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

Contents
Children Who Survived the Holocaust: Reflections of a Child Survivor/Psychiatrist

Robert Krell, M.D.

Many psychiatrists who found a refuge in England, America, Australia, lost their entire families. Did psychiatry remain untouched by these tragedies? What about psychiatrists who were themselves survivors of concentration camps? How has the Holocaust shaped contemporary psychiatric thought?

The inclusion of PTSD in the DSM III of 1980 drew attention to the Holocaust survivor literature, which consisted primarily of observations on adult Holocaust survivors and on children of survivors, the so-called 2nd generation. Very little was written about the children themselves.

My eyes were opened by Rabbi Israel Meier Lau, then Chief Rabbi of Nethanya, who observed, at the 1981 World Gathering of Holocaust Survivors in Jerusalem, "I am the youngest survivor of Buchenwald. My father, the Rabbi of Piotrowsk, died in Treblinka, my mother in Ravensbruck. I was 8 years old at Liberation."

Such a devastating opening. It was then I first realized that he and my cousin and so many friends and acquaintances shared the same fate. We were genocidal war's leftovers. Sheltered by Christians, many remained Christians. Most of us who were hidden remained hidden. We were the children so comfortable with silence that silence became our vocabulary. We did not complain of illness, it meant discovery. We pleased our hiders, displeasure meant betrayal. We learned new names, unlearned old habits, mastered different prayers and languages. All of us relied on the good will of an adult, even in the concentration camps. Without help, there was zero chance of survival. We had a slim chance even with help. Of 108,000 Dutch Jews who were deported, 4,700 returned. Of 24,000 Dutch Jews in hiding, a further 8,000 were betrayed and/or found and deported. In all, 80% of Dutch Jews perished - a figure exceeded only by Polish Jewry.

German troops in retreat tried to destroy the death camps. They did not entirely succeed at Auschwitz, due to the speed of the advancing Russian army. Tens of thousands of inmates had already been marched elsewhere. At Buchenwald, 1,000 children were found at Liberation. About 470 of these were sent to Ecouis, a converted sanatorium in Normandy, and others to Taverny, Paris, to recover.(15) A survivor friend recalls being addressed there by a psychiatrist. They were told they were too damaged ever to recover and function as useful human beings. He agrees in retrospect that they were pretty wild but "we had to let out our anger."

Interestingly, the Buchenwald children included Elie Wiesel, Israel Lau, now the Chief Rabbi of Israel, his older brother Naftalie Lavie, the former Israel Consul General to New York, and my friend Robert Waisman, a very successful businessman, husband and father, and others "who made it."(16) (17) How they recovered is not very well known. Of course, those who did not recover are forgotten.

My family resettled in Canada in 1951. I was the world's most eager immigrant. Leaving behind my Dutch foster parents was difficult, but to my young eyes The Hague was a city of ghosts and Europe a graveyard. I had heard too much of death in those postwar years. Canada was not like that.

My Christian mother had said many times I was a child saved to help children. Not much analysis required there. Rather than a pediatrician, which I believe she had in mind, I became a child psychiatrist. The head of my pediatrics department remarked, on my return to the University of British Columbia, "Krell, I am so disappointed in you. You're a pediatrician gone wrong."

It was then, at age 30, after the completion of various specialty exams, that the Holocaust memories returned in full force. Not that they ever went away. I had simply pushed them aside in order to study.

Dean John F. McCreary, of the UBC Medical School, showed me a medal Queen Wilhelmina of the Netherlands had awarded him for his role as a pediatrician with the Canadian Armed Forces. He had examined Dutch children and organized their nutritional needs after the winter famine of 1945. He told me he made a side-trip to Bergen-Belsen, took photos of mass graves, but never again referred to it. He gave me his photographs. His silence has puzzled me to this day. Wouldn't it have been worthwhile to teach what he had seen?

Involvement of physicians was considerable, perhaps crucial, to the unfolding of genocide. We should know that.

Why aren't the roles examined of German/Austrian physicians, especially psychiatrists and pediatricians? They belonged to one of the most sophisticated medical systems of that period. It happened there. We belong now to one of the most sophisticated medical systems of our time. What about us? Can it happen here? How much, or how little, would it take to pervert our professionalism?

Why are there no chapters in major psychiatry texts about child or adult survivors of the Holocaust, and no discussion of possible treatment approaches for them? Is our profession still in denial? Probably.

One child psychiatrist, head of a major American child psychiatry outpatient department, asked me in the early 1980s: "When you see a child of survivors, do you routinely ask about the parents' background?" I had not thought it possible for a child psychiatrist to work without routinely asking about the parental background of any patient, if possible from the parents themselves. A psychologist at that time had written up the case history of a young woman in treatment with him for 2 years before he "discovered" her parents were survivors. When he finally found out, he simply blamed her problems on the parents whom he had never met and had entirely ignored within treatment.

Why this behaviour? Why avoid questions connected with a survivor background? Is it guilt about living in security? Is it fear of hearing about what cannot be treated? Is it anger? - The victims should have tried harder to escape.

Whatever the precise answer, avoidance is partly an attempt to escape the victim's rage. And there is no greater rage.(18) Collusion in silence with victims of the extreme - of those who experienced humiliation, torture, torment - is common. Silence feels safer. Better not ask.

Yet rage exists. It exists because of, and about, the perpetrators, not the healers. It must be understood and recognized before healing can take place. Ask any victim of severe abuse.

In fact, ask any of us, with compassion and without fear, and you'll hear a story that may be healing, not only for the teller, but for the listener. [Page 3 of 3]

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References
15. Hemmendinger, J. (1994) The Children of Buchenwald: After Liberation and Now. Echoes of the Holocaust 3: 40-51.
16. Moskovitz, S. and Krell, R. (1990) Child Survivors of the Holocaust: Psychological Adaptations to Survival. Israel J Psychiatry and Related Sciences 27:81 91.
17. Krell, R. (1993) Child Survivors of the Holocaust - Strategies of Adaptation. Canad J Psychiatry 38: 384-389.
18. Krell, R. (1994) The Psychiatric Treatment of Holocaust Survivors. In "The Widening Circle of Genocide. Vol. 3 in the series Genocide: A Critical Bibliographic Review" (ed. Israel W. Charny) Publisher: Transaction Press. Rutgers University.