The Emotional Reactions of Psychiatrists when Confronting Survivors of Persecution

For many years I have dealt with psychiatric opinions concerned with survivors of Nazi persecution and have had some interesting and strange experiences revolving around the evaluation of former concentration camp inmates and outlawed people who had existed in hiding for years.

Such evaluation is a complex task, for it is the expert's duty, apart from the usual communication with a troubled human being, to assess the degree of permanent psychic damage caused by persecution. A recent “Forum” discussion, other publications about the topic, and self-observations have stimulated me to summarize and classify attitudes and motivations of experts as well as the corresponding reactions on the part of the survivors.

Several papers have focused on flagrant psychiatric misjudgments and asked for a redress of grievances. Eissler (3) points to the lasting feud between psychiatrists appointed by German consulates, indemnification offices or courts and those experts who establish a counteropinion on behalf of the survivor. He discusses the frightening alienation and utter incapacity for empathy on the part of the appointed psychiatrists, giving detailed examples of prejudice, and he considers those survivors entitled to additional restitution because of the humiliation suffered during the processing of their restitution claims.

Due to his own involvement in such evaluations, Eissler admits being overwhelmed by the incomparable, gruesome experiences of the victims, and he doubts that any expert can achieve an optimal combination of empathy and distance. He feels that objectivity toward survivors is an inadequate approach, that it represents an emotional block in the experts threatened by the intense anxiety of losing their identity. In his view, (4, 5) one important additional motivation of these experts is their “archaic contempt for the humiliated connected with the whole

problem of sado-masochism and the reaction to various shades of narcissism.“

Niederland (24) finds much superf