Early Trauma and Resilience

Theory Through the Eyes of Child Survivors of the Holocaust

By Svetlana Shklarov MD, Ph.D, RSW

Somehow, we children who were meant to die, have lived. We have survived even our survival. And in our various stages of continued hiding many have carved out substantive lives with careers and family. And some have even broken through the silence to write books, to rescue and defend our people, to re-ignite Jewish life. An incredible struggle.

Krell, Messages and Memories, 1999, p. 93

The area of professional and academic literature devoted to traumatic experiences of child survivors of the Holocaust is densely populated by writers who either belong to this group themselves or are closely related to it through family or community ties. There is hardly any other field of scientific knowledge where so many contributors to academic research approach the phenomena under study from within, based on their own lived experiences. The presence of child survivors’ voice in the academic discourse surrounding their own struggle with posttraumatic sequelae had many implications. Two aspects are particularly meaningful. First, the fact of their involvement with academic research on trauma, in itself, presented strong evidence of their remarkable resilience, and also indicated the deep impact of severely traumatizing experiences on their lives. It is known that a disproportional number of children who lived through the Holocaust have become psychiatrists, psychologists, paediatricians, nurses, or members of other helping professions (e. g., Moskovitz, 1983; Krell, 1999). Krell noted that, perhaps, the identity of children who survived due to the kindness of their rescuers, as they grew up, had incorporated the rescuing as a driving force of their lives. Second, the survivors’ voice rendered an invaluable enrichment to this field of knowledge by providing participant meanings to the research. It may be speculated that the child survivors’ authentic involvement largely contributed to the shift towards the study of resilience in trauma-related psychiatric literature, after the long-dominant emphasis on documenting and measuring posttraumatic pathology. The professional engagement of child survivors has illuminated the universe of knowledge related to resilient responses and profound psychological effects of early trauma.

The histories of Jewish child survivors of the Holocaust who live with the effects of early traumata represent an unprecedented material for studying trauma sequelae across the lifespan (Valent, 1998a). Although the experiences of this group provided classical examples for traumatological research, they often presented non-classical, unexpected findings that did not fit the established theories, thus contributing to the development of new knowledge and calling for new research methods. In this article I explore the ways in which the studies of and by child survivors of the Holocaust related to the existing theories of resilience. I chose to refer mostly to the theoretical contributions made by people who themselves live with the trauma of the Holocaust.

Ambiguities of the Inquiry into Resilience after the Holocaust

Within the study of Holocaust trauma in children, the conceptual exploration of resilience was rooted in the specific context of knowledge about the unprecedented experiences of a large number of survivors. For many reasons, initially after the liberation, a great body of literature was developed mainly to document the negative consequences of massive psychic trauma (Eitinger & Krell, 1885; Lempp, 1995). Some authors indicated that in research related to the victims of Nazi persecution, one of the strongest factors inhibiting the study of positive outcomes was an appalling contradiction between the unspeakable terror of the atrocities and the very notion of the “positive” effects of related trauma (e.g., Sigal, 1995). Data on resilience were omitted from research also because mental health professionals were the primary contributors to the literature, and only those survivors who were in need of help came to their attention (Fogelman, 2001).

In the first three decades after the war, the phenomenon of healthy adaptation did not appear among expected findings or as a centre of the academic attention (David, 2008). However, the inquiry into survivors’ experiences presented indications towards positive outcomes even in the work of early researchers (e.g., Shuval observed hardening among survivors as early as 1957). These aspects began to attract research efforts most evidently in the late 1970s and 1980s, after the publication of follow-up studies conducted with groups of child survivors who resettled in England (Moskovitz, 1983), Israel, and Canada (Sigal & Weinfeld, 1989). For example, by analyzing life narratives of child survivors, Moskovitz challenged the common assumption that severe early deprivation inevitably leads to impaired adjustment and lifelong emotional disability. She also criticized formal predictive attempts based on the objective measuring of pre-trauma personality features and other protective factors and vulnerability traits. Many other studies documented the resilience and posttraumatic sequelae of child survivors, and questioned the established diagnostic systems, intervention practices, and methods of conventional research (Pynoos, Steinberg, & Goenjian, 1996; Bluglass, 2001). Child survivors became one of the most illustrative groups that provided examples for the study of resilience.

One of the lessons drawn from the history of the inquiry with child survivors was that professional expert positions repeatedly proved problematic. Despite the prediction of many psychiatrists who concluded shortly after the war that the severely damaged children would never be normal again, most of them grew up to be well adjusted and highly functioning adults, as external evaluations and research documented in recent decades. At the same time, however, it soon became apparent that the professional “premature assumptions of ‘adjustment’” (Bluglass, 2001, p. 50) should be also taken with great caution. Many studies showed that well adapted child survivors may still carry deep, never healing scars (e.g., Amir & Lev-Wiesel, 2003; Halasz, 2001a, 2001b). The simultaneous evidence of resilient adjustment and devastating inner wounds was difficult to conceptualize. Psychiatrist Henry Krystal, himself a survivor, observed, “It is not rare in the ‘survivor syndrome’ to see people fully sane during the day, but psychotic every night” (cited in Greenspan, 1999, p. 99). The complexity of conceptualizing adjustment in the context of severe trauma remains one of the prevailing themes in research with child survivors of the Holocaust.

Identity, Memory, and Silence: The Social Context of Coping with Trauma

The issues of memory, identity, silence, and suppressed recollection are central to many studies of trauma sequelae and resilience (e.g., Herman, 1992; J. Kestenberg, 1998; Mazor, Gampel, Enright, & Orenstein, 1990). Themes pertaining to the cultural and contextual aspects of personal identity and collective memory are closely related to the experiences of child survivors of the Holocaust.

The experiences of unclear identity, limited ability to recount one’s story, and blurred memories of the past have been identified in Western child survivors (Cohen, 2005; Krell, 1995, 1999). As opposed to adult survivors, many children who had to rebuild their lives after the war did not possess memories of their pre-Holocaust families, traditions, or cultures that could shape their identities. The confusion of identity was exacerbated by the fact that many Jewish children adopted an adjustment strategy of striving to perfectly blend with others and hide or suppress knowledge about their roots (Balint, 2001; Cohen, 2005; Wajnryb, 2001). Forced silence together with ambivalent identity was shown to result in a sense of powerlessness, which further interfered with the healing of childhood trauma. Moskovitz (1983), in her survey of child survivors thirty years after liberation, found that their “enormous hunger to know about oneself [became] more unbearable with silence” (p. 228). The author concluded that unknown or unclear identity significantly contributed to the children’s posttraumatic pain (see also Balint, 2001; Fine, 2001).

Research has shown that the suppression of open recounting of past experiences may affect the process of posttraumatic healing. Danieli (1999) described the process of the silencing Holocaust survivors’ experiences in North America when they arrived there shortly after the war. She coined the term “conspiracy of silence” to signify the survivors’ experiences of profound silence surrounding their war experiences, and found that these factors significantly inhibited the healing processes. Following Symonds (1980), Danieli (1994b, 1999) called this impact a “second wound;” i.e., the prevalent social discourse that effectively prevents the survivors’ memories from becoming part of the collective memory also prevents their voices from being heard. This pervasive conflict, adding to the impact of the persecution, affected every level of functioning and coping for these people: personal identity, family dynamics, parent-child relationships, community interactions, and historical self-identification. Although the majority of survivors managed to build new lives, in many cases it came with the overwhelming cost of personality changes and disturbed family and intergenerational relationships (Epstein, 1979; Williams, 1993).

There is an additional side of child survivors’ experiences, a study of which may be immensely important for theoretical exploration. Personal stories of children who had lived through the Holocaust were greatly influenced by the societies where they resettled after the war, and by public and professional discourses that dominated these societies. Paradoxically, Jewish children who survived through hiding in the Nazi-occupied Europe continued to live “in hiding” long after the liberation. They rediscovered and identified themselves as a distinct group of survivors only in the mid-1980s when they began to publicly retell their stories, after a latent period of almost forty years. Until that time, they were confined to silence, because soon after the liberation they were told that their stories were not important, that they had been too young to clearly remember, or that their suffering was not the “real” suffering in comparison with that of concentration camp survivors. According to Valent (1993) in Australia, Krell (1999) in Canada, and Cohen (2005) in Israel, most child survivors themselves did not recognize their survivor identities during this latent period of time, having succumbed to the above discourse that made them believe they had been only children, lucky to have lived.

How did the imposed silence and dominant public discourses impact the post-war development and adjustment of the children? What significance did the magnitude of the events have on their lives? Prince (1998) used the term “historical trauma” to characterise the social nature of these experiences “occurring in the course of human history, that has an impact both on the development of individual persons and on the further stream of history” (p. 44). The historical and collective nature of trauma, its cumulative character, among many other features, constituted both unique and universal characteristics that influenced these children’s posttraumatic adjustment.

Many researchers have found that communal rejection and political oppression create the environment in which the mechanisms of adjustment can become severely impaired in trauma survivors. For example, de Young (1998) described collective trauma in the context of oppression, in which

[The] cultural system can offer no real explanation for the event or its aftermath, [and] the members of the culture are left epistemically disempowered, that is, they are at a loss to explain what happened and why, and to derive any meaning from their own suffering. (p. 3)

Smith (1985) also found that individual resilience during mass atrocities can be enhanced by cultural protection or impaired by the lack thereof. The sense of belonging and social validation renders the specific opportunity to identify with unitary, communal experiential meanings. The support of relevant societal or inter-generational meanings provides trauma survivors with a shielding “cushion” in the process of their working through trauma (see also Sadavoy, 1997, about societal hostility towards returning Vietnam veterans, which affected their coping).

In the context of these literature findings, Jewish child survivors can be described as an extremely vulnerable group, deprived of social and communal protection in the processes of their identity development and working through trauma. The paradoxical relationships between the seemingly high vulnerability, the evidence of deep consequences of severe trauma, and the documented resilience of survivors have been broadly discussed in the research literature (e.g., Carney, 2004; Greenspan, 1998, 1999).

Resilience Definitions: The Complexity

Defining resilience in the context of child survivors of the Holocaust is associated with unprecedented ambiguity due to the severity of the trauma and the timing of the traumatic impact at a critically formative period of children’s lives. One of the simplest definitions was suggested by psychiatrist Sigal (1995), “By resilience I mean a capacity to adapt well to external and internal stresses” (p. 1). However, the simplicity proved illusory for many reasons, one of them being the uncertainty of defining the process of “adapting well,” or the positive outcome towards which the resilience is a pathway. Krell (1999), a psychiatrist and a child survivor, noted that distinguishing between positive and negative adjustment may be paradoxically ambiguous. The author stated, “I view survivors as emotionally disturbed only if they claim to never suffer depressions, nightmares, panic attacks, insomnia. To claim normality is abnormal” (p. 62).

The study of child survivors’ experiences proved fecund within a variety of disciplines and approaches, and produced an array of discourses associated with explaining the phenomena of trauma and resilience. Definitions pertaining to various discourses differ widely. As such, the dynamics of resilience and vulnerability in the course of posttraumatic reactions were broadly discussed in the framework of medical and psychiatric models, with the focus on operationalized definitions, measurement scales, and quantitative and controlled studies (McFarlane & Yehuda, 1996). Psychiatrist Paul Valent (1998b), himself a child survivor of the Holocaust, commented that purely medical approaches lacked insight into social, cultural, and experiential content components, and failed to account for adaptive, fulfillment responses.

Similar pitfalls are inherent in psychosocial approaches to resilience that are focused on pragmatic explanation, expert interventions, and conventional measurement of positive outcomes. Greene (2002), in her article on Holocaust survivors’ resilience, quoted a classical psychosocial definition, “Resilience is an innate self-righting mechanism that assists people in redirecting their lives onto an adaptive path following disadvantageous or stressful circumstances” (p. 6). The psychosocial framework, in its quest to measure and “promote resilience” (Greene, p. 15), may also miss the complexity of individual processes involved in transcending the adversity of trauma.

Conceptualizing resilience may be associated with a variety of interpretations. Valent (1998c) linked the metaphoric meaning of the resilience concept with the linguistic origins of the word: “Resilience, according to the dictionary, means recoiling or springing back to the original shape after bending, stretching, or compression. Psychological resilience implies a similar springing back after having been subject to severe stressors” (p. 517). The author extended the interpretation of this basic definition by warning that the understanding of resilience remains restricted if it is perceived as an isolated concept. Although a useful explanatory tool, the concept “may be a self-comforting device which concentrates on the indomitable and triumphant human spirit and hides the devastating nature and pessimism of major childhood adversity” (Valent, p. 517). The metaphor of a resilient balloon, which is able to bounce back, is thus oversimplified. Valent broadened the metaphoric meaning of this simplification through this supplemental definition:

Resilience is the capacity to spring back, form knots, be patched, and if necessary be encased in a cute package or be otherwise molded [sic] by the environment. Resilience also involves eventual exposure and recognition of what is inside, and untangling of knots and distortions. (p. 531)

Similar to most metaphors, the concept of resilience does not fully describe human experiences. Trauma survivors do not, in reality, “spring back to the original shape,” because most still bear inner residual signs of the tragedy, even if their adjustment seems full. Bluglass (2001) commented that the word “recovery,” for example, is “not popular” among survivors of traumatic experiences, and that the variations and degrees of positive adjustment are endless and difficult to objectively evaluate or externally measure. The author warned against the over-normalization inherent in the professional study of resilience. Such caution corresponds with Valent’s (1998a) comment that the concept of resilience might lead the observers to accepting the St. Matthew effect where “those who have will receive, and those have not will have taken away” (p. 217).

Concepts and Terms: The Values

In accordance with the ambiguity of defining resilience, many related questions arise. How is the positive outcome towards which the resilience is a pathway to be defined? What do we consider a desirable state for the individual after encountering severe trauma, so that she or he can be considered resilient? What are the values that guide resilience theories, and how may they influence the definitions of outcomes that are called positive?

Personal posttraumatic outcomes are relative to circumstances and individual history. For example, many survivors have indicated that their selfless involvement in work and constantly keeping busy had become their ways to cope. High productivity in adults who were child survivors of the Holocaust has been widely described, admired, and considered as evidence of their resilience. However, some researchers interpreted the productivity itself as a symptom and labelled it “workaholism” (see comments on such interpretations in Suedfeld, Paterson, & Krell, 2005). Thus, the personal trait of high altruistic productivity may be described in a number of contradictory ways. It can be seen as a coping mechanism, a resilience indicator, or a symptom of posttraumatic damage. Some writers in the area of positive psychology claimed that personal productivity and altruistic attitudes were illustrative of “posttraumatic growth” and wisdom (Tedeschi & Calhoun, 1995, 1996; Linley, 2003). Conversely, the life-long high involvement in productive work can be interpreted as a risk factor in later life, because it has been shown that the loss of productivity may be associated with the relapse of posttraumatic symptoms in aging individuals (Graziano, 2003).

In the complex context of “life-trauma dialectics” (Valent, 1998b), the value-laden categorizing of positive outcomes in conventional research may be associated with an error of reducing human experiences to a set of abstract, pragmatic evaluative concepts. Categorization should be therefore taken with great caution.

In this context, the observable criteria of positive or negative outcomes become uncertain because of the fallacy of attaching prescriptive values to externally defined measures of positive change. In her follow-up study of child survivors’ adjustment, Moskovitz (1983) cautioned against the attempts at definitive evaluation: “Has our eagerness for scientific evaluation of functioning restricted our criteria for valuing human beings and led us unwittingly to judgements of superior and inferior, via assorted categories of normal and abnormal?” (p. 226). Labeling survivors’ lived experiences as functionally positive outcomes within the resilience discourse may be as damaging as deeming their reactions dysfunctional as part of the medical or psychiatric model. The interpretation of the meanings of positive outcomes, successful coping, and sufficient functioning, tied to the metaphoric connotations of the resilience concept, remains one of the central subjects of discussion in the literature.

The relationship between survivors’ inner, subjective pain and outward high functioning remains one of the most ambiguous themes of discussion in the literature. Referring to the seemingly paradoxical coexistence of good adjustment and painful memories, Valent (1998c) used a metaphor of a “saturated solution on the verge of crystallization.” Even when visibly well adjusted and symptom free, an individual may be intensely affected: “The solution looks normal, but much internal energy is devoted to making it seem so” (p. 119). This state of unresolved inner tension may cause distraction from the enjoyment of life, posttraumatic symptoms, or somatic illness. The understanding of this dichotomy within the dialectic of life and trauma represents an essential part of Valent’s theory of resilience, in which “each aspect of resilience has a corresponding potential hurt and wound” (1998a, p. 519). According to the author, the theory emerged from his personal experience as a survivor, and professional work with child survivors.

Research Methods and Generating Theory

Because characteristics of child survivors are so complex and unique, and because of the risk of trivializing the experiences of Holocaust survivors through impersonalized quantitative categorization, a great number of recent studies were based on descriptive qualitative methods. The prevalence of qualitative studies tends to raise questions about generalizability of findings across populations, and is associated with a call for nomothetic, as opposed to idiographic, methods (e.g., Suedfeld, 1996; Krell, Suedfeld & Soriano, 2004). Indeed, the findings based on child survivors possess great potential for universality and a high theoretical value. This group shares features with other traumatized populations, such as survivors of genocide or non-war trauma such as sexual abuse, although there have also been indications of fundamental differences between them (Valent, 1993, 1998c; Savin & Robinson, 2002).

However, in the attempt to generalize theories of resilience based on the experiences of child survivors, it is essential to consider both the general nature of human response to trauma and the unique historical and cultural context of this particular group (de Vires, Suedenfeld, Krell, Blando, & Southard, 2005). It is possible that some general theories of human adjustment will not fit this group (which happened with the negative psychiatric predictions shortly after liberation), or that some authentic meanings that are significant to these participants will be missed or misinterpreted in search for nomothetic knowledge, and through employing general theoretical frameworks. Therefore, idiographic studies have great value in that they allow discovering the particular, experiential aspects of this area of knowledge. With respect to theory development, most valid in this area may be those theories that are based on empirical data gathered directly from child survivors, whether these theories are drawn from qualitative or quantitative studies, or both. Such theories are directly grounded in exploring the lifelong histories of people, their inherent meanings, and have conceptual, nomothetic, and contextually rooted character.

Conclusion

Children who survived the Holocaust in Europe emerged from their unspeakable experiences with severe trauma. However, the pessimistic predictions of most theorists at the time of liberation did not realize what the follow-up research forty and fifty years after the war documented: that most of them demonstrated high functioning, good social adaptation, and active community and spiritual involvement. At the same time, there was evidence that people in this group also revealed posttraumatic signs ranging widely from minor, isolated psychological symptoms to clinically diagnosed posttraumatic stress disorder, impaired quality of life, or personality changes. In many survivors the features of supreme adaptation and selfless social productivity may coexist or alternate with symptoms of deep psychological damage. How can this dichotomy be explained? Can theoretical conceptualization embrace the experiences of these people and define, name, explain, and predict the outcomes of their struggle with trauma? What meanings may be attributed by child survivors themselves?

Perhaps some answers to these questions are more descriptive or narrative than qualitative. It is possible that great value will be attached to further research studies that will avoid the error of abstract conceptualizing, similar to Greenspan’s (1998) narrative-based book, which, according to the author, was “driven by the … convictions that more and more talk about Holocaust survivors (which has characterized recent years) does not necessarily lead to better talking with them” (p. xi). However, an opposite epistemological conviction that the life histories of child survivors can become a source of generalizable theoretical knowledge is also valid. It has been demonstrated that theoretical knowledge, when grounded in the authentic meanings and particular social context of child survivors of the Holocaust, can capture both the universal and unique features of their life-trauma dialectic.

 

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4 thoughts on “Early Trauma and Resilience”

  1. Dear Svetlana,
    Congratulations on a terrific article. It articulates beautifully my own feelings.
    A couple of comments i have been struggling with:
    1. We see now only child survivors who have survived, not those who have suffered/died in previous decades. I think they exceed those in the general population.
    2. Anecdotally i Have observed problems in children of child survivors, including a distressingly high number of deaths. Have you found that?
    Lastly, and this may be a personal hubris: Why have references not been published beyond Herman ?
    Warm regards,
    Paul Valent

  2. I am a child survivor, 8 years when I was placed into a TB sanatorium, 8 years and two month after they tried to kill me with Scarlett fever and Measles. I made it .
    I was than taken to the KZ Sachsenhausen,25 km from Berlin in December f 1944. Officially, this camp had no children and has not been declared as a experimental station for children.
    From December 1944 to the end of April 1945 when we was liberated by Polish and Russian forces. I have seen at least 20 children in March of 1945. We were 8 or 9 children at the day of liberation, two where girls.
    I was used in experiments, to kill me. I had Spine surgery, that took years later 8 hours to repair. Per my pain doctor I had poison placed into my spine. They tried to kill me by a neck shoot, by feeding me poison. By trying to made me sterile. But I made it. I lost my memory for almost 40 years, when it came back with all its might. I am still alive, I hope I am able one day to finish my story. Everything in this article is full of truth.
    Hard to read for me, as it is not written for a lay person.
    What hurts me personally the most, that my family of husband and three boys blame me for not being the mother that I could have been. They tell me I was to overprotective. Nobody of my children and grandchildren is interested to know anything about me. Yes, I am still in therapy, in the moment EMDr, music and talk and tapping, that seem to help me . I read your article for the first time April 8.2013. The night before the Shoah commemoration. How did I find it- with GOD’s help. Why am I still alive, GOD took care of me. I hope to live many more years, I am now 76 years old. Walking. but steadily in pain.

  3. Dear Paul,
    Thank you for your warm response and questions. I am sorry I didn’t respond right away – I just found your note.
    I admire your work and your life story, and your writings were a major inspiration and source of wisdom for me when I did my study, and I am very grateful to you for this. It’s so thoughtful of you to respond to my article.
    To your questions:
    1. I too was struggling with the thought that those survivors who have lived through the adversities and succeeded get all the attention in research, media and the minds of the society, while there were so many of others, not that fortunate. I don’t have an answer to this question, but I too was thinking about it often.
    2. The problems of children of child survivors were not the focus of my attention, so I don’t know much. But I read about different views on this issue. Inter-generational issues of trauma are so very complex, and I agree with you – being a daughter of a child survivor, I might have some stories to tell too.
    3. Yes there was a list beyond Herman and it somehow got lost in publication. I will write to the publisher and ask to correct it. Thank you for noticing!
    Thank you again for your response.
    Svetlana

  4. Dear Eve,
    What a story. I am honored that you read my article and it made sense to you. I know my language might be difficult to read a times, it’s my fault.
    Have you recorded your story? It’s hard for me to know, but my heart goes out to you when I read that your sons were not interested to know much about your life. But in my experience, people often become interested in their parents’ roots and life stories as they grow older. And that’s when they are grateful to find records, old photos, or written stories. I think your story is amazing and extremely important – not only important for your family, but also for other people to know.
    Thank you very much for sharing.
    Keep well,
    Svetlana

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