The Holocaust and Its Effects on Survivors: An Overview

The Nazi Holocaust has had continuing and widely reverberating consequences not only for the Jewish survivors but for the world at large. These consequences are detailed, first through a personal account of an Auschwitz survivor, and then through a discussion of the adaptive measures of concentration camp inmates and the long-term psychiatric and psychological effects on survivors and their families. The Survivor or Concentration Camp Syndrome and its relationship to the Post-Traumatic Stress Disorder is described. Indirect effects of the Holocaust have been manifested in various ways, particularly through various levels of psychologic denial displayed by Holocaust criminals and (at least during the early postwar period) by the German public. The Holocaust has had profound effects on the ways the Jewish people regard themselves and are seen by others. Finally, the Holocaust can be seen as offering a kind of paradigmatic signature to the worldview of the end of the 20th century, emphasizing the persistence of evil and the limitations of the idea of progress.     

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.     

The Role of Group Experiences in the Healing Process of Massive Childhood Holocaust Trauma

This paper proposes that Holocaust child survivors profoundly benefit from participating in a variety of group modalities. From participant observation and interviews we demonstrate that affiliation in organizations, social events, commemorations, rituals, and particular therapeutic groups each contributes to the well-being of Holocaust child survivors. Mourning is enhanced by joining forces with others from a historical event that left many children orphans, bereft of a home, a community, a country, and an identity. Group participants achieve individuation and ego integration, and gain clarity about the complex psychological consequences of surviving the Holocaust. A fragmented identity is restored through the opportunity of interacting with others whose identity has been ruptured by similar cataclysmic events.Senior Research Fellow, Graduate Center of CUNY. Codirector, Psychotherapy with Generations of the Holocaust and Related Traumas, Training Institute for Mental Health. Codirector, Child Development ResearchSenior Member and Faculty, National Psychological Association for Psychoanalysis. Codirector, Child Development Research     

Dispositional Mindfulness,Psychological Distress,and Posttraumatic Growth in Cancer Patients

Cancer has different psychological and physical outcomes. The present study was conducted to examine psychological distress, posttraumatic growth, and dispositional mindfulness in cancer patients. A total of 109 cancer patients entered the research. The Five-Facet Mindfulness Questionnaire (FFMQ), the Depression Anxiety Stress Scales (DASS-21), and the Posttraumatic Growth Inventory (PTGI) were used for data collection. The regression analysis revealed that dispositional mindfulness can be a significant predictor of psychological distress and posttraumatic growth in cancer patients. The results also showed that mindfulness is related significantly to psychological outcomes and adaptation in cancer patients and should be further addressed in cancer treatment.     

War-Related Dream Themes in Germany from 1956 to 2000

Based on the continuity hypothesis of dreaming, the effects of World War II on the dreams of German persons have been studied. The present study included four representative samples from 1956 to 2000 (repeated cross-sectional surveys). Although a decline of war-related dream themes over time was found, the heightened rate of these themes in the oldest age group (60 years and older) in the year 2000 indicate the long-lasting effect of emotionally salient life experiences on dreams. The present findings indicate that the method of dream content analysis is a very informative approach to study the effects of political events on the inner life of people and, thus, of value for the field of political science.     

Posttraumatic Stress Symptoms and Stressful Life Events Predict the Long-term Adjustment of Survivors of Childhood Cancer and Their Mothers

Objectives: To examine prospectively the impact of posttraumatic stress symptoms (PTSS) in response to childhood cancer and treatment on general adjustment while accounting for the role of other stressful life events and appraisal of life threat and treatment intensity. Methods: As part of a larger study assessing PTSS, 56 childhood cancer survivors, aged 8 to 18, and 65 mothers completed self-report measures of PTSS and appraisal of the intensity and life threat associated with cancer treatment at time 1 and self-report measures of stressful life events and general adjustment at time 2 (approximately 18 months after time 1). Results: For child survivors and their mothers, posttraumatic stress at time 1 significantly predicted general adjustment at time 2, over and above the significant contribution of lifetime stressful events. The life events variable did not function as a mediator in the association of PTSS and general adjustment. Conclusions: Trauma responses to childhood cancer and its treatment have implications for the long-term adaptation of children and their families. Early signs and symptoms of posttraumatic stress and stressful life experiences require early assessment and intervention.     

Clinically Significant Change After Cognitive Restructuring for Adult Survivors of Childhood Sexual Abuse

This study investigated the outcome of cognitive restructuring for adult survivors of childhood sexual abuse in terms of clinically significant change. Twenty-six participants were assessed for depression, State anxiety, State anger, State guilt and self-esteem before and after 10 weekly sessions of group Rational-emotive behavior therapy, and at follow-up after 8 weeks. In contrast to a previous analysis of the data in terms of statistical significance, indicating significant improvements on all variables from pre- to posttreatment, an analysis based on clinically significant change showed a differentiated treatment effect. Cognitive restructuring was found to be highly effective in facilitating recovery on anxiety, depression and anger, but less effective for guilt and low self-esteem. Only 3 patients (11, 54%) recovered on all 5 variables, while 10 patients (38, 46%) showed recovery on at least 4 variables. Relationship to the perpetrator and pre-treatment irrational evaluative beliefs (measured by means of the Survey of Personal Beliefs) were found to be the best predictors of treatment outcome. A poor response to treatment was associated with the perpetrator being a close family member and with more Other-directed Shoulds, while recovery was associated with the perpetrator being a friend or stranger and with more Awfulizing, Self-directed Shoulds and negative Self-worth beliefs.     

Psychological Distress and Symptoms of Posttraumatic Stress Disorder in Jewish Adolescents Following a Brief Exposure to Concentration Camps

We investigated the psychological impact of an organized visit to Polish concentration camps on Jewish-American adolescents. Eighty-seven adolescents who participated in a B'nai B'rith memorial visit to concentration camps in Poland completed measures of general psychological adjustment and posttraumatic stress disorder (PTSD) at four time-points: pretest, posttest, 6-month follow-up and 12-month follow-up. Measures included the SCL-90-R, the Mississippi Scale for PTSD, and the Impact of Events Scale (IES) for PTSD. On the SCL-90-R, changes in somatization, interpersonal sensitivity, obsessive-compulsive tendencies, depression, anxiety, and phobic anxiety were observed over time, with peak symptom scores at posttest and 6-month follow-up. Scores on the Mississippi Scale for PTSD and the IES Intrusion subscale also increased at 6-months. Predictors of PTSD symptoms on the Mississippi Scale included previous psychiatric treatment and SCL-90-R symptoms of paranoia, depression, and psychosis. Elevated psychotic symptoms on the SCL-90-R predicted PTSD symptoms on the IES. Jewish adolescents with preexisting symptoms of generalized distress or psychoticism appeared at increased risk for PTSD symptoms following exposure to Holocaust stimuli. This study contributes a prospective, multi-measure assessment of trauma reactions in adolescents.     

The Social Context of Adaptation to Traumatic Events: Soviet Jews and the Holocaust

Much of the literature on trauma focuses on the impact of a single traumatic event and its psychological sequelae on a given individual. Little attention has been paid to the effects of multiple traumatic events within one lifetime, or the importance of understanding the relation of the social context of the trauma(s) to the experience of the trauma survivor. This study presents a qualitative analysis of interviews with older survivors of the Nazi attempt to exterminate the Jews (the Holocaust), who had recently migrated from the former Soviet Union to the United States. In-depth depictions of the effects of multiple traumas on the mental health of single individuals are presented. Further emphasis is placed on the specific social context of trauma to more fully understand the older adult trauma survivor.     

Posttraumatic Stress in Survivors of Childhood Cancer and Mothers: Development and Validation of the Impact of Traumatic Stressors Interview Schedule (ITSIS)

This study presents initial data validating the use of a new instrument, the Impact of Traumatic Stressors Interview Schedule (ITSIS), to assess the occurrence of cancer-related posttraumatic stress in childhood cancer survivors and their mothers. Sixty-six child/adolescent cancer survivors and 64 of their mothers, as well as 130 young adult survivors, completed the ITSIS and other measures of posttraumatic stress and general distress. Five ITSIS factors were identified for the mothers and for the young adult survivors, and three ITSIS factors were identified for the child/adolescent survivors. Factors in all three samples reflected symptoms of posttraumatic distress, concern over medical late effects, communication, and changes in self due to cancer. Only young adult survivors had a factor reflecting a positive engagement with the cancer history. Factors correlated with validation measures in predicted ways. The findings further the conceptualization of posttraumatic stress in pediatric cancer by describing the traumatic experience for survivors and mothers. Comparing factors across samples allows an examination of different influences of cancer within families and over the course of development.     

The Role of Beliefs in the Relationship Between Health Problems and Posttraumatic Stress in Adolescent and Young Adult Cancer Survivors

In addition to the potential for ongoing health concerns, adolescent and young adult (AYA) childhood cancer survivors frequently report posttraumatic stress symptoms (PTSS). The current study examines whether beliefs about health moderate the relationship between the number of health problems and PTSS 2 months later in 140 survivors. Beliefs, as measured by scales of the Health Competence Beliefs Inventory (HCBI), negatively related to PTSS while health problems positively related to PTSS. Three scales of the HCBI-health perceptions, satisfaction with healthcare and cognitive competence—were significant moderators. The relationship between health problems and PTSS was stronger in the presence of less adaptive beliefs. These beliefs represent potentially malleable intervention targets for reducing PTSS in childhood cancer survivors.     

Personality Disorders in Older Adult Inpatients with Chronic Mental Illness

It has been hypothesized that some types of personality disorders tend to remit with age whereas others may become more prominent. The present study determined the prevalence and nature of 13 personality disorders with a self-report inventory (Coolidge Axis II Inventory) in an older group of chronically mentally ill inpatients (N = 30, mean age = 63 years) and a younger group of similar patients (N = 30, mean age = 39 years). All patients met DSM-IV criteria for either Schizophrenia, Schizoaffective Disorder, Bipolar Disorder, or recurrent severe Major Depression with psychotic features. The prevalence rate of personality disorders was high for both groups: 58% for the older sample and 66% for the younger group. The younger group was more likely to be diagnosed Antisocial, Borderline, Passive-Aggressive, Sadistic, and Schizotypal, but the groups were not different in the rates of Obsessive-Compulsive Disorder. This study supports the hypothesis that some personality disorders remit with age. However, no evidence was found to suggest that other personality disorders become more prominent in older adult psychiatric populations. Suggestions for future research are offered.     

The reception of Holocaust research in the world of psychology

After having spoken to lay and professional audiences in Germany, Switzerland, Austria, England, France and in the United States on the effects of the Shoah on people in psychotherapy today and found varying reactions, I decided to pursue the question in a more consequential way. I devised a questionnaire which I sent to a large number of international psychoanalytic societies. My initial impressions were confirmed: Freudian societies generally devote more work to the topic. Some Jungian societies with especially interested individuals have also devoted a substantial amount of work to the Shoah and its aftermaths. The Jungian hesitancy has to do with our often more archetypal approach and with shame about Jung's statements on the Jewish archetype. On the collective level, the presence of a survivor population seems to make research on the topic more difficult. A certain amount of time must evolve before a society (be it professional, individual or political) deals with collective trauma, be it the Shoah or political oppression. On the personal level, intimacy (also in future, adult relationships) seems blocked when fantasies about parents' implications in the Shoah prevail. The bottom line of both phenomena is taboo, a prohibition against touching tameh. I propose that the IAAP supports research projects on the Shoah. They could also, as the Freudians do, offer a special prize at each international conference for the best piece of research on the topic of collective trauma.     

A Study of Posttraumatic Stress in a Student Population

The authors examined the incidence of posttraumatic stress (PTS), with respect to levels of exposure to traumatic events, in a British student population. Respondents (N = 700) completed a standard questionnaire booklet that contained a posttraumatic stress disorder interview. The questionnaire collected personal demographic information and was used by researchers to ascertain whether respondents had experienced a traumatic event. Consistent with previous American studies, PTS was found to be relatively common; 23.3% of the sample showed either current or past PTS. Female participants had a significantly higher incidence of PTS than did male participants, although the latter were more likely to report having experienced a traumatic event. The experience of trauma was significantly associated with the likelihood of PTS. The authors discuss implications of their results in terms of long-term consequences of unresolved trauma.     

Measuring Implicit British Perceptions of German Intentions in 1938–1939

Implicit British perceptions of German leaders during the period September 30, 1938–September 1, 1939 (from the Munich Agreements to the German invasion of Poland) are studied with a "ratio of threat accentuation" measure. This ratio is calculated by comparing the densities of power motive imagery in two kinds of archival material: full texts of major Hitler speeches versus summaries in The Times of London, and British versus German accounts of meetings between British diplomats and major Nazi leaders. In both cases, the British ratio of threat accentuation increases following the unexpected German occupation of Prague and the rest of Czechoslovakia on March 15, 1939. These changes in implicit perception are congruent with changes in British explicit perceptions and foreign policy after the German action.     

Thoughts on representation in therapy of Holocaust survivors1

This paper presents the problems of representation and lack of representation in treating Holocaust survivors, through clinical vignettes and various theoreticians. The years of Nazi persecution and murder brought about a destruction of symbolization and turning inner and external reality into the Thing itself, the concrete, or, in Lacan’s words, ‘The Thing’. The paper presents two ideas related to praxis as well as theory in treating Holocaust survivors: the first is related to the therapist’s treatment of the Holocaust nightmare expressing the traumatic events just as they happened 63 years previously; the second deals with the attempt at subjectification, in contrast to the objectification forced by the Nazis on their victims.     

Use of the Personality Assessment Inventory in Assessment of Posttraumatic Stress Disorder in Women

This study investigated the utility of the Personality Assessment Inventory (PAI) for the assessment of posttraumatic stress disorder (PTSD). Participants were 55 community-residing adult women who were administered a comprehensive battery that included the PAI and the Clinician-Administered PTSD Scale (CAPS). Participants were classified as either PTSD or non-PTSD based on the CAPS, and PAI profiles were compared between the two groups. Significant group differences were found for seven PAI clinical scales (Anxiety, Depression, Anxiety-Related Disorders, Somatic Complaints, Paranoia, Borderline Features, and Schizophrenia), one validity scale (Negative Impression), and two treatment scales (Nonsupport and Treatment Rejection). When all PAI scales and component subscales are considered, the largest group differences were found for the physiological subscale of the Depression scale (DEP-P) and the Traumatic Stress subscale of the Anxiety-Related Disorders scale (ARD-T). ARD-T and DEP-P also demonstrated excellent diagnostic utility. Finally, correlations between PAI scales and four CAPS symptom clusters provided additional validity evidence, in particular supporting a distinction between effortful avoidance and numbing. Taken together, these results support the use of the PAI in the assessment of PTSD.This study was the basis of a Masters thesis for Meghan McDevitt-Murphy. Portions of this study were presented at the annual meeting of the Association for Advancement of Behavior Therapy, November 2000.     

MMPI-2 Assessment of Varying Levels of Posttraumatic Stress in Vietnam Combat Veterans

The effectiveness of the MMPI-2 in the detection of posttraumatic stress (PTS) symptomatology was investigated. Forty-nine veterans at a VA posttraumatic stress clinic were evaluated for PTS symptomatology according to DSM-III-R criteria. The ability of the MMPI-2 to differentiate between Vietnam combat veterans (VCV) who met DSM-III-R criteria for posttraumatic stress disorder (PTSD; N = 36) and those who reported varying levels of posttraumatic stress symptoms (PTSS; N = 13) was examined. Overall, the MMPI-2 was effective in differentiating between the two groups of veterans. Of the 15 MMPI-2 scales used to evaluate PTS symptomatology, 12 significantly differentiated veterans with PTSD from those with PTSS. Diagnostic efficiency statistics for the MMPI-2 PTSD scales (PS and PK) were calculated at four cutoff points (T 65, 70, 75, and 80). The PS Scale was the most robust and effective index in differentiating between veterans with PTSD and those with PTSS. Implications for the assessment of varying degrees of PTS are discussed.     

Comparative analysis of the risk-handling procedures for gene technology applications in medical and plant science

In this paper we analyse how the risks associated with research on transgenic plants are regulated in Sweden. The paper outlines the way in which pilot projects in the plant sciences are overseen in Sweden, and discusses the international and national background to the current regulatory system. The historical, and hitherto unexplored, reasons for the evolution of current administrative and legislative procedures in plant science are of particular interest. Specifically, we discuss similarities and differences in the regulation of medicine and plant science, and we examine the tendency towards dichotomizing risk — focusing on social/ethical risks in medicine and biological risks in plant science. The context of this article is the Synpraxia research project, an inter-disciplinary program combining expertise in sciences and the humanities.