In many families, traditions are cherished as the glue that binds generations. They’re passed down like heirlooms: recipes, rituals, phrases, and values—shared touchstones that offer identity and continuity. But not all traditions are benign. Some are invisible threads of control, shame, and conditional love. Some traditions, quietly handed down, teach us not how to live, but how to comply, how to hide, how to endure. How to succeed in an unfair, dysfunctional world.
These inherited dynamics can be hard to see precisely because they’re so normalized. They’re absorbed early, often without question: Don’t talk back. Don’t get too emotional. Don’t bring shame to the family. Mistakes must be punished. Deviance from family values must be corrected. Pain must be kept private. When someone breaks these rules, some families respond with scapegoating, gaslighting, or exclusion. In some, humiliation, manipulation, violence, and threats of violence are considered part of learning a lesson. And in some, even expressions of love can come with strings attached—resources, information, and even genuine affection can be withheld until their loved one “straightens up and flies right.”
What does this have to do with “madness”?
Plenty. Because when we talk about psychiatric diagnoses that are said to “run in families”—like schizophrenia or bipolar—we are still often asked to look at the genes. But the focus on genetics doesn’t tell the whole story. While there may be some genetic component, a growing body of research suggests that epigenetics—the study of how experience can alter gene expression—may provide an even more nuanced understanding of how traditions of distress are inherited.
Epigenetics refers to the way external factors, such as trauma or stress, can alter the expression of genes without changing the genetic code itself. These changes can affect how we respond to stress, regulate emotions, and develop mental health conditions. Rather than just focusing on inherited genes, we need to consider how early experiences, especially those within families, can influence epigenetic changes that impact mental health. For example, trauma or chronic stress can leave epigenetic marks on genes involved in the stress response, emotional regulation, and brain development, predisposing individuals to psychiatric conditions. This suggests that mental health conditions may not only be passed down through genetics but also through the inheritance of trauma and environmental influences embedded in family traditions.
Mental health, like lived experience, doesn’t exist in a vacuum. The familial and societal environments we grow up in profoundly shape how we experience and express mental distress. Consider the old school advice for housebreaking pets: “rub their nose in it: bad dog!” Though now a debunked theory of housebreaking, it’s been metaphorically applied to human correction, too. At its core, it’s about using shame and punishment as a tool for correction.
Though often justified as “tough love” or discipline or training, the real outcome is emotional harm. It sends the message that love and acceptance are conditional—that you’re lovable only when you’re conforming, not when you’re simply being yourself. And maybe it’s unfair to rub someone’s nose in the family’s mess in the first place.
With dogs, most experienced trainers will tell you that rubbing their nose in feces or urine doesn’t help housebreaking. It breaks trust. It causes confusion. It triggers stress and anxiety, and may lead to avoidance or even aggression. It may lead to suppressing natural signals. Most importantly, it fails to teach the behavior you actually want. The lessons being learned are not the lessons being taught. Still, some traditions die hard.
Families pass these patterns down not only through direct actions but through silence, denial, and implicit agreement. The phrase “That’s just how we do things” becomes a shield against reflection. Attempts to question or reject these traditions are often met with resistance or scorn. The one who pushes back may become the black sheep—the “troubled one,” the “problem,” or eventually, the “mentally ill.” Such responses highlight how deeply ingrained these traditions are—and how deeply resistant to change.
Could it be that what psychiatry calls madness is, in some cases, a natural rebellion against being shaped by these harmful traditions? A form of internal protest against the unbearable pressure to conform, to be silent, to carry the emotional load of generations without breaking?
The Impact of Early Relational Trauma
Some researchers have studied how early relational trauma—especially chronic emotional abuse or neglect—shapes brain development. Martin Teicher’s research emphasizes how early emotional and physical neglect can cause long-lasting psychological harm, influencing the development of mental health in adulthood. Similarly, the World Health Organization’s 2025 guidance on mental health reform underscores the importance of addressing the social and structural determinants of mental health, including adverse childhood experiences (ACEs). These experiences, which often occur within the family unit, significantly correlate with increased risks for psychiatric conditions, substance use, and chronic illnesses.
Rather than focusing on individual pathology, it may be useful to consider the intergenerational transmission of trauma. Families often pass down emotional and behavioral patterns that affect not only their immediate relationships but also their children’s capacity to cope with the world. When children grow up in an environment where emotional distress is hidden, conflict is suppressed, and compliance is demanded, they internalize these norms, which may later manifest as depression, anxiety, or other “mental disorders.” The body and mind, in their struggle to survive these oppressive traditions, can rebel in the form of what is clinically labeled as “madness.”
This brings us back to the familial context in which these patterns develop. For many, these contexts are shaped by family traditions that prioritize control over emotional health, or silence over vulnerability. The unspoken expectation that children should bear the weight of these burdens can set the stage for future psychological struggles.
The Pathologization of Family Systems
Yet, our cultural default is still to pathologize the individual, rather than examining the social and familial systems they emerged from. By focusing solely on individuals’ professional or arm-chair “diagnoses”, we overlook the environmental factors in which individuals are embedded—particularly in the family environment.
In line with the 2025 WHO guidance, we need to adopt a systemic approach to mental health that takes into account the full scope of a person’s life, including the intergenerational dynamics at play. This approach emphasizes the need for multi-sectoral collaboration and the addressing of social and structural determinants, which include family dynamics and traditions. Families, in many cases, are not merely a source of comfort and support but also a breeding ground for dysfunction, unhealed trauma, and emotional neglect.
The socialization that takes place in family settings can foster resilience and healthy emotional development, but when these environments are laden with shame, emotional deprivation, or neglect, they become breeding grounds for the distressing conditions that become diagnosed and treated. To address the root causes, we need to look beyond the individual at the larger systems they are part of—including the family and cultural frameworks that shape one’s sense of self.
Hidden Sources of Distress in the Family Tradition
“Madness” might sometimes be a natural response to unnatural expectations and punishments embedded within family traditions. The very customs we prize as “family values” often developed as survival or success mechanisms within a broader context of societal dysfunction—and rather than protecting us, they can become hidden sources of distress that ultimately fuel what we call madness. For example, when a family’s survival hinges on maintaining a façade of perfection or strength, any deviation from these ideals can be seen as a threat to the family’s identity and cohesion. Consequently, individuals who do not fit this mold—whether due to emotional sensitivity, mental health struggles, or simply non-conformity to dysfunctional societal norms—are often scapegoated and labeled as the “problem.”
For those who suffer under the weight of these contradictions, the deepest wounds come when loved ones—those who should know better—side with the mainstream narrative. And become the face of it. Instead of offering refuge or understanding, they reinforce the very norms that cause harm, becoming instruments of dysfunction in the life of someone they claim to love. This betrayal cuts deeper than societal rejection because it cloaks itself in concern and duty, masking compliance with cruelty.
To speak of this is not to blame families, but to open space for truth. Often, these traditions were born out of survival—out of the desire to adapt to societal pressures or to avoid stigma. Or perhaps out of a drive to be “winners,” in keeping with the family tradition of success. They may have been passed down from previous generations shaped by war, poverty, or societal repression. But if we don’t examine and interrupt them, we risk preserving harm in the name of heritage.
Inherited Roles and Expectations
We inherit more than genes. We inherit stories, roles, expectations, and the means by which love is earned or denied. Reform of mental health systems involves recognizing the intersectionality of various factors, such as family dynamics, cultural practices, and socioeconomic status. Inherited patterns might shape how individuals experience the world and their sense of agency in it. The pressure to conform to family roles or expectations, often learned in childhood, can be a significant source of psychological distress, particularly when those roles are rigid or toxic.
If we’re serious about understanding human distress—and building more humane responses to it—we need to look beyond the individual. We need to consider how so-called family values can sometimes serve as vectors of trauma. These traditions—often rooted in outdated notions of discipline, control, and shame—can prevent individuals from fully embracing their authentic selves, which is essential for mental health and well-being.
Maybe healing begins with a new tradition: listening. By fostering spaces where individuals can share their experiences, unmasking the hidden wounds passed down through generations, we can begin to challenge the conventions that limit our growth. Healing begins with listening, but it also begins with examining the traditions that have long been accepted without question. Are these traditions protecting us, or are they subtly creating the very conditions for distress that we label as madness?
