Over the past decade, sections of our media have taken up and publicised a serious medical disorder affecting the Australian community. Those of indigenous descent are said to be suffering a traumatic condition caused by British colonisation.
The passage of time, generational succession and racial intermarriage do not alleviate this affliction, because—like diabetes, high blood pressure and asthma—the medical condition is passed down through families. This syndrome is responsible for many Aborigines suffering diminished mental health and thereby becoming wedged in social disadvantage. It is the root cause for chronic depression, alcoholism, drug dependency, eating disorders, poor educational achievement, family dysfunction, domestic violence, sexual abuse and suicide. The worst thing about this debilitating disorder is that it was caused by events involving forebears, sometimes whose names are unknown, many years ago.
This essay appears in the current Quadrant.
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Most Australians are concerned when they are made aware of this alarming condition. In good faith they believe the innocent victims must be helped, and government is morally obliged to act. “Intergenerational trauma” is increasingly referred to in publicity pressing for greater action on reconciliation, presented as a priority issue. This traumatic disorder now figures in talk of schemes to compensate those of indigenous descent for historical injustices. Charities are springing up to assist children who are being born with this medical condition. In August 2021 the federal government directed $378 million of funding to the Healing Foundation, with a promise of $254 million more, in order to run trauma recovery programs for Aborigines.
The Healing Foundation is a government-funded body set up in 2009 to support initiatives which redress the historical removal of indigenous children from their families. The focus is on developing trauma-focused welfare services in Aboriginal communities. Fiona Cornford, the Foundation’s CEO, has a background in welfare administration, while her organisation’s board members include professionals from social work and public administration, plus Aboriginal activists and an academic. All identify as indigenous.
No medical specialist in Aboriginal health sits on the board or is listed in senior management of the Healing Foundation, which is incorporated as an unlisted public company. There is not even a token GP. It is unclear if any medical professional or clinical psychologist expert in the diagnosis and treatment of trauma has input into the Healing Foundation’s $632 million programs funded by the Australian government.
Stating it uses “Aboriginal healing” to achieve positive wellbeing outcomes, the Foundation’s website is vague on medical practicalities. It explains that Foundation workers visit indigenous communities, meeting with local people “to define healing, understand the impacts of colonisation in their local context, discuss their healing needs, share information about healing work in their communities and develop healing strategies”. The words doctor, diagnosis, treatment and medication are conspicuously absent from this patter. Instead, “healing” is explained as “a holistic process, which addresses mental, physical, emotional and spiritual needs, and involves connections to culture, family and land”. Trauma victims are cured through special “healing centres” which “incorporate traditional and western practices, [and] operate with Aboriginal and Torres Strait Islander spirituality and culture at their core”.
These are bureaucratic weasel words which suggest much while not stating whether each person gets a medical examination, or what treatment options are available. One would think diagnosing who is traumatised, and how severely, were essential first steps in tackling the incidence of trauma in indigenous communities. But the orientation is upon hazy “Aboriginal healing”, not on delivering tangible medical results in improved mental health.
The Foundation’s website presents itself as a first stop for information on Aboriginal trauma. Much of it is designed for schools and teaching support. Most interesting is the “Timeline of Trauma and Healing in Australia” which is an updated version of a chart circulated by the Communist Party in the 1970s. It reiterates the Soviet-period view that in Australia all philanthropic efforts directed towards Aborigines have been inherently cruel.
The website supplies key facts about Aboriginal trauma, although it does not refer to any scientific research into the medical condition. Sources are not even given for what it does explain—such as the claim, “In Australia, intergenerational trauma predominantly affects the children, grandchildren and future generations of the Stolen Generations.” Where this fact comes from is not listed. How can we follow it up? Who authored the relevant articles and what medical journals did they publish data in?
Trauma in the sense being used is the medical term for disorders of a psychological nature. The Greek word trauma means scar, and when medical professionals speak of these traumatic injuries they are referring to mental scars which significantly affect a patient’s mental health. Most of us will be aware of traumatic stress—commonly called “shock”—where an individual has sustained a psychological injury. Often the condition is temporary, but trauma may lead to continued disability.
My mother would speak of a neighbour during her childhood who had returned from the Western Front with “shell shock” (now called a “post-traumatic stress condition”). He was severely depressed, and incapacitated by a tremor shaking his limbs. He couldn’t work. At the time nothing could be done medically, and after years of this ordeal he took his own life.
In my childhood two family friends struggled with disorders arising from ordeals as prisoners of war after the fall of Singapore. Each was on medical programs for former servicemen. They managed after a fashion, although their general health was very uneven, and both were troubled by periods of disturbed sleep, flashbacks and low spirits. I also had a school friend with relatives who had endured persecution and imprisonment by the Nazis. They likewise were troubled by recurring mental health problems which were difficult to treat.
My most direct encounter with a traumatic disorder occurred when a relative had his safety imperilled for a significant period of time. Afterwards he became listless, had sleep problems and nightmares, gained weight, and couldn’t cope with everyday things. Fortunately, medical science now has a sophisticated grasp of traumatic disorders. So after being diagnosed by a GP and referred to a suitable specialist, my relative was prescribed a course of treatment, including medication and psychotherapy, with steady monitoring and adjustments as his mental condition improved. He recovered fully.
There is no science on “intergenerational trauma”. Trawling through medical and psychology sections of university libraries one struggles to find research papers in journals, let alone clinical texts dealing with the condition, its diagnosis and treatment. Instead, discussion is dominated by historically-oriented writings on abuses suffered by Aborigines. Much is authored not by medical practitioners or clinical psychologists, but by welfare workers, social theorists, political activists and well-meaning academics, then published in their non-medical fields. Research-based clinical insights into this undefined disorder are elusive. Catalogues in some university libraries steer the curious into Australian literature, where more novels and fictional stories deal with the condition than do mental health publications in the stacks.
The absence of medical evidence means the stress in writings is on reciting past racist excesses without either offering scientific findings or establishing a link with mental health problems. Misusing clinical terms, some authors try to medicalise an adverse social condition or lifestyle. Other writers and speakers breeze over a lack of scientific discussion by directing attention to well-regarded sources which do not actually substantiate their claims.
This occurred at the National Press Club in Canberra on June 2 last year. Fiona Cornford, the Healing Foundation’s CEO, spoke on Aboriginal health in a televised address. “Intergenerational trauma is real,” she said at one point, “and the Australian Institute of Health and Welfare (AIHW) has provided clear evidence.” This was not correct.
The AIHW, an official body which analyses statistics to assist in shaping government policy, had the previous year published a nationwide report, Australia’s Health 2020. After stating that “Indigenous Australians as a group still experience poorer health outcomes compared with non-Indigenous Australians”, an entire chapter of this comprehensive study was devoted to Aboriginal health. It identified kidney disease, rheumatic fever and rheumatic heart disease, eye health and hearing health as the key medical problems afflicting indigenous people, especially those in remote areas. But intergenerational trauma did not rate a single mention in this authoritative health report.
The AIHW employs the term “intergenerational” very carefully. It is used to indicate statistical patterns detected across two or more generations. In 2017 the Healing Foundation itself commissioned the AIHW to conduct a quantitative analysis of members of the Stolen Generations, with a view to finding such patterns. The AIHW divided its research into three studies: a general report on the Stolen Generations (published in 2018); a report on Stolen Generations members aged fifty and over (2018); and the report Children Living in Households with Members of the Stolen Generations (2019).
The third report used for raw data two social surveys of indigenous people conducted by the Australian Bureau of Statistics in 2008 and 2014-15. From these it was able to show that many children under fifteen in those households were being raised in disadvantage. Affected homes sat in the lowest 30 per cent in terms of income, for instance, and there were household cash flow problems, with no one in the home able to raise $2000 in an emergency. As for the children, they were firm in their Aboriginal identity, often participating in cultural events and ceremonies, as well as identifying with a clan, tribal or language group, and recognising their homeland. But there were stress problems in their lives, and difficulties with schooling. Truancy was common, many children also claiming to be treated unfairly at school due to being indigenous.
The AIHW found illuminating patterns buried in the ABS data—such as whether at least one adult in the same household as the child had completed Year 12 at school, statistics showing the presence of such individuals corresponded to enhanced general wellbeing and future prospects for indigenous youngsters. The analysis did find a pattern of intergenerational disadvantage affecting the children. However, nothing could be shown on trauma because there was no medical data, the sole figures the survey gathered being from a multiple-point question asking about children’s health generally (parents chose one of poor/fair/good/very good/excellent). So statistics on any medical condition, not just trauma, do not appear in Children Living in Households with Members of the Stolen Generations.
In fact the word trauma occurs only once in the entire document. The final sentence of its summary runs, “This report demonstrates a transfer of intergenerational poverty and trauma.” Those last two words are misleading and untrue. Questions need to be asked about how they got into the summary.
The theory of “intergenerational trauma” has a chequered past. As we have seen, “trauma” is a medical term for certain mental health disorders. But “intergenerational” is a phrase from sociology used to label behaviour passed from parents to children. For instance, smoking, poor diet, heavy gambling, a contempt for education, and parental violence are known to be intergenerational. They are elements in a behaviour pattern evident within one or a cluster of families. So “intergenerational trauma” is a neologism from outside the discipline of medicine.
Speculation about indigenous trauma started during the 1970s and 1980s with concern for Native Americans. Some writers argued that their escalating social problems arose from psychic wounds, early discussion in the United States borrowing ideas from pop psychologists such as L. Ron Hubbard and Alvin Toffler. The founder of Scientology, Hubbard argued that our health and well-being are adversely influenced by “engrams”, lingering memories of traumatic events in our past lives. Meanwhile, Toffler claimed that people from traditional cultures are vulnerable to “future shock”, a form of traumatic alienation arising from the inability to cope with hastening technological-cum-social change. It was therefore reasoned that Native Americans were suffering psychic trauma caused by a wrenching disconnection from their traditional way of life.
Discussion became more sophisticated over the 1990s as the broader issue was attached to post-colonial studies, and academia moved in. Vocabulary was now medicalised, and sociological terms were applied in new ways. Stress shifted from claiming Native Americans had unseen psychic wounds or struggled with existential trauma, to a focus on the palpable mental health and social problems evident across communities.
The term “intergenerational trauma” was soon coined, being claimed as a real, if still to be researched, medical disorder underpinning most social and emotional problems suffered by individuals from indigenous or ethnic minorities. Family breakdown, escalating depression, alcoholism, domestic violence, rising crime rates were attributed to this crippling condition. Lack of scientific proof did not hinder some American enthusiasts from proclaiming that this mental health disorder affected victims at a genetic level: “Every cell in my body is filled with the code of generations of trauma, of death, of birth, of migration, of history,” writes Stephanie Foo in her book What My Bones Know, claiming she inherited “complex PTSD” from her Asian ancestors.
Even as arguments were being formulated, discussion intensified with the appearance of dedicated websites started by lobby groups. Debate moved into Canada, where indigenous activists, sociologists, academics and welfare workers argued that indigenous communities were afflicted by this unacknowledged medical disorder caused by British colonisation. Insisting that “transgenerational” or “intergenerational trauma” underpinned most social, welfare and medical problems experienced by indigenous peoples, lobbyists insisted the Canadian government devise redress schemes.
The new illness then migrated across the Pacific. Indigenous activists, public intellectuals, social theorists and academic historians in Australia and New Zealand were soon claiming Aborigines and Maoris were stricken with the same mental health condition, likewise calling on governments to act.
Yet in each country heated talk of this new disorder has lacked a medical component. No clinical advice is available on diagnosis. How does a medical practitioner identify this trauma? Matters are further complicated because known traumatic disorders are personal injuries which cannot be transferred to others, like the psychological equivalent of a broken limb. So how do we establish that the personal traumatic injury of an indigenous individual in colonial times has subsequently mutated into a mental health condition passed to their descendants?
And might individuals of mixed descent have inherited the disorder through non-indigenous forebears? How can we be sure those of English descent are not suffering from trauma caused by the invasions of the Romans, Saxons, Vikings and Normans? And might Australians of other ethnic backgrounds suffer from inherited trauma?
Prescribed treatment remains a mighty blank. Where are the scientific publications on therapies, and data on their effectiveness? Have there been clinical tests to ascertain if medications successful in treating other traumatic illnesses are effective with this disorder? And what of a cure? Or will intergenerational trauma continue to be transmitted to future generations?
The global COVID-19 pandemic has highlighted a disconnect between medical science and talk of intergenerational trauma. Australia’s news media embraced medical experts and research scientists to report on the virus. These authorities were front and centre in every news bulletin and current affairs show, talking infection rate metrics, presenting detailed medical information, and summarising the science replete with animations showing how the virus assaults human cells at a microscopic level.
Journalists daily sought out the current numbers and geographic distribution of people infected, cases in hospitals, and deaths, as well as running data on inoculations. They also delivered intermittent updates on: diagnosis and medical testing; how to prevent infection and the spread of illness; development and efficacy of vaccines, including explanations of how they stimulate antibodies; treatment and a search for medications to use on seriously ill patients. Attention was directed into medical research, the news media running interviews with team leaders at scientific institutes and university medical faculties working on the virus.
None of this media scrutiny is applied when attention shifts to intergenerational trauma. Information is not so much vague, as formless. No explanation is given on detection and diagnosis of the disorder, let alone whether medical practitioners have been used to check Aboriginal communities for trauma victims. Metrics are elusive, with no firm figures on the number of people afflicted by the condition, their ages, and geographic distribution. Especially shady are treatment and therapies. What these encompass, and whether they are delivered by medical practitioners and clinical psychologists, is never declared. Instead, “Aboriginal healing” is cited as the wonder cure-all.
Judging by the television current affairs shows 7.30, The Project and The Drum, it is clear there are currently two separate tiers of medical journalism: one for Covid, and another for intergenerational trauma. Medical science is front and centre when reporting the pandemic, but never mentioned if the topic is Aboriginal trauma. These differences especially stood out when Covid entered indigenous communities, firm medical facts being delivered about vaccination rates and hospital treatment. No official brushed off an insistent Stan Grant by announcing indigenous communities infected with Covid would be saved by intensive “Aboriginal healing”.
“Experts” have even appeared on current affairs programs to discuss the issues. Scientists and medical practitioners handle Covid, delivering genuine medical information. Whereas social activists and welfare workers deal with intergenerational trauma, complaining of historical racism while saying nothing that is medically informative. When the focus is intergenerational trauma, medical journalism is switched off.
Insurers and government bodies have fixed procedures for dealing with individuals suffering from trauma. It is a medical condition, so just saying you are traumatised is not sufficient, especially if a compensation entitlement is involved. The psychological disorder must be diagnosed by a qualified medical practitioner; and it is usual to require a second opinion by a specialist in mental health. As well, a clear cause for the injury needs to be shown. The sufferer demonstrates that their mental condition was triggered by a particular incident, or set of events, to establish the legitimacy of their claim.
Once these terms are satisfied, the primary stress is on treating the disorder and working towards a cure. The individual follows a prescribed course of treatment to alleviate the traumatic condition. Doctors or therapists monitor the patient’s condition, regularly reporting back on medical progress. Failure by a patient to follow their treatment program without consulting the supervising doctor usually results in compensation being voided.
As in any compensation case, the injury’s existence must be medically proven, its cause shown, with treatment followed as necessary. The object is to ensure that people burdened with real mental health problems are getting the professional care and specialist support they need and are entitled to.
This attentiveness, long required by regulators for non-indigenous trauma cases, contrasts strongly with how new Aboriginal trauma programs are being run. Indigenous schemes appear to involve no formal diagnosis by medical professionals, and no effort to confirm that mental health problems are indeed based on trauma. Treatment is ambiguous, short-term and not medically supervised.
As a consequence, there is open scepticism about Aboriginal trauma across the health profession, including doctors working in indigenous care. Indeed, during my research for this article, a medical specialist offered this advice: “Whenever people claim to have trauma,” he said, “just ask two questions. First, who diagnosed it? Second, what treatment has been prescribed? If you can’t get straight answers, we’re not talking about genuine medical cases.”
Christopher Heathcote, a frequent contributor, lives in Melbourne.