as the MPM model or TIC. Implementing MPM and TIC can serve as the bridge that has been missing between communities of color who are skeptical or afraid to seek professionals for help. Newer research has displayed how structural family therapy can be used to conceptualize trauma experienced by African American adolescents (Chappelle & Tadros, 2021). Therefore, we suggest this be an avenue of future research. Further, it may also be a starting point to see these initiatives spread to other systemic institutions like the criminal justice system and academic communities.

The relationships between systemic institutions and ethnic communities must be repaired by first recognizing the historical trauma systemic institutions caused Black and Brown people.