Echoes of the Holocaust
Shalom Robinson, M.D., Editor

Contents
Delayed and Long-term Effects of Persecution Suffered in Childhood and Youth

Reinhart Lempp, M.D. *

In 1979, the psychiatrist Hans Keilson presented the first systematic study of children who had suffered from persecution by the Nazis. Until then, only a small number of studies had been written. Even though they were published in the Sixties, these studies were concerned with the fate of these children, and their mental problems, at or soon after Liberation. Here I will just refer to reports by Anna Freud and S. Dann, 1962, by M. Kos-Robes on the children of Theresienstadt, 1964, or Klimkova-Deutschowa and von Wangh, published by Herberg in 1971, and the study by Langmeier and Matejcek, 1977.

Hans Keilson's systematic study examined Jewish orphans who had survived the concentration camps or were hiding in Holland. Keilson re-examined 204 after an average of 25 years following the actual period of persecution. Keilson's most important finding was the long-term effect of manifest damage by "sequential traumatization," that is the effect of a sequence of several similar negative psychological experiences. The great importance of "sequential traumatization" has since become an established scientific fact in child and adolescent psychiatry, quite apart from its bearing on the psychiatry of persecution.

At the same time, but independently of Keilson, I published the first results of my own investigations, which I arrived at after consulting 45 expert opinions based on files for compensation for Jewish children and young adults who had suffered Nazi persecution in concentration camps, ghettos and in hiding between birth and approximately age 20. They were between 21 and 55 years old at the time of the establishment of an authority for compensation based on their documented history. It was possible to show in this non-selected group that age-dependence existed with regard to the symptoms expressed due to delayed effects.

Those who were young children at the time of persecution particularly displayed problems in their social contacts and their sense of independence. Those persecuted during pre-puberty and puberty showed the chronic depressive personality disorders described by von Baeyer, Häfner and Kisker as a typical persecution syndrome in adults. Children who had spent their first years with their parents without hindrance, and had suffered persecution only later, from approximately their 11th year, appeared to be relatively less affected. However, the small number of cases, and their very different personal histories, did not allow any definite differentiation.

Fifteen years have passed, and I have given my own opinion, and evaluated other expert opinions arrived at for the compensation authorities and the courts. They amount to approximately 140 cases. I was able personally to examine the larger part of these cases, and not restrict myself to studying the files. About half these 140 cases involved Sinti and Roma (two tribes of gypsies), all of whom I have examined personally. The people concerned are now between 50 and 70 years of age.

My prolonged study yields results important also for general psychiatry and psycho-pathology:

1. Findings from earlier studies in the characteristic psycho-pathological effects of psychological traumatization due to persecution can be confirmed. This is true for the neurotic personality impairment of those affected during early childhood, and for the chronic depressive personality changes of those affected during later childhood or youth.

2. Mental stress caused by Nazi persecution did not cease on May 8, 1945. The years that followed were full of mental stress: detention in DP camps with all the attendant uncertainties; illegal immigration to Palestine; internment in Cyprus; and war in Palestine. There was also the attempt at integration in an alien environment in the United States, Australia or South America. Even though they had no longer to fear for their lives, the young in particular felt their uprootedness, became aware of their loneliness, the loss of all their relatives, and an uncertain future. Mental stress in many cases lasted for years.

The return to a normal lifestyle was much more stressful for the gypsies than for the rest of the population, in the post-war period, since they had to struggle for years to gain acknowledgement as a racially persecuted people, and received little or no support and recognition in this respect. Until the Sixties, the deportation of Sinti families to Poland, the former Generalgouvernement of Nazi Germany, was not officially recognized as racial persecution. The German authorities based their decision, ironically enough, until 1963, on a decree by the Minister of the Interior of the Reich, Heinrich Himmler. The decree stated that the deportation of Sinti families was a form of resettlement preceding permanent settlement. The Federal Supreme Court (Bundesgerichtshof) decision of December 18, 1963 (RZW 1964, p. 209) finally recognized this enforced policy as racial persecution. The lateness of the decision meant that only the younger generation of gypsies could be integrated to any extent into German society. The generation that suffered from Himmler's decree has a pariah status even today.

3. Continued mental stress after the war led to the symptomatic manifestation of psychological persecution injuries. Due to continued psychological stress, the typical psychoneurotic symptoms had to be suppressed, or were hardly ever diagnosed. Psychosomatic symptoms, typical of this period, were regarded as merely organic disorders, and not related to persecution. As everyday life became more stabilized, such neurotic symptoms as depression and anxiety became more apparent. This frequently caused a change in symptoms, and many experts missed the connective link symptoms ** which are considered essential for official acknowledgement. All too often this led to unjustified refusal due to failure to recognize the original link to the persecution.

In some cases, even a frequent change of symptoms could be observed, as, for example, in Jews living in Argentina, who subjectively experienced again a "persecution situation," at the time of the military dictatorship, with increased police presence and arrests in open daylight. They again suffered from psychosomatic disorders. However, when some of them emigrated to Israel, the anxiety-neurotic component was again apparent. [Page 1 of 2]

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*Prof. R. Lempp, Stuttgart, Germany

**Connective link symptom is a translation of the German "Brückensymptom," an essential criterion in the establishment of an expert medical opinion for compensation purposes. The recognition of this "Brückensymptom" (literally bridge symptom) as link between the currently existing symptoms and the original traumatization is vital in granting the claimed compensation. (Translator's note.)