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

Long-Term Psychological Morbidity of Incarceration in Auschwitz

Zdzislaw Jan Ryn

Personality Alterations
Concentration-camp stresses left two kinds of aftereffects in the mental sphere: personality changes and certain psychopathological syndromes. Polish investigators have adopted a holistic approach to the personality and mental disturbances related to PTSD.

This attitude was assumed by Kepinski (1970), who was an ex-prisoner of Miranda de Ebro concentration camp (Ryn, 1978) and graduated from the Polish Faculty of Medicine of Edinburgh University (Ryn, 1979).

The extent and type of personality alterations that occurred under camp stress depended first of all on the age of the prisoner when imprisoned, the duration of incarceration, and the intensity of psychic trauma. The so-called dehumanization of prisoners, "breaking" of their personality, was part of meticulously planned biological and psychological methods of treating prisoners. Sophisticated methods of moral deprivation were also applied, successfully leading to demoralization and degradation through the attenuation of positive emotions, together with rewards for antisocial and immoral attitudes and behavior (Glinska, 1967, 1969; Sterkowicz, 1969). Concentration-camp incarceration changed the prisoner's "moral self-portrait" (Kepinski, 1976), breeding permanent alterations of personality.

Personality disturbances revealed themselves almost immediately after liberation from the camp and considerably impaired prisoners' abilities to adjust to new life circumstances (Orwid, 1962). Prisoners felt alienated from and misunderstood by others and had a feeling of injury. Personality changes were displayed mainly in social attitudes, characterological and emotional disturbances, and a changed outlook on the world and life characterized by fixed depressive mood, a feeling of the senselessness of life, and fear of both death and life (Lesniak, 1964, 1965).

The self-image of ex-prisoners differed significantly from the general population: ex-inmates displayed lower levels of self-acceptance, and were characterized above all by a high degree of discrepancy between their real and ideal selves (Jakubik, 1981).

Serious personality changes have also been observed in people who were born in concentration camps or who were incarcerated in their early childhood. Axial symptoms of the changes consist of disturbances in the emotional sphere (Sarnecki, 1966), demonstrated by the predominance of primitive emotions, such as fear, anxiety, and anger, and by impulsiveness, obsessive-compulsive states, and antisocial attitudes.

Several characteristic phases of this personality change can be distinguished: (a) the phase in which all strength is put forth and defense mechanisms are released, gradually fading until they become exhausted; (b) the phase of chronic and deep asthenia of personality in the first months or years after liberation; and (c) the phase in which depressive moods and impaired vitality become fixated.

Mental Disturbances
Ex-inmates liberated from the concentration camps were in the condition of utmost inanition and suffered from various somatic complaints. Problems of a psychological nature had to be temporarily left in the background.

In the course of investigations carried out with 100 former prisoners at the Psychiatric Clinic in Kraków in the early 1960s, the following symptoms were reported: irritability, temper outbursts, anxiety, headaches, memory and sleep disturbances, heart complaints, tearfulness, giddiness, and sexual disturbances. These symptoms were the basis for identification of the following pathological syndromes: progressive asthenia, neurasthenic neurosis, encephalopathy, premature involution, depressive-apathetic states, anxiety neurosis, and epilepsy (Szymusik, 1964). The disease had a chronic, progressive character and was refractory. Altogether, mental disturbances were recorded in 60% of the examined ex-prisoners.

In investigations carried out in our clinic with a group of 130 former inmates who had been subjected to pseudomedical experiments, disturbances of psycho-organic character were predominant (Gatarski, Orwid, and Dominik, 1969). Diagnoses of depressive syndromes, personality alterations, and difficulties in adaptation were also common. In the syndromes identified as psycho-organic, affective-drives disturbances prevailed, for instance, impulsiveness, emotional instability, states of dysphoria, memory disturbances, and poor concentration. Depression comprised several psychopathological syndromes ranging from superficial neurotic disturbances to deep, chronic depressive-anxiety syndromes.

The predominance of the psycho-organic syndromes was also observed by Póltawska (1978), who conducted psychiatric examinations of 150 former inmates at our clinic from 1974 to 1976. Symptoms of organic brain damage were most frequently recorded in men and were related to physical injuries received in the camp and to earlier aging. States of flashbacks were often observed in individuals with psycho-organic syndrome whose memory efficiency was considerably lowered.

The general tendency of the postcamp disease to become more organic with the passage of time was confirmed by the investigations carried out by Sternalski (1978) in 1973 and 1974. A still higher percentage of this type of diagnosis can be found in the results of the investigations carried out in the 1980s. In a group of 541 former inmates, psycho-organic syndromes amounted to 86% of the diagnoses such as premature sclerosis and aging, post-traumatic neurological syndromes and characterological disturbances with organic background, encephalopathy, epilepsy, and injuries resulting from pseudomedical experiments (Sobczyk, 1980; Sobczyk et al., 1980). [Page 2 of 4]

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