Socio-psychiatric After-effects of Imprisonment in the Auschwitz-Birkenau Concentration Camp

Socjopsychiatryczne następstwa pobytu w obozie koncentracyjnym Oświęcim-Brzezinka


Maria Orwid, PhD, 1930–2009, Professor of Psychiatry, Director of Department of Child and Adolescent Psychiatry, Collegium Medicum, Jagiellonian University, Kraków. Former prisoner of the Przemyśl ghetto.

Research into the socio-psychiatric adjustment to post-camp life by survivors of the Auschwitz-Birkenau concentration camp has aimed at answering the following questions: what were the problems and conflicts met by prisoners coming back to free life from the concentration camp; which life situations, resulting from the necessity of contact with other people and leading a social life, intensified those problems; and how the problems of the former prisoners differed from those encountered in their pre-camp life.

The research concerned both psychological experiences and the influence that the former prisoners exerted on their social environment. Theoretical phenomena discussed were connected with adjustment problems and frequently could be specified in such terms. Thus, the research largely concerned the ways in which the camp survivors adjusted, or rather readjusted, to the conditions of normal life.

The camp situation reduced all adjustment problems to one of survival. The prisoners were exposed to exceptional and intense psychological and biological stress. Camp life was deprived of elements usually present in normal existence; elements of performing tasks that would bring satisfaction and would not only be of tragic necessity; elements of achieving personal ambitions; normal contact with other people; a sense of freedom and personal dignity, etc. A man who returned from the camp was obviously free from imminent danger, a situation referred to as ‘decompression’ by Frankl. At the same time, however, he was confronted with the normal problems and conflicts of human life that required assuming specific attitudes and commitments; he faced again the usual requirements of his surroundings, had to restore or create his own new model of life in a given social group, and establish the usual inter-personal relationships. The dynamics of returning to a normal social life and the behaviour of former prisoners since the time of their liberation were thus the objects of the investigation.

In analysing the examination reports, certain phenomena can be observed distinguishable from all other problems appearing in the research material. The phenomena constituted the criteria according to which the group of former prisoners was divided. It was obviously possible, based on the data quoted in the literature, to accept a priori some essential criteria that might help to state whether a given subject did or did not have adjustment problems after liberation (such as, for instance, problems connected with returning to professional work, behaviour in the family, contact with other people). This, however, would automatically lead to the ignorance of other important phenomena or symptoms. Analysis of the examined material resulted in the observation that it would be impossible to view adjustment problems as a continuum from bad to good adjustment, because of the fact that such phenomena were much more complicated and connected with various life domains, frequently unrelated. For example, the same man could have great difficulties at work and no problems in the emotional sphere; possible variants were very numerous. Classification of the described material might not be formally and methodically uniform. It appeared, however, that an analysis of all the aspects of human behaviour should lead to a description of the aspects that was as comprehensive as possible, rather than an observation made on a priori and theoretical assumptions.

Before the presentation of the analysis results, a few short selected remarks concerning the reference literature should be made. Since the bibliography on the subject is very wide, the remarks quoted here refer only to those works that deal with specific aspects of adjustment problems.

According to Kozielecki, for instance, psychology today is the science of adjustment understood as an axial function or function complex, conditioning cognitive processes, motivation, and the way in which an individual behaves in the outside world.

The adjustment problem is scientifically approached in categories which are biological (e.g. Massermann, Menniger), socio-psychological, and legal (e.g. Merton, Cohen, Kroeber, Keesing, Kelman, Lapierre, Fromm, Lazarus, Kluckhohn, Kłosowska).

According to the dictionary definition, the term ‘to adjust’ should be understood as ‘to form individual behaviour in such a way that a harmonious and affective coexistence with one’s cultural environment is achieved’. Thus, the term incorporates such problems as adjustment in terms of feeling psychologically good, creating personal attitudes and a value hierarchy based on the models accepted in a given environment, as well as problems connected with ranges and groups of reference for each individual human being. It is clear from the remarks above that the term ‘adjustment’ is not specified in an explicit scientific way and it embraces many different problems, apparently unrelated.

Although the American bibliography has always favoured the motto ‘accept the world’ as a criterion of appropriate adjustment, such authors as Fromm and Lazarus claim that the postulate of appropriate adjustment as the main aim in the life of each human limits the individual possibilities of development and activity. This attitude is obviously also opposed by existentialists.

One of the main issues in sociology and social psychology today is the theory of reference groups, which assumes that an individual forms his own views and attitudes in reference to different groups to which he belongs and groups to which he does not belong. Members of various social groups, according to Merton, may have common reference ranges. Individual humans have their individual contexts that influence their attitudes and these may be, for instance, impersonal social categories as well as specific people, with whom the individuals communicate. A group of reference, according to Tamotsu, may be as imaginary as, for instance, humanity for whom a scientist would work, future generations, or the past excessively glorified in the critical analyses of the present events.

A range of reference for human behaviour is connected with the problem of normative patterns or patterns of behaviour. The problem concerns adjustment of the behaviour of an individual to generally accepted norms. Kluckhohn, among others, states that the behaviour of an individual and the system of values accepted by this individual constitute a unity as a cultural pattern and an individual life history of a given man. Thus, he treats the personal system of values as a ‘private’ form of group values.

In every system of life and culture, as Keesing states, the patterns of behaviour and the systems of normative values are closely related. If there is a change in the accepted way of individual life, which results in the fact that the individual finds himself in new changed situations (cultural patterns), changes in attitudes, habits, and characteristics of this individual must also appear. This phenomenon is referred to as ‘readjustment’ (e.g. Kroebarg).

Among Polish authors, Kłosowska has discussed this problem and emphasised the existence of a pattern or a repeated structure of the behaviour. She believes that socially accepted ranges of behaviour exist, and that each individual has to search for an appropriate pattern of behaviour on his own; that is, he has to be able to define his own position in life. The theoretical views presented above specify the position of the problem in scientific research and cast some light on the relationship between the problem discussed and the theory of adjustment. It should be mentioned, however, that former prisoners and their experiences constitute so specific a range of problems that it would be difficult to explain them only on the basis of accepted scientific categories.

Works on KZ-Syndrome are not included in the discussion here since they are discussed by A. Szymusik.

Analysis of the problem specified above comprised quantitative and qualitative analyses of the material, concerning 100 subjects who were former prisoners of the concentration camp.

The analysis resulted in the following conclusions:

1. There was a tendency, although not statistically significant, in the estimation of adjustment difficulties in women and men. Women had some advantage in the sphere of transitory problems, whilst men in longer-term ones.
2. Since the framework of age in the whole group of the subjects did not vary much in the individual groups of adjustment, it was impossible to make a statistical estimation of the influence of age on possible adjustment problems.
3. Analysis of the correlation between membership of different social groups and adjustment problems, led to the observation that 44 percent of manual workers showed good adjustment to the post-camp life. Statistically, most problems in adjustment were experienced by white-collar workers. Craftsmen constituted an intermediate group and did not differ statistically from either white-collar or manual workers.
4. It could be observed that 80 percent of the subjects did not have adjustment problems in their pre-camp life, but only 30 percent of this group did not have such problems after leaving the camp.
5. An essential influence on the intensity of the after-effects of the camp experiences was exerted by the length of the period spent in the camp. The most numerous disorders were observed for inmates imprisoned for 3.7 years.
6. In the group of the subjects examined, the same people could adjust much better to the camp life (55.3 percent) than to the post-camp reality (31.2 percent). Thus, a significant increase in the number of adjustment problems in normal life in comparison with the camp period could be observed.
7. There was no fundamental influence of the conditions faced in the post-camp life on the fact that the after-effects of the camp experience did or did not develop. Such influence could be observed in some cases but not to a statistically significant degree.

The qualitative analysis was an attempt to obtain a synthetic view of the patho- sociological mechanisms that could be observed in the examined group.

From a psychiatric perspective, the problem described here was equally, if not even more, important than a strict statistical analysis.

There were a small number of subjects whose reactions were different to those of the rest of the group, and it would be difficult to assign those subjects to specific groups of phenomena. It would appear, however, that the psychiatrist, as well as any other doctor, is entitled to use his own intuition and professional experience as instruments in the analysis of certain aspects of the problem described here. The remarks given below are not a direct quotation from the examination reports. They constitute a kind of psychiatric interpolation, which may allow for some generalisations on the specific material.

The starting point in all the considerations was the reaction to liberation. Out of the variety of feelings quoted by the former prisoners, two types of reactions could be seen:

The first type, generally speaking, was asthenic; people were filled with joy, frequently unrestrained and sometimes accompanied by psychomotor excitement. An objective ‘matter-of-fact’ attitude towards specific life situations was very frequent; that is, organising food, organising means to return home, or even participating in lynching SS-men or helping the victorious army to administer justice. Many subjects emphasised that they felt dazed, and that the world surrounding them appeared unreal. A similar phenomenon was described by Teutsch when he discussed a very different situation, when people were first confronted with the camp conditions. He referred to such a phenomenon as to a special type of a de-realization phenomenon. Although both phenomena appeared in different objective situations – imprisonment in the camp and returning to free life – they could be compared because their psychological elements were similar, in both cases, a prisoner or a former prisoner found himself in a completely new world.

This initial daze lasted a long time: from several months to several years and was expressed by a sudden jump into the business of various everyday activities. The former prisoners came back to normal life without taking any rest and without any chance to have time to take a careful look around. They immediately started very intensive activities, largely in the three areas of life: professional work, ideological and social activities, and social entertainment. Usually they worked more than others did, too much, too intensely, and frequently beyond their capabilities. Their attitude to work was different to the pre-camp period. In the post-camp life, their hyperactivity often led to conflicts with their environment, which constituted a kind of vicious circle. The psychological mechanism of this phenomenon was very complex and took different forms in different individuals. Some general characteristic elements, however, can be described. All former prisoners probably experienced strong neurotic anxiety, which deprived them of the possibility of appropriate gradual adjustment to life and forced them to engage continuously in excessive activity. They probably did not find satisfaction in the reality they encountered after liberation. Everyday life was too narrow for them, which is why they had to search for some other reality, artificially created by themselves. In psychiatric terminology, they lived in a world of overvalues. Most probably, the majority of them wanted to make up for the time wasted in the camp that often covered the best years of their creative youth. Others believed that their social and political work would provide an opportunity to gain revenge. Some others appeared to be convinced that through their intensive activities they would be able to prevent the possible danger of the recurrence of situations similar to those of World War II. All of them probably searched for a sense in life, and the sense of the great misery they had experienced in the camp and their subsequent activities were to compensate for the emptiness they found instead.

This phenomenon could be psychiatrically described as overexpansion, the hyper-compensation so frequently found in many neuroses that are accompanied by inferiority complexes, anxiety, and uneasiness. The vicious circle produced a permanent, strong, psychological tension. In fact, such people never managed to return to normal life, never accepted the surrounding world, and always continued to fight. For many of them the fight was a continuation of their internal attitude during the camp period, whilst for others it became a new way of life. Since they constantly lived in a world of overvalues, their tolerance of normal, everyday conflicts was very low. Frequently even unimportant difficulties of life, in comparison with what they had had to live through in the camp, led to periods of breakdowns, depression, suicidal inclinations, or neurotic alcohol abuse. Many of them had not found their place in the world even after many years. They had problems at work, and were misunderstood by others because of their constant belligerent attitude. Almost all Communist Party members active during the Stalinist period had many conflicts within the party.

The way of life described above can be considered an adjustment problem because it was always accompanied by disharmony: only one area of life was accepted as the ‘centre of gravity’, often with complete ignorance of all other aspects of human existence. Disharmony was characteristic of the lifestyle and provided a constant compensation for psychological problems; the former prisoners worked very intensely, searched for a sense to life, and actively spent every moment of their leisure time. That was also a vicious circle since this type of attitude created a new source of conflict.

Some of the subjects were aware of the fact that their lifestyle was a kind of self-defence, an alternative to the surrounding emptiness. Others, although they behaved similarly, could not grasp the reasons for their behaviour. Thus, the hyper-compensation period might be qualified as a defence mechanism.

In this particular case, however, as often happens in nature, the defence mechanism performed a function opposite to the intended one; that is, it produced even deeper breakdowns and social seclusion of either separate individuals or whole groups. It may be possible that biological factors also played an important role since camp survivors, after years of hunger and excessive stress in the camp, did not have any time to achieve a somatic regeneration due to the life they led.

(Obviously, not all former prisoners who had gone through such periods had difficulties in adjustment to normal activities, or dropped out of everyday life and failed to find their place in normal existence.)

Barracks at the former Auschwitz-Birkenau concentration camp. Photograph by Z.J. Ryn

The other type of reaction to liberation was, generalising again, asthenic. People with reactions of this type could not be pleased by the fact that they had regained freedom. Their reaction was one of sorrow, with doubts about the future, fear of life, and there were even people who were sorry to finish this period in their life and to be forced to start a new one, to go into the unknown (‘psychasthenics’). They were frightened by the prospect of the necessity to get food, prepare their return journey home, make new contacts with people, and undertake normal everyday activities. There were also others who appeared to be ignorant of the fact of their liberation. They passively allowed society to take care of them and make all the decisions for them. Most probably, these were cases very close to ‘musulmanism’. Only after a long time did they gradually take part in normal life. They frequently spent long periods with their families or in hospitals. They rested, were therapeutically treated, looked at the free world with a certain anxiety, and were not able – or not strong enough — to return to normal life, to undertake professional work, to be active. In extreme cases, they were supported by their families for as long as four years and they were frightened or were not able to start work. From a psychiatric perspective, this phenomenon was accompanied by apathy frequently connected with abulia, moods of depression, anxiety, constant recollection of the camp events as well as a permanent sense of danger, sleep disturbances, and an inferiority complex.

The lives of these people developed in various ways. There were subjects who, in fact, never managed to find their place in life since after undertaking professional work they developed an asthenic-depressive-anxious syndrome. Very many of them, however, did not encounter many problems and did not go through many periods of breakdown after they returned to professional work and started everyday life again. They managed effectively to shape both their professional and private lives.

The group described here is qualified by the majority of authors as having KZ-Syndrome; the clinical description of the group is not included since it does not constitute the subject matter of the present paper. The analysis of this syndrome in terms of adjustment, however, might be interesting. On one hand, from a social perspective, the several-year period of lack of working capacities, inactivity, complete lack of lower social commitment – which is an important factor of human life – and withdrawal (Merton) is clearly a serious distortion in the adjustment to normal life. On the other hand, however, in addition to its etiology, the fact of withdrawing from life for some time after such strong stress as the camp experiences, might help some former prisoners to become used to normal life. It appears that such a gradual return reduced at least some of the problems to the right proportions and saved some subjects from states of total confusion, which happened so often among the members of the group described here.

Naturally, although no conscious defensive attitudes or defence mechanisms were possible in this group, these side effects of the period of progressive asthenia were sometimes positive. Both types of behaviour described above could be considered as a single group of problems since in both groups, disorders, though of the two different extremes, concerned the sphere of human activities.

An axial patho-psychological adjustment problem for former prisoners, however, was difficulty in establishing relationships with people who had not lived through the camp. This refers to both the hyper-compensation group and to the asthenic group, as well as to those who could not be assigned to either of the two types of reactions. We may venture an opinion that for all the prisoners who ever had problems after liberation, interpersonal relations were made even more difficult. That phenomenon appeared in different forms and degrees of intensity; for instance, such people did not feel well in the company of strangers – that is, people who had never been camp prisoners – or they simply avoided contact with such people. They were reluctant to make new friends, and even contact with old friends became difficult. They felt best in the company of camp mates or those who had spent some time in a camp. They thought that people ridiculed them because they had wasted so much of their time and their education was incomplete. In their opinion, other people did not treat them properly because of the fact that their behaviour was different from the behaviour of those who had not lived through the camp. Other people’s problems appeared unimportant and the former prisoners were convinced that they were the only ones who knew what suffering meant. They were also convinced that the concentration camp had enabled them to see the depths of misery and since others were deprived of such an experience, they were not able to understand many things. They were frequently full of an unspecified rancour against everybody because others had lived largely normally, whilst they had suffered in the camp. Camp survivors were naturally also convinced that only their camp mates were able to understand the countless painful moments they had had to live through and even that single fact was enough to isolate them from the rest of society. Sometimes the awareness of alienation based on special experiences was transformed into a sense of wrong which in turn led to the claim that in every situation former prisoners should be treated in a special way, differently from ‘ordinary’ people.

Some of the camp survivors had a deep sense of loneliness and alienation even when they were with their friends or family, a feeling that disappeared only when they found themselves in the company of other Holocaust survivors. The subjects often became alienated from their natural environment, such as with their families or co-workers, and they were not able to produce any deep relationships that would be only natural in free life. This was an extraordinary phenomenon, since survivors were not a separate social group and did not even know one another. Each of them generally led a normal life with normal interpersonal relations and formally belonged to a different social group. The mere consciousness that someone whom they did not know personally had spent some time in the camp was enough to want to get into touch with such a person and confide in him. Thus, the problem of personal friendships determining the phenomenon of this special alienation did not exist at all. Among the subjects, we met several couples that married after the war and for whom the fact that both partners went through the camp experiences was the motive recognised by both sides as a basic condition of mutual understanding. Attempts were made to approach such problems in adjustment to the outside world from the perspective of the usual psychiatric assessment made in similar situations. For instance, there were attempts to grasp the correlation between such problems and the personality types, kinds of camp existence and finally the degree of difficulties former prisoners were confronted with after the liberation. However, it was impossible to find an explanation for this specific phenomenon. The subjects from the alienated group presented various types of pre-camp personalities. Frequently they might be described as synthonic, sociable types. Concerning camp experiences, it could only be observed that for many prisoners, factors that could be described as ‘psychological-moral’ were responsible for the most tiring experiences. For example, some of the former prisoners stated that the worst thing for them was the humiliation of human dignity, helplessness against violence, lack of the possibility to be alone, inadmissible sanitary conditions, and the sight of other people’s misery. On the other hand, a large group of prisoners complained of starvation, permanent danger, physical torture, etc. Concerning the conditions met after the liberation, despite the fact that in individual cases personal frustrations such as family conflicts or a clear disproportion between expectations and reality could be observed, in general, the ‘objective’ situation did not influence the sense of loneliness and conflicts with other people. It may be assumed that the reason for such a state might be an experience such as the stress syndrome met in the camp life. This also constituted the only element that consciously or subconsciously became a unifying factor in the lives of the former prisoners, the factor that at the same time conditioned their alienation from the rest of the world. It should also be added that difficulties in establishing relationships were of varying intensity and duration; though sometimes already after several months the former prisoners were able to engage in normal interpersonal relationships, a great number acquired this ability only after several years or were never able to establish such contacts.

If we approach the problem from a sociological perspective, it is clear that former prisoners of the concentration camps constitute a specific group of reference, and they are not able to form groups of reference in their normal, everyday environment. Their group is of a very special kind because its essence consists neither of personal contacts nor of specific interpersonal relationships, nor even of common purposes the members of the group might fight for; instead, the group is abstract, based on an awareness of common experiences in the camp. The range of reference for the members of this group is a specific period in their lives including such a rich variety of different qualities that everyone who experienced them automatically appears to be friendly and understanding.

The sense of otherness and all the ridiculous situations the camp survivors faced after liberation also played an important part in other aspects of their life. The ‘symptoms’ described here could be generally referred to as the frustration of certain behaviour patterns. This term, however, does not include all the shades of the phenomenon, which comprises very different variants with different ranges of reference and thus is difficult to classify in any of the known categories. In one’s usual everyday life one has to perform various activities, which are not even recorded in one’s memory. We take part in social life and observe social habits that seem only natural since we have been raised in a given cultural circle. It is a truism to repeat that human behaviour exists in elements of group patterns already internalised in our early childhood and performed in our later life, sometimes even without our awareness. All those elements constitute something that might be called a ‘contact-surface’ of our relationships with the social environment, which provides us with a basis for establishing relationships with other people and the outside world.

The sphere of such problems also included conflict situations for former prisoners. They left the camp where life was deprived of cultural protection, generally accepted ways of behaviour and forms as well as norms were destroyed, and adapted to specific situations. When they returned to freedom, the former prisoners often could not undertake the usual normal tasks and everyday activities that they had performed in the pre-camp period. The usual social structure, simple social mechanisms became strange, odd, and ridiculous. A disintegration of the internalised forms of behaviour could be commonly observed. They had to learn everything again: for instance, they could not become used to the fact that people referred to each other formally, that one was expected to use a spoon at meals, or that one could simply buy food. They did not know how to use money; they forgot the obvious fact that money was a universal socio-economic means of exchange. They laughed at funerals and only after several years managed to become used to the fact that an individual death should also be respected. It was beyond their understanding that people just walked in the streets. Some of them used to step out of others’ way. They could not understand simple kindness. There were also those who cried at the slightest sign of formal kindness. They complained that they did not know how to behave in society or in a smaller group, how to talk to people and how to arrange the simplest matter. Some of the subjects stated that the mechanism of interpersonal relations in the free world was very complex, whereas in the camp everything was simple and more primitive in both a ‘good’ and ‘bad’ sense. The distinction of whether one was talking to a ‘good’ or a ‘bad’ person did not require any special abilities in the camp, whereas after liberation it all became very difficult. Characteristically such opinions were expressed by people who, judging by their pre-camp occupation, were predisposed to communicating with people without any problems (for instance, lawyers). An individual but very interesting case was a subject who maintained that he was afraid of a life without orders and regulations.

As can be seen from the remarks presented above, it would be difficult to specify the symptoms with the help of some group terms taken from the literature on the subject, since those symptoms are often related to various facts as far as the range of reference is concerned. However, although such difficulties could be recognised, the phenomena described here required mention and an attempt to analyse them, regardless of all the formal methodological problems.

A short description of the analysis of life developments of former prisoners of the Auschwitz-Birkenau concentration camp given above leads to the conclusion that in the majority of prisoners, the camp trauma left a permanent mark in the form of adjustment difficulties to the normal conditions of life, especially in the area of establishing interpersonal relationships.

Translated from Przegląd Lekarski – Oświęcim, 1964.


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