Enduring the unendurable: the allostatic weight of intergenerational and transgenerational trauma in Gaza

Trauma in the Gaza Strip has been examined through frameworks such as post-traumatic stress disorder (PTSD), continuous traumatic stress (CTS), complex PTSD, intergenerational trauma and allostatic load. Existing frameworks address important dimensions individually but have not sufficiently integrated them in the Gazan context. This research note proposes the framework of continuous recursive pervasive trauma (CRPT) to address these gaps. CRPT conceptualises trauma as a self-­reinforcing system through four mechanisms. Firstly, ongoing violence, displacement, deprivation and insecurity prevent recovery. Secondly, prior traumatic experiences amplify responses to subsequent stressors. Thirdly, chronic stress becomes biologically embedded through mechanisms of allostatic overload. Lastly, trauma is reproduced across generations through biological, familial, cultural and structural pathways. The framework further considers culturally specific forms of endurance, particularly the Palestinian concept of Sumud, as a response that may sustain meaning and survival while coexisting with psychological and physiological burden. By integrating psychological, physiological and intergenerational perspectives, CRPT offers a more comprehensive understanding of trauma in Gaza and provides a conceptual basis for future empirical research, trauma-informed intervention and humanitarian policy in contexts of prolonged structural violence.