The so-called “KZ-Syndrome”: An attempt at a synthesis

It was about twelve years ago that Stanisław Kłodziński MD, a former prisoner of Auschwitz, applied to some of his friends from the Department of Adult Psychiatry at the Medical Academy in Kraków with a request that they should undertake an investigation into concentration camp problems. The suggestion was accepted though not without hesitation. The questions were whether it would be possible for people who had not lived through the camp experience to understand those who had survived that hell; whether the former prisoners would be willing to discuss their problems with “non‑prisoners”; whether going back to tragic experiences would not be cruel; whether it would be possible to imagine the situation in the camp; and whether the human imagination would be vivid enough to deal with the events of that time. The hesitation naturally resulted from the fact that it appeared impossible to psychologically grasp and comprehend matters that exceeded the limits of human endurance.

Due to the help offered by the Kraków Section of the Auschwitz Society, contact with former prisoners could be established and in the end constituted a strong impulse to start research into such complex phenomena. Conversations with those people were completely absorbing. It was no longer possible to disregard the numerous aspects of their problems. These people, though apparently the same as others, proved different. The “otherness” became obvious whenever they started to talk about the camp. They looked as if they were brought back to life, their eyes glittered, they became younger, the years that had passed since the camp times were suddenly eliminated, and everything was vivid and fresh in their memory. It was obvious that they could not escape the circle of camp problems. There were horrible things present in that circle but there were also beautiful things there, the pit of human debasement but also human kindness and nobility; they learnt everything about humanity. Despite this, or perhaps because of this, however, they were all overwhelmed by the misery of human existence, they wanted to know how it was possible that so much evil accumulated in the limited territory of the concentration camp and how it was at all possible that they managed to survive, to oppose that evil. They frequently constituted a puzzle for themselves, they were aware of the misery of the human nature and elusiveness of human norms, forms and appearances, as no other people could ever be; for them, “the emperor had no clothes.”

Psychiatric contact with such people proved to be much easier than with those who never reached the very bottom of human existence, as for a psychiatrist it is essential to obtain an answer to the question of what human nature is really like, what is hidden under the mask of mimicry, gestures, and words. A psychiatrist may say that he has established contact with his patient only when they have both arrived at a sincere conversation and managed to remove all mutual pretence. Those who managed to survive the camp also frequently wondered what the truth about human nature was, how a given person would behave in the camp situation, how much would remain of their dignity, or their righteousness if they found themselves “there.” Thus, the mutual aversion towards appearances and masks was a unifying element between former prisoners and psychiatrists.

Every former camp prisoner could admit the same as Maria Zarębińska (1969) did: “I witnessed such horrible things, such deep human misery, such great savagery, the elimination of all possible human elements and simple instinctive reactions of tender hearts and I can certainly claim I saw everything that a human being can see and experience both in hell and in heaven.”

Another problem arose when the first records of conversations with former prisoners were collected; that is, how to compose a general picture of people who “saw it all” out of individual life histories, each of which was a collection of experiences that were usually extremely difficult to convey. Their pre-camp lives had to be reconstructed as well as their camp experiences and lives after they left camp (Orwid et al., 1964). There were also doubts concerning the objectivity of the method applied and its scientific character, as the method was primarily based on the ability to understand the subject’s situation. Many events were blotted out of the former prisoners’ memory, and many became falsified for various reasons. When generalisations were attempted, individual and unrepeatable profiles were in danger of being washed away. It was so difficult to choose the most essential details from the whole mass of elements. The most appropriate choice was not always supported by statistical analysis. All such questions and problems arose when the first life histories of 100 examined subjects were analysed (Leśniak et al., 1961). The subsequent examination was extended and comprised a group of several dozen “Auschwitz children,” that is, people who either were born in the concentration camp or were imprisoned there in their childhood. Although their problems were different from the problems of “adult” prisoners, some common features could also be found.

Contact with anybody who lived through the camp must bring many questions to every psychiatrist. Sometimes the questions reach the structure of his professional orientation. Such structure refers to one basic question, the hypothetical answer to which is attempted by every psychiatrist, namely, what is a human being? It appears that a psychiatrist who has never talked to former camp prisoners formulates his answer in a different way than one who has had the opportunity of contact with such people. This may be explained by the fact that the camp situation was an extreme one with human problems forced into it, with unforeseen perspectives confronting human nature.

Such a broadening of psychiatric perspectives appeared to constitute the reason for numerous difficulties that were met when attempts at scientific analysis of experiences resulting from contacts with the former prisoners were made. It was frequently necessary to go beyond the limits of psychiatric thinking. The conclusions from the first observations were quite daring.

Contact with the former prisoners did not end with the conclusion of the first series of examinations. The camp survivors used to, and still do, call at the department and ask for medical advice. They were offered questionnaires to complete (Dominik, 1967). A great many of the former prisoners who were subjects of pseudoscientific experiments in the camp were for many years under careful examination at the Department of Infectious Diseases at the Medical Academy in Kraków under the supervision of Prof. Władysław Fejkiel and Dr. Maria Nowak-Gołąbowa. Among various group examinations, psychiatric and electroencephalographic tests are of greatest importance (Gątarski et al., 1969). Already, about 500 former prisoners have been examined at the Department of Adult Psychiatry at the Medical Academy in Kraków.

Further examinations and contact usually supported the observations made when the analysis of the first life stories of 100 camp survivors was attempted. Research carried out in other scientific centres has also supported the first observations. This is evidence for the reliability of cognitive methods of psychiatry, which have always been, to some extent, controversial for psychiatrists themselves.

After ten years of examinations and observations, we may attempt a more adequate delineation of specific features characteristic of people who managed to survive the concentration camp. The first research workers who dealt with the health of camp survivors after the war already showed the occurrence of some features that were commonly referred to as “progressive asthenia” (French asthénie progressive), “post‑camp asthenia,” or “KZ‑Syndrome” (concentration camp syndrome). It was interesting that pathological changes observed in the former prisoners originating in the camp period were very different, somatically and psychologically. Premature atherosclerosis of the coronary vessels might be a camp after-effect in one prisoner, and premature atherosclerosis of the cerebral vessels or pulmonary tuberculosis in another. The after-effects of the camp experiences might also include illnesses of the alimentary canal, rheumatic arthritis, premature involution, chronic neurasthenic and anxious-depressive syndromes, alcohol abuse, epilepsy, etc. (Szymusik, 1962, 1964).

In some cases, the correlation between the camp experiences and the syndromes was obvious; in others, it required a careful analysis. Frequently, the consequences of the camp could be observed only several years after the war. The basic question, however, was what made various pathological after‑effects uniform, so that a common term “KZ‑Syndrome” could be applied.

The simplest answer to this question would be that their etiology is a unifying factor: the internment in the camp. It appeared, however, that etiology was not essential. Everybody who met camp survivors was certainly struck by their unspecified similarity. All of them were different and suffered from different ailments because of their camp experiences, and still they had something in common. It appears that this observation was one of the earliest motives for the first research workers who introduced the term “KZ‑Syndrome” or “progressive asthenia.” This fact had always been emphasised in the examinations made by the Kraków centre and gradually became more and more distinct in the course of time. Therefore, the claim made by all researchers dealing with the somatic and psychological after‑effects of the concentration camp appeared justified; that the phenomena of the concentration camp syndromes should be introduced to medical terminology as a separate diagnostic unit of a special etiology, with a characteristic, though heterogeneous, clinical manifestation and a specific method of medical treatment.

Despite the fact that all the examinations carried out after the war and several years later, or even as late as 25 years after the war, emphasised the specificity of people from the camp, such specificity was difficult to define. The definition of a “concentration camp syndrome,” post‑camp illness, or any other accepted term could not be based on the number of symptoms (concentration camp after‑effects), as such a list would be extremely long.

Instead, a definition of this unspecified characteristic, which is a factor reducing various symptoms and various human profiles to a common denominator, should be attempted. The term “KZ‑Syndrome” was introduced as the result of this unspecified characteristic which can still be observed in former prisoners although it is already 25 years since the war, and which is perhaps even stronger now than it was immediately after liberation.

It is not easy, however, to define our experiences. Therefore, although many examinations have already been made, it is still impossible to define the essence of the “concentration camp syndrome.” It includes something unspecified that united all those who went through the camp experience. It appears that the detailed specification of the “KZ-Syndrome” criteria would never be possible as it would never be possible to define the characteristics of the former prisoners, if we did not go back to the very beginning, that is, to the camp period. Camp experiences exceed the limits of human imagination and possibly also the limits of human ability to understand another person’s life. Without this first and basic move, however, it would be impossible to arrive at a definition of the “concentration camp syndrome.” Due to many literary works on camp problems, it is easier to imagine life there. However, it will always be an unclear and misty picture and a researcher must sometimes feel like Ms Gurdun, a character created by Gawalewicz, who after having listened to many camp stories told by the former prisoners, finally asked whether they had night‑lamps by their beds in the camp (Gawalewicz, 1968, 1965). It may appear that the gap between those who were in the camp and those who never suffered such experiences is too big. What such people feel and experience is beyond the limits of human understanding (Jaspers’ “verstehende”).

A psychiatrist can never give up an attempt to cross the border, to go beyond the limits, even though sometimes he also is not able to understand the psychological experiences of the sick. He must aim at a general outlook into an individual world of sensations. If we decide to approach the problem of camp experiences in such a way, we should emphasise three moments that appeared essential for the further fate of the former prisoners. These are a very wide range of camp experiences, psychosomatic unity, and camp autism.

The initiation into the camp hell was a shock that was stronger than any other trauma of human life. All authors dealing with the concentration camps emphasise the initial reaction to imprisonment which was generally experienced, and which led to death in many prisoners (Teutsch, 1962, 1964). A prisoner had to adjust to camp life within the first several weeks or months, otherwise he had to die. Two problems were important in the adjustment process. Firstly, prisoners had to become indifferent to everything that was going on around them, had to withdraw into their internal world, and become dull and apathetic but without reaching the Muselmann state, the state of total apathy. This defensive insensitivity was referred to as “camp autism.” On the other hand, however, every prisoner had to find their angel in the camp hell, that is, a person or a group who would treat them in a human way and thus allow them to save the remains of their humanity.

It appears possible that the fact of finding another person in the camp was equally as shocking as the fact of the imprisonment. It was a positive shock, a paradise in the camp hell. A person cannot live with only one colour. There is always black where there is white. Camp life, however, offered too wide a range of opposing colours; they were not normal life contrasts but true hell and heaven. Masks disappeared, and everyone was left naked. It truly was a specific psychiatric experiment, as described by former prisoner, Piotr Wesełucha M.D. Human criminal and holy nature was suddenly exposed to public view. A psychiatrist is sometimes able to see this “lining” of human life; in the camp the lining was on the outside. Which is why all former prisoners are very sensitive to authenticity in interpersonal relations; they feel best among their camp mates because it is only other former prisoners who can understand them; other people cannot be fully trusted. Thus, the changes observed in the personality of the former prisoners are to some extent similar to those that result from a psychosis, especially of a dissociation type. Both the former prisoners and those who have suffered from psychosis have difficulties in returning to reality (Leśniak, 1965). The range of experiences was too great to squeeze into the colours of life.

In such an anus mundi, the normal world fell to pieces together with its values, ideals, and important and unimportant matters. The normal world became unreal; it came back in dreams; it appeared to be possible but perhaps on some other planet. When the present world falls to pieces, a person feels lost, seized with fear, is not able to plan his or her future; hence the feeling of hopelessness. In such a situation, a smile offered by another person, a kind word or a little help became heavenly, opened future prospects, and brought back faith in one’s own humanity and the humanity of the others. And after such a moment, there are no stronger interpersonal relations either in the pre- or post‑camp life, because no contact with any other person could bring such a specific revelation as the moment when another person was discovered in the camp hell.

In normal everyday life, interpersonal relations are more or less casual; one meets people rather than really lives with them, a mask of social norms prevents the intrusion of another person into one’s intimacy. Therefore, people are lonely despite all the contact they have with their environment. It may sound paradoxical, but the feeling of loneliness was less intense in the camp than in the conditions of normal social life. Former prisoners usually feel well among their camp mates, their companions in distress; they are only able to lose their feeling of loneliness and lack of understanding on the part of other people among their fellow prisoners (Orwid, 1962, 1964) because it was in the camp that they had a true encounter with another person. All such contacts frequently saved their lives, transformed prison numbers into people again.

The importance of interpersonal relations was different in the camp than in normal life. A usually trivial gesture, which would pass unnoticed in our everyday reality and would be regarded conventional, came as a revelation in the camp, as a heavenly sign, and could save life and bring back faith in life.

A thesis of the psychosomatic unity of human beings, basic for medical thinking, is usually proved at the beginning and at the end of life as well as in extreme situations. Both in small children and in old people the subjective is combined with the objective, a psychological breakdown leads to a somatic breakdown or even to death. The same occurs in extreme situations. Then, a person is also close to death, and when the subjective integrality of all organic functions, in other words, his or her psychological life, breaks down, it is accompanied by a general breakdown. A prisoner who did not want to live and could not stand the camp life any more was most frequently dead by the next morning, or passed into the Muselmann state. On the other hand, a kindly word from a friend could save his life. Nowhere else were the importance and essence of psychotherapy so clear as in the conditions of camp life. If in a camp hospital (at the time when it had been taken over by political prisoners) people with serious somatic illnesses returned to health, it was not because of medicine they were given but due to the attitude of their camp mates, doctors, nurses and fellow patients. This was probably the most beautiful chapter in the history of psychotherapy. This was the true “therapeutic society” so widely discussed today.

The notion of psychosomatic unity, though so obvious for every doctor, is apparently unconvincing since it is contradictory to the natural split between soma and consciousness in every human being, between physical and psychological actions of which one is the object and the other the subject. This split appears to express the controlling functions of the organism, at least to some extent. There is always a relationship of subject and object between that which controls, and that which is controlled. In the human organism there are many controlling activities and only a small number of them reach the level of consciousness; the rest are usually automatic from the beginning (e.g. vegetative activities) or become automatic due to frequent repetition (e.g. walking). A child learning to walk is conscious of every movement connected with this function; there is a fight between the subject that wants to master a new function, walking, and the object – everything else that opposes this function. As a new function is mastered, the fight is weaker; it is transferred to other tasks (e.g. the function of writing). The mastered function becomes an “obedient object,” a “physical function,” or a “body”; a simple psychological order is enough (“I’m going”) and the obedient body performs it. For a dancer, or mountain climber, etc., the fight is continued; every movement is conscious. This is not only a physical but also a psychological function; the body is “soulful,” consciously experienced. Thus, the split between subject and object reflects a constant fight for the possibility of realising new aims, the transformation of potential activity structures into realised structures.

In the camp, activities that were automatic a long time ago became a battlefield again. Every step, body posture, or movement of the hand became important, and might frequently decide between life and death. Eating and the relieving of physical needs were of primary importance. From the psychoanalytical perspective, it was a regression to the early childhood when a child learns to perform such activities and they become central to all other experiences. That is why the emotional bonds between prisoners had something of a mothering character; a kindly gesture had the importance of a kindly gesture made by a mother. Therefore, the will to survive was so essential to the ability to survive. Every movement was important, essential; one had to fight with oneself all the time. When a prisoner was not able to fight any more, this could be seen in his or her eyes. “Those eyes, heralds (of death) in the camp,” wrote Prof. Stanisław Pigoń (1964, 1966), “were a special problem. I saw them so many times. We learnt their meaning by experience. As a farmer can forecast the weather looking at a cloud that covers the sun, we were also able to see the quietly approaching death in the eyes of some prisoners. We already knew someone would be dead in three days time.” The split between soma and consciousness was eliminated by the camp life. The laxity of internal discipline connected with the desire to survive was equivalent to the period at the end of life. The Muselmann state was a typical example of giving up the fight.

It is difficult for a doctor to estimate the concentration camp after‑effects, since it is hard to ascertain cause‑and‑effect relationship with those events. The problem is whether ageing, tuberculosis, circulatory diseases, neuroses, alcohol abuse, epilepsy, etc., did in fact originate in the camp experiences. Frequently, pathological symptoms appeared only after many years. Can a causal nexus be ascertained when there is no continuity in time? Which etiological factors resulted in post‑camp diseases? Was it starvation, mechanical traumas, infectious diseases, or psychological traumas? These are some of the problems met by the doctors who are to estimate disabilities of former prisoners for certification purpose (Szymusik, 1965). If we assume the psychosomatic unity of the organism that dramatically appeared in the camp it will be easier to answer the above‑mentioned questions.

The extreme mobilisation of the whole organism that was a necessity of camp life and which was manifested in the consciousness of the prisoner in the form of the decision to survive regardless of how difficult it might be, appeared to constitute the basic etiological factor. Normally a person would not be able to stand such strain for long. There were cases in which a too sudden mobilisation of the endocrine‑vegetative system led to death (observations made by Cannon, which were the basis for Selye’s concept of stress). Other etiological factors were also important, especially starvation, but almost all of them finally resolved themselves into the extreme mobilisation of the organism. For some, starvation was unbearable and led to the Muselmann state; for others, starvation was a torture that concentrated all thoughts but could be endured. Thus, the final form was always a fight against the inertia of one’s own body.

When various correlations are considered, it does not appear reasonable to separate psychological and physical factors. They are so closely connected that any attempts to make splits are artificial. Starvation, infectious diseases (especially exanthematic and abdominal typhus), head injuries, etc., could always lead to the injury of the central nervous system. Such injury might be manifested in a chronic neurotic syndrome for many years and only after a long time lead to psycho‑organic symptoms, which obviously draw the doctor’s attention to a proper etiology that might have been earlier overlooked. On the other hand, the long‑lasting psychological tension that was a permanent element of camp life might result in premature process of atherosclerosis, or weaken the general immunity of the organism. In such a case, a distinctly somatic syndrome resulted from psychological traumas (Szymusik, 1962, 1964). Considerations of this type have only a theoretical value; in practice, we cannot separate individual factors. The problem of causal nexus can thus be considered only as an overall problem.

The extreme mobilisation of the organism that was mentioned above and which was a necessary condition to survive the camp must have left some traces from a medical perspective. But how should we explain the fact that a great number of prisoners did not need any medical help for many years after the liberation? And why only after a long time, did some of them exhibit disorders of a somatic or psychological nature, which might be associated with the camp experience? First, the process of premature involution can be observed. There are certain prisoners who have stayed in good health and have had a good frame of mind until the present time, and who frequently are more lively and youthful than those who never experienced the camp nightmare. Such people constitute a considerably small group and are a puzzle from the medical perspective. It is possible, though, that some pathological changes that might have resulted from the camp period could be seen in a close and detailed examination. From a theoretical perspective, such changes should exist. Strong and long-lasting trauma, such as the camp experiences, cannot pass without leaving any permanent traces in the organism. The traces may be latent for many years and suddenly explode because of certain physical and psychological factors, sometimes even unimportant ones.

Such traces can be observed during detailed psychiatric examinations, in the form of largely discrete post-camp personality disorders, difficulties in adjustment to normal life, changes in the basic life attitudes and the hierarchy of values, treating the camp period as a permanent source of reference, which, in turn, is manifested in dreams about the camp, camp hyper-amnesia, etc. Naturally, these relate to the area of the consciousness, but if we accept the concept of the psychosomatic unity, so drastically exhibited in the camp, such facts should be treated in the same way as psychological ones.

In order to understand how it was possible to maintain good health after the camp experience, we have to return to the camp period itself and answer the question of how it was at all possible to survive the camp. Undoubtedly, the prisoners had to become callously indifferent to numerous experiences, which would be impossible to endure in normal life. One had to withdraw into his internal life and a solid point of reference there, such as faith in survival, the conviction that even the greatest evil must end one day, thoughts of family, religious faith, or thoughts about the punishment of the persecutors. (Teutsch, 1962, 1964).

The facts mentioned above are beautifully described by Prof. Stanisław Pigoń (1966) in his “Recollections from the Sachsenhausen camp”:

“‘Old fortresses’ consisted of two levels. Above the ‘lower’ castle, there was always a ‘higher’ castle on solid rock. When the lower castle was given up, the higher one could still fight for a long time. A good piece of advice an old highland robber gave to Rafał Olbromski in the Orawa prison was, ‘hold out.’ And we found ourselves in a situation where we had to find such a ‘higher’ castle in ourselves, a base that could never be destroyed, cling to it with all our might and never loosen our grasp on it, not even for a moment. We had to forget about resignation, prostration, and to hide in the darkest corner of our soul and remain there like a stone in the soil. Let them blow me up. There was our salvation. These are not empty words. I found such a base in myself, and perhaps that is why I managed to survive. It does not matter now what the base was; it matters that I found it and that it was my refuge where I could hide from the onrush of hatred. Such an ability was not a matter of age but a matter of how great one’s fundamental strength was.”

For a psychiatrist, there is something of a schizophrenic autism in such a phenomenon: the surrounding world becomes unbearable, a person withdraws into themmselves, cuts off all bonds with the environment, and lives in their own world that suddenly or gradually becomes real. Therefore, the expression “camp autism” is very appropriate. Autism was obviously not absolute. Contact with friends and colleagues, this point of light in the camp hell, was essential for survival. This was a general phenomenon but without it, “adaptation” would be impossible (Teutsch, 1962, 1964). But, similarly to schizophrenia, where we can distinguish between full and empty autism, in the camp situation there were those who managed to find their “higher castle” and those who never found it. This is how Pigoń describes such prisoners:

“Since I am talking about the tactics of defence used by prisoners to hide from the avalanche of evil and extermination, let me mention a method that I never dared to judge: was it easier or more difficult than the one described above? Anyhow, there were not many who dared to try it. It was a specific kind of ataraxy combined with some unexplainable inner signification. Those who decided to assume such an attitude were called Muselmänner, both with sympathy and disdain. It was a specific phenomenon that was developed by camp conditions. At the bottom of disregard, in total apathy to death, they were able to overcome and suppress their misery, be indifferent to the shrillness of pain. There was one in our barrack; I looked at him terrified. Emaciated, hardly able to move, he went into the middle of torment with a persistent challenge: try to kill me! And it happened that the persecutor, fed up with him, went away defeated. I saw it.”

It was most surprising that former prisoners adjusted to post‑camp life with greater difficulties than to the camp conditions (Orwid, 1962, 1964). Such a situation resulted from many objective facts. There were many unfulfilled expectations and hopes. For many years the misery and heroism of such people was not properly understood. The problems of everyday life appeared trivial in comparison with those they had suffered in the camp. The forms of interpersonal relations, with their hypocrisy and narrow-mindedness, shocked them. Similarly as after a severe schizophrenic psychosis, when the diseased come back to normal life and everything looks grey and trivial in comparison with the experience from the period of psychosis, people from “there” could not get used to normal life for many months or even years.

There are limits to human experience, which cannot be gone beyond without impunity. If the border is crossed, there is no way back to the previous life. Something in the basic structure is changed: one is not the same as before. This otherness is usually referred to as “personality change” and in the case of schizophrenia the technical term “defect” is used, not very appropriate for a human being.

Personality changes observed in the former prisoners (Leśniak, 1965) refer to three areas:

1. General life dynamic, that is, subjectively perceived as a frame of mind,
2. Attitude towards people, and,
3. Ability to restrain oneself.

Worse moods, lack of confidence in others and poorer ability to restrain oneself (greater excitability and irritability) are most common. However, changes in the opposite direction can also be sometimes observed: increased life dynamics, greater confidence in people to the verge of naivete, or greater ability to restrain oneself in the form of passivity.

Those who have relatives and friends among former prisoners must have sometimes experienced an unpleasant feeling that they cannot understand them; that they feel much better in the company of their fellow prisoners than with the family or pre‑camp friends. In “their group,” that is, among their camp friends, they become more lively, open, forget about all social hierarchies and forms connected with them, and have a specific camp sense of humour. Not all former prisoners keep in touch with other camp survivors; there are those who avoid such contact, as well as any thoughts about the camp. These are usually persons who have not managed to “digest” the camp yet; camp experiences are still too painful to return to (Orwid, 1962, 1964).

Every person has their “small islands” of recollections, which are present even against their will. The islands may be various, greater and smaller, nice and ugly. They appear to accompany a given mood and situation and sometimes they come back without any reason. For former prisoners, their camp experiences are a great island, too great to allow them to see the rest of the world, so great that all the small islands look unimportant. The island has become the main point of reference (Orwid, 1962, 1964) in their post‑camp life. It has changed their attitude to life, their hierarchy of values, relationships with people, and influenced their life purposes; it comes back in dreams with an agonising regularity. It is impossible to leave this island.

During the Second Polish Congress of ZBoWiD doctors (28-29 May, 1968) a postulate was put forward that “due to its specificity and the individuality of the clinical syndrome, the so‑called KZ‑Syndrome, which was recognised in the scientific world, should be included in the international classification of illnesses and a proper statistical number should be assigned to it, which would be essential when medical certification is required. Since different terms are used to refer to this syndrome, the choice of the most proper one should be left to the experts, ZBoWiD doctors, and to linguists who would act as consultants.” (Jagoda and Masłowski, 1969).

When an analysis of the post‑camp pathological after‑effects is made, the camp period itself should be taken into consideration. Three factors, as this work suggests, play an important part: the range of experiences (the “hell” and “heaven” of the camp life); the psychosomatic unity that was drastically manifested “in extremes” in camp life; and a specific autism which consisted in searching for a “point of support” that would make survival possible. The specific character of the Nazi concentration camps has conditioned the specificity of post‑camp pathological changes. Despite many common features, they are not identical to changes that can be observed after internment in prisoner‑of‑war camps (the so‑called “barbed wire illness”) or with the after‑effects of any others types of concentration camps. Thus, the term “KZ-Syndrome” appears to be the most appropriate one to define such changes.

Translated from Przegląd Lekarski – Oświęcim, 1970.