Transformation of Perception of Trauma by Child Survivors of the Holocaust in Group Therapy

Intensive work with child survivors of the Holocaust has made us aware of the clinical importance of understanding the ways children perceive their traumas and the conclusions they draw about how they must live their lives. When these perceptions are transformed congruently with the child's development, the survivors can cope quite well. In this paper we refer to now middle-aged survivors who are still guided by their child perceptions. We will describe how we have used conjoint group psychotherapy to facilitate processes of transformation even at this late stage. The model we provide for trauma work with Holocaust survivors whose traumatization occurred decades ago may well provide tools to reduce future suffering of children who are victims of massive traumatization today.     

Separation-individuation conflicts in children of Holocaust Survivors

This article examines the developmental conflicts of children of Holocaust Survivors with specific emphasis on psychic trauma and second-generation Survivor effects. Issues related to depression, guilt, and aggression are discussed in relation to Mahler's separation-individuation process. Developmental failures at early phases may predispose these children toward low self-esteem, narcissistic vulnerability, identity problems, and impairments in interpersonal relations. The need for further research and clinical investigation is emphasized to help develop preventive measures and attenuate the effects of the Holocaust on future generations.     

Sexual Abuse Survivors: Identifying Symptoms and Special Treatment Considerations

Because of the prevalence of child sexual abuse, many adult counseling clients will have sexual abuse in their histories. Counselors should familiarize themselves with the symptoms of sexual abuse survivors to assist with disclosure. Failure to address the abuse will interfere with the success of the counseling process. Special sensitivity is required of counselors to provide a safe environment in which survivors can examine the pervasive impact of the abuse on their lives, explore and ventilate their feelings, and resolve the trauma so it ceases to block their development. An eclectic approach, including group counseling, is recommended.     

Testimonies in the Treatment of Genocidal Trauma

This article describes an approach to the treatment of genocide survivors that addresses both the personal and communal/historical dimensions of their experiences. I begin by outlining the characteristics of massive psychic trauma as background for using video testimonies in the treatment of Holocaust survivors. I then discuss videotaped interviews with perpetrators as an illustrative contrast to survivors' testimonies. The third section explains my position as a psychoanalyst encountering historical trauma and its relationship to my own experiences as a survivor. Following a brief history of videotaping as a medium for recording testimonies, I conclude by demonstrating the ways in which active listening can lead to the revelation of new dimensions of historical as well as personal truth.     

The Holocaust after 70 years: Holocaust survivors in the United States

Over 70 years, there have been different narratives of the Holocaust survivors coming to the United States. Survivors’ stories begin with an event of major historical significance. Difficulties in conceptualizing historical trauma, along with common distortions and myths about Holocaust survivors and their children are examined. This article proposes that it is impossible to discuss the consequences of extreme suffering without consideration of historical meaning and social context with which they are entwined. The evolution of the social representation of the Holocaust and the contradictions in clinical attributions to survivors and their children with consideration of the future is described. Attributions to survivors and their children with consideration of the future is described.     

Contaminated Generativity: Holocaust Survivors and Their Children in Germany

This paper addresses the trauma transfer from survivors of the Shoah to the Second Generation in Germany. What does it mean for both generations to beget children after Auschwitz? This necessarily entails perceiving non-Jewish Germans and their way of dealing with history. Survivors cannot live without their memory, nor is it possible for them to conceive of a life unencumbered by this constant “contaminant”. It is not possible to integrate the persecution experiences. On the contrary, decades after liberation, dissociated elements of traumatic memories penetrate everyday experiences, thought, affect and imagination as contaminants. Occasionally, these fragments of persecution experiences, like “encapsulated memories” hidden in crypts suddenly break open and frighten the survivors themselves and even more so the people around them.     

The Phenomenology of Posttraumatic Distress in Older Adult Holocaust Survivors

This paper focuses on the effects of the Holocaust on its survivors more than 55 years after the end of World War II. The emphasis is on survivors who were either adults during the Holocaust and who are now over the age of 70, or survivors who were children during the Holocaust and whose age is now between 56 and 70. The central question was: What kinds of posttraumatic phenomena are seen in older adult survivors? After an overview of the field, the situation of survivors in Israel is presented in 2 ways. Results of a survey of survivors who were referred to Amcha, the National Israeli Center for Psychosocial Support of Survivors of the Holocaust, is provided to give some insight in a clinical population. In addition, 2 case histories of survivors are presented to give a more in-depth perspective. The gap between the data from the questionnaires and the clinical material has relevance for the way in which we conceptualize the late consequences of massive trauma.     

Observations on the First International Conference on Children of Holocaust Survivors

This first large-scale gathering of children of Holocaust survivors revealed — more from the unanticipated group process of the conference than from its official proceedings — that the second generation seeks a collective identity subordinate neither to the older generation of parents nor of mental-health authorities. Vital moments of tension and reconciliation at the conference between the children's self-help movement (with a sizable membership of young mental-health professionals) and distinguished mental-health experts indicated the legitimacy of intergenerational encounter and the place that it will likely be accorded in future meetings.     

Psychoanalytic Considerations Regarding the Occupational Therapy Setting for Treatment of the Psychotic Patient

Occupational therapists have always been concerned with the treatment of the psychotic patient. Oddly enough, the traditional setting offered to these patients in occupational therapy has not been the object of too much thought or consideration. In order to attain a therapeutic process, the therapeutic setting must be defined furst. The need for such a measure appears essential in therapy with the psychotic patient since his/her own internal structure is impaired. To understand fully the process of the therapy one must take a look at the impact of all dimensions of the setting. This paper discusses the psychodynamic consequences of the setting in occupational therapy in the treatment of psychotic patients.     

Facing the Holocaust in Generations of Families of Survivors: The Case of Partial Relevance and Interpersonal Values

This qualitative study examined the meaning of the Holocaust for 10 Israeli families of survivors in which there are three generations. Thirty-two individuals (24 women, 8 men) were asked to tell their life story. The interviews were analyzed for themes related to PR (Partial Relevance, Bar-On & Selah, 1991) and the interpersonal values held by family members, using SYMLOG methods (Bales, 1999). The first generation agreed on the importance of the value of family teamwork and showed medium to high range PR scores. The second and the third generations showed low, medium, and high range PR scores and tended to value both family teamwork and more non- conforming behavior.     

Developmental Play Therapy: A Treatment Approach for Child Victims of Sexual Molestation

The author describes the use of developmental play therapy as a treatment approach for young children who have been sexually molested.     

Child Care in Cross-Cultural Perspectives: Implications for the Future Organization of Child Care in the United States

In every society care of children is primarily a female responsibility, yet there is still tremendous cross-cultural variation in the organization of child care. Three characteristics of child care in small-scale traditional agrarian societies are discussed: role integration, use of auxiliary caregivers, and the effects of certain ecological patterns on childrearing. Data concerning each of these points is presented, along with implications for the future organization of child care in our own society. These implications are based on, first, the assumption of adaptiveness in forms of child care organization that have evolved over periods of time in these relatively stable societies, and, secondly, on the notion that concepts of child care that work in other societies can, in many cases, be adapted to current conditions in the United States.     

The United States Cover-up of Japanese Wartime Medical Atrocities: Complicity Committed in the National Interest and Two Proposals for Contemporary Action

To monopolize the scientific data gained by Japanese physicians and researchers from vivisections and other barbarous experiments performed on living humans in biological warfare programs such as Unit 731, immediately after the war the United States (US) government secretly granted those involved immunity from war crimes prosecution, withdrew vital information from the International Military Tribunal for the Far East, and publicly denounced otherwise irrefutable evidence from other sources such as the Russian Khabarovsk trial. Acting in “the national interest” and for the security of the US, authorities in the US tramped justice and morality, and engaged in what the English common law tradition clearly defines as “complicity after the fact.” To repair this historical injustice, the US government should issue an official apology and offer appropriate compensation for having covered up Japanese medical war crimes for six decades. To help prevent similar acts of aiding principal offender(s) in the future, international declarations or codes of human rights and medical ethics should include a clause banning any kind of complicity in any unethical medicine—whether before or after the fact—by any state or group for whatever reasons.     

Effects of Incest in Aging Survivors: Psychopathology and Treatment Issues

Most older people who have been sexually abused in childhood have probably never been treated for the consequences of their destructive experiences. The character pathology and long-term effects of child sexual abuse are described. Parallels were drawn between delayed Posttraumatic Stress Disorder seen in older veterans and World War II victims and later-life onset of posttraumatic psychopathology in aging incest survivors. Special geropsychological treatment issues, such as the appropriateness of explicit inquiry regarding a history of abuse and the role of power, gender, and shame in the psychotherapeutic relationship, are presented. The dilemma of uncovering repressed malignant childhood trauma in aging individuals is discussed. With proper medical and psychological preparation, demanding curative interventions with older survivors may be considered.     

Group Cognitive Behavioral Treatment for PTSD: Treatment of Motor Vehicle Accident Survivors

Individual cognitive behavioral therapies (CBT) are now considered the first-line treatment for posttraumatic stress disorder (PTSD; Foa, Keane, & Friedman, 2000). As mental health reimbursement becomes more restricted, it is imperative that we adapt individual-format therapies for use in a small group format. Group therapies have a number of advantages, including provision of a natural support group, the ability to reach more patients, and greater cost efficiency. In this article, we describe the development of a group CBT for PTSD in the aftermath of a serious motor vehicle accident (MVA). Issues unique to the group treatment format are discussed, along with special considerations such as strategies to reduce the potential for triggering reexperiencing symptoms during group sessions. A case example is presented, along with discussion of group process issues. Although still in the early stages, this group CBT may offer promise as an effective treatment of MVA-related PTSD.     

The Child Behavior Checklist for Group Care Workers: A Study Regarding the Factor Structure

In this study we examined the factor structure of the Child Behavior Checklist (CBCL) filled out by group care workers. Group care workers' judgements were collected on 846 children and adolescents treated in various residential settings in The Netherlands. Using confirmatory factor analysis, we were able to show that the original CBCL factor model based on parental judgments of child behavior also fits for the judgments of group care workers. This means that the well known 8 narrow-band syndromes (Withdrawn, Somatic Complaints, etc.) as well as the 2 broad-band syndromes (Internalizing and Externalizing) can be used to interpret the CBCL scores of group care workers. This confirmation of the CBCL factor structure is a first step to add a group care worker version to the CBCL family. However, as a second step, normative data need to be gathered to further enhance the use of the CBCL for group care workers.     

Levels of Social Support and Coping Strategies in Adult Survivors of Child Sexual Abuse

The study examined the effects of levels of social support and types of coping strategies on the psychological adjustment of adult survivors of childhood sexual abuse. Five hundred students from two universities in the Limpopo Province of South Africa participated in this study (males =115, females = 383). Mixed methods were used for the collection and data analysis. Higher the level of social support received correlated with superior psychological adjustment. The specific types of coping styles adopted did not affect psychological adjustment in the survivors.     

A Behavioral Treatment of Child Abuse:

The following case presents the behavioral analysis and treatment of abuse in an 18-year-old unmarried mother. Both her children were being abused. Treatment involved teaching child management techniques, thought-stopping, programming activities incompatible with abuse, and increasing the mother's sources of reinforcement. A foster home was also arranged for use in emergencies and types of behavior and levels of attainment expected from children at various ages were outlined. Combined instances of abuse decreased from 10 in the week prior to intervention to 0 by week nine and remained at this level for the rest of the 21 week treatment period. A follow-up 18 months later indicated no further occurence of abuse.