The Results of Psychiatric Examinations of Persons Born, or Imprisoned in their Childhood, in Nazi Concentration Camps

Wyniki badań psychiatrycznych osób urodzonych lub więzionych w dzieciństwie w hitlerowskich obozach koncentracyjnych

Authors

Wanda Półtawska, MD, born 1921, psychiatrist, Department of Psychiatry, Academy of Medicine in Kraków (em.). Director of Institute of Family Theology, Pontifical Academy of Theology, Kraków. Former prisoner of the Ravensbrück concentration camp No. 7709.

Andrzej Jakubik, PhD, born 1938, psychiatrist and psychologist, Professor at the Institute of Psychiatry and Neurology, Warsaw.

Józef Sarnecki, PhD, 1924–1998, psychologist, Health Centre for the Mother and Child, Kraków.

Julian Gątarski, MD, 1922–1982, psychiatrist, Department of Psychiatry, Academy of Medicine in Kraków.

An examination of a group of the so-called ‘Auschwitz children’ was carried out as a continuation of medical examinations of former Nazi concentration camp prisoners. Such examinations were first initiated by ZBoWiD (The Association of Fighters for Liberty and Democracy) and the Krakow section of the Polish Medical Society. The term ‘Auschwitz children’ denotes the youngest prisoners who were either born in the Nazi camps or imprisoned there in their childhood.

As the literature on the subject indicates, strong after-effects and disorders were left in the consciousness of former prisoners (Leśniak, 1964; Szymusik, 1964; Orwid, 1964; Teutsch, 1964). Examinations of the ‘Auschwitz children’ were oriented in a similar way and thus their aim was to observe concentration camp after-effects in the central nervous system as well as to provide an answer to the following question: what, if any, negative influence was exerted upon the consciousness of the youngest prisoners by the concentration camp experience, and what personality changes could be observed in them? Consequently, psychiatric and psychological issues were of the greatest importance.

The lack of precise information about the names and present addresses of such persons proved to be of great difficulty. Tadeusz Szymański, a curator of the Auschwitz-Birkenau State Museum, devoted a lot of time and effort to eliminating such obstacles and managed to find the majority of addresses.

Another problem was the collection of material; not only because such a long period had passed since the war and because the events from some years before were to be described in detail, but also because it was sometimes difficult make contact with prisoners who lived in various, more distant parts of the country. Although quite a large number of former prisoners lived in Warsaw, the rest of them were scattered to different, distant places. The most basic problem, however, was negative attitude of some of the camp survivors towards psychiatric examination, and the tendency to avoid conversations about concentration camp events. This resulted from certain specific personality features, as became clear in the course of further analysis. It was very difficult to break psychological barriers in some persons; some simply refused to discuss the subject at all or, even if they promised to take part in the examinations, did not keep their appointments. Finally, the examination comprised 50 subjects: 30 women and 20 men.

The upper age limit was 14 years at the time of imprisonment. The examination included psychiatric, general somatic, and neurological tests, and in some cases, other specialised examinations such as gynaecological or psychological assessments, based on these tests. Moreover, in order to supplement the material and make a thorough study of some reactions, a questionnaire was prepared consisting of the following nine sections:

1. A general statistical section with questions about the personal data of the subject, his own or adoptive family, his social status including education, occupation, and places of work. This section also included a question about diseases and periods spent in hospital during the imprisonment in the camps.
2. The second, the biosocial section, included questions concerning everyday routines, leisure, favourite activities and entertainment, favourite books, films, shows, and hobbies.
3. The third section asked for statements ‘about oneself, referring to actual and ideal professions and thus included subjects’ opinions about themselves.
4. In the fourth section, there were questions about other people, for instance, ‘what is your ideal of a colleague, a woman’, etc.
5. The fifth section was called ‘Estimation’ and included estimation questions such as ‘estimate yourself, a close friend, school, entertainment’ etc, and aimed at collecting a number of judgements.
6. The sixth section comprised questions about dreams and hypothetical requests like ‘what are your three greatest wishes’, ‘how would you spend a free month’, ‘what would you like to change in your life’, etc.
7. The seventh section included complementary questions, which, in majority of the cases, were left without answers.
8. The eighth section was the question: ‘What do you know about Auschwitz, is it history or reality for you, and to what degree does it influence you?’.
9. The ninth section dealt with ‘outlooks’, with only two questions in this section: ‘What do you think the present-day young generation’, and ‘are you different from them; if so, then what is the difference?’

Since the first few cases already led us to suspect encephalopathic, organic syndromes, an encephalographic examination (EEG) was added in each case. The examination was performed on 44 subjects, either at the Department of Adult Psychiatry at the Medical Academy in Kraków, where all other examinations were also performed, or at the EEG Laboratory in Pruszków that was available due to the help offered by Halina Ekiert, MD.

Psychiatric and psychological examinations were made in 50 subjects. Even those who were initially reluctant to undergo such examinations usually decided to cooperate in the investigation after initial talks with the investigators.

Eventually all persons with whom the investigators managed to contact decided to participate in the examinations. In some cases, EEG examinations were impossible both because EEG laboratories were too distant from the place of residence, and because some subjects were not patient enough to keep their appointments. Out of 50 subjects who underwent psychiatric and psychological examinations and who completed the questionnaires, six persons did not turn up for the electroencephalographic examination.


Child survivors of the Auschwitz concentration camp

Some of the persons identified by Tadeusz Szymański had changed their addresses, or did not live permanently at home (such as a sailor who spent a greater part of the year out of the country) and it was impossible to reach them. There were 18 persons who have not yet been examined: 14 of them were found by the curator of the Auschwitz Museum, and four came from the Potulice camp and were identified by former ‘children’ who remembered their camp mates. It is difficult to estimate whether the examined group was statistically significant and representative of the population of the youngest prisoners, as it is also impossible to estimate the number of those who are still alive. It appeared, however, that the number of 50 persons would allow at least some preliminary conclusions to be made, and in that sense the attempt to analyse the material collected would appear justified.

The term ‘Auschwitz children’ is conventional and symbolic; it also refers to children who were imprisoned in camps other than Auschwitz (such as Ravensbrück, Potulice, Bergen-Belsen, Buchenwald, Majdanek, and Płaszów). Some of the subjects were incarcerated in many different camps, and three subjects came from unidentified camps as the orphanages that adopted them in 1945 registered only that they came from camps on German territory.

Division into groups was based on how old the children were on imprisonment in the camp (from the date of birth to 14 years of age). The following groups were distinguished:

1. The youngest group including those who were born in the concentration camps (a group of 18 persons: 11 girls and 7 boys that were marked with the symbol ‘N’ – babies).
2. A group of children whose place of birth could not be identified but who spent some time in the concentration camps and were taken from there when they were too small to give their age and names. It also included children recognised by older former child prisoners, but who were not older than six at the time of their imprisonment. This group included 16 persons and was marked with the symbol ‘M’ – small children (10 girls and 6 boys).
3. A group of older children who remembered their personal data and were older than six at the time of imprisonment. This group was marked with the symbol ‘D’; ‘d’ denoted children between the six and ten years old, of which there were four such children, three girls and a boy. ‘D’ stood for children of more than 10, of which there were twelve such children, six girls and six boys. Altogether, the oldest group included 16 persons: nine girls and seven boys.

The research resulted in material that could have been analysed from many different perspectives. This work deals with the problem of the personality structure – a psychiatric analysis made from the perspective of observable syndromes; a psychological analysis and an analysis of electroencephalographic records were also included in the investigation.

It should be emphasised from the beginning that no mental illness was recognised in any of the subjects, and all the diagnostic analyses referred to personality features and syndromes that were qualified partly as neurotic and partly as encephalopathic. Although all the subjects considered themselves healthy, in every case some symptoms permitting psychiatric qualification could be found.

Even those subjects who initially stated that they felt quite well, later supplemented their statements with the remarks such as, ‘I am well but very nervous’, ‘I am a healthy but jumpy person’. Nobody still claimed to be perfectly healthy by the end of the examinations, and finally, all subjects talked about their subjective complaints. Since it would be difficult to quote the details of all the cases, we shall limit ourselves to the recapitulation and presentation of the final results.

Subjective complaints of the subjects were arranged in the following order:

1. Nervousness – 46 subjects complained of this ailment and some distinguished between explosiveness and impetuosity.
2. Headaches – some subjects used such adjectives as ‘extremely strong’, some described the place as ‘in the occiput’, ‘in the forehead’, or ‘at the top of the skull’, etc.; some mentioned permanent or paroxysmal aches.
3. Sleep disturbances – some subjects complained of insomnia, some of nightmares, some had difficulties in falling asleep and felt sleepy during the day. Those three complaints were uniform for all groups of children, whereas the next complaint:
4. Anxiety – occurred more often in the group of older children than in the group of small children.
5. Emaciation, exhaustion and sudden tiredness were complaints made only by the groups marked as ‘M’, ‘d’, or ‘D’, and not by the youngest group ‘N’.
6. Neurotic ailments concerned cardiac, liver and stomach complaints.
7. Arthralgia appeared most often in the older group, which complained of one more phenomenon, namely:
8. Bad frame of mind.

Intensity of a given ailment was not so much dependent on the current age of a former ‘child’, but on its age at the time of the imprisonment and the length of time spent in the camp. Therefore, it was necessary to compare different cases according to such data.

In some cases, it was impossible to define the period spent in the camp. Some children were not tattooed or their numbers were not clear enough to read.

It could also be deduced, for instance, that children who came from Ravensbrück must have been born there, and then only in the last months of 1944 or in the first months of 1945 as all the children born earlier were killed in the camp.

In Auschwitz, children were initially scattered in different blocks, which was sometimes done on purpose by older women in order to hide children. Some were put in ‘sick rooms’ and finally, due the efforts of from Dr. J. Kościuszkowa, all children were allowed to live in a special children’s block, from the turn of 1943. Only a small number of children managed to survive longer than a year in Auschwitz, and there were even such persons among the subjects who were imprisoned in 1942. There were also persons who were brought to Auschwitz from other camps.

The length of the period spent in camp was also taken into consideration and, in the case of children born in the camp, as were such facts as whether a mother spent her whole pregnancy in the camp or only the latter part.

Thus, the examinations were carried out and psychiatric diagnoses made, with age, year of birth, and the length of the period spent in the camp taken into consideration. It should be emphasised that the diagnosis was difficult in the sense that it could not be based on any clear clinical syndromes but usually on very subtle changes. Establishing life development, essential for understanding personality structure, also proved difficult and in some cases even impossible, when events very distant in time were to be described.

However, attempts to complete the life stories were made in all cases and they were based on the information provided by their mothers and adoptive families or their guardians.

In the course of collecting the data, one more obstacle appeared, of a psychological nature. Some mothers refused to answer questions about the lives of their children or some ‘children’ made requests that their ‘mum should not be asked about that, [as] mum’s had enough of the camp’. Some such persons suggested, ‘mum’s so nervous after the camp, she should not be reminded about the camp again’, or ‘her nervous system is in such a state that she mustn’t be reminded of the camp’.

Despite all the difficulties, however, it was finally possible to complete the collected material to such a degree that it allowed for a psychiatric diagnosis based on both the results of direct examinations and data obtained from the interview, psychological examinations and the questionnaire.

The psychiatric diagnosis was not dependent on the EEG examination results, as it was limited to observable syndromes and somatic background was not considered, as after so many years it would be very difficult to estimate when changes first appeared. As a result, the diagnosis was made in correlation with an electroencephalographic analysis, which was disclosed only later, to emphasise a possible organic background. Despite the fact that EEG results were not considered during the examinations, there was a group of subjects whose symptoms suggested a clear diagnosis of psycho-organic syndrome.

Further, there were also changes that might be classified in the group of personality disturbances. Considering diagnostic difficulties, however, such a group included both persons whose personality structures suggested certain psychopathic elements, and those who exhibited permanent neurotic syndromes.

The third group was distinguished based on features generally referred to as’immaturity’. All the cases in this group were divided into three subgroups:

I. Psycho-organic syndrome – a group with dominant organic features and subjective complaints comprising headaches and dizziness, fits with a loss of consciousness or ‘moments of forgetfulness’ without the loss of consciousness, paroxysmal headaches with nausea, defective memory, irritability of a dysphoric type, convulsion seizures and their equivalent, and lower intellect. A detailed diagnosis resulted in a further division of this group into the following subunits:

  1. a picture as if after encephalitis descent with hypophrenia,
  2. encephalopathy,
  3. epilepsy.

II. Disorders in personality development towards psychopathic features; the subjects were described in detail as:

  1. impulsive with anti-social tendencies and conflicts in interpersonal relations,
  2. clearly ‘neurotic’ or dysthymic,
  3. depressive inclined to have depressive reactions and even suicidal thoughts or tendencies,
  4. schizoidal.

This group, as well as the next one, included subjects classified there not only on the basis of subjective complaints and ailments but also on the interview. Obviously, as always in psychiatry, this division is conventional and cannot be rigid regarding psychological features, but it is made based on the dominant personality characteristics. The picture may be of a mixed character, but the subject must be classified in the appropriate group based on dominant characteristics.

III. Distinct features of immaturity, divided into:

  1. infantile personality with dominant emotional immaturity,
  2. infantile personality with dominant psycho-asthenic features,
  3. infantile personality with distinct reactions of anxiety. Reactions of anxiety could be observed independently of the diagnosis, as were connected with the subjects’ age. In group III particularly distinct reactions were observed, whereas the remaining groups all included weaker reactions.

The first group (I) comprised all the cases with clear dominant symptoms of an organic injury in the clinical manifestation such as:

  1. syndromes equivalent to encephalitis or meningoencephalitis origin, with a secondary syndrome of hypophrenia;
  2. cases without psychopathic personality features but with distinct paroxysmal periods of irritability or dysphoria appearing regardless of outside causes, disappearing without traces, connected with somatic ailments such as pains, dizziness, paroxysmal pains of a hemicrania type, syncopes suspected of equivalent directions but (excluding one case) never observed during the examinations,
  3. one case of epilepsy.
Group I included 11 persons (7 women and 4 men).

The comparison of ages and length of periods spent in the camp is presented in Table I.

Table I: Data concerning group I (7 women, 4 men)

There were pathological EEG records of general or focal changes in 10 cases in the group illustrated by Table I. In one case, the record was normal despite clinically confirmed epilepsy.

This group included five small children marked with the symbol ‘M’ and one child born in the camp in 1943 but marked 'N'. The children were imprisoned in the first three years of their lives and the length of time spent in the camp was, in all cases, more than half a year. Correlation between the intensity of pathological changes and the length of the camp period could be clearly observed. Children who spent more than two or even three years in Auschwitz demonstrated the most intense symptoms.

This group also included four older children between the ages of 8 and 14 who spent a shorter time in the camp, around nine months, but who manifested encephalopathic syndromes.

Finally, this group also included one subject with very little definite personal data; he was taken from the camp when he was two or three years old; he was able neither to identify the camp he had been in before the one he was collected from, nor to specify the time he spent there. The year of his birth was assumed to be 1939, and at the time of liberation, he could not speak and did not know his name. This was the one case in which epilepsy was confirmed clinically.

Regarding somatic illnesses in the first months of liberation, in five cases pulmonary tuberculosis was recorded and in six cases arthralgia.

Further to the main symptoms described above, which constituted the basis for the group specification, there were also such symptoms as:

  1. depressive reactions and inclination to depression in five persons, who described it in the following way: ‘I can’t say why I am sad’, ‘I was always different from other children, I was sad’, ‘Sometimes I wonder what I live for and think I should do something to myself, ‘I could never be happy, that hangs heavy on me’;
  2. only three persons in this group admitted reactions of anxiety, although one other pointed at a distinct anxiety, and was described by his father as, ‘he is still afraid’, ‘he is afraid of different situations’.

Case 10, a female. Unspecified date of birth. Judging by her tattoo, she was brought to Auschwitz in the middle of 1943 and two years later, after liberation, her date of birth was recorded as 1939. She did not remember the camp but she knew her name. The first data came from the time she was in an orphanage, to where she was brought in April 1945. For the first two weeks, staff in the orphanage were convinced she was unable to speak. It was clear that she understood orders, and ‘she looked intelligent but said nothing’. The person interviewed said, ‘It was such a long time ago, but the behaviour of this child was so strange that I shall never forget it’. After some three months, the girl started to speak. Then she would have fits of sudden fury, suddenly in the middle of games she would start to beat other children, shout, but then would be silent and shy again.

It was extremely difficult to change her clothes. She was brought in 'a rag' and did not want to take it off for more than a month, she slept with her ‘clothes’ on, and made such a row at any attempt to make her take it off that she was left alone. Only after more than a month, her teacher remembered,’ did she allow me to change her clothes but I clearly remember what the child told me: “when you give me a new dress, you will burn me”. Finally, I managed to convince her that nobody was going to burn her and she allowed me to dress her. She suffered from intense anxiety for a long time, she woke up crying, or shouted German words or parts of words in her sleep trembling all over her body and was a bedwetter for a long time. The teacher could not remember what illnesses the girl had suffered from but she stated, ‘I know she must have had tuberculosis because she went to a sanatorium later and I remember that she suffered from some chronic suppurating conjunctivitis for a long time, her eyes were always gummy’. When the girl was brought to the orphanage, she liked school and her first attempts indicated that she might be talented. Very quickly, however, her progress stopped. Her teacher recollected, ‘I know because I taught her, she was very hard-working and ambitious but it was obvious that she could not acquire any knowledge, she was able to remember only for several minutes, and tried to read and write with great effort’. A long time passed before she managed to learn anything. It occasionally happened that she could remember something more but sometimes she was ‘somewhere else’ and did not react to her environment.

Somatic examination: A tattoo number on the left arm, a number of scars on the chest, very wide pupils, weak reaction to light, regular, very lively, deep reflexes.

An EEG picture revealed very distinct general features of diffused encephalopathy.


Children at a Nazi German concentration camp

Psychiatric examination: poor mimicry, initially very difficult contact, suspicious. Only at the end of the conversation did she say spontaneously that ‘it’s worst when you don’t have a family’, she constantly returned to the subject of a family. She did not think she was ill but remarked, ‘I have had such terrible headaches ever since I was a child and I am very excitable’. She knew she had suffered from tuberculosis because she spent two years in a sanatorium. Her earliest recollections were connected with her mother; she maintained she could remember her mother’s face and a child in her arms, and then a big fire, her mother shouting and crying; she also remembered many children, perhaps more than a hundred. Her only recollections from the camp were, ‘They beat my back all the time whenever I could not stand, all the children were weak and those who were not able to stand were beaten on their backs and heads. I was beaten all the time and I was hungry because they gave us only strange bitter spinach’. She also remembered she stood barefoot on snow and her feet were ‘so black and they hurt so much’. From a later period, she could remember soldiers who gave children fur-lined gloves and sheepskin coats, and she was finally warm. The next recollections were from the orphanage. Nobody beat her there but she remembered she cried at night; there was nobody around her. She still cries at night when she wakes up and realises that she is alone in the world. When asked what she would like to change in her life, she sighed and said like a small child: ‘to have a mummy and daddy, but it’s impossible, I am so depressed, I left my fate in Auschwitz. How often do I think I should do away with myself, I can’t manage on my own, I’d like to have someone close, anybody, who could help me, now I always feel lonely in the world and you cannot know how terrible it is’.

She described herself: ‘I am the dullest person in the world because my memory is bad. I could not learn even when I was small, I wanted to learn a poem as other children used to do and I spent the whole night learning but I couldn’t remember anything in the morning and now if I have to remember something I make knots on a thread. If only I could remember properly’. She said everything very calmly without a trace of melodrama and repeated with great resignation, ‘I have never had anybody who could help me in my life and who could help me be happy’.

On the day of the examination, she shouted in her sleep at night, sat up with her eyes open, behaved as if she was pushing something away, and shouted inarticulately. When she was delicately put back to bed, she was soon calm though she moved and pronounced single words like ‘mummy, mummy’ for a long time and she cried. In the morning, she did not remember anything of the night’s incident. She spontaneously began to talk about Germans, that she was still afraid of them, that if it were not for them her life would have been different. During the examination, she generally felt bad, with a suggestion of sorrow, and with clearly childlike behaviour, a striking sense of having been wronged, and loneliness. Her parents were clearly dominant in her thoughts, though at the time of the examinations she was 27 years old.

Psychological examination: The subject lives alone, has very little experience and very little contact with others, and feels very lonely and deserted. The fact that she has no parents, and especially that she has no mother, makes her very depressed. She feels forgotten, deserted and is convinced that nobody loves her. She tries to cope with hard work on her own, looks at the world with the eyes of a frightened child, is not able to act in it appropriately, and does not understand it. All interpersonal contact terrifies her. She is afraid of people though she needs their friendly support. She knows, however, that people are only ready to use her; at least, such were her past experiences. She has a strong inferiority complex, easily gives up her plans in fear of failure: she cannot be successful. She is sad and depressed; there is no joy of life in her, no enthusiasm, and no drive. She has a tragic awareness of her fate as a lonely child brought up in an orphanage.

Emotional conflicts are manifested by withdrawing from the outside world, and fear of any interpersonal relations.

EEG record and interview data: paroxysmal changes in moods, escapes, defective memory, physical symptoms such as headaches and dizziness after physical effort (thus also hyperventilation symptoms) suggest a state after an injury of the central nervous system, similar to the ones observed after encephalitis.

A question is still left unanswered as regards group I, as to whether the subjects suffered an infection of the central nervous system, or whether the changes resulted from starvation. Regardless of the causes that brought about such states, however, this group of subjects exhibits clear organic changes.

The second group (II) comprises cases analysed together from the perspective of personality changes. The sub-groups were distinguished according to dominant features and, as usual in a psychiatric diagnosis, they are not totally uniform but differ in individual cases. The subjects were assigned to the same group in order to facilitate the classification. Both psychopathy and chronic neurotic syndrome was included here, to emphasise the fact that they differ from usual neurotic symptoms since they are not accompanied by situations that might constitute the source of neuroses; they appeared to originate in a stress situation that a subject was in, 20 years ago.

This group included 13 persons (nine men and four women), and the following syndromes were identified:

Table II: Data concerning group II (4 women, 9 men)


IIa – impulsive personality of an anti-social character,
IIb – dysthymic personality with neurotic symptoms and changeable moods,
IIc – personality with a dominant depressive tendency,
IId – personality with distinct schizoidal features.
The cases that comprised different features were marked by double symbols, e.g. a+d, or a+c.

Table II presents the cases ordered according to the year of birth, the length of the period spent in the camp, age on imprisonment as well as diagnosis and EEG examination results. The analysis of the age of the subjects who were classified in the group illustrated by Table II indicated that five subjects were born in the camp, one was probably born in the camp, two were about two years old at the time of their imprisonment, one was eight, and four were more than 10 years old.

Regarding the children born in the camp, four of this group have pathological EEG records with general or focal features, one child born in 1944 has no pathological changes in its EEG, one of the older children did not agree to take EEG examinations, one has pathological records, and four have normal ones. Two of the younger children from group II who were not born in the camp have general pathological records. Thus, out of 12 cases in this group, seven show electroencephalographic changes. As was mentioned earlier, the subjects were not grouped according to similar EEG examination results but according to personality features that appeared to exceed the limits of the norm. The problem is whether, in such a case, the period spent in the camp can be responsible for a given personality type, and whether observed symptoms are connected with a pathological EEG record.

To illustrate the problems of this group more vividly, the subjects should perhaps be approached from a slightly different perspective than that of psychiatry; namely, the cases should be introduced with regard to their social status. The group includes four subjects of an unknown origin; two subjects have found their parents only recently. Three subjects lost their parents in the camp and left the camp as orphans who remembered their names but did not have homes. Two subjects lost their fathers in the camp, and were raised by their mothers. Only two subjects had homes and families.

Environmental conditions exerted an obvious influence upon the development of personality characteristics. Case 12 is a typical example in this group.

A boy born in December 1941, as was recently established (his ‘previous’ year of birth was 1943). He was taken from the camp by his adoptive parents and raised as an only child. It appeared initially that he would not be able to survive, as he was extremely thin. His head was a crust of’ scabs and lice’, his eyes ‘ were gummy, and they ran for a long time’. There were many marks on his body as if from a needle. He used to wake up at night suddenly, shouted and cried in his sleep. He suffered from tuberculosis.

When he finally recovered from various illnesses, he went to school where he was different from other children, mainly because of his irritability. When he was unexpectedly touched, he immediately reacted with aggression. Sometimes he looked through the window, deep in thought, as if he did not hear or see anything. When he saw a uniformed person, he either ran away or beat him with his fists. He was stubborn, obstinate, and secretive. He grew very attached to his adoptive mother. Once, when an old man was dying in the neighbourhood, he rushed there followed by his mother who found him radiant. He asked, ‘Mum, so a man can die on his own? I thought that he had to be strangled’. He lied even when it was not necessary. He used to hide food and different objects in various places at home for a long time. He was a good pupil but they did not understand him at school. His teacher confessed, ‘he is strange’. After he passed his final secondary school exams, he became a student but he changed to another college after only three months. A year ago, when two girls from the Auschwitz camp found their families, his mother was also found and he went to visit her, but was even more secretive when he returned from this visit. It could not have been a surprise for him that he was an adopted child. Since the time he found his own family, however, he has become more nervous. His adoptive mother complained, ‘Now I am unhappy and so is he, and so is the other woman, because he does not call her “mother”’. Somatic and neurological examinations indicated that he was frail, asthenic, had a small scar in the right superciliary arch and clear symptoms of vegetative dystonia.

Psychiatric examination: contact apparently easy but superficial. Only after many conversations did he admit that it had been very painful for him to learn that he was an adopted child. He secretly went back to Auschwitz and tried to find some traces of his own mother. He felt bad, suffered from sleep disturbances, easily became tired, and people irritated him. His adoptive mother also irritated him because she was overprotective. He made the following statement about his own mother, ‘she does not possess any of the features I imagined she should have. My adoptive mother clearly has a grudge against me because of the other mother, and my own mother is also full of rancour against me because I did not express my happiness when I first saw her’.

Psychological examination: a good level of intelligence, which influences the subject’s behaviour in a fundamental way. He modifies and plans his behaviour based on result analysis, he has an introvert inclination, is aware of his own consciousness, and knows himself well, which is accompanied, however, by a general psychological immaturity. He is very inconsistent emotionally, and full of suppressed aggression. He is rather unfriendly towards people; he is afraid of interpersonal relations and tries to mask this with indifference and loftiness. He is in constant emotional tension, which leads to states of anxiety. The superficial psychological balance in fact results in inappropriate reactions, unexpected for himself. He becomes aggressive and arrives at situations of conflict with his friends and with strangers. He is also in conflict with his parents, which is accompanied by a strong sense of having been wronged. The examinations point to schizoidal and depressive tendencies, and a lack of stability.

The diagnosis was marked with symbols IIa+b+d, which means his personality is both impulsive and schizoidal, and in a state of neurotic tension.

It may appear that neurotic tension cannot be conditioned by distant camp experiences. The analysis of his life, however, indicates that the tension that has been present for several years has been conditioned by that period and has its origin there. Initially, this was anxiety tension, about which his mother referred to. Anxiety was sometimes expressed as aggression, especially when he was unexpectedly surprised. Aggression led to conflicts with his environment, which in turn resulted in deeper schizoidal features. He feels alienated, and is in constant search for his origins. The fact that he found his mother did not change anything; on the contrary, the conflict is greater because there are now two women who want to and have the right ‘to possess him’. Such a state may be described as late after-effects of the same cause. Undoubtedly, the period spent in the camp is still a burden to him.

The third group (III) includes subjects with infantile features:

IIIa – emotional immaturity,
IIIb – infantile personality with distinct psychasthenic features; dominant features are weakness, sensitivity, great receptivity;
IIIc – symbol ‘c’ indicates clear anxiety that is still manifested at present.

This group includes 19 subjects in whom immaturity was the only disorder, and 7 subjects who also exhibit other symptoms discussed in cases of other groups alongside infantile personality. Thus, the group comprises 26 subjects altogether: 19 women and 7 men.

The following are the general symptoms listed according to their frequency of occurrence: bad frame of mood, anxiety, changeable moods, nervousness, easily tiring, sleep disturbances, nightmares, specific somatic ailments such as headaches, arthralgia, cardiac pains, etc., as well as so- called nervous complaints, which are neither very intense nor dominant.

Some subjects did not mention any ailments and estimated their health situation as very good; the analysis of the collective material, however, clearly indicates that they should be classified in this group.

Group III is further divided into the following sub-groups: the first includes subjects with clearly infantile reactions, constant, affectively lively, somewhat exaggerated, with changeable moods and naive interpretations of the surrounding phenomena. The second sub-group is constituted of distinct psychasthenic and physically asthenic subjects. Women constitute the majority of this sub-group; there are 19 of them in the group of 26 persons. Out of 21 EEG examinations, in 12 cases, three records were pathological, in three cases immature, and the rest of this sub-group did not participate in the examinations. Thus, the question is whether we can only speak about immaturity if the EEG examinations indicate pathological changes (13 pathological records out of 21 records made).

The following case is typical for group IIIa.

Case 19. A girl born in 1943 in the concentration camp. Her mother was arrested in the second month of her pregnancy, spent two weeks in prison and was transported to the concentration camp. At the end of the third month of her pregnancy, she fell ill with an infectious disease with a very high temperature and loss of consciousness. She was in a’sickroom’. After she gave birth, her child was the first left alive in the camp. She stayed with it for six weeks and tried to feed it, but she did not have milk and fed the child with only herbs. Three days after the delivery, the child contracted pemphigus and then caught malaria from the mother. The child was never bathed during those six months. After that period, both mother and her child were released from the camp. The child was dying. Immediately after the malaria with which it left the camp, it fell ill with pneumonia and then with infectious jaundice. Additionally, it turned out that the child also suffered from tuberculosis, which was present for the next several years. The girl went to school at the age of seven, was a poor pupil, and repeated the fourth form. Her mother could not say whether the reason was that she was not able to learn properly or whether it was caused by the fact that she had to spend some time in hospital because of her tuberculosis. Finally, she finished seven forms but did not want and was not able to continue her education. She liked music, and learnt to play the accordion and the piano on her own. When she finished her primary education, she started work in a shop. Then she fell in love, and was married in 1964. She gave up work. Her marriage was successful but she had frequent rows with her mother-in-law. She was always nervous, always used to pick her fingers, always kept her hands busy, and was never calm. She was afraid of motor vehicles, and ran away when she saw a car or heard its sound.

The somatic examination pointed to a compensated heart defect, and symptoms of vegetative dystonia. The EEG record showed pathological features in bilateral right and left temporal leads.

Psychiatric examination: she was very active, lively, her fingers were busy all the time, and thumbed the table. She spoke a lot and very quickly, without restraint, and smiled a lot. Her earliest recollections from childhood were that she learnt to play the mouthorgan, but was not allowed to continue because of tuberculosis. She was medically treated in a sanatorium until 1960. Subjectively she feels well, although she is aware of her tuberculosis and heart problems but she does not care. She grew attached to her mother, and she is not able to live without her. She came accompanied by her mother to participate in the examinations. She had married a year ago and at the time of the examination was pregnant. She was happy but was afraid that the child might be nervous. She spoke about her husband with admiration. She often thought of Auschwitz since, as she put it, ‘I cannot be a musician because of the camp, if I hadn’t caught tuberculosis and all other illnesses the doctors would have allowed me to play. Now my life is broken’. She lightly converses about her ‘broken life’, and then adds spontaneously ‘I can't dance either, only a little, but I get tired easily’. She becomes sad when she says it. She adds, I am still afraid of Germans’.

Psychological examination: an even-tempered person both in interpersonal social relations and according to what outside symptoms suggest. Despite her psychasthenic inclinations, she rationally solves her emotional problems, mainly through watching her behaviour and preventing emotional reactions. She is aware of her psychological features, and this knowledge helps her to avoid conflict and assume an objective attitude towards the outside world. The examinations pointed to anxiety and suppressed aggression, of which the subject was not aware but which led to uneasiness manifested as over- protectiveness and worrying about the people closest to her. Examination results are within the norm with infantile features in some reactions.

Diagnosis: she was classified in the third group ‘a’, that is, among infantile, emotionally immature subjects.

Group III also comprised subjects who appeared infantile but with clear, dominant psychasthenic features, giving the impression that they were shy, uncertain, scared children, though they did not admit to any anxiety. This group also included mixed cases where neurotic features could be clearly observed alongside features of immaturity. The neuroses were of a permanent character, and dated back to periods of traumatic childhood. These subjects had always had neurotic symptoms, as far as they could remember.

Case 49 is characteristic of the mixed group.

The subject was born in 1930 and was 10 at the time of imprisonment in the camp. She was in different camps until the end of the war, over a period of three years. She could recollect the camp period easily: ‘I would like to forget it but I can’t, I would like to forget even a part of it but the memories are still very clear, impossible to eliminate. I was panicky, afraid, it was one great terror, and I cannot understand why I did not die. Now I am not afraid of anything specific but there are moments in the middle of the day or even during some entertainment, when I cannot overcome sudden irrational fear, I am bathed in sweat and try to calm myself down. “You idiot”, I say, “the war is over”, but it does not help, I can’t get rid of it’.

Following liberation, she did not dare go outside alone and did not want to go to school. She was afraid. After liberation her parents, who were also imprisoned in the camp, returned and created the most favourable conditions for her to develop normally. They took her to a psychiatrist and she was medically treated for two years. The doctor diagnosed a reactive-depressive syndrome. When asked whether she had children, she reacted typically and said, ‘I would like to but I am afraid that my child might have the same problems as I do and I cannot make up my mind, though I know it’s silly’. Her most terrifying recollections were about ‘human savageness’ and she quoted, not a murder scene, but a story of her camp mate, four years older than she was then, who ate her mother’s slice of bread and said, ‘You have already lived long enough, you can die, now it’s my turn, I want to live’. She was afraid of Germans and hated them. A shocking experience for her was when she was in Germany, German children evoked the greatest hatred in her. She could not cope with this awareness and shortened her stay there.

She never made friends with girls of her age. She was always very attached to her parents, and could make no decision without their advice. They constantly treated her as a child; she had never worked, and they supported her.

Somatic examination: wide pupils, and a bilaterally strongly positive Chvostek reflex. EEG record with pathological features in back left-hand side leads.

Psychiatric examination: contact easily established, spontaneous unrestrained statements, no resistance towards any examinations. She definitely feels harmed by the Germans, and is convinced that her neurotic symptoms and anxiety are irreversible. She believes she is ‘ill-humoured and not quite normal’, and that this is the result of camp experiences. She feels lonely among people and is afraid of them, and would never be able to confide in them. She can confide only in her closest relatives, and has never been able to understand young people of her age. She is convinced she is a lost cause, and nothing can be changed. ‘The shadow of the past still hangs over me’.

Psychological examination: she lives in psychological and social seclusion. She discusses her past experiences with apparent indifference and objectivity. She is aware of the fact that the camp period fundamentally influences her present state of mind. She is slightly moody, and depends on others from whom she requires absolute devotion. She is constantly in a state of mental inertness and does not make any effort to change it; she feels most comfortable in such a state. She is very inactive; she does not have any purpose in life, and is indifferent to everything she might possibly do. She has a sense of emptiness and wasted life. She reluctantly talks about the camp period but during the examination it is clear that this is the one thing she constantly thinks of, as if her life had stopped at that time.

Examinations point to psychasthenic inclination, a one-track mind, inclination to perseverance, states of bad moods, and a sense of dissatisfaction. Impulsiveness and epileptic features can also be observed.

Diagnosis: slightly infantile sensitive personality, distinct permanent anxiety neurosis. The pathological EEG record might suggest encephalopathy.

Surmising the characteristics of the three diagnostic groups described above, it should be emphasised that the examinations did not disclose any mental illnesses in the proper meaning of the word, in any of the examined subjects. The symptoms described above are classed as psychopathological from a psychiatric perspective, and refer to personality structure. Regardless of psychiatric diagnoses, which are always conditioned by the subjective estimation of the subject, all subjects exhibited a distinct sense of otherness whenever they found themselves among their peers.

All subjects believe they are very nervous and that this is connected with their camp experiences. Therefore, the analysis of the subjective experiences and the statements made by the subjects is probably more important than a descriptive psychiatric analysis.

In the cases quoted above, so-called macabre situations were purposefully avoided. Average cases were presented and not the ones that evoke horror, since average situations could best show the harm done to the youngest prisoners of the Nazi camps.

It might be interesting to compare the subjects from the perspective of their age. In the whole group there were only five subjects born between 1928 and 1931 (two women and two men), 12 subjects were born between 1932 and 1938 (eight women and four men) and 33 subjects were born between 1939 and 1945 (20 women and 13 men).

The estimation of the period spent in the camp should also include foetal life, since mothers starving during the periods of their pregnancy also exerted a negative influence upon their child’s further development. Such data are illustrated by Table IV where symbol ‘N’ refers to those born in the camp, ‘M’ to children up to 6 years of age, ‘d’ to those from 6 to 10 years of age, and ‘D’ to those above 10 years of age.

There are still six children without clearly known dates of birth, and it is impossible to state whether they were born before their mothers were arrested (three boys and three girls). Those children joined the group of small children under six.

Table V presents the correlation between the age and the length of the period spent in the camp with a psychiatric diagnosis and EEG examination results.

As Table V indicates, out of 17 EEG records made in the group of subjects born in the camp (one subject did not turn up for the examination), seven records are distinctly pathological, three are described as immature and six as normal. Regarding psychiatric diagnoses (Fig. 1), 12 subjects out of 18 were classified in the ‘immature’ group, eight of whom are described as emotionally immature and five as psychasthenically immature. The remaining five cases were classified in the second group of unstable personalities of psychopathic features. Two men in this group had clear features of group Ha, that is, impetuosity with an antisocial tendency, five men exhibited schizoidal features, two subjects had an inclination to depression and one had an encephalopathic picture with hypophrenia (Ia).

Thus two thirds of the group were classified in the group of immature persons. The following problems that were specified based on the questionnaire answers should be regarded more carefully:

1. The attitude towards the camp and the Germans,
2. The attitude towards people of the same age and camp mates,
3. Self-estimation.

Problem 1: All subjects from this group know a lot about Auschwitz and are interested in the literature on the camp. They spontaneously write that they hate Germans. One of them expressed his attitude in the following way:

‘My parents and friends who went through this hell told me about the camp history. I call it hell because this is the way in which those who were there and experienced the bestiality of the “German super-people” refer to the camp. Those who managed to survive reluctantly recollect that period again.

Table III. Data concerning group III (19 women, 7 men)

I hate them, Germans, for all that they did. I want them to be most severely punished’.

Such and similar statements can be found in all the questionnaires. This entire group wants to know as much as possible about Auschwitz and other camps and expresses sharp and univocal judgements about Germans. They all frequently use the words, ‘I hate them’.

Problem 2: The opinion about ‘contemporary youth’ is very interesting and clearly suggests that the majority of subjects feel different, even though they write: ‘I am the same, it’s only that...’. They say: ‘The youth today is demoralised and so am I, I am the same, the only difference is that they are in education, and I'm not;'; ‘the difference is that they are happy and I am always kind of angry’; ‘Young people today are lucky, they are carefree, can be educated, become somebody, and my plans are crossed by my illnesses’; ‘I am more serious than my friends’; ‘They are too well-off. They don’t appreciate school, learning. Society and the law are too tolerant towards their goings- on. They have too many facilities provided by the state and they are not able to appreciate it’; ‘My attitude to school is more serious’; ‘They are too comfortable and they are spoilt’.

Four subjects did not think they differed at all from their colleagues, and one did not answer this question.

Conversations with the subjects indicate that they all felt different and believe that the camp was responsible for this fact. It appeared they feel a kind of sympathy towards each other and constitute a group. Not only the Ravensbrück group, which is a very close and good group with many common experiences, thanks to their tutor Mrs Cezara Skoryna-Dicksteinowa, but all young people born in concentration camps constitute a social group, and feel they are the members of this group.

Problem 3: In self-estimations different expressions are used; the most often repeated words are ‘nervous’, ‘impetuous’, ‘I am an unlucky person’,

‘I am average, sensitive, I like dreaming’, ‘impatient, nervous’, ‘I would like to change myself, ‘I get nervous but only for a while’.

Table IV: Data concerning age on imprisonment

When asked whether they would have been different if they had not been born in the camp, they all said yes immediately, or after only a short hesitation, ‘(perhaps) yes’. They feel the difference between themselves and other young people who had ‘experienced nothing’; one characteristic is that despite the fact that they do not directly remember events that took place in Auschwitz, they all use the phrase ‘to live through,’ when they talk about the camp. It is their experience although they do not remember it directly. Such an attitude may result from conversations with adults about the camp, especially since there are children in this group who returned home with their mothers (17 children out of 18), or could hear about the camp from their family. In a sense, this group is privileged in comparison with the next group since children in this group had at least one parent (nine children came back with their mothers as their fathers were killed in the camp, eight children found both parents, and only one child was given to an adoptive family by her own mother).

Table V: Subjects born in the camp (18 persons including 11 women and 7 men, group marked with the symbol “N”)

It is possible that the imagination of these children was haunted by their mothers’ experiences? Thus a new problem appears, very obvious against the background of the collected material. This is a need to analyse the consciousness of the mothers, and the influence of not only their time in the camp but also of the fact that they were there with their children and delivered them in camp conditions. Judging by what we know about the camp conditions, it appears obvious that a woman that looked at her baby and knew that she was not able to provide it with even the minimum necessary to survive, or that a woman who delivered her child in such unbelievable conditions, must have undergone extremely heavy trauma.

The awareness of something so incredibly horrid, terrifying – since it would be difficult to imagine something worse than the experiences of mothers in the camp – certainly left very clear marks in such persons. Therefore, consciously or subconsciously, the recollections of the Holocaust that they transmitted to their children were not only set in an atmosphere of terror but were also vivid, despite such a great distance in time. In such a way, they were assimilated by their children.

This may explain a further problem very distinct in the group: most of the subjects have features of immaturity and prolonged childhood, but even from their mothers’ reports, it was obvious that they are very protective towards their children although the children are now adults. Over-protectiveness and exaggerated tenderness are psychologically justified, since such mothers want to protect their children even when the danger is over. For them, their child will always be in danger.

It would be worthwhile to examine the mothers and investigate their conscious and subconscious feelings that originated in the camp. It appears that mothers still remember their experiences from that time and pass them to their children. As a result, the subjects are able to react so vividly to events that they cannot remember. The analysis of the hostile attitude towards Germans, which is a relatively natural reaction in the circumstances, indicates however that' children' hate them more than the adults do. The reason may be that the children lost their fathers there and the camp ruined their lives in many cases, or it may be a natural reaction based on the assumption that young people’s experiences are always more intense. The problem certainly requires further consideration. This question was put to all the subjects at the request of Prof. J. Aleksandrowicz, to provide additional data for the study of hatred made by the Kraków section of the Psychological Hygiene Society.

The next age group includes children whose place and date of birth could not be specified and children were too small to remember their details. This group also includes children who were less than six at the time of the imprisonment. They neither remember the camp nor can recollect anything except for only unclear, individual pictures, ‘there were wires there’, ‘there was a very narrow street’, ‘someone led me over a long bridge’, ‘it was very cold and I cried’, ‘I remember how they hit me on the my head all the time and I was very scared’, ‘I knew I was very thin and ugly when I walked’, ‘I remember someone was carrying me over a long bridge’. Sometimes they simply write, ‘I don’t remember much but I know it was horrible’, or,’ a long stove next door’.

There are 16 subjects in this group (ten girls and six boys). Their ages at the time of imprisonment and diagnoses are presented in Table VI.

Table VI: Subjects imprisoned between I and 6 year of age (10 women, 6 men, group marked with the symbol “M”)

Fifteen EEG examinations were made in this group. Twelve of them are pathological and in the 13th case, the record was normal but epilepsy was diagnosed and thus in 13 cases out of 15, encephalopathy was diagnosed. This is much more than in the younger group, and may result from the fact that the children from this group, though not born in the camp, were imprisoned as small children and their camp periods were much longer than in the cases of children born there. One child among those born in the camp spent more than 20 months there and this child belongs to the same diagnostic group, that is, to la with serious brain injuries, whereas other children born in the camp spent a short time there, not more than nine months. The average period spent in the camp in the case of children born there was 4.4 months, whereas in this group it was a year and a half. Children from the other groups were mostly children from the Warsaw Uprising, from transports that came to Auschwitz when there was already a children’s block there, or they were children born a short time before liberation. Older children were usually separated from their mothers, therefore the younger ones could not remember anything about their family background; three of them found their families after 20 years had passed, and six of them still know nothing about their origins. Such subjects suffer not only from the after-effects of starvation and camp experiences but they also have psychological problems connected with their unspecified origin.

The problem of neurotic syndromes resulting from adoption is not included here: in order to avoid objections that such syndromes are frequently met in all adopted children (which would appear to be shown by the results from the control group), we concentrated on the problems connected with longer periods spent in the camp.

The following is a thorough study of the estimation of the subject’s place in the world and the after-effects of the camp period made by the subjects themselves. The following problems should be considered:

1. My attitude to the fact that ‘I am a former prisoner’ of Auschwitz and the resulting attitude towards Germans,
2. My attitude towards people of my age and towards others,
3. My self-estimation.

The awareness that ‘I am a former prisoner’ takes a very specific form in this group. Unlike children who were born in the camp and spent time there with their mothers, who speak about themselves as former prisoners and sometimes identify with the experiences of their mothers, this group makes statements that are weaker, conditioned, and of the type, ‘it would be difficult to say that I was a prisoner since I was a child then and I remember nothing’. Three subjects stated, ‘the former prisoners do not regard us as prisoners and they may be right’.

Statements are made much more carefully in this group, as if it were more difficult to speak about the camp. Some subjects even refuse to discuss Auschwitz at all.

The previous group took pride in the fact that they knew a lot about the Occupation and especially about Auschwitz, whereas this group taciturn and prefers to forget. They write, ‘I want to break free from this nightmare, I don’t want to hear of it any more’, ‘I want to get it off my chest, ‘I don’t want to remember’. They add, ‘Auschwitz belongs to a past I don’t want to remember’; 'what's left of that time is my aversion to German, resentment about my childhood, and a weak body (I was never strong);' ‘I can remember almost nothing but I know it was terrible’; ‘I don’t like to go back to that time’, ‘I don’t want to think about it, I get terrible nightmares’; ‘All the time I wonder where I am from and what is my origin’; ‘it is difficult to live burdened with the past, I don’t want to talk about it’.

Four subjects say nothing about Auschwitz; they do not want to speak. Asked about their attitude towards Germans, they do not explode with spontaneous hatred as the previous group did, and do not speak about it directly, as if it were impossible to express the misery they suffered, as if it were beyond the ‘limits of reaction’.

Characteristic of this group is a much stronger sense of the fear of Germans and of the next war, whereas the previous group hated without fear. The subjects from this group clearly show dominant features of anxiety that become more intense with age, as indicated by further analysis. The older the children are, the greater their awareness of apprehension.

It should be added that in this group are more subjects who suffered from somatic illnesses such as pulmonary tuberculosis or tuberculosis of the bones (five subjects).

Table VII: Data concerning the subjects with the symbols “d” and “D”

Table VIII: Fairy test

Regarding the question ‘my attitude towards others’, there is a greater sense of otherness in this group than in the previous one. The subjects write, ‘I am more suspicious, I have a pessimistic attitude to life and I always think I am ill-fated and I am always unlucky’; ‘I am frequently told I am too serious’; ‘I don’t like their entertainment’; ‘I don’t like today’s youth, I am much more serious’; ‘they have no respect for older people, to say nothing of their parents, because they have them, they don’t know what it is like when you cannot have even bad parents, because they have them and are silly’.

Further to the sense of otherness, critical judgements also appear, sometimes well founded, and a clear tendency to oppose those who ‘don’t know what they want’ with a hidden implication of, ‘I do know’. There is a new factor in this group: nostalgia for a family of their own and astonishment at people who have a family but don't appreciate it.

This may be a ‘positive’ influence of experiences that evoke a greater awareness, reflection, and a sense of a hierarchy of values.

Problem 3: These subjects have a much more pessimistic attitude towards themselves than the other group. This group produced such statements like ‘Well, I am ill-fated, and that is why I can never manage’. A pessimistic tone is definitely dominant in the statements, ‘I am an average person’, ’I am nervous, unstable, changeable, I think I have a weak character’, ‘I am melancholic, over-critical, and too emotional’.

The term ‘nervous’ is also often repeated during conversations. By ‘nervousness’ they usually understand explosiveness and changeable moods, as well as sensitivity that would be consistent with comparative diagnoses. This group includes five subjects (out of sixteen) diagnosed with psychopathy and instability, seven subjects have distinct psychasthenic and sensitive features, four subjects exhibit a clear psycho-organic syndrome, one subject suffers from epilepsy, one has a neurotic syndrome and one subject has schizoidal features.

From the perspective of EEG examination results, the syndromes mentioned above might qualify as encephalopathy.

There is still the group of older children to be discussed, children who were from 6-10 at the time of their imprisonment, and the oldest children who were more than 10 at the time of the imprisonment. The group included 16 persons: nine girls and seven boys.

As Table VII suggests, EEG examinations were made in 12 persons out of the whole number of 16. Eight of them have pathological records.

Regarding diagnoses, neurotic syndromes are dominant (seven subjects), three subjects were diagnosed with encephalopathy, and six with immaturity, two of whom have psychasthenia and the rest ‘emotional’ immaturity.

The analysis of ‘nervousness’ indicates more frequent reactions of anxiety, as if older children had a greater awareness of what they experienced. Anxiety is strong and permanent.

Based on the questionnaire, the following problems were analysed:

1. Attitude towards Auschwitz and Germans;
2. Attitude towards the environment;
3. Self-estimation.

Statements concerning point 1, ‘Auschwitz has always made a horrible impression on me, I often see it in my dreams, I try to have an objective attitude towards the events from the camp and Germans but it always is negative. Can we assess it in any other way from a historical perspective?’;

‘My attitude to Germans is clearly hostile, I don’t believe in friendly Polish- German relations, I don’t even believe those who are on our side, as a nation they are different than we are, personally I am also full of rancour for my life’;

‘I have an objective attitude towards Germans, there were some good people among them and they fought against the Nazis, and there were Poles in the camp who were worse than Germans’, ‘I know there were different Germans, some were imprisoned in the camp with me and were good to me, not all of them are the same, just as it always is with any people’; ‘Auschwitz is not history for me, it is reality’; ‘My attitude towards Germans can be expressed in one sentence: I believe that the whole German nation is responsible for all the crimes of that time, they should all be prosecuted, when I hear German abroad or on the radio things fall out of my hands’;’ So what, if it is already 20 years’; ‘Unfortunately those recollections are always vivid and always come back to me when I try to remember something else, they are brought back by the smell of fire or other things’; ‘The smell of a simple bonfire with baked potatoes, for me will always be the recollections of a crematorium’ (the subject was 10 in the camp); ‘Every German word brings associations with German orders heard in the camp, a kapo,' 'I refuse to go to Germany on business, they are all the same’; ‘the very word “Germans” is enough to evoke fear, people cannot understand it’; ‘I am not able to talk about Auschwitz, it is indescribable’.

The second and the third problems, ‘attitude towards people of the same age’ and ‘self-estimation’, can best be illustrated by the statements made by the subjects themselves. The majority of the subjects admit: ‘I am nervous and jumpy’. Nobody in the group is able to claim they do not feel nervous. Some use the word ‘explosive’, others ‘nervous’, but for them, both terms are synonymous.

Moreover, the entire group has an awareness of a special ‘mark’ left on them, a traumatic stamp, an otherness that resulted from tragic past experiences that can never be wiped from their memory. At the same time, all such remarks are made discreetly, unobtrusively. They are aware of the ‘mark’ but they do not demonstrate it.

They feel different from other young people because of this mark; as if they suffered from the problem observed in adults and investigated by M. Orwid, the problem of adjustment to life that is still present although so many years since the camp period have passed. The conviction of a determinant, an irreversible factor that cannot be eliminated, is dominant. Therefore, their attitude towards other young people is tinged with rancour for this ‘otherness’. This sense of alienation has a background of anxiety and constant readiness to become anxious, and is the source of internal tension. The subjects state, ‘Well, their life was easier, they do not have to be anxious and I had to be afraid’; ‘They know little of the camps and they don’t wear the mark that is on me all the time, and this is what really matters’; ‘I envy them their self-confidence and easy life and that they do not think of the war as of their own reality’; ‘I do not feel well as far as my nerves are concerned, I am afraid, I can’t bear a situation when someone follows me in the street, sometimes I have the impression that someone is standing behind my back, I am afraid at night, I have nightmares, I easily get nervous. I think I am the same as other young people, it’s only that I am not healthy’; ‘Because of those experiences I can’t understand them, I don’t like their behaviour’; ‘I went through the mill and now I am hard-working’; ‘Young people appear to be care-free, they take life easily, I am different because I have a matter- of-fact attitude to life and I can easily be satisfied with what I can get and I never complain’.

Such remarks and many others made during the examinations emphasise the tragedy of a childhood spent in the camp, and indicate a greater awareness of the past experiences in this group than in the group of younger children. The intensity of the experiences in this group appears to be stronger even than in the case of adult prisoners. Adolescence apparently constituted a more favourable background for such experiences to be stored in the long-term memory and to condition the future development of the young prisoners. Undoubtedly, the ‘pubertas’ period, or rather the ‘prepubertas’ period, provided the subjects with special sensitivity to traumatic stress that was due to the fact that such a period is always characterised by a greater range of emotions.

Interestingly in addition to definitely negative reactions, and permanent, long-lasting irrational anxiety, we can also observe attitudes that might be considered positive after-effects of the tragic experiences: the attitude towards the world, others, and other young people is tinged with critical judgement, the negative assessment of youth is largely consciously underlined by the need to contrast the attitudes represented by the subjects and other young people.

When they make judgements about their environment, they not only state ‘I am different’ but also ‘I am positively different’. They criticise features that they think are negative, they make very severe judgements about others, they very strongly disapprove of contemporary outlooks on life, which bears a hidden implication that their attitudes are much more positive. The interesting thing is that they appear to associate their positive features with the camp experiences and that they appear to believe that the fact of ‘being in the camp’ is a source of their positive features. Some of them say, ‘I was in the camp and that is why I have a more serious attitude to life’.

A mature attitude to life expressed in the ability to find positive aspects of negative situations can be observed much more frequently among the members of this group than among the members of the younger group. A thorough study of this phenomenon was made based on the data obtained from the questionnaire. The aim of one of the last questions was to assess the subjects’ ability to be critical, of the maturity of their judgements and their attitudes towards material and immaterial values. The question was simple and was based on ‘a fairy test’ usually used with children: ‘If you met a fairy that offered to fulfil your three wishes, what would the wishes be?’ The analysis of the answers to this question confirmed the hypothesis of infantilism in the first group and greater maturity and positive estimation of the tragic past in the older group.

The answers to the questions were grouped according to their contents:

1. Clearly egoistic and material desires (statements like, to win a million, to have a lot of money, to have a lot of money all the time, to win a car, to become a millionaire);
2. Egoistic wishes tinged with emotional attitudes though also concerning material values or things connected with them (e.g. journeys abroad, one’s own house, flat);
3. Wishes dictated by ambition (higher education, higher post, doctorate, assistant professor’s degree);
4. Personal wishes not connected with material values (health, friendliness of other people, one’s own home, joy of life, good wife, children, love);
5. Altruistic wishes for the whole of humanity without reference to one’s own person (no more wars, no more suffering of children, no more children experiencing what I had to experience, peace all over the world, desire to do something for people, to be useful for people, etc.).

Before the conclusions of the analysed material are discussed, it should be emphasised that the results of the analysis will never entitle us to make any apodictic statements but they can be used only as the basis of suggestions and hypotheses. Since it is impossible to give an exact number of children imprisoned in concentration camps, we can never be sure whether the examined group may be considered representative of the whole population. It would also be impossible to state whether the features described above resulted from personality changes or whether they are of a constitutional character. Such estimations are particularly difficult in cases where no information about the parents of the subjects could be obtained.

Not all the symptoms can be considered as originating in the camp; some of them might have been provoked by later factors. In the majority of cases, it was impossible to specify the exact living conditions in the camp. Moreover, the data concerning the frequency of occurrence of the disorders described above are not numerous enough to be considered representative either of the young people who were imprisoned in the camps during the Occupation, or those from the general population. Finally, the number of the subjects is too small and does not allow for any statistical generalisations.

The literature dealing with the problems of former concentration camp prisoners often emphasises personality disorders in such persons. This present investigation, however, does not aim at making any statements about possible disorders; the basic purpose is to examine the way in which the young prisoners’ personalities developed after the camp period, especially since they were too young to have developed personalities before imprisonment. Thus, it is rather a question of how the camp conditions influenced individual personality development.

The problem has many aspects and should be approached from many different angles, for instance, from the perspective of somatic development (somatic illnesses and their after-effects, physical constitution), intellectual abilities (intelligence tests which were not included in the present investigation), or sociological analysis (after-effects of the loss of parents, the period spent in an orphanage, etc.). In the case of adult subjects, there is always the possibility of making an analysis of disorders through the comparison of data from the pre-camp period and the data obtained from later examinations. Unfortunately, there is no such possibility in the case of children.

Despite these reservations, however, it is worthwhile to discuss some of the observations.

The problem of the camp influence is slightly simpler here than in the first diagnostic group which comprised distinct organic syndromes (11 subjects were included there). The observed symptoms, undoubtedly pathological, point to the traumatic background and the correlation with the traumatic experiences in the camp appears to be obvious. As the data from interviews suggest, only one person suffered from a skull injury after the liberation that led to the intensification of the earlier symptoms. The question of whether the observed disorders originated from mechanical injuries in the camp or whether they resulted from starvation and subsequent brain anoxia, still remains unanswered.

The clinical manifestations of the second diagnostic group (personality disorders in 13 persons) and of the third group (immaturity in 26 persons) were examined from the perspective of psychological changes and no distinct organic changes were found in the subjects in both groups. It is striking, however, that the majority of cases in these groups have pathological EEG records (7 subjects out of 12 in the second group, 12 subjects out of 21 examined in the third group). The ratio of all the subjects is 29 to 44, that is, about two thirds with an additional case of epilepsy with a normal EEG record that should also be included here. Thus, the above cases may be classed among the encephalopathic group on this basis.

There is a great similarity between the observed symptoms and a syndrome described in adult prisoners, referred to as KZ-Syndrome by German authors, and by others as asthénie générale, asthénie partielle, or asthénie progressive. All the subjects complained of irritability, headaches, tiredness, etc., and all of them complained of their changeable moods. It appears that such symptoms should allow of the same diagnosis.

Targowla (1955) specified five reasons for the etiology of the syndrome: starvation, cold, lack of hygiene, excessive work (‘surmenage’) and the atmosphere of fear (‘climat d’angoisse’). Excessive work is not relevant in the cases described here, since children did not work in the camp. The four remaining reasons, however, are undoubtedly adequate. The atmosphere of fear appears to have had a particularly great influence on the camp‘children’. ‘We don't like talking about our experiences. We don’t need to explain anything to those who were in the camp and those who were not there will never manage to understand what we experienced then and what we still have to experience’.

Translated from Przegląd Lekarski – Oświęcim, 1966.

References

1. Frankl W.E.: ‘Psycholog w obozie koncentracyjnym’. [‘A Psychologist in the Concentration Camp’]. Warsaw, 1962, 11.
2. Kościuszkowa J.: ‘Losy dzieci w obozie koncentracyjnym w Oświęcimiu.’ [‘Fate of Children in the Auschwitz Concentration Camp’]. Przegląd Lekarski, 1961, 17, 60-61.
3. Leśniak R.: ‘Zmiany osobowości u byłych więźniów obozu koncentracyjnego Oświęcim-Brzezinka. Doniesienie wstępne.’ [‘Post-camp Personality Disorders in Former Prisoners of the Auschwitz-Birkenau Camp’]. Przegląd Lekarski, 1964, 20, 29-30.
4. Orwid M.: ‘Socjo-psychiatryczne następstwa pobytu w obozie koncentracyjnym Oświęcim-Brzezinka.’ [‘Socio-psychiatric After-effects of the Period Spent in the Auschwitz-Birkenau Concentration Camp’]. Przegląd Lekarski, 1964, 20, 17-23.
5. Szymusik A.: ‘Astenia poobozowa u byłych więźniów obozu koncentracyjnego w Oświęcimiu.’ [‘Progressive Asthenia in Former Prisoners of the Auschwitz Concentration Camp’]. Przegląd Lekarski, 1964, 20, 23-29.
6. Targowla R.: ‘Syndrom der Asthenie der Deportierten’, in Michels M., Gesunheitsschäden durch Verfolgung und Gefangenschaft und ihre Spätfolgen, 1955, 30-40.
7. Teutsch A.: ‘Reakcje psychiczne w czasie działania psychofizycznego stressu [stresu] u 100 byłych więźniów w obozie koncentracyjnym Oświęcim-Brzezinka.’ [‘Psychological Reactions during Psychosomatic Stress in 100 Former Prisoners of the Auschwitz-Birkenau Concentration Camp’]. Przegląd Lekarski, 1964, 20, 12-17.

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