Sequential Traumatization in Children: A Clinical and Statistical Follow-Up Study on the Fate of the Jewish War Orphans in the Netherlands (review)

156 SHOFAR Winter 1996 Vol. 14, No.2 most of the survivors were able to go on with their lives despite mourning for loss of family and of less fortunate peers. Werner Israel Halpern, M.D. Rochester, New York Sequential Traumatization in Children: A Clinical and Statistical Follow-Up Study on the Fate of the Jewish War Orphans in the Netherlands, by Hans Keilson with the collaboration of Herman R. Sarphatie, translated from the German byYvonne Beame, Hilary Coleman, Deidre Winter. Jerusalem: The Magnes Press of Hebrew University, 1992. 463 pp. $30.00. Nazi scientists experimented in torture to test the human body's limit of endurance to the most egregious environments. No findings of value were derived from their cruel actions. Are there benefits to be found in the psychological study of Holocaust survivors that can throw light on human vulnerability and resilience to the effects of massive trauma and on rehabilitation efforts? If such traumatization occurs during childhood and youth, what is the expected outcome? In Sequential Traumatization in Children,· a child psychiatrist provides an in-depth 25-year follow-up study of 204 of some 2000 Jewish Holocaust orphans to test existing theories of human development via the effects of sudden separation from parents, uprooting, deportation to concentration camps, being hidden by Gentile foster families, frequent moves to avoid discovery, fear of betrayal, a changed personal and religious identity, chronic awareness of oppression and danger, the postwar struggles with facing the loss of parents, and loyalty conflicts about past and present group affiliation. The author, Hans Keilson, had emigrated to Holland from Germany in 1936 after he had finished his medical training two years earlier. During the war he was in hiding and worked with the Dutch resistance organization. In 1945, he was a founding member in the Netherlands of the Jewish Orphans Organization I.e Esrat HaYeled (To the Aid of the Child), which allowed him to become familiar with many of the children who, as adults, were the subjects of his study. This position, in combination with his professional discipline, gave him a special perspective on linking the earlier developmental and experiential reports about the children to their later coping styles and personality structure 25 years after the war. Book Reviews 157 This volume represents a ten-year effort of reviewing current developmental theories as found in the professional literature, pertinent demographics about the group under study, case descriptions, and data submitted to statistical analysis. According to Keilson, the children's suffering took the form of three sequential traumatic events over a prolonged time period (1942--:1945). The initial insult to the child's developing integrity occurred when parents entrusted their offspring for safekeeping to non-Jewish friends, acquaintances, or even strangers. During the period of being hidden throughout the time of persecution, when the foster child and his or her protectors lived under the threat of betrayal and death under the prevailing wartime conditions, the second sequence of traumatization took its psychic toll. Finally, the third sequential traumatic event, that of facing a guardianship decision which threatened the attachment the child may have made to the foster family and of reawakening feelings of abandonment, introduced the additional stress factor of reintegration into a new social and presumably a more normal developmental continuity. Moreover, group loyalty issues surfaced at that juncture, especially in disputed guardianships, when children were torn between their attachment to the religion. of their former protectors and the faith of their deceased Jewish parents. All told, the combined and cumulative impact on the child's emotional, cognitive, and moral development appeared to lend itself to testing a number of hypotheses. The global question which Keilson posed concerned itself with the relationship of massive cumulative traumatization to children of different age groups and developmental stages. A secondary question dealt with the intensity of trauma on personality outcome, although he had to conclude that the severity of trauma could not be measured with precision, given the many variables which influence individual experience. A detailed conceptual rationale introduces the book's clinical section, the core of ~ which includes a collection of illustrative case studies and interpretive extrapolations of psychiatric dynamics and diagnoses. The concluding section...