the impact of the holocaust on the second generation: norwegian jewish holocaust survivors and their...

Journal of Traumatic Stress, Vol 9, No. 3, 1996

The Impact of the Holocaust on the Second Generation: Norwegian Jewish Holocaust Survivors and Their Children

Ellinor E Major’

The entire population of Norwegian-born Jews who survived the German concentration camps and their children was examined, and compared to Norwegian-born Jews who escaped to Sweden, and their children. An attempt is made to look for the symptoms described as a “second generation syndrome” by several authors. The present findings do not support the presence of serious psychopathology among the children of Norwegian-born Jewish survivors as a group, but indicate a certain degree of psychological vulnerability among these children. A s adults, they are more often engaged in healthlsocial care professions and organizations and also show signs of greater assimilation to their non-Jewish surroundings than the comparison group. KEY WORDS: concentration camp survivors; second generation; Holocaust; syndrome.

The aim of the present study was to investigate whether children of Nonvegian born Jewish concentration camp suMvors suffered from a second generation syndrome or some of the psychological disturbances described in numerous clinical presentations during their adolescence. Research on the long-term effects of concentration camp (CC) experiences upon survivors has resulted in an often accepted definition of the CC-syndrome (Eitinger & Askevold, 1968) or the survivor syndrome (Niederland, 1968). In the late 1960s there emerged the first studies describing psycho- pathological problems in the children of CC-suMvors (Rakoff, Sigal, & Ep- stein, 1966; Trossman, 1968). The parent survivors were portrayed as having impaired rearing functioning (Rosenberger, 1973; Russell, 1974); serious

‘Division of Disaster Psychiatry, University of Oslo/The Joint Norwegian Armed Forces Medical Services, Oslo, Norway.

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0894-9867~7a)-044lSO9.50/1 0 1996 lnlsrnalional Socicly for mumatic Stms Studies

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separation-individuation problems, as well as behavioral disturbances were reported in the children (Barocas & Barocas, 1980; de Graaf, 1975; Frey- berg, 1980; Sigal, Silver, Rakoff, & Ellin, 1973). Others maintained that, when faced with problems, the children of survivors would suffer from a “second generation syndrome” or “complex” (Kestenberg, 1982; Kinsler, 1981; Levine, 1982).

A central question concerns how the trauma from the concentration camps was transmitted to the children of survivors (Barocas & Barocas, 1980; Danieli, 1985; Kestenberg, 1982). While many clinicians tended to generalize their findings to apply to most children of Holocaust survivors, some of the controlled studies of nonclinical samples found no evidence in support of a second generation syndrome or other forms of severe pa- thology. Investigators (Keinan, Mikulincer, & Rybricki, 1988; Leon, Butcher, Kleinman, Goldburg, & Almagor, 1981; Sigal & Weinfeld, 1985; Zlotogorski, 1985) studied ego-functioning, general well-being, aggression difficulties, anxiety, depression and perception of parents without obtaining significant differences between nonclinical samples of children of Holocaust survivors and comparison groups. Mental health was found to be within normal limits. Some authors (Weiss, O’Connel, & Siiter, 1986) have pointed to an “immigration effect” as a major contributor to observed psychopathology in the children of survivors. This effect has been a methodological problem in the majority of the investigations. Most of the survivors studied after World War I1 were Jewish immigrants, so that it has been difficult to evaluate which of the problems were concentration-camp related and which resulted from the status of being refugees. The psychological traumas suffered by immigrants or refugees are well documented (Banchevska, 1981; Rakoff, 1981).

We decided to study the population of Norwegian born Jewish survivors only and to compare them with Norwegian born Jews who were in Sweden during the war; we could thereby eliminate the. “immigration effect”. During the war, about 60% of the Jewish population of Noway (N = 762) were deported to the German concentration camps. Of the deported 762 Jews, 650 were born in Norway, and of these ll men (i.e., 2%) survived the camps. No Jews survived the war as residents in Norway. In 1944 there were registered 560 Jews with Norwegian citizenship as refugees in Sweden. Of these, 90 were men under the age of 45 (Mendelsohn, 1986).

We assumed that the CC survivors would suffer from more symptoms than the Jews who fled to Sweden. The children of the survivors were like- wise expected to have suffered from more psychological problems during their adolescence than the children of those in Sweden, but less than children of survivors who were immigrants as described in the literature. We wanted especially to ascertain whether a second generation syndrome could

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The Impact of the Holocaust on the Second Generation 443

have been present in our population. Furthermore we reasoned that in order to compensate for the Nazi's annihilation of the Jews and Jewish traditions, the children of CC survivors would show a stronger Jewish identity, be more anxious about antisemitism and the future of Jews in Norway and in Israel than the children of those Jews who escaped to Sweden.

Method

Participants

There are only two Jewish communities in Norway, to which nearly all the Jewish population belongs. The official register of these communities was perused for persons who fulfilled the following inclusion criteria: (1) they were Norwegian born, (2) they had either survived the Nazi concentration camps or had escaped to Sweden during the war and returned to Norway after the war, and (3) they had children born after 1945.

Targetgroups. Of the 11 Norwegian born men who survived the camps, four were childless. When this study started, only five of the remaining seven survivors were still alive and met the inclusion criteria. These five survivors all married after the war and had, in all, 15 children. In addition, the 4 children of the two survivors who had died after the war, but before this study started, also participated. Thus the participating five survivors (CC fathers) and the 19 children (CC children) constitute the total population of Norwegian born Jewish survivors and their children. They all agreed to participate, yielding a response rate of 100%.

Comparison groups. The comparison groups consisted of Norwegian born Jewish men who escaped to Sweden, and their children. The official register left us with 23 men (Sw fathers) who fulfilled the inclusion criteria. Eighteen agreed to participate (78%). Of their 46 children (Sw children), 37 agreed to participate (80%).

Descriptions of spouses/mothers were based upon the reports of the husbanddchildren in the questionnaires and interviews. Demographic characteristics of these groups can be seen in Table 1.

Instruments

All participants completed a 25-page self-report questionnaire specially constructed for each group which covered most outcomes described in the literature. The respective questionnaires for the first and second generation were slightly different, as the first generation specifically was asked about

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Table 1. Sociodemographic Variables: Fathers and Children

CC Fathers Sw Fathers CC Children Sw Children n = 5 n = 18 n = 19 n = 37

Age

(Range) M

Marital status Married Divorced Widower Single

Occupation Self-employed University educated

Health professions Student Service. professions Other Disabled

72 75-66

72 87-58

37 44-26

35 35-18

n 22 (59) 4 (11) 0

30

4 (80)

1

0 0 0

5 j i4j 0

Table 2. Mean and t-Values for Perception of Parents and Childhood H o m e

CC Children Sw Children n = 1 9 n = 3 7 t df P

Father introverted Father optimistic Father suspicious Father ruled over me Father controlling Father strong

Mother introverted Mother optimistic Mother suspicious Mother ruled over me Mother controlling Mother strong

expectations for me

expectations for me

2.5 3.2 2.4 1.9 2.1

2.8 3.7 2.5 1.9 2.0

2.01 1.65 0.70 0.22 0.12

53 33 37 38 36

< .05 n.s. ns . n.s. n.s.

1.6 2.7 3.2 2.5 2.2 2.2

1.5 2.6 3.7 25 1.8 2.0

0.90 0.71 1.40 0.08 2.03 0.74

32 38 36 34 38 36

n.s. n.s. n s . ns . c .05 n.s.

1.9 1.5 2.23 36 < .05

Harmonious childhood home 2.1 1.7 2.02 29 c .05

"Score: l=very muchn=not at all.


war experiences and the CC symptoms. Items were either scored dichotomously (yedno) or on a 3-point scale from very much (scored as 1) to littlehot at all (scored as 3). The following exemplifies those sections of the second generation questionnaire relevant for this presentation:

Description of childhood hornelrelatiom to parents. The variables shown in a b l e 2 were included and each item rated on a 3-point scale.

Jewish identity. This section included the variables shown in Table 3 of which some items were scored dichotomously, others on a 3-point scale.

Communication about the Holocaust. The subjects scored the, presence/absence of openness in the family dichotomously and also rated degree of openness on a 3-point scale.

Personal characteristics and mental health. The literature has pointed to adolescence as the critical period for children of Holocaust survivors. Subjects were thus asked about the presence of each of the 12 symptoms and four characteristics during their adolescence shown in Table 4. Nine of the 16 symptoms/characteristics were based on the clinical descriptions in the relevant literature, seven in the CC syndrome (Eitinger & Askevold, 1968) and in posttraumatic stress disorder (F’TSD) (DSM-I11 R, American Psychiatric Association [MA], 1987). Each symptodcharacteristic was scored dichotomously. If the 12 symptoms were to constitute a “second- generation syndrome,” there should be statistically significant differences (pC.05) between the two offspring groups for half of these symptoms. This choice was made on the basis of the previous Norwegian study of CC survivors (Eitinger & Askevold, 1968) in which half of the CC symptoms were required to regard the CC syndrome as present. The participants were also asked to rate their perception of optimism and suspiciousness at time of investigation on a 3-point scale.

Interview

The aim of the interview was to gain a more thorough insight into topics covered in the questionnaires (rather than to test the reliability of the self-report answers). It was also considered an ethical obligation to fol- low up the sensitive parts of the questionnaire with a personal interview. In all, 73 of the total of 79 participants were personally interviewed by the author. Two of the first-generation participants died before the interview could take place, and four second generation respondents were abroad at the time. The majority of the interviews were conducted in the homes of the participants. Each participant was asked about the various health problems they had mentioned in the questionnaires, but no formal psychiatric diagnoses were made.

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Table 3. Differences Between the Two Second Generation Groups with regard to Jewish Identity“

CC Children Sw Children n = 1 9 n = 3 7

% % r2 df D

Important to stick to Jewish traditions View themselves as Norwegian Jews No connection with Jewish community Strong connection with Norwegian

Married a Jewish spouse Proud of being Jewish Anxious about the future of

Anxious about the future of Israel

community

Norwegian Jews

11

53

50

32 25 53

19 25

46

84

6

54 52 75

43 49

10.56

7.94

14.25

2.18 2.82 3.82

2.79 2.52

2 c.01

3 <.05

2 c.001

2 n.s. 1 <.lo 2 ns .

1 c.10 1 <.01

“By chi-square.

Table 4. Percentages of Symptoms and Characteristics Making Up the Proposed “Second Generation Syndrome” in the Two Second Generation Group?

CC Children Sw Children n = 1 9 n = 3 7

% % x2 df P

Depressive periods Holocaust-related nightmares Anxiety Aggression Nervousness Suicidal thoughts Stress reactions to war stimuli Separation conflicts Psychosomatic complaints Eating disorders Behavior (school) problems Use of psychiatric health service

42 63 16 26 21 16 24 21 16 11 68 31

16 41 8

13 8 8

22 35 24

5 34 14

4.06 1 c.05 1.99 1 n.s. 0.77 1 n.s. 1.46 2 n.s. 0.7 1 n.s. 0.71 1 n.s. 4.45 4 n.s. 1.14 3 n.s. 0.54 1 n.s. 0.50 1 n.s. 5.77 1 <.05 1-50 3 n.s.

Other characteristics High Sense of responsibility 53 25 6.26 2 <.05 Work in social care professions/

Want participation in second-

Named after perished relatives 33 28 0.17 I n.s.

organizations 63 32 4-82 1 <.05

generation groups 53 23 4.18 1 c.05

“By chi-square.


Results

The following results were based on the questionnaires only.

Differences Between First- Generation Groups

The CC fathers suffered from significantly more CC symptoms (difficulties in concentration, fatigue, restlessness, hot-temperedness, irritability, dizziness, nightmares and sleeping difficulties, sadness, anxiety) than the Sw fathers (CC fathers, M = 5.2, Sw fathers, M = 1.1, t = 3.67, df = 4.2, p < -05). Their evaluation of their relationship to their children or their own Jewish identity did not reveal any significant differences.

Differences Between Second Generation Groups

Parents and childhood. The description of parents and childhood home is found in Bble 2. The CC children evaluated their fathers to be more introverted, their mothers to expect less and to rule less over them, and also their childhood home to be less harmonious than the Sw-children.

Jewish identity. Concerning their Jewish identity, the CC children on most items showed signs of a weaker Jewish identity; fewer CC children found it important to stick to Jewish traditions, fewer married a Jewish spouse and more had no connection with the Jewish community to which they belonged, compared to the Sw children (Table 3).

Communication. A chi-squared analysis showed that only 50% of the CC children reported open communication about the Holocaust at home compared to 78% of the Sw children (x2 = 4.6, p < .05). For the groups together, lack of open communication was associated with ratings of a less harmonious childhood home (t = 2.01, df = 53, p < .05), more introverted mothers ( t = 2.50, df = 52, p < .02) and more pessimistic fathers (t = 3.05, df = 53,p c -01).

Mental health. Table 4 shows significant differences between offspring groups on 2 of the 12 symptoms; depression and school related behavioral problems. The CC children had a mean of 3.4 symptoms, compared to 2.4 in the Sw children (t = 1.59, df = 54, p = .12). Four CC children (21%) reported six symptoms or more, compared to two Sw children (5%). Six CC children had undergone psychological or psychiatric treatment (31 %) because of psychological problems; one of these had been hospitalized and two were disabled because of psychological difficulties. In comparison, five of the 37 Sw children had been in psychological or psychiatric treatment (14%). Concerning the “other characteristics”, significantly more CC chil-

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dren wished to participate in a second generation group to share their experiences with others if such had been in existence. Also significantly more CC children had been or were engaged in health care professions or organizations than the Sw children and reported a higher sense of responsibility than the Sw children. There was a significant correlation between reporting “taking a lot of responsibility at home” and being engaged in the health care professions or organizations for the CC children (r = .58, p < .01). This correlation was not found among the Sw children (r = .05, n.s.). Among the CC children, there was also a higher correlation between symptoms and being engaged in health care (r = .38,p < .lo) than among the Sw children (r = .09, n.s). Considering the groups together, more women than men reported anxiety (women = 19%, men = 0%) and nightmares (women = 63%, men = 33%). No significant sex differences concerning the other symptoms were found. There were no significant differences in the participants’ ratings of own optimism and suspiciousness at time of investigation.

Discussion

The strength of the present study is that we succeeded in eliminating the immigration effect and in obtaining a second generation group consist- ing of the total population with a response rate of 100%. The response rates of the comparison groups (over 75% participation) are also considered quite acceptable. Although all groups are rather small, they constitute the total population of Jewish Norwegian-born survivors and their children and most of population of the comparisons. The survivors might be an un- representative sample of the 650 Nomegian-born Jews who were deported from Norway, but the 98% who perished in the camps cannot be studied. Many different theories have been put forward as to why some of the CC inmates survived. The author has been able to ascertain rhrough witnesses that three of the five survivors had expertise in crafts which proved life- saving, while three others were close friends who helped each other in various situations. It is beyond the scope of the present paper to address this problem further. Those who fled to Sweden were the only comparable group who had not been in the concentration camps since no Norwegian Jews survived in Norway throughout WWII. Some of the Jews who escaped to Sweden had life endangering experiences during their escape, and all of them suffered massive losses of close relatives. Thus the main variable differentiating the groups was their camp internment.

Choosing an instrument that could measure all the different items of interest described in the literature within the limits of one questionnaire


turned out to be a difficult task-we therefore decided to construct a spe- cial questionnaire. This choice certainly limited the possibilities for com- paring our results with those of others using standardized measures. The main purpose of the present study, however, was to look for differences between the two offspring groups in light of their fathers’ different war experiences.

Concerning mental health problems, the focus was on the period of adolescence, as these years have been referred to as the critical period (Barocas & Barocas, 1980). Registering symptoms of a possible second generation syndrome and the use of health services during their adolescence was considered more important than formal psychiatric diagnoses.

There are limitations to an approach using retrospective data on adolescence, and it is possible that neither the questionnaires nor the interviews caught the real frequency of the various problems or health aspects. This objection, however, would apply to all participating groups and should not eliminate the differences between them. The face-to-face interviews in most instances added to and confirmed the information given in the questionnaires and were appreciated by most participants.

The presence of the CC symptoms reported by the CC fathers is very much in accordance with results obtained by others (Eitinger, 1972; Eitin- ger & Askevold, 1968). As both groups were Norwegian-born and suffered massive losses of close ones, the CC trauma is the most probable reason for the difference in number of symptoms between the first generation groups.

Concerning the second generation groups, we decided to include all siblings in each family, although the population might thus have been weighted towards large families. The CC children evaluated their childhood homes to be significantly less harmonious, their fathers to be more introverted and their mothers to expect less and to rule less over them than did the Sw children. One cannot rule out that the fathers’ CC imprisonment affected the whole family atmosphere in some families.

The results concerning less endorsement of Jewish identity among the children of CC survivors contradicted our own hypothesis as well as other findings (Heller, 1982). The assimilation tendency which our data seemed to reflect may be a coping strategy for reducing unconscious fear of possible renewed antisemitism. This suggestion is supported by the CC children reporting less fear and anxiety with regard to antisemitism than the Sw children. Fewer CC children identified themselves as Norwegian Jews; they were less attached to both the Jewish and the Norwegian communities. This may be interpreted as an attempt to root their identity and security in a more supranational one. The fathers and children in both groups belonged to the two Jewish communities in Norway, so that this should not

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give rise to the differences in endorsement of Jewish identity. However, one of the CC fathers married a non-Jewish woman. This may explain the absence of Jewish identification in their three children (16%) and might thus have contributed to the results.

Clinical studies have pointed to the possible harmful effects of too much or too little communication about Holocaust experiences (Bergmann & Jucovy, 1982; Lichtman, 1984; Robinson & Winnik, 1982; Trossman, 1968). In the present study, there was significantly less open communication about war traumas in the CC families. This result is in accordance with the findings of others (Kav-Venaki, Nadler, & Gershoni, 1983). When com- bining the groups, lack of open communication was significantly associated with a less harmonious childhood home, with more introverted mothers and more pessimistic fathers, but not with symptoms in the children. Gen- eral lack of communication about traumatic events is often described as a “family secret” within family therapy (Imber-Black, 1993) which might af- fect the family atmosphere as well as the development of symptoms. Com- munication about the Holocaust might in some way reflect the climate in the family and be expressed through different aspects of parental behavior, although not automatically through symptoms.

So far no investigations have determined which, or how many, symptoms should be present before a case can be labeled-a “second generation syndrome.” In our study, we used the principle from the Norwegian CC study (Eitinger & Askevold, 1968), requiring at least the presence of half of the CC symptoms to regard the syndrome as being present. More CC children endorsed 10 of the 12 symptoms, but significant differences between the groups were obtained only for 2 symptoms. The differences in the total number of symptoms were not statistically significant between the two offspring groups. Based on the criteria chosen here, there seems to be little evidence that the CC children as a group suffered from a “second- generation syndrome” during their adolescence. However, four (21%) of the CC children reported at least half of the symptoms, ix., six symptoms or more, which might indicate that these children during their adolescence had been suffering from an array of symptoms indicating such a syndrome. These four CC children came from three different families; this result can thus not be explained by the dysfunction of one large family.

The four “other characteristics” may be viewed as negative as well as positive consequences of growing up in a survivor family. Three of these reached significance: The CC children reported a significantly greater sense of responsibility as they grew up. The more frequent engagement of the CC children in health care professiondorganizations supports earlier sug- gestions that children of Holocaust survivors are drawn to the health professions (Russell, Plotkin, & Heapy, 1985). In the present study,


engagement in health care turned out to be significantly correlated with “sense of responsibility,” and to a lesser degree also with symptoms for the CC children. One possible interpretation is that the CC children’s “helping role” in the family from childhood and adolescence into adulthood trans- ferred in working life to an interest within the healtldsocial care professions. This may be viewed as a primarily positive consequence of growing up in a survivor family. Even so, one should take into consideration the possibility that helping others could also reflect an unconscious need of self-help, as those CC children who were engaged in health care also dis- played more symptoms than those who were not engaged.

The participants’ perception of optimism and suspiciousness at time of investigation revealed no significant differences between the groups and expressed a rather high degree of general optimism and low degree of suspiciousness. The personal face-to-face interviews revealed that most offspring functioned adequately at the time of investigation, although there were exceptions. Despite different measures, our results might be compared to the findings of an Israeli study (Schwartz, Dohrenwend, & Levav, 1994); children of Holocaust survivors were found to have higher rates of past psychiatric disorders than controls, but no evidence for higher rates of current psychiatric disorders was obtained.

The most important result of the present study, be it when considering adolescence or time of investigation, was our finding of great variation- from being disabled to functioning very well. Those reporting several symptoms held the view that their fathers’ camp imprisonment and post-war symptomatology had influenced their life in a problematic way. It seems reasonable to state that the findings indicate that the CC children constitute a somewhat more vulnerable group regarding psychological problems. It is possible that such vulnerability might be transformed into psychopathology in situations of stress, as found in one study from Israel (Solomon, Kotler, & Mikulincer, 1988). These authors found higher rates of PTSD in children of Holocaust survivors who had been exposed to severe stress during the Lebanon war in 1982, compared to controls. One cannot rule out that the children of the Norwegian Holocaust survivors would also display more symptoms of psychopathology if faced with severe stress, due to such vulnerability.

Overall, our results seem to be in between those of the clinical literature reporting serious mental health problems and those studies with nonclinical samples reporting few or no differences in mental health between children of Holocaust survivors and control groups. There are some possible explanations for these different findings: The clinical studies include only patients with psychopathology while many of the nonclinical studies report response rates of 50% or less, making it difficult to decide

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if only those with few problems participated. Neither of these alternatives will give a correct picture of the prevalence of psychopathology among the second generation. Furthermore, the immigration effect is not an issue in the present study. Others (Leon et al., 1981; Sigal & Weinfeld, 1985; Weiss et al., 1986) who controlled for this effect did not find differences in pa- thology between children of survivors and children of other immigrants. In our study, none of the mothers were CC survivors, which may influence the results since mothers nearly always are the primary caretakers of children. Finally, our five fathers survived an annihilation camp, while most studies have mixed survivors of ghettos, labor camps and partisan resistance in their groups of “Holocaust survivors.”

The present study cannot give an answer regarding which and how many symptoms should be present in order to qualify a person for the di- agnosis of “second generation syndrome.” The results do indicate that psychopathology is not a necessary consequence of having a father who suffers from long term effects of his CC stay, even if some reported to have been affected in a negative way. The small population and methodological limitations must be taken into consideration when applying the results to other populations. This calls for larger studies of nonimmigrant survivors and their offspring. The results could be of importance for the understanding, and in some cases the treatment, of children of other traumatized populations.

Acknowledgments

This study was supported by the Norwegian Association of Disabled War Veterans. I wish to thank my supervisors Professor Lars Weisaeth and Professor emeritus Leo Eitinger for their most valuable assistance.

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