Social Science & Medicine 134 (2015) 87e94

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Social Science & Medicine

journal homepage: www.elsevier.com/locate/socscimed

Living in “survival mode:” Intergenerational transmission of trauma

from the Holodomor genocide of 1932e1933 in Ukraine
Brent Bezo a, *, Stefania Maggi b
a
Department of Psychology, Carleton University, Loeb B550, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada
b
Department of Psychology and Institute of Interdisciplinary Studies, Carleton University, 2201 Dunton Tower, 1125 Colonel By Drive, Ottawa, Ontario K1S
5B6, Canada

a r t i c l e i n f o a b s t r a c t

Article history: Qualitative methodology was used to investigate the intergenerational impact of the 1932e1933 Hol-
Available online 15 April 2015 odomor genocide on three generations in 15 Ukrainian families. Each family, residing in Ukraine, con-
sisted of a first generation survivor, a second generation adult child and a third generation adult
Keywords: grandchild of the same line. The findings show that the Holodomor, a genocide that claimed millions of
Ukraine lives by forced starvation, still exerts substantial effects on generations born decades later. Specifically,
Intergenerational transmission of trauma
thematic analysis of the 45 semi-structured, in-depth interviews, done between July and November 2010,
Collective trauma
revealed that a constellation of emotions, inner states and trauma-based coping strategies emerged in
Historical trauma
Trauma
the survivors during the genocide period and were subsequently transmitted into the second and third
Trauma transmission generations. This constellation, summarized by participants as living in “survival mode,” included horror,
Holodomor fear, mistrust, sadness, shame, anger, stress and anxiety, decreased self-worth, stockpiling of food,
Genocide reverence for food, overemphasis on food and overeating, inability to discard unneeded items, an
indifference toward others, social hostility and risky health behaviours. Since both the family and
community-society were found to be involved in trauma transmission, the findings highlight the
importance of multi-framework approaches for studying and healing collective trauma.
© 2015 Published by Elsevier Ltd.

1. Introduction perspectives are also important for healing traumatized children

Our current understanding of intergenerational transmission of
trauma comes from research with collective trauma survivors and
their descendants from studies of the Holocaust, the Armenian
genocide, the second world war (WWII) internment of Japanese-
Americans and the colonization of Indigenous peoples. This
research suggests that the impacts of collective trauma are passed
down from generation to generation and, therefore, affect not only
survivors, but their descendants at the levels of the individual,
family and community-society (Evans-Campbell, 2008). As such, in
order to accommodate the complex sequelae of collective trauma
and its intergenerational impacts, multi-level frameworks that
include the individual, family, and community-society have been
proposed for the study and healing of collective trauma (Evans-
Campbell, 2008; Kirmayer et al., 2014). Such multi-level
* Corresponding author.
E-mail addresses: brent.bezo@carleton.ca (B. Bezo), stefania_maggi@carleton.ca
(S. Maggi).
(Pat-Horenczyk et al., 2014).
At the level of the individual, children of Holocaust survivors
have reported fear and mistrust (Rowland-Klein and Dunlop, 1997),
depressive mood (Major, 1996), and guilt related to their personal
happiness (Bar-On et al., 1998) and parents' experiences (Wiseman
et al., 2006) as intergenerational impacts. Third generation studies
have shown that grandchildren of Holocaust survivors had higher
state and trait anger, perceived others negatively (Iliceto et al.,
2011) and themselves less positively, and were rated by their
peers as having lower socio-emotional functioning (Scharf, 2007).
Descendants of Armenian genocide survivors reported shame
(Karenian et al., 2010), while Aboriginal Canadians with parental
and grandparental history within the residential school system had
increased suicidal thoughts and attempts (Elias et al., 2012).
Pertaining to the family level, adult children of Holocaust sur-
vivors reported parent-child enmeshment (Rowland-Klein and
Dunlop, 1997), overprotective parenting (Bar-On et al., 1998;
Rowland-Klein and Dunlop, 1997) and parent-child role-reversal
(Bar-On et al., 1998) as intergenerational impacts. Compared to
their counterparts with one or no parent from a Holocaust survivor

http://dx.doi.org/10.1016/j.socscimed.2015.04.009
0277-9536/© 2015 Published by Elsevier Ltd.
88 B. Bezo, S. Maggi / Social Science & Medicine 134 (2015) 87e94
family, grandchildren, with both parents being offspring of Holo-
caust survivors, had more ambivalent styles of attachment and less
accepting parents who did not encourage autonomy (Scharf, 2007).
In terms of family communication, offspring of survivors of both the
Holocaust (Kav-Venaki et al., 1983) and Japanese-American WWII
internment (Nagata and Cheng, 2003) reported little intra-familial
conversation about the traumatic events. In addition, Aboriginal
Canadians viewed family violence, child abuse and lack of parental
nurturing as impacts of intergenerational trauma, stemming from
the residential school system experience (Ball, 2010).
Intergenerational trauma is also posited to affect the
community-society via loss of culture, values and way of life.
However, the impacts on this level are understudied and, hence,
less well understood (Evans-Campbell, 2008).
Overall, while many studies have shown adverse intergenera-
tional impacts of collective trauma, some have not. For instance,
adult daughters, unlike their Holocaust survivor mothers, did not
exhibit a lack of resolution of trauma or signs of traumatic stress
(Sagi-Schwartz et al., 2003). Also, as noted by Sagi-Schwartz et al.
(2008), other research found little evidence of psychopathology
in adult children of Holocaust survivors (van IJzendoorn et al.,
2003), except when confronted with life-threatening situations
such as serious illness (Baider et al., 2000) or military combat
(Solomon et al., 1988).
While psychodynamic, social learning and biological perspec-
tives (Kellerman, 2001) have individually been proposed as trans-
mission mechanisms, the family has often been viewed as the
vehicle for intergenerational transmission (Rowland-Klein and
Dunlop, 1997; Wiseman et al., 2006). Dedicated to unravelling the
interplay between social and biological forces, the emerging field of
epigenetics postulates that social experiences, including familial
ones, result in epigenetic changes that affect an individual's genetic
expression, in-utero, during early development, and throughout
the life course. This field further hypothesizes that epigenetic
changes are heritable and “may serve as a cellular memory”
(Champagne, 2010, p. 570) of human experiences that also shape
the neurodevelopment, behaviours, and the health and well-being
of future generations (Champagne, 2010). In the context of inter-
generational transmission of trauma, epigenetics may provide a
framework to understand how survivor families are affected by
complex transgenerational trajectories, stemming from their ex-
periences with collective trauma.
This Canadian study examined the impact of collective trauma
experiences, stemming from the 1932e1933 Holodomor genocide
of Ukrainians, on the survivor generation and their adult children
and grandchildren. A brief overview of the Holodomor is presented
for context. The Holodomor was a Soviet-Russian orchestrated
genocide (Naimark, 2010) devised to kill and subdue ethnic
Ukrainians and destroy their culture and aspiration of statehood, as
separate from the Soviet Union (Klid and Motyl, 2012). Beginning in
the late 1920s and continuing into the 1930s, Stalin ordered the
mass arrest and execution of Ukrainian political leaders, academics/
intellectuals, writers, linguists, artists, singers, students, clergy and
lawyers (Conquest, 1986). During this period, Ukrainian uprisings
against the Soviet-Russian regime occurred (Conquest, 1986; Mace,
1986), but by this time much of the nation's intelligentsia and
leadership, capable of mobilizing a revolt, had been arrested or
executed (Conquest, 1986).
Then, in 1932e1933, Stalin and his chief architects, Lazar
Kaganovich and Viacheslav Molotov orchestrated a genocide
against the Ukrainian people (Klid and Motyl, 2012). With the goal
of starving Ukrainians, Stalin directed confiscation of harvests and
foods in Ukraine. Watch towers were erected across the Ukrainian
countryside to prevent the population from accessing food supplies
(Conquest, 1986). In addition, blockades and travel restrictions
prevented Ukrainians from searching for food (Marples, 2012).
Exact death tolls are uncertain, as Stalin displeased with census
data from Ukraine after the genocidal period, ordered the execution
of the lead census takers (Subtelny, 2009) and subsequently sup-
pressed the data (Conquest, 1986). However, estimates of death
tolls (Conquest, 1986; Maksudov, 1986) from starvation of Ukrai-
nians range from 3 to 6 million (Subtelny, 2009). In addition, mil-
lions more were shot or deported by cattle cars to Siberian
concentration camps where they perished (Conquest, 1986). Even
though referred to as one of the most horrible events of the
twentieth century, the Holodomor is not well known as the Soviet
regime denied its occurrence (Conquest, 1986). The Ukrainian word
Holodomor, meaning “murder by hunger” (Klid and Motyl, 2012,
p.xxix), has been adopted by western writers and academics to
define the genocide of Ukrainians.
The objective of this study was to investigate whether potential
trauma, stemming from the Holodomor, continues to exert an
intergenerational impact. A qualitative thematic analysis was used
to explore how first, second and third generation Ukrainians
perceived the impact of the Holodomor on their lives. As far as we
know, this is the first study to investigate the intergenerational
transmission of trauma stemming from the Holodomor in Ukraine
and to examine this genocide from a social science perspective.
2. Method
Interviews were conducted with families comprising a grand-
parent survivor, an adult child, and an adult grandchild of the same
line. This approach allowed for comparison between the three
generations to answer our research question: how does potential
trauma, stemming from the Holodomor, continue to exert an
intergenerational impact? All interviews were conducted in
Ukraine in the Ukrainian language. Braun and Clarke's (2006)
guidelines for thematic analysis were used. Specifically, patterns
in the data were identified to help answer the research question,
themes were identified to represent the data, themselves, as
opposed to fitting a preselected theory, and themes were not
prioritized according to their prevalence in the data.
2.1. Participants
Forty five participants (Mage ¼ 58.1 years, 64.4% women, age
range: 22e91 years) were selected to represent three successive
generations, belonging to 15 families. Each family consisted of a
first generation survivor, a second generation adult child and a
third generation adult grandchild of the same line. Although gender
balance was attempted during recruitment, 87% of the first gener-
ation participants were female. Given that the average life expec-
tancy for men in Ukraine is 62.3 years (United Nations [UN], 2012),
a higher ratio of females to males was anticipated for first gener-
ation participants. Of the second and third generations, combined,
53% were female and 47% were male.
The average age of the first generation participant was 86.4 years
(Min ¼ 82.2, Max ¼ 91.0). On average, the survivors were 8e9 years
of age during the 1932e1933 period. Eighty percent of the first
generation participants had lost approximately 3 family members to
the Holodomor genocide. Fifty three percent of the first generation
participants had not completed elementary or high school; 13% had
finished high school and 33% had a bachelor level post-secondary
education. All of the first generation participants were retirees and
many had worked as teachers or communal farm workers. Most
(80%) of the first generation participants were widowers or widows.
The average age of the second generation participant was 57.6
years (Min ¼ 51.6, Max ¼ 65.2). The majority (87%) of the second
generation obtained a minimum of a bachelor-level university
 B. Bezo, S. Maggi / Social Science & Medicine 134 (2015) 87e94
degree. Most (87%) of the second generation were still in the
workforce and their employment positions were more varied as
compared to the first generation. For example, the second gener-
ation included a public servant, engineers, a writer, a mechanic, an
agronomist, a professor, a seamstress, a veterinarian, a store clerk, a
retired electrician, an actor and a teacher.
The average age of the third generation participant was 30.3
years (Min ¼ 22.3, Max ¼ 40.2). The majority (93%) of the third
generation also had a minimum of a bachelor-level university de-
gree and were in the workforce. The third generation included a
business owner, a lawyer, an IT specialist, a teacher, a stay-at-home
mother, a public policy analyst, a business manager, a property
manager, advertising executives, and a sales representative. The
third generation also included a few post-secondary students. In
addition, many of the third generation were parents and had chil-
dren under the age of 18 years.
Purposeful sampling (Jackson et al., 1994), through a snow-
balling technique, was utilized to recruit participants who were
willing to talk about and able to recall and provide in-depth de-
scriptions of their experiences and perceptions. To increase
credibility-validity (Patton, 1990), the interviewer travelled over
6000 km in Ukraine to ensure the sample possessed geographical
diversity, in terms of regional, and urban and rural variation.
2.2. Procedure
2.2.1. Data collection
The interviews were semi-standardized (Berg, 2004). Main
interview questions were developed using guidelines from Patton
(1990) and Rubin and Rubin (2005) to help elicit descriptions of
experiences, opinions and feelings of the Holodomor and its po-
tential impact on participants' lives and to gain insight into the
processes of trauma transmission. Open-ended questions such as
“What does the Holodomor mean to you?” and “What emotions
come to mind regarding the Holodomor?” were used to also allow
participants to respond in their own way and explore new ideas in
the interviews.
To create an atmosphere of safety and comfort, interviews were
conducted in the participants' places of choice. Most participants
chose to be interviewed in their homes. Because of the familial
locations of the interviews, participants of the first and second
generations, in particular, shared family photographs and scrap-
books, personal historical documents, books on local-regional his-
tories, newspaper articles and their own personal writings. This
sharing, coupled with the in-depth interviews, amplified the
connection with the participants.
In order to avoid participant distress in the first generation
survivors of this study, explicit questions about their personal ex-
periences with atrocity were not asked. This decision was taken
because trauma created by deliberate human design can have
greater psychological consequence as compared to those associated
with accidents or natural disasters (Loo, 1993; Stewart, 1996); as
well, trauma seems to have its greatest impact during the child-
hood years (van der Kolk et al., 2006). However, early on in the
interviews, all participants of the survivor generation spontane-
ously chose to speak openly about their traumatic experiences. In
fact, some first generation participants began speaking to the
interviewer about their experiences and perceptions of the Hol-
odomor, literally, on their front door steps.
The interviews began with introductions, an explanation of the
research goals, and informed consent. Participants were assured of
anonymity and individual data confidentiality. Participants were
also told that they could cease the interview at anytime or refuse to
answer any question. Risks and benefits related to participating
were provided. In addition, a list of local support services to help
89
with potential post-interview distress accompanied the consent
forms. In order to minimize interview-related stress, the conver-
sations commenced with a neutral question, “What does it mean
for you to be Ukrainian?” as per the tenet of Patton (1990). In-
terviews were also conducted individually to ensure the privacy of
all participants and to allow for participants to communicate their
perceptions and experiences in their own way. To allow for addi-
tional participant input, interviews ended with the question, “Is
there anything else you would like to add?” On average, interviews
lasted 53 min and were conducted by this study's lead author (who
became fluent in Ukrainian after having resided in Ukraine for 5
years prior to this study). The interviews were conducted between
July and November 2010. Ethics approval was granted by Carleton
University's psychology research ethics board.
2.2.2. Data analysis
All interviews were audio recorded, transcribed into text and
then translated into English. Given the exploratory nature of the
study, data collection and partial data analysis were conducted
concurrently. This initial, partial analysis, combined with field
notes, helped to determine the need for 3 follow-up interviews to
explore additional information with participants. The remainder of
the data analysis was conducted in Canada where a more system-
atic, inductive content analysis was employed. Analysis began with
reading and re-reading the transcripts. The tenets of Rubin and
Rubin (2005) helped in looking for concepts and themes. Specif-
ically, questions from the interview guide, issues raised by partic-
ipants, indirectly revealed concepts, the comparison of concepts to
each other, and between interviews were used to code the data.
Guidelines by Jackson et al. (1994) were used to break down the
text of the interview transcripts into meaning units, which were
assigned Level 1 codes. Next, comparison of Level 1 codes combined
with their further breakdown allowed for the formation of Level 2
codes (i.e., the categories or themes), which in turn were compared
and merged into the superordinate themes, or Level 3 codes. These
superordinate themes formed the results of the study. Use of
computer software, N Vivo, manually created charts, memos, and
notes were enlisted to facilitate the coding process. The first author
coded the transcripts, while regularly scheduled meetings allowed
both authors to develop the themes together. Alternative patterns
in the data, or negative cases, were also considered. For example,
one second generation participant simultaneously spoke of the
Holodomor as not changing their personal “reality” or the “trajec-
tory” of Ukrainians, while then proceeding to note many negative
impacts of the genocide on themself and their family. In applying
the tenet of Rubin and Rubin (2005), we deemed this interview to
possess contradiction, instead of being a negative case e as it was
still consistent with overall patterns in the data. In conducting this
particular interview, the interviewer chose not to adhere to Rubin
and Rubin's (2005) suggestion of following up with a more
confrontational question to a conflicting answer, as this particular
participant noted a preference for not speaking about the Hol-
odomor outside of the family unit. In an attempt to distinguish
between the data and our interpretation of the data, we use phrases
such as the participants “spoke of,” “noted,” “reported” etc. versus
providing explanation for the interpretation presented, respec-
tively. Lastly, in applying the guidelines of Rubin and Rubin (2005)
in presenting the results, elision dots ( … ) are sometimes used to
shorten excerpts, yet, preserve their meanings, while missing
words are sometimes placed in brackets to complete thoughts.
3. Results
Findings from this study suggest that the 1932e1933 Hol-
odomor genocide of Ukrainians continues to impact not only
90 B. Bezo, S. Maggi / Social Science & Medicine 134 (2015) 87e94
survivors, but also their adult children and grandchildren. Specif-
ically, two superordinate themes were identified as stemming from
the genocide: (i) emotions and inner states, and (ii) trauma-based
coping strategies. All generations reported that the changes in
emotion and inner states, combined with adoption of coping stra-
tegies in the first generation were originally beneficial for survival
during the collective trauma of 1932e1933. However, in addition to
still affecting the survivors, these themes were also reported to be
prevalent in, and affecting the daily lives of, the second and third
generations, even though the descendants viewed them as “irra-
tional.” The reported emotions and internal states were horror, fear,
sadness, shame, anger, stress and anxiety, and low self-worth. The
reported trauma-based coping strategies were stockpiling of food,
extreme reverence for food, overemphasis on food and overeating,
inability to discard unwanted items, indifference toward others,
social hostility and risky health behaviours. A few first and most
second and third generation participants succinctly summarized
these emotions-inner states and trauma-based coping strategies as
living in “survival mode.” Specifically, life was reported to involve a
“constant need for survival” and “self-preservation” that precludes
the ability to “live in the present” and “enjoy life” as explained by
one third generation participant:
This reality is something that is passed along from one's parents.
You constantly find yourself in a situation, in your mind that you
are always in survivor mode. One cannot simply let go and relax.
There are never moments when one can fully enjoy life.
3.1. Emotions and inner states
All first generation participants stated that they related to the
Holodomor with a sense of horror. One survivor's summation
captured this succinctly as being “the most horrible thing that a
person could experience in their life.” In general, survivors attrib-
uted this sense of horror to watching “parents die before my eyes,”
seeing siblings, relatives and friends forcibly starved to death, the
“swelling” associated with starvation, “this horror in the streets, all
of these dead bodies,” having everything taken away, watching
individuals shot to death, seeing masses of bodies being thrown
“into a hole in the ground,” the eating of corpses and cannibalism.
One female survivor recounted: “She [mother of a friend] pulled up
this onion and they killed her for this. They took the onion she had
dug up and pushed it into the mouth of her dead body. It was
horrific.”
In narratives similar to the survivor generation, most of the
second and many of the third generation spoke of horror related to
their family oral histories of forced starvation even of children and
how “[they] threw bodies of the dead children into a pile in a hole
in the ground,” “incidences of cannibalism,” how “people simply
swelled up from utter hunger and starvation,” and how parents
could not feed their children. One second generation male
conveyed how his mother told him of women who, as they were
dying, still attempted to breastfeed their babies.
Most participants also reported fear as stemming from the
genocide; three different kinds of fear were talked about. First,
many members of all generations similarly noted their “fear of
another genocide,” in that if the genocide happened once, it could
happen again. For example, one second generation male participant
noted that “there is always a risk that things could be repeated as
they were back then,” while one third generation female partici-
pant said that, “perhaps someone will come into power. Lord never
let this happen, who will cause us to live through a similar
Holodomor.”
Second, a “fear to take action” was described as possessing a fear
to oppose, challenge, openly question, speak out against or strive to
change the status quo, authority, government, public policy, or
legislation, thus creating a “passivity” and “slave mentality.” As one
third generation female explained, “all of us wish to be alive, only
alive.” First generation participants explained how this fear initially
emerged in relation to resisting. Specifically, resistance to the Soviet
regime during and immediately after the Holodomor often resulted
in targeted death and imprisonment. Conversely, submission was
viewed as a means to potentially secure safety and avoid death. The
second and third generations reported that they “inherited,” via
learning, this “fear to take action” from their parents as explained
by one second generation male participant:
To fight what has been internalized is extremely difficult. Each
of us has a mechanism in our heads which censures us. This fear.
This fear does not allow us to be free on the inside. We obtained
independence, however, our inheritance, not what we person-
ally lived through, but rather our parents and grandparents.
However, this fear is passed along from generation to genera-
tion. You learn that you should be silent. If you say something,
there will be a negative consequence.
Third, first generation participants spoke of how the targeting of
Ukrainians during the Holodomor produced a “fear and mistrust” in
others, even in fellow Ukrainians. The second and third generations
reported that family oral histories of Holodomor-related atrocities,
coupled with the knowledge that Ukrainians were targeted,
contributed to a general fear and mistrust of others that was
responsible for isolation from, and a general suspicion and wariness
of, others.
Sadness was reported by many of the first and second and most
of the third generation participants. The first generation reported
painful memories as a source of sadness. For example, “So many
emotions are sorrowful ones, only sorrowful ones” and “from time
to time, one wants to cry when they remember this” were typical
first generation explanations. Sadness stemming from the loss of
family members was reported by more first generation participants
than the second, who in turn, reported this issue more than the
third. Conversely, more third generation participants reported
sadness related to the fact that Ukrainians, in general, were tar-
geted for genocide, perished, and experienced the Holodomor than
the second, who in turn reported this issue more than the first.
Second and third generation participants also reported a sense of
sadness for never having had the opportunity to know antecedent
family members, as explained by one female, second generation
participant:
My mom had a big family. But only some of them survived. And
the same with my dad's family. Only some survived. I never met
my grandma who passed away because of a lack of food. And I
just know from my dad how wonderful she was, how educated
she was.
Many of the participants reported feeling a sense of ethnic-
related shame. Coding of this theme included terms such as
“shame,” “humiliation,” “degradation,” “embarrassment,” “an
inferior sense of being” and “being made fools of” as a result of the
Holodomor being inflicted on Ukrainians. Reports of this shame
increased with each younger generation. Some second generation
men also reported feeling shame as stemming from the notion that
the genocide was utilized as a mechanism to destroy the partici-
pants' “independent way of life” and turn them into “slaves” of the
Soviet regime.
 B. Bezo, S. Maggi / Social Science & Medicine 134 (2015) 87e94
Of all the reported emotions, anger was the least discussed by
participants. Six reasons for Holodomor-related anger were re-
ported by some participants of all generations: (i) anger that the
genocide occurred; (ii) anger toward “those” perpetrators, in terms
of “such a rage that they could dare” orchestrate this genocide; (iii)
anger associated with the inhumanity of genocide in terms of “how
people were judged as being so terrible, humans did this to other
humans.” (iv) anger over the denial of the Holodomor; (v) anger
related to the genocide's destruction of identity and way of life; and
(vi) anger that there has been no justice for the perpetrators.
Only women raised the issues of stress and anxiety and decreased
self-worth as Holodomor-related impacts still affecting their own
lives. A few first generation females spoke of anxiety, in terms of
being “nervous and worried,” as a result of surviving the atrocities
of the Holodomor. The second generation did not raise this issue.
However, differing from their grandmothers' reports, some third
generation female participants reported observing their parents'
and grandparents' perpetual motion in a “survival mode” to influ-
ence and direct their own “constant regimen of work and activity,”
maintenance of food and other “surpluses,” (as described below in
the trauma-based coping strategy theme) and the need to always
strive to do “more.” Further, “this constant need for survival” was
reported to result in stress and anxiety that affected the ability to
enjoy life, in terms of making time for personal development and
forging stronger interpersonal relationships with friends and
family. A third generation female's account illustrates how her
family members' constant motion in “survival mode” affects her
life:
I believe today that this [survival mode] approach was detri-
mental to discussion and interaction between family members,
as there are times when you just want to sit and share-speak and
my mother is constantly busy … Similarly, my grandmother is
constantly focused on planting her garden, planting potatoes,
frankly, we are not able to eat all that she grows. It is a constant
battle … But, if to take my life example, this provides us with
opportunities to strive for more and to try harder. Because when
I see that when my grandmother can barely stand and move and
she continues to do more and more, then I realize that if I have a
pain I simply have to think, well if my grandmother can do ten
times more, then you somehow manage to force yourself to do
more despite the moaning … There needs to be time for inter-
action with my children as this is something that is lacking for
me. This is something that was lacking for me as a child with my
parents because they were constantly busy with something.
All female grandchildren who noted stress and anxiety also
commented on its negative impact on self-worth. Specifically, the
stress and anxiety of the “survival mode” were noted as being
responsible for feelings of regret and doubt associated with per-
ceptions of not being able to do “more” and the lack of achievement
in stockpiling (noted in trauma-based coping strategies, below).
This regret and doubt periodically extended to other areas in their
lives as perceived “lost opportunities” from never having achieved
enough in the past and doubts about ever being able to adequately
achieve in the realms of employment, personal development and
everyday tasks. In turn, these regrets and doubts were reported to
be responsible for decreases in self-worth. A few female grand-
children reported the lowering of self-worth to the point where
they referred to themselves as “stupid” or “losers.”
3.2. Trauma-based coping strategies
A few of the first, some of the second, and many of the third
91
generation reported the stockpiling of food supplies as stemming
from the impact of the Holodomor genocide. One first generation
female captured this issue succinctly by noting that “murder by
starvation had such an impact” that it still causes her to “save” and
“store” “dry bread,” “sugar,” “flour” in order “to prepare for any
unforeseen situation.” In turn, having been taught statements like
“you never know what life will bring next,” in relation to food, the
second and third generations reported how their “mentality” of
creating stockpiles of surplus foods were learned from parents and
grandparents as protective strategies to defend against future
threats. Although the second and third generations emphasized
that “the need to always have a surplus” is not rational, they “still
cannot allow one's self to live without a surplus” as explained by a
third generation female:
We once purchased a lot of salt. We had not managed to
consume this salt over a period of years living in our original
apartment. We still transported this salt to our new apartment.
Plain rock salt. Similarly, I remember a surplus of sugar and flour
in sacks in her [great-grandmother's] attic. This surplus was
prepared and stored at regular intervals of frequency. This is yet
another example of the consequences. This is what my grand-
mother did. This is what my mother did.
A few of the first and many of the second and third generations
also reported that the genocide produced an extreme reverence for
food. The first generation reported their life-long reverence as
stemming from the safeguarding and confiscation of food during
the forced starvation. In turn, the second and third generations
explained that they were directly taught by their parents that food
was life-saving and, hence, very valuable during the Holodomor
and, therefore, should never be discarded. One male second gen-
eration participant captured this learned sentiment with parental
statements from his childhood such as “you have to understand
that for every little bit of crumb a person could live for another
week” and “if only we had the good fortune of finding a piece of
bread in the field, and, you on the other hand are scattering your
bread about.” One female third generation participant spoke of the
realization of this reverence in her life:
The Holodomor made this valuing of bread even more extreme.
A piece of bread can save a person from hunger if you eat just a
little bit. Then, when I travelled outside of Ukraine, I realized
that this is only prevalent in Ukraine. This safeguarding and
sacredness of bread. Beyond our borders, people can throw
bread away. For me, this was a genuine shock. Then, later I un-
derstood that people who have not experienced such a thing or
whose ancestors did not survive such an experience, have a
completely different frame of reference.
One first, one second and a few third generation participants
also expressed an overemphasis on food and overeating as stemming
from a means to compensate for the restricted food access during
the Holodomor. One third generation participant referred to this
issue as “the cult of food in our family,” learned and “passed down”
from generation to generation, whereby “primary consideration” is
given to food preparation and the notion of “am I providing enough
to eat?” As such, “all other needs are not seen as important”
including “discussion and interaction between family members.”
This “cult of food” was said to be irrational and her survivor
grandmother's “number one rule” that is maintained by her mother
and now herself as a “consequence of the shock and horror that was
experienced at that time. Something could happen and we could be
left without food.”
92 B. Bezo, S. Maggi / Social Science & Medicine 134 (2015) 87e94
Additionally, some second and third generation participants
reported being overweight due to a Holodomor-instilled, fear-
based, parental pressure for overeating in their childhoods, as
illustrated by a second generation male participant:
I feel that my generation, those children who are born to those
people who survived the Holodomor, they are physically larger
and overfed. This fear that there will be nothing to eat. My
mother would literally stuff me. I would say, ‘I do not want to
eat.’ She would force me, ‘eat, eat, eat.’ … Our parents, fearful of
this reality would stuff our refrigerators and freezers with food.
They would force their children to eat. They would ask, ‘the
sandwich we sent to school with you, did you eat it? Eat it. Eat it.
Eat it.’ This fear, it is not normal. For instance, this is a violation
of the natural function of the human body, because to overfeed
an individual is not proper … I remember that I was never thin.
Despite my not being thin, average weight, I was always being
forced to eat. This obviously stems from that reality.
A few of the third generation participants attributed their
inability to discard an excessive build-up of unwanted and un-
needed items in their living spaces to the impact of the Holodomor.
These participants reported that, as a response to having lost
everything during the genocide, their grandparents excessively
saved items with the belief that they will have future value should
another massive calamity occur. This need to save was reported to
be learned intergenerationally as explained by a third generation
female:
If you were to look at her house, she [grandmother] has a lot of
different stuff that she will never need but she still has it just in
case. Because she did not have before, so just in case. It is her life
motto now. In our attic, it is overwhelmed with, sometimes,
with strange things. Because she is collecting everything. She
cannot force herself to throw something away … It is even true
for my parents' generation. I can see it … I notice that, for me it is
not always easy to get rid of old stuff … I will find one hundred
ways to not throw it away.
Most participants, of all generations, reported that the extreme
conditions during the genocide forced individuals to focus greater
emphasis on the struggle for personal and familial survival as
opposed to the survival or struggle of others. Hence, an indifference
toward others emerged, that was reported not as an intrinsic self-
ishness, but rather the result of the perceived need for self-
preservation that emerged during the Holodomor, as explained
by one first generation survivor:
People were pushed to the brink where there was nowhere else
to turn and nothing else to do … She [childhood friend] jumped
out into the street and said, ‘my mother died.’ And, they
responded, ‘we may die along this roadway. And so what if she
died?’ You see this is what it did to people. They were not even
able to grasp the situation of a young child left without family.
Second and third generation participants also reported that this
indifference toward others still affects their generations and is
responsible for Ukrainians being “less generous and caring,” whereby
individuals in communities and society are not concerned with each
other's well-being and “no one is concerned with helping one
another.” The indifference was noted to have been learned by each
successive generation in their community-societal environments.
A few third generation participants reported that the break-
down of amiable, interpersonal relationships during the genocidal
period, coupled with the perceived need for self-preservation and
“survival” created an increased social hostility. As a result, “people
became more harsh with one another and would take advantage of
one another.” In this context, one third generation female partici-
pant reflected:
As you walk the streets in a different country, you do not have
the same feeling of survival mode that you feel in Ukraine. In
Ukraine, this survival mode is felt and exists. And, regardless of
where you travel, it is always felt among people. I think that one
of the consequences is that people are more abrupt as if you are
surviving in a jungle. More biological relationships. You find
yourself responding more abruptly to certain things, circum-
stances that would usually require you to be softer and more
respectful.
This social hostility was also reported to have been learned at
the community-society level, by each successive generation, and
was held responsible for witnessed bullying and physical fighting
“about absolutely nothing” among Ukrainian children as “the
young in particular” “do not have trust in each other.”
Some first and second generation participants raised the issue of
risky health behaviours, such as alcohol and drug abuse and the
spread of AIDS, as stemming from the impact of the Holodomor.
Specifically, alcohol abuse was reported to have emerged as a coping
strategy to lessen stress in the aftermath of genocide. None of the
participants reported alcohol abuse in their own lives, but felt the
issue warranted being raised. Alcohol abuse was described as a
men's issue. Participants noted that males began using alcohol after
the Holodomor in an attempt to counter the likelihood of appearing
independent and anti-Soviet. In this context, any appearance of
independence, good health, strength, and anti-Soviet sentiment
was used by the regime as a pretext to execute men. Therefore, as a
survival and coping strategy, the appearance of isolation, poor
health, and weakness was more advantageous. This weakness was
then learned and reinforced by each successive generation of men
and still persists because “it is easy to be weak,” “very passive” and
“just abuse alcohol.” This learned passivity was also posited to be
the root cause of ambivalence toward risky health behaviours that
leads to the contraction of AIDS and drug abuse where “the young
generation still suffers from the impact of the past [Holodomor].”
4. Discussion
For this study, narratives of grandparents and their adult chil-
dren and grandchildren were analyzed to obtain a three generation
perspective on survivor families' perceptions of the Holodomor and
its intergenerational impact. The findings suggest that the genocide
still exerts an impact on survivors and their adult children and
grandchildren, even decades later. All generations spoke of the
intergenerational genocidal impact in terms of what we identified
as two superordinate themes: (i) emotions and inner states, and (ii)
trauma-based coping strategies.
Some aspects of these themes are consistent with the results of
previous studies in this field, while others are novel. In terms of
emotions and inner states, this study's findings of fear of another
genocide, fear and mistrust of others, sadness, shame, and anger have
been previously reported in studies of survivor families of the
Holocaust (Rowland-Klein and Dunlop, 1997; Iliceto et al., 2011),
the Armenian genocide (Karenian et al., 2010) and/or the WWII
internment of Japanese-Americans (Nagata, 1993). However, novel
to this study were the reported intergenerational emotions and
inner states of horror, fear to take action, stress and anxiety, and
decreased self-worth. Also, unique to this study is its findings of
 B. Bezo, S. Maggi / Social Science & Medicine 134 (2015) 87e94
trauma-based behaviours that persist into the second and third
generations and include stockpiling of food, extreme reverence for
food, overemphasis on food and overeating, inability to discard un-
wanted and unneeded items, indifference toward others, increased
social hostility, and risky health behaviours including alcohol and
drug abuse, and increased HIV/AIDS.
Participants from all generations summarized the “survival
mode” emotions and internal states, and trauma-based coping
strategies as being part of a perpetual need for self-preservation or
coping with the long-term impacts of genocide. In this sense,
participant descriptions are congruent with Chemtob et al. (1997)
conceptualization of trauma survivors' “survival mode of func-
tioning” (p. 22) as a means of self-preservation, characterized by
the perceived presence or expectancy of external life-threatening
situations. However, the second and third generations of this
study, who never experienced the Holodomor, also emphasized
their continual need for survival as stemming from the trans-
generational impact of trauma inflicted by this genocide. In terms of
gender differences, intergenerational alcohol abuse was reported as
a male issue, while anxiety and self-worth were noted as female
ones. Our results are consistent with the literature that suggests
male and female trauma survivors, respectively, are more likely to
engage in externalizing (Chandy et al., 1996; Hamburger et al.,
2008) and internalizing behaviours (Chandy et al., 1996; Ghafoori
et al., 2013). However, our results suggest that these latter issues,
stemming from collective trauma, also persist into the second and
third generations. Participant reports of risky health behaviours and
social hostility might at least partially provide an explanatory
framework, from the participants' perspectives, for cross-national
data of mostly northern hemisphere countries showing that
Ukraine has the highest youth (World Health Organization [WHO],
2008) and adult (Bezo et al., 2012) alcohol use. Comparatively in
Europe, Ukraine also has a high prevalence of HIV (UN, 2010) and
physical fighting in adolescents (WHO, 2008).
Previous studies have shown the family as the vehicle for
trauma transmission. However, our findings suggest that the
mechanism for transmission e at least in the Ukrainian context -
not only involves families, as noted in the literature, but also
exposure to the environment that exists outside of the family. For
example, participants noted the transmission of fear and mistrust
through the family, while indifference toward others was passed
down via the community-societal environment. As such, our find-
ings also suggest the role of community-society in trauma trans-
mission, an area that is still not well studied (Evans-Campbell,
2008).
This study had limitations. First, since the average male life
expectancy in Ukraine is 62.3 years (UN, 2012), this study had a
higher female to male ratio for the survivor participants. Second,
purposeful sampling, via a snowballing technique, sourced partic-
ipants who were willing to share their experiences (Patton, 1990)
rather than generalize to the population (Jackson, 2003). Third, the
prevalence of topics may be underreported, as participants may be
reluctant to disclose sensitive information during interviews
(Tourangeau and Smith, 1996). In terms of future study, quantifi-
cation is necessary to ascertain how representative the current
findings are to the general population of Ukraine. In addition,
investigation on survivors, who emigrated from Ukraine after the
Holodomor, and their North American-born descendants might
help determine the role of environmental context in intergenera-
tional transmission of trauma. Given that these families were
embedded in environments free from further Soviet acts and cur-
rent hostility, via Russia's recent annexation of Crimea (Mankoff,
2014), military invasion of eastern Ukraine (Kramer and Gordon,
2014) and continual denial of the existence of the Ukrainian state
(Eremenko, 2014), their experiences may have set them on a
93
trajectory differing from their counterparts in modern-day Ukraine.
For those that remained in Ukraine, future study might determine
whether the “survival mode” strategy is maladaptive or beneficial,
given the continued acts, post-Holodomor, against Ukraine.
5. Conclusion
Our results give credence to the notion that a distinction needs
to be made between individual and collective traumas, in terms of
definition and healing. Specifically, trauma afflicted on the indi-
vidual has achieved clinical and political recognition via construc-
tion of posttraumatic stress disorder that emphasizes an ahistorical
perspective (Crawford, 2013). However, our results suggest that
collective trauma and its intergenerational transmission affects not
only the individual, but also the family and community-society, and
retains a historical perspective. One poignant example of the latter
is that even almost eight decades later, the second and third gen-
erations continue to use coping strategies like stockpiling of food, a
behaviour that originally emerged in survivors faced with geno-
cidal starvation in 1932e33. Thus, given the more complex nature
of collective trauma, our results suggest its study and healing
require multi-level frameworks that include the individual, the
family system, and the greater community. Lastly, our findings
resonate with Hirsch's (2008) concept of “postmemory” (p. 106),
whereby the communication of knowledge and oral accounts be-
tween generations, whether verifiable by independent sources as
fact or lore, constitute memories in their own right that operate in
the present and impact descendants.
Acknowledgements
This research was funded by the Social Sciences and Humanities
Research Council of Canada's (doctoral fellowship) reference
number: 752-2013-2539, the Ontario Graduate Scholarship Pro-
gram and the Canadian Institute of Ukrainian Studies of the Uni-
versity of Alberta.
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