Healing Their Wounds: Psychotherapy with Holocaust Survivors and Their Families (review)

144 SHOFAR Healing Their Wounds: Psychotherapy with Holocaust Survivors and Their Families, edited by Paul Marcus and Alan Rosenberg. New York: Praeger, 1989. 304 pp. This edited book has something for just about anyone interested in the post-Holocaust lives of survivors and their children. In the first two chapters Kren and Steinberg provide a psychoanalytic framework for understanding the psychodynamics of survivors and present a review of the clinical literature on survivors and their children, respectively. Next Jucovy considers individual and family-oriented treatment approaches with suggestions about such procedural issues as minimizing resistance and the timing of interpretations. Focusing upon the children of Nazis, Kestenberg introduces the concept of transposition to explain how major historical events may be perpetuated across generations. She also presents an unsupported hypothesis that Jewish children may have become the displacement victims of Nazi-death wishes originally directed toward their own children. One of the best chapters in this book is the interview with Anna Ornstein (a psychiatrist and a survivor), conducted by Marcus and Rosenberg. Dr. Ornstein rejects the stigmatization of the entire survivor population and suggests that in the context of treatment, the survivor should not be treated differently from other patients so long as the therapist remains aware of countertransference possibilities. She is also more sanguine about the adaptive capacities of survivors, whereas Freyberg, in her chapter, focuses solely on the negative consequences of survival. Fogelman in her very useful discussion of the group psychotherapeutic process deals with such issues as types and quality of parent-child communication and Jewish identity. In their chapter on family therapy, Perel and Saul acknowledge that the clinical samples they discuss are not necessarily representative of the entire survivor population. Their discussion on treatment strategies to restructure "enmeshed" families derives from a "family systems theory" perspective. Two chapters written by rabbis make unique contributions to this book. In the first, Rabbi Skolnik provides guidelines for working with survivors within the synagogue environment. Not a survivor himself, Rabbi Skolnik felt at one with his survivor congregants when after describing his experiences visiting Auschwitz he broke down in tears. In the second Rabbi Cohen deals in a provocative way with post-Holocaust beliefs in God. How, in the face of genocide, may one continue to believe in the goodness of God? The editors contributed a chapter on the religious beliefs of survivors and Volume 10, No.2 Winter 1992 145 how they could playa role in treatment. They compared the responses to suffering among survivors who maintained their religious beliefs with those whose faith was diminished or lost. Also from a religious perspective, Rustow discusses the identity problems of Jewish children who were separated from their mothers during the war and spent the remaining war years in various Catholic institutions with changed names and obligations to participate in new religious rituals. Based upon their findings with the MMPI comparing traumatized families with controls who had emigrated to the United States before World War II, Almagor and Leon found that survivor MMPI profiles were within normal limits and no significant differences were found between children of survivors and controls. Most survivors are now apporaching old age, and it is therefore important to understand the relationships between the stressors of aging and previous Holocaust traumatization. Kahana, Harel, and Kahana address the methodological challenges confronting investigators who want to study the elderly survivor population. Their approach to this population is to understand the coping and adaptive strategies survivors used after losing entire families to the Holocaust. Because of the overlap in symptoms between survivors and controls, the authors caution against treating survivors as a homogeneous group. Furthermore, many of the survivors studied by these authors were able to find something positive in their past adversities to communicate to the rest of the world in the hope of preventing the occurrence of future atrocities. In his chapter on alternative treatment approaches with survivors, Krell challenges a number of potentially negative assumptions made about survivors: their use of denial, the uniform experience of guilt about having survived, and identification with the aggressor. Krell also takes issue with those who describe concentration camp inmates as having undergone "infantile regression" in the pathological sense...