I'm a therapist who specializes in generational and racial trauma. I see patients underdiagnosed all the time because people don't talk openly about it.

• Christiana Awosan is a licensed marriage and family therapist based in New York City who specializes in generational and racial trauma.
• Black and brown patients are most at-risk for suffering from PTSD related to generational and racial trauma.
• Awosan spoke to Insider reporter Brianna Holt about how generational trauma manifests itself and how she believes it has been underdiagnosed.

This is an as-told-to essay based on a conversation with Christiana Awosan, a licensed marriage and family therapist based in New York City who specializes in generational and racial trauma. It has been edited for length and clarity.

Generational trauma, which can also be intergenerational trauma or transgenerational trauma, is basically when experiences that are detrimental emotionally, mentally, physically, relationally, and even spiritually, are passed down from one generation to the next generation, whether knowingly or unknowingly.

It can be passed down either implicitly or explicitly, whether by the person actually experiencing the weakness in the generation above them, or it can be passed down through narratives that the family speaks to each other about. 

Racial trauma and generational trauma are intertwined because racial trauma can be passed down generationally. For example, when Black families have "the talk" with their kids about racism and safety and how to handle situations with police, that is based on experiences of being discriminated against and traumatized because of skin color.

That itself is a form of generational-racial trauma because you have to explain this to your kid, and it's not because you want to, it's because society still disavows, dehumanizes, discriminates, and ostracizes Black people and people of color just because of their skin.

We don't want to talk about race, and particularly whiteness, in our society

We don't usually put racial trauma in the same categories as sexual abuse, or the trauma that veterans go through. I think that's because we don't want to talk about race, and particularly whiteness, in our society. These forms of trauma date back to the transatlantic slave trade and the impact of the enslavement and torture of African Americans.

Following that, the Jim Crow era created this feeling of devaluation, from constantly seeing people who look like you being devalued, ostracized, and being deemed as not good enough.

People need to understand that after slavery was abolished, there was no mental or emotional care that allowed African Americans to talk about the emotional, psychological, and spiritual impacts. So that trauma continued to be  passed down from generation to generation, and we still don't fully have that kind of care. 

When you feel voiceless, your rage increases as well

When we enter new spaces, and in particular predominantly white spaces, the effects of generational trauma can show up. This could look like imposter syndrome, anxiety, increased heart rate, or a loss of focus.

Other physical manifestations of generational trauma are a lack of sleep, physical pain like back aches, or irregular eating habits. Then there's the emotional manifestations, like depression, anxiety, isolation.

There's also relational manifestation, which mostly presents itself as a feeling of not being able to use your voice when you are experiencing or witnessing racism. So if you feel like you don't have the words to fully explain what's happening to you, especially with people who cannot inherently relate to or understand what you're experiencing, you begin to internalize that and take it out on your loved ones and the people who are closest to you.

I see people either isolate themselves from their partner or get really angry and upset with them. When you feel voiceless, your rage increases as well. We call these invisible racial trauma wounds – we don't see them.

Racial and generational trauma goes underdiagnosed all the time

As a relational therapist, I believe that social cultural oppression, such as racism, sexism, heterosexism, etc., creates interpersonal and intergenerational trauma that assaults the dignity and humanity of individuals and those they are in relationship with. My aim is to assist and journey with my clients to identify and develop culturally affirming and healing ways and patterns of processing trauma that would be transmitted generationally.  

Racial and generational trauma goes underdiagnosed all the time because race, racism, and whiteness are still not things we feel comfortable talking about in society. So when a client comes into therapy, they often aren't aware that they're going through this, or don't want to mention it because they don't know how their therapist might react to it.

Most clinicians are not trained to pay attention to racial trauma and are unable to actually assess it, or notice the symptoms and signs of it. But if you find a therapist that specializes in this form of trauma, going to therapy can be very helpful in noticing how this trauma manifests itself physically, mentally, emotionally, relationally, and spiritually in your body.