Complex PTSD Increases Transmission of Trauma to Offspring of Tutsi Genocide Survivors

Thus blood of the innocent will not be shed, bringing bloodguilt upon you in the land that Hashem your God is allotting to you. Deuteronomy 19:10 (The Israel Bible™)

Researchers at Israel’s Bar-Ilan University – in collaboration with a Rwandan therapist and genocide survivor – have taken a close look at the genocide against the Tutsi people of Rwanda almost a quarter of a century after it occurred.  

As many as 1 million Tutsi people were murdered in the mass slaughter during the Rwandan Civil War, which began in 1990. It was led by members of the Hutu majority government during the 100-day period from April 7 to mid-July 1994. Hutu civilians used machetes, clubs, blunt objects and other weapons and were encouraged to rape, maim, and kill their Tutsi neighbors and to destroy or steal their property. The killing ended after the Tutsi-backed and heavily armed Rwandan Patriotic Front (RPF), led by Paul Kagame, took control of the capital and the country.

The genocide was planned by members of the core Hutu political elite, many of whom occupied positions at top levels of the national government. Perpetrators came from the Rwandan army, the gendarmerie, and government-backed militias. A ceasefire in the civil war was reached in 1993.

The rapes used as a weapon of war led to promises that persist today, including HIV infection, including of babies born to mothers infected with the AIDS virus while being raped. Due to the wholesale slaughter of both men and women, many households were headed by widows or totally orphaned children. The destruction of infrastructure and the severe depopulation of the country crippled the economy, challenging the nascent government to achieve rapid economic growth and stabilization. Severe post-trauma was the result for many.

The children of Tutsi survivors who weren’t even born at the time of the slaughter are among those most affected by trauma, according to the new Israeli study, which has just been published in the journal Psychiatry Research.

The study assessed complex post-traumatic stress disorder (CPTSD) among Tutsi genocide survivors and its impact on their children. The researchers found that the intergenerational effects of genocide were most prominent among offspring of survivors who suffer from CPTSD. 

The parent groups did not differ in level of exposure to the genocide nor in the percentage of participants who underwent other traumatic events. When examining separate types of genocide exposure, 41.1% of the parents reported being injured, 89.8% reported seeing people being killed, 88.1% saw people wounded, and 67.8% and 91.7% had at least one family member who was injured or killed, respectively. The offspring in the three groups did not differ in any of the background characteristics. All offspring were single and only one reported experiencing traumatic event.

These offspring suffer from more symptoms – such as nightmares and preoccupation with the horrors – and feel less equipped to handle adverse situations.  The findings also hint at the possibility that while both parental PTSD and CPTSD increase secondary traumatization in offspring, parental CPTSD additionally affects offspring self-perceptions.

Whereas PTSD includes symptoms such as nightmares and overall restlessness, CPTSD includes even more serious problems such as affective dysregulation (a term used in the mental health community to refer to an emotional response that is poorly modulate, and does not fall within the conventionally accepted range of emotive response), a negative view of oneself and disturbed relationships.

Following studies pointing to additional consequences of extreme traumatic events such as genocide, which are not covered by existing diagnosis of PTSD, CPTSD is scheduled to appear in the upcoming 11th Revision of the International Classification of Diseases (ICD-11) as a new diagnosis.

The preliminary findings, published in the journal, highlight CPTSD as a rather-frequent debilitating condition among Tutsi genocide survivors. “For the first time, to the best of our knowledge, these findings demonstrate that CPTSD may have grave consequences not only for survivors themselves but also for their offspring who were born after the genocide,” said Prof. Amit Shrira, of Bar-Ilan’s department of social sciences, who co-authored the study with Dr. Ben Mollov, a Bar-Ilan political scientist who specializes in conflict resolution, and Chantal Mudahogora, a therapist who survived the Tutsi genocide and currently lives in Canada. 

Most existing literature on the subject focuses on the effects of parental PTSD, but the researchers said they knew of no works that looked at parental complex PTSD, he added. This pattern is also evident among Holocaust survivors and their offspring, whom Shrira has studied extensively.

“We need to understand that genocide and massive trauma can leave their mark not only on survivors who were directly exposed, but also on their offspring and probably on other family relatives, as well,” added Mollov.

“We also know from previous studies that the effects of trauma may extend across several generations and linger for decades after the focal trauma took place. These insights should guide policy makers and clinicians when planning interventions aimed at mitigating the plight of traumatized individuals and their families, particularly in terms of increasing resilience.  This can also bear relevance for improved intergroup relations,” he said.

Ben Mollov (left) and Chantal Mudahogora. (Courtesy Bar Ilan University)

It became possible for Shrira and Mollov to study the genocide against Tutsi of Rwanda and cooperate with Mudahogora when Mudahogora heard Mollov present a research paper in Bangkok. When she shared with him her concern about the effects of post trauma on survivors of the genocide and their offspring, Mollov brought Shrira, who has studied extensively intergenerational trauma suffered by Holocaust survivors and their offspring, into the research partnership.

As the researchers learned more about survivors of the Tutsi genocide, they were especially surprised to discover that they live among the Hutus who took part in the mass killing, They also became aware of the fact from Mudahogora that through the “Unity and Reconciliation Program” spearheaded by the Rwandan government, together with non-profit organizations and faith-based groups, both ethnic groups are making progress in living together peacefully and in harmony.

There are even cases of Tutsi survivors who married Hutu perpetrators and embraced them into their families. The researchers intend soon to gain a better understanding of this phenomenon among survivors and their offspring.

The researchers hope to present their findings at a seminar in Rwanda and offer assistance in developing applied research and intervention strategies, such as treatment of trauma and seeking to promote unity and reconciliation, to Rwandan stakeholders.

With the agreement between Israeli Prime Minister Benjamin Netanyahu and Rwandan President Kagame to open embassies in each other’s countries and establish closer ties, the researchers hope that their applied research can help strengthen Israeli-Rwandan relations for the social benefit of Rwanda. 

Despite limitations, our preliminary findings highlight CPTSD as a rather frequent debilitating condition among Tutsi genocide survivors, and for the first time to the best of our knowledge, document CPTSD association with more severe responses among survivors’ offspring.



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