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Thoughts from the Fourth Meeting of the Discussion Group for Children of Holocaust Survivors in Boro Park, Tues. 9/13/16.

Someone recently told me of a friend, a son of Holocaust survivors, who admitted that when he decided to marry his wife, the thought crossed his mind that, should they ever have to flee with children, she is the kind of woman who would be able to cope and handle the stress of it. The man was acknowledging what feels like a somewhat shameful, fearful, irrationally catastrophic thought, which nonetheless popped irresistibly into his mind at such a meaningful moment in life. This is an example of Holocaust imagery and trauma-related associations which many second generation individuals are well familiar with. Such unbidden associations weave themselves into the fabric of daily life of those who grew up with trauma survivor parents. This is one of the characteristic experiences that reflect the intergenerational transmission of effects related to the Holocaust.

Second generation, the children of Holocaust survivors born after the war ended, have been shown in studies to have more Holocaust imagery, dreams, thoughts and associations than non-Holocaust related peers. In fact, one study found that the Holocaust plays a more prominent role in the psychological world of children of survivors than events that happened in their own personal lives. The offspring of Holocaust survivors have also been observed to have lower self-perceptions of independence and self-sufficiency, but higher achievement motivation and higher self-criticism than non-Holocaust related peers. Scores indicating elevated anxiety, depressive experiences, and feelings of alienation found in many studies remained within the normative-high range, reflecting absence of serious psychopathology (such as clinical level psychiatric conditions) in the children of survivors. No impairments in functional aspects were observed, corroborating the conclusion that the intergenerational transmission of effects related to the Holocaust is more latent, manifested in the subjective experience of the second generation. The effects of growing up with survivor parents seem to be more evident in the internal world of the children, in their feelings and responses to places and situations, rather than in measures of their external coping or accomplishments.

The body of research about the second generation has grown by now to include several hundreds of studies. Differences between children of survivors and peers were observed during adolescence and young adulthood, in various measures addressing the main task of those phases in life, the differentiation of self from parents and the achievement of a separate identity and sense of self. Children of Holocaust survivors had greater difficulties than peers differentiating themselves from their parents, going away to college or living at a geographic distance from the parents, and making their own decisions about romantic partners, degree of religiosity and other life style choices. Some of the findings of different studies seem contradictory with one another, and other studies show findings which are perplexing. For example, several studies found that, upon reaching middle age, children of survivors manifest more health problems than non-Holocaust related peers, while reporting higher levels of feelings of well-being. This seemingly baffling finding was explained as potentially reflecting the use of repressive coping mechanisms, similar to those typical of many Holocaust survivor parents. Survivors were described in some studies as showing a phenomenon termed “hardening” or “steeling”, which pertained to their capacity to tolerate significant hardships and push through, ignoring fatigue, pain, and other difficulties, a certain denial of physical and emotional pain. It was suggested that the children of survivors have utilized similarly repressive coping with regards to signs of physical problems which they might have ignored, until such problems become more severe health issues.

A large body of findings from different studies have accumulated over the 1980’s and 1990’s, presenting a rich and intricate picture of observations about many facets of the experiences of the second generation as they moved through many life transitions from adolescence to adulthood. Comprehensive reviews that appeared in the 1990’s (see my review and Solomon’s review in Danieli’s book, 1998, “The International Handbook Of Legacies Of Trauma”) attempted to synthesize and integrate the various observations in order to draw conclusions about general trends and characteristics. These reviews rendered a complex profile of both strengths and vulnerabilities that characterize the second generation across different domains of life. After 2000, sophisticated statistical methods further compared the findings from different studies (see for example, van Ijzendoorn et al., 2003), corroborating the conclusions from the earlier reviews, that there is no evidence for psychological disorders in the second generation as a group. More recently, the focus has shifted to the more subtle manifestations of ‘latent’ intergenerational transmission, expressed in particular types of remembered childhood experiences and in unique psychological concerns and relational themes. These studies, using complex methods of systematically analyzing interview data, deepen the insights to the internal subjective world of the children of survivors (Scharf, 2011; Wiseman, 2008).

There are no formal data about post traumatic reactions in Holocaust survivors immediately after the end of WWII, as the diagnosis of PTSD was not yet in existence and, with few exceptions, there are no data about the mental status of the survivors at that time. However, research in the trauma field, looking at the effects of trauma in more recent civilian populations exposed to mass traumatization, offers a way to infer what might have been the mental health consequences of surviving the Holocaust, in the initial years after liberation, and what the children, especially those born early after the end of the war, were exposed to.

Following the introduction of the diagnosis of Post Traumatic Stress Disorder (PTSD) into the psychiatric nomenclature in 1980, a torrent of studies in different trauma exposed populations has confirmed the adverse impact of various traumatic events on many of those who experience them. It has become known that, in the aftermath of a disaster, between 10%-40% of those exposed will develop symptoms of PTSD within the first year. Of those, about one third will spontaneously recover, and one third will go on to develop the more chronic course of PTSD. Yet others will develop delayed PTSD, after having initially coped well with the trauma. Delayed onset of symptoms can occur at any time in response to perceived lack of social support after the end of the trauma, as the person attempts to reintegrate into society, in the face of a new loss, or when facing illness and aging. A study of large samples of trauma survivors from 20 countries undertaken by the World Health Organization (Karam, 2014) showed that individuals exposed to more than four traumatic events are at higher risk for more severe distress and more significant functional impairment. This “trauma threshold” has been far exceeded by the typical experiences of most Holocaust survivors, who suffered prolonged, multiple, complex trauma. A meta-analysis of 160 disaster victims from around the globe (“60,000 Disaster Victims Speak”, Norris, 2002) showed high prevalence rates of psychological disorders, health problems, non-specific psychological distress, problems in living, and loss of the ability to access resources.

Recent changes introduced to the definition of PTSD in the new edition of the DSM-5 (2013), the manual used for the formal diagnosis of mental health conditions, brought an important component into consideration. Not only the obvious symptoms of avoidance and numbing, hyper-arousal and intrusive memories occur after trauma. Long lasting and pervasive changes in personality and in one’s belief system may result from exposure to a trauma, and are particularly observed among survivors of complex trauma, those experiences of long duration, multiple repeated traumatic events, from which the individual has no escape. This type of complex trauma more adequately captures the experiences of Holocaust survivors.

Recent studies in aging Holocaust survivors and others who survived WW II in Europe as children show high levels of persistent post-traumatic reactions even 60 years later. Despite such findings, the good socio-economic adaptation and the success of the Holocaust survivors as a group cannot be disputed. Even in the absence of psychological, psychiatric and other rehabilitative services, Holocaust survivors managed to establish families, re-build communities and participate in the societies to which they immigrated productively and successfully (see Helmreich, 1992, “Against All Odds”). Additionally, as previously mentioned, survivors also managed to raise a generation that appears to not manifest any serious psychopathology and, as a group, exhibit high socio-economic achievements.

The children of Holocaust survivors inherited a legacy of strengths, resiliencies, adaptive coping and pain. Each family of survivors was different, and each child adapted differently to the family environment in which they grew. Even siblings often show very different patterns of coping and adaptation to the particular stressors of family life. However, some common themes in the experiences of growing up in Holocaust survivor families have been identified as characteristic, and those continue to inform and influence the inner subjective perspective and world of adult children of survivors, and to impact their relationships in later life.

An excerpt from the movie “Fugitive Pieces” (2008, director Jeremy Podeswa) was shown to demonstrate the processes by which intergenerational transmission of trauma takes place within the context of the relationship with generally loving, nurturing parents. In this excerpt, a young child, who is snuggled against his father in what appears to be clearly a warm and loving relationship, gets bored with the adults’ discussion around him, slides off the sofa and puts his half-eaten apple on the table to go elsewhere. The boy’s survivor father gets triggered by the wasteful act of eating only half the apple and throwing away the rest. The scene powerfully captures the impact of the trauma-related memories of starvation and deprivation on the interaction of the father with his son.

Our next meeting in November will begin to address some of the unique themes in the childhood recollected experiences of children of survivors, and their influence on the relationships with spouses, partners, children, and other significant people in their adult lives.

Irit Felsen


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