Myths and Taboos among Israeli First- and Second-Generation Psychiatrists in Regard to the Holocaust Haim Dasberg, M.D. Clinicians' Reactions Following this introduction I want to clarify my thesis, that clinicians, including psychiatrists and psychotherapists, are the most typical representatives of the society they are a part of (Dasberg, 1987). They are conservatives: they value diplomas and professorships, need social stability and are sworn to age-old traditional codes. They do not stand above or beside the societies they belong to, and have no insights different from others: they share society's prejudices, blind spots, taboos, and myths. Also, we, the professionals, like the rest, are unable to look into the eyes of those who return from death, without turning our eyes away or without building psychological defenses of massive denial (Kurt Eissler). I will now illustrate this with a series of historical examples: I. Back in the late 1940s, '50s, and '60s, a multitude of disorders of the masses of immigrants arriving in Israel were attended to, including tuberculosis, alcoholism, and suicide. However, mental health or psychiatry were not conspicuously represented. II. Some psychoanalytic case studies of survivors were published (V. Bental, R. Joffe, and several others). Curiosities, it seems to me! The psychoanalytical blank-screen attitudes of neutrality that prevailed in those days were not what was needed for the multitude of people after massive losses. III. The new Wiederguttmachung experts of the '50s, '60s, and early '70s, whose attitudes are reflected in numerous old files, show only misunderstanding, devaluation, and ignorance of posttrauma psychiatry despite their occasional goodwill. IV. Medical files in university hospitals did not contain enough material, or clinical conclusions related to Holocaust survival. Instead, there prevailed massive denial. Prof. Leo Eitinger, a visitor to Israel in the 1960s, wrote about this. V. The first systematic psychiatric studies in the 1960s dealt with hospitalized survivors in psychiatric wards. Prof. Heinz Winnik, who was my teacher (and who had escaped from a concentration camp for Communists in Romania in 1942), began a study of psychopathological differences between camp survivors of the Reich and survivors of Soviet-Russian camps or exile. Prof. Hillel Klein studied hospitalized Holocaust survivors in the 1960s. He himself was a camp survivor. Only later, much later, he also concentrated on the psychology of guilt feelings among other survivors, their family life, social adaptation, and second-generation research. VI. Prof. Raphael Mozes (1978) with his orthodox psychoanalytical training (later the organizer and chairman of the International Psychoanalytic Congress in Jerusalem in the 1970s), insisted at first on the classical Freudian doctrine that infantile neurosis is the background of all later post-trauma problems. This was already after Mozes' confrontation with massive numbers of battle-shocked soldiers in 1973. I worked with Mozes in a military medical team at that time. Mozes left Germany in the early 1930s and rejoined political normalcy in Jewish Palestine. In later publications, in 1984, for example, he was less orthodox and confessed that on "looking back," the entire problem of European refugees had been misunderstood; now he stressed the role of later, postinfantile traumatic experience. (That is, he recognized the weight of the "Erlebniss," as von Bayer, Haeffner, and Kisker showed vis-à-vis the old-fashioned, constitutional German psychiatry that still prevailed in postwar Germany [1964]). VII. During the late 1970s and the '80s, many different types of nonclinical and nonhospital survivor research were conducted using questionnaires and rating scales, statistically comparing survivors with nonsurvivors, young with old survivors, Wieder-guttmachung beneficiaries with controls, etc., in fields such as gerontology, community medicine, gynecology, industrial medicine, and among dying patients, and other human research samples (reviewed by Dasberg, 1987). This produced a great deal of fragmented information that no one actually used in practice. The real stories still remained in the dark. The Breaking Up of the Taboo I. In the 1970s and '80s, with the gradual breaking up of the monolithic myths and taboos and the growing individuation of society, there began to appear a new openness toward the survivor as an individual, together with the acknowledgment of the existence also of the second generation coming of age. II. Survivors themselves published hundreds of memoirs. They now came out of the closet where they had been hiding their backgrounds. Conventions of Hidden Children, Child Survivors, and Holocaust Survivors, as well as scientific congresses on the Holocaust, are organized with increasing frequency. III. Shamai Davidson studied non-patient survivors in their families (1980) and founded a chair for the study of the psychosocial consequences of the Holocaust at Bar-Ilan University's School of Social Work in 1983, the Elie Wiesel Chair. He died in 1986 and I then held the Wiesel Chair after him until 1994, when Dr. Yossi Haddar took over until his untimely death. During this period close to 350 advanced social work students on the M.A. and Ph.D. levels from numerous public services attended our courses. IV. In 1988, Mozes (after his publication on "Looking Back") organized an international congress in Jerusalem on the meaning of the Holocaust for those not directly affected. Today, in retrospect, I wonder at the naÔveté of attempting to belong and not belong at the same time, as if having been there oneself or not having been there oneself would make a difference for the therapist. There was still a need to keep a certain distance, a combination of denial and acknowledgment. V. Then, in the late 1980s, AMCHA was founded. I was the organization's clinical adviser from the start. AMCHA attempts to restore memory: 1. Individual memory, 2. Trauma memory, and 3. An old Diaspora family-memory, on the individual and on the family level. 4. Only some of AMCHA's clients are diagnosed as clinical patients with definite psychopathology. The rest apply for other various nonclinical forms of memory-processing. Post-Holocaust families are now composed once again of three or four generations; this is a new biological and cultural situation. A new narrative and family myths are needed. This is what AMCHA facilitates. Rehumanization and Individual-ization of the Holocaust Myth This is reflected in an entirely new type of research: not psychopathology and not statistical comparisons of anonymous survivors with control groups, but rather, in our current decade, we are witnessing the flourishing of narrative research, biographical and rebiogra-phical research, also as clinical sciences. The story of lifelong coping and readaptive myth-making, and also transgenerational narrative, now forms the focus of current research. What counts now is to tell the story in a dialogical interview situation or in groups or to the new generation of grandchildren (e.g., Bar-On, 1998; Dasberg, 1998; Rosenthal, 1997; Tauber, 1998; Valent, 1994; Yeheskel, 1999). The "salutogenic" effect of working through and of reshaping the traumatic memories is now recognized. Art after Auschwitz is in great demand now and a research topic in itself. [Page 2 of 4]