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The author chronicles his psychiatric work with the inmates at Bergen-Belsen, a Nazi concentration camp. He describes the psychopathic behavioral problems, enuresis, nightmares, and rageful aggression that developed among the children and adolescents in the camp. Causes of these problems included: hunger, fear, exhaustion, parental absence and irritability, denial of the environmental horror, and the constant witnessing of the Nazis degrading their parents' dignity and
authority. While cases of reactive psychosis in adults were evident, many inmates who were mentally ill before incarceration actually improved in the camp, whereas some who were healthy beforehand now became morbidly depressed, anxious, or worse. The unconscious need for punishment, now satisfied by the Nazis' brutality, may have alleviated already existing symptoms, while the focus on external terror may have refocused and lessened pathological anxiety that before the war stemmed primarily from unconscious fantasy. “Survivor guilt,” struggles against dying from apathy and lack of hope, and suicide attempts are also discussed.