Healing 101: Relief from Flashbacks

Can Holocaust Trauma Affect 'Third Generation'?

Can Holocaust Trauma Affect 'Third Generation'?

Studies Debate Impact on Grandchildren of Survivors

By Josh Nathan-Kazis

Forward - September 5, 2012

Is learning about the Holocaust from your survivor grandparents more traumatic than learning about it from“ Schindler’s List”?

Apparently not, according to a new study by Perella Perlstein, herself an ultra-Orthodox granddaughter of Holocaust survivors.

That wasn’t the result Perlstein expected when she began the study, conducted while she was a graduate student at Hofstra University. Her work examined the responses of ultra-Orthodox grandchildren of survivors to psychological tests designed to measure symptoms of secondary Holocaust trauma.

Perlstein’s results, published in July in the peer-reviewed scientific journal Traumatology, found that these survivor grandchildren responded no differently from other members of the ultra-Orthodox community when it came to the Holocaust.

This is just one entry in a growing, hotly contested field of research into the psychological impact on the so-called “third generation” — the grandchildren of Holocaust survivors.

One researcher is looking at how the Holocaust may have altered the way genes are expressed in the grandchildren of survivors. Another is building questionnaires to measure how Holocaust trauma has affected the family experiences of second-generation and third-generation descendants. Others have already concluded that the Holocaust has no indirect traumatic impact on the third generation.

Even the terms of the conversation are up for debate. Some experts dispute the notion that trauma can ever be experienced second or third hand. Others say that the experiences of Holocaust victims are so diverse that no broad characterizations can be made about trauma’s impact.

“We are not in the area of science here,” said Chaya Roth, a clinical professor of psychology at the University of Illinois who has written on the intergenerational transmission of Holocaust memories. “We are in the area of hypotheses. So forget about truth.”

The study of the third generation is a relatively new field that has grown out of earlier research into the effects of the Holocaust on children of survivors. That work began in the late 1960s and early ’70s, concurrent with the fading of the taboos surrounding the discussion of the Holocaust and its psychological impact.

Some researchers at the time found individual cases suggesting that children of traumatized survivors could be at risk for symptoms of traumalike anxiety and depression. Others, who tried to repeat these findings in broader scientific studies, found less evidence to support the notion that trauma could be transmitted between generations.

The third generation has its own unique set of experiences, quite different from that of their parents. The second generation “grew up at a time when Holocaust survivors were shunned in society,” said Eva Fogelman, a therapist who has written extensively on the issue. “Grandchildren of survivors grew up at a time in society when Holocaust survivors had regained their sense of dignity…. We have a transformation from shame to pride in the third generation.”

As was the case with studies of the second generation, controlled epidemiological studies have so far found scant proof of intergenerational transmission of trauma onto the third generation.

One meta-analysis of the available research published in 2008 by an Israeli and two Dutch researchers found no evidence for what it called “tertiary traumatization.”

The authors of the study, which was published in the journal Attachment & Human Development, recommend that third-generation offspring be “stimulated to search for the roots of their problems in other directions besides the Holocaust experience of their grandparents.”

Those skeptical findings have left some researchers undaunted.

Yael Danieli - Clinical Psychologist

Yael Danieli, a clinical psychologist who has researched and written on the children of Holocaust survivors, is currently working on developing a survey that will help measure the experiences of the children and grandchildren of Holocaust survivors. The project, funded by a $50,000 grant facilitated by the Conference on Jewish Material Claims Against Germany and the Anti-Defamation League, will create what Danieli says is the first measure of third-generation survivors’ experiences.

The survey, which is still in development, is headlined “Family Adaptation to Trauma.” It asks multiple-choice questions about family life among the descendants of survivors, and is designed for use in future studies by other researchers.

“The grandchildren literally forced us to look at them,” Danieli said. “It will be the first scientifically valid reliable measure of the experience.”

Other researchers are following different tracks.

Rachel Yehuda, PhD

Rachel Yehuda, a professor of psychiatry and neuroscience at Mount Sinai Medical Center, is gathering subjects for a study that will examine whether the Holocaust could have actually changed how genes are expressed in the grandchildren of survivors.

Yehuda’s field, called epigenetics, rests on the notion that outside factors can change how traits are passed to children from their parents.

According to Yehuda, earlier studies have shown second-generation descendants to have a different capacity for stress than nondescendants of survivors. That could have been the result of an adaptive change triggered by the highly stressful experiences of their parents during the Holocaust.

Yehuda said that there are some case reports of third-generation descendants experiencing eating disorders and anxiety. Her current work could show whether those traits are broadly representative of the population.

“I think that [this research] should be done, because if there are intergenerational effects that last beyond one generation, it’s important to know,” Yehuda said. “It’s not going to just be about the Holocaust.”

The researchers who have found no evidence of intergenerational transmission remain skeptical.

The findings of the Attachment & Human Development paper comport with the results of two dissertations advised by Hofstra University professor Robert W. Motta, including Perlstein’s.

“I went into the studies expecting, as [the graduate students] did, that there would be transfer to the third generation,” Motta said. “But we didn’t find that in either study. Believe me, that is not what we were looking for and not what we expected.”

For some, the entire notion that trauma could affect people who didn’t directly experience it seems like pseudoscience.

“This is where the psychological psychobabble gets spread like wildfire,” Fogelman said. 

“Transmission of trauma? Trauma is not transmitted. People either experience trauma or they don’t experience trauma.”

The third generation themselves, for their part, aren’t interested in the academic debates over terminology, according to Leora Klein, a board member and founding member of 3GNY, a group for grandchildren of Holocaust survivors. They just want answers.

“There’s a need, an urgency to figure out where the Holocaust is now in our lives as descendants of survivors,” Klein. said “Luckily our parents were not born in a time of horror, but they were deeply, deeply, deeply affected by their parents’ experience.”

Study: Molestation strongest Holocaust trauma

Study: Molestation strongest Holocaust trauma

Ynet News - Jan. 26, 2006

According to new study, sexual abuse traumas have greater effect on survivors than any other experienced during Holocaust years. 'Abuse still causes incessant thoughts, nightmares,' researcher says Ahiya Raved

 

A new study conducted at the Haifa University reveals that Holocaust survivors who suffered sexual abuse during World War II were much more traumatized by molestation than by any other of the horrifying experiences they went through during that period.

The study, the first ever to focus on the subject, is set to be presented next Sunday in the framework of a conference to mark the international Holocaust Memorial Day at the university.

 

Prof. Rachel Lev-Wiesel, who conducted the research, said that although the survivors experienced other traumatic events during the holocaust, including the loss of parents, physical abuse and hunger, the memory of sexual abuse remained etched in their minds more than anything else.

 

"This abuse still causes incessant thoughts on the subject and nightmares," Lev-Wiesel said.

 

'Survivors told stories with clarity, precision'

 

The study consists of interviews with 22 men and women in Israel and the United States, who were willing to share with the researcher stories about the abuse they underwent during the war.

 

Lev-Wiesel said that some people who offered to take part in the study were rejected, because she believed they would not be able to cope with the burden of memories and the self-exposure involved with the interview.

 

The average age of the interviewees stood at 68 years, and Lev-Wiesel said all have told their story with clarity and precision, in contradiction to how people usually speak of a traumatic event.

 

This is proof, Lev-Wiesel said, that the survivors retell the story in their heads over and over again, reliving the past daily.

 

All the survivors interviewed for the study have spent the war years on the run from the Nazis, some at hiding in the houses of Christians, others moving from place to place with the partisans, an easy prey for menacing adults along the way.

 

According to Prof. Lev-Wiesel, this fact does not eliminate the possibility similar incidents took place at ghettos as well.

 

Abuser usually close to victim

In some of the cases revealed in the study, the abuse was carried out by relatives or other Jews, which alleviated the trauma and embarrassment among survivors.

 

In one of the cases the abuser was a man who helped smuggle children from one place to another, in another it was a father who sexually abused his daughter, and in several other incidents – mothers who molested their sons.

 

Prof. Lev-Wiesel stressed that situations of stress and war do not create pedophiles, but that they enable such people to operate more freely.

 

Comfort zone: Three alumni put mind, body and spirit in harmony at The Awakening Center

Comfort zone:  Three alumni put mind, body and spirit in harmony at The Awakening Center
by Carla Beecher-Moehn
UIC Alumni Magazine - January/February 1997 (Volume 1, Issue 2)

Making people feel comfortable is the goal of therapists Amy Grabowski (left), Victoria Polin and Kate Fiello.

“More than anything, we want people to feel comfortable and safe here," said Amy Grabowski, M.A. ’86, the director and founder of the Awakening Center on North Lincoln Avenue just south of Belmont. So it’s no coincidence that visitors are greeted in the center’s small waiting room by classical music playing quietly, herbal teas sitting in a box waiting to be steeped and literature offering information on such topics as sexual abuse, eating disorders and surviving trauma.

As the literature suggests, the Awakening Center’s therapists counsel people for depression and anxiety and specialize in eating disorders and physical, mental and sexual abuse.

Of the four therapists who staff the center, three are UIC alumni. Grabowski earned a master’s in art therapy. Victoria Polin, M.A. ’91 received a master’s in art therapy, and Kate Fiello, M.S.W. ’89, a movement therapist, received a master’s in social work. The fourth associate, Marianne Evans-Ramsay, is a licensed and registered dietitian/nutritionist who specializes in disordered eating.

The four women not only share a home-like office space, complete with comfy couches and pictures on the walls, but also a similar philosophy about the need for the mind, body and spirit to work in harmony.

"Whether it’s with individuals or groups, each of us works toward helping clients establish a balance and harmony within themselves," said Grabowski. "We help them achieve a sense of calmness, compassion and inner strength within their core self."

"The result," she continued, "is a feeling of balance and the ability to love the person that they were meant to be."

Grabowski started the center two years ago after running a private practice for seven years. She wanted a place that would offer counseling, treatment and solace for those suffering from depression, anxiety and low self-esteem. She also wanted to help couples and parents who needed help with communication and parenting skills. As a result, the center’s staff provides clients with a safe haven from their fears. Some clients also need to work out such traumatic experiences as incest, rape, physical and/or mental abuse, and even the anguish of political terrorism.

As a creative therapist and a licensed clinical professional counselor, Grabowski specializes in women’s issues, especially eating disorders, body image problems and anxiety. She uses art therapy and phototherapy to help her clients work through their problems.

"I focus on emotional attunement," she said, "and use a theory called Internal Family Systems Therapy whose goal is to create an inner peace and cooperation among the personality’s different parts."

The theory’s premise is that people have many facets of themselves — some are in harmony and some are polarized. The therapy tries to create a balance between them.

A basket on the coffee table in Grabowski’s office holds figures that clients use to help them understand themselves better: there are Barbie dolls, gargoyles, a potato person, an Oreo cookie figure, a witch, an angel and mythical figures.

"These figures represent different aspects of ourselves," she said while setting up several of the dolls. "We use them to symbolize the relationship between the parts. There are pairs of parts that are polarized in extreme roles — which is often where problems arise.

"As we try to get the two parts to become less extreme and more in balance, clients begin to see how one part of them may be very critical of the part of them that is fearful or playful.

"They set up a sort of diorama with these figures that helps them talk with each part of themselves individually, as opposed to having their many parts arguing in their head all the time."

Clients pick one figure to represent their core self. "I like to call that figure the conductor — it’s conducting the orchestra of our different selves. Many people don’t have a good feeling about who that part is. While we’re uncovering who that person is, the figure is always on the table so they can see what they’re working toward becoming."

When Grabowski uses phototherapy, clients bring in several photos of themselves at various young ages. If they were traumatized, a part of them is typically stuck at that age and may keep reliving the experience. Grabowski makes a photo copy of the picture which the client uses to draw on or cut out for use in a collage.

"People have strong feelings toward themselves at a certain age," she continued. "With the photos, they can see themselves and it often softens their feelings about who they were then. They become more compassionate toward that part of themselves. They think, ‘I was so young.’ There are many aspects of therapy that tap into those parts, unburdening them or letting go of something from the past."

Kate Fiello uses movement to help clients get back in touch with their bodies. Many of her clients have eating disorders like anorexia nervosa or may be overweight.

"Many of my clients are disconnected from their bodies — they may view them as a bad object and have difficulty relating to it," said Fiello from the large office that serves as a studio for the movement and art therapy sessions. The space is comfortable and warm.

Fiello’s clients have undergone some type of abuse or trauma that has caused them to separate their minds from their bodies. Fiello’s goal is to get them back in touch with their bodies through movement in hopes that the reconnection will free them from the fear of feeling their bodies.

"I start slowly, because at some level, my clients realize they need to be in their bodies to heal, but they’re terrified of their bodies because that’s where they were traumatized."

Fiello, who is a licensed clinical social worker, begins with breathing awareness — clients begin to notice the rhythm of their breath. What does it feel like? Where is it moving? Does their chest move, their stomach? Is there a part of the body that’s not letting the breath in? What might that tell them about how they’re feeling?

"For instance, when you’re scared, your breath shortens and your chest tightens up," Fiello said. "When you’re relaxed, the breath is more fluid. I want my clients to gently listen to their breath and then scan their body from head to toe to see how it’s feeling. Is their head light or heavy? It’s basic kinesthetic sensing and gets them to start being comfortable with their bodies."

Most of her clients are women who are stuck. They intellectually understand their eating disorders — they know all the dynamics of the disorder in their head, but they haven’t integrated it with their bodies. They’re emotionally repressed. The sensing exercise brings them closer to those feelings.

According to Fiello, many of these women fear that if they get in touch with their feelings, they’ll explode. They don’t have a sense of where their bodies begin and end.

"They think, ‘If my body feels numb now, how will I deal with all the emotions once I start feeling again.’ So I help them with their body boundaries and we try to modulate the degree of the feelings."

One woman in a session with Fiello got angry and had the urge to kick her feet, but was afraid that if she really let her feet feel her anger, she might kick apart the room. So Fiello regulated her kicking from one to 10. Once the woman reached the highest level and kicked the hardest at 10, Fiello helped her control it and bring it back down to one.

"It doesn’t have to be overwhelming," Fiello said. "They can learn to feel a little bit at a time."

A highly distorted body image is a hallmark of anorexia. It is hard to fathom how anorexics think they are fat when they are literally wasting away. To gauge how far off their image is of themselves, Fiello asks new patients to close their eyes and measure with their extended hands how wide they think their hips are. They then lower their arms and open their eyes to see how much wider they imagine themselves to be than they really are.

It’s also common for overeaters to imagine they are smaller than they truly are, added Fiello.

"Culturally, we are just not taught to be in tune with our bodies. We’re taught to intellectualize."

One reason trauma victims become anorexic, according to Fiello, is on an unconscious level, the smaller they become, the less they’ll be seen, and, therefore, won’t get hurt.

"Many times my clients don’t know how to say no or how to stand up for themselves," Fiello said. "To protect themselves, trauma survivors dissociated from their bodies when they were being abused — they just left their bodies and went away in their minds. So over time, when things get stressful, they have the same reaction, which leaves them powerless. I try to teach them to be present in their bodies and become aware of that pattern of dissociation. Then they can start taking care of themselves.

"By thinking of their body as a container, they can feel their boundaries and take control of their lives.

"I love seeing people come alive again, when they begin to embody themselves again. I get to witness the fullness of them. Their personalities become richer as they grow and evolve. It’s wonderful to help them find that."

Vicki Polin also loves seeing her clients grow and change.

"I like watching people fulfill their dreams and wishes and do the things I know they can do," she said.

Polin, who works with victims as young as age 4, directs the Trauma, Recovery and Empowerment Services at the center. Also a licensed clinical professional counselor and a registered art therapist, Polin uses an eclectic approach of both verbal and creative therapies.

"Because many of us get stuck in self-defeating and unfulfilling life patterns in an attempt to re-create our own personal universe, psychotherapy offers a way to rediscover our own potential and bring a balance of mind, body and spirit," Polin said.

Previously, Polin coordinated an international organization for adult survivors of child sexual abuse and has volunteered as a rape crisis advocate in hospitals.

"That job inspired me to get a master’s in art therapy from UIC in work that I thought was important," she said.

Last January, Polin started a free group for adult survivors of childhood sexual abuse at the Awakening Center. The group meets Saturday mornings at the center and represents people from all racial and economic backgrounds. When Polin found that men weren’t attending because of the stigma attached to being sexually abused as children, she changed the name of the program from survivors of sexual abuse to survivors of childhood trauma.

"All of the sudden, I started getting Holocaust survivors and victims of political terrorism. It was very interesting how things opened up."

But no matter what the abuse, the ramifications were the same: having low self-esteem, being unable to do things they wanted to do, and having flashbacks and nightmares — the same symptoms as post traumatic stress disorder.

Polin has noticed a new trend in clients: Children of Flower Children.

"Lately I’ve seen several clients who grew up traveling across the country in a van with their parents where there was free sex, and drugs and alcohol abuse," noted Polin. "It’s a whole different kind of abuse that we haven’t paid attention to. These young adults, who are now in their 20s, had very little structure. Some of these people try to be free and wild, but they’ll have flashbacks of their parents having sex, which can be traumatizing to a 3- or 4-year-old child. These clients are trying to figure out if they were sexually abused or just very sexualized as children."

Polin has found art therapy especially useful when patients are trying to understand a trauma that happened when they were very young — before their language skills were fully developed.

"Non-verbal therapy, like art work, seems to help. They draw a picture of the feeling, whether it’s realistic or abstract, or they may do a collage. The pictures may seem cryptic at first, but over time, the pictures come together and clients seem to find some resolution."

Polin recalls Harriet Wadeson, UIC associate professor of art and design, saying, "Memorize every theory we give you while you’re in school and the day you graduate, forget it all and you’ll learn it all over again when you get out in the field."

"It’s true," Polin said. "Unless you’re out there working with people, you’re clueless. It was two years of hell, that program. But if you can make it through, you can make it through anything. It was really helpful."

UIC’s art therapy program teaches its students ways to recognize when a patient is on the mend. Polin knows when clients are getting ready to leave therapy when their lives start to change for the better.

"If they go back to school, or divorce an abusive husband, or maybe go after a new job they’ve been talking about — I know that something is happening there. If I think they’re ready, I’ll try to nudge them out. Sometimes it’s scary for them to leave because this is a safe place."

As clients work through their problems, they begin to realize they’re not to blame for what happened to them, and they learn to deal with their anger and rage. They begin to see they can live life on their own terms.

"I try to follow their lead, because most have let choice be taken away from them," she said. "I know many times clients want to think I will tell them what to do to make their lives better, but the answers are really within them."

In summing up the philosophy of the center, Grabowski added, "Our name, the Awakening Center, means that we hope to awaken the balanced self inside us that is there, but dormant. As we become enlightened, we awaken ourselves to the core person
inside."

Victoria Polin recently compiled the "1997 Chicagoland Area Sexual Abuse Resource Guide for Care Providers and Consumers".

A Recovery Bill of Rights for Trauma Survivors

A Recovery Bill of Rights for Trauma Survivors
© (1995) Thomas V. Maguire, Ph.D.

As a matter of personal Authority, you have the right 

1. to manage your life according to your own values and judgment.
2. to direct your recovery, answerable to no one for your goals,
3. to gather information to make intelligent decisions about
4. your recovery. . . . . to seek help from a variety of sources, unhindered by demands for exclusivity.
5. to decline help from anyone without having to justify the decision.
6. to have faith in your powers of self-restoration and to seek allies who share that faith
7. to trust allies in healing as much as any adult can trust another, but no more
8. to be afraid and to avoid what frightens you
9. to decide for yourself whether, when, and where to confront your fear.
10. to learn by experimenting, that is, to make mistakes.
11. For the preservation of personal Boundaries, you have the right
12. to be touched only with your permission, and only in ways that are comfortable.
13. to choose to speak or remain silent, about any topic and at any moment
14. to choose to accept or decline feedback, suggestions, or interpretations
15. to ask for help in healing, without having to accept help with work, play, or love. challenge any crossing of your boundaries.
16. to take appropriate action to end any trespass that does not cease when challenged.
17. In the sphere of personal Communication, you have the right
18. to ask for explanation of communications you do not understand.
19. to express a contrary view when you do understand and you disagree.
20. to acknowledge your feelings, without having to justify them as assertions of fact or actions affecting others.
21. to ask for changes when your needs are not being met
22. to speak of your experience, with respect for your doubts and uncertainties.
23. to resolve doubt without deferring to the views or wishes of anyone.
24. Specific to the Domain of Psychotherapy, you have the right
25. to hire a therapist or counselor as coach, not boss, of your recovery. receive expert and faithful assistance in healing from your therapist. be assured that your therapist will refuse to engage in any other relationship with you (business, social, or sexual) for life
26. to be secure against revelation of anything you have disclosed to your therapist, unless a court of law commands it.
27. to have your therapist's undivided loyalty in relation to any and all perpetrators, abusers, or oppressors.
28. to receive informative answers to questions about your condition, your hopes for recovery, the goals and methods of treatment, and your therapist's qualifications. have a strong interest by your therapist in your safety, with a readiness to use all lawful means to neutralize an imminent threat to your life or that of someone else
29. to have your therapist's commitment to you not depend on your "good behavior", unless criminal activity or ongoing threats to safety are involved
30. to know reliably the times of sessions and of your therapist's availability ,including, if you so desire, a commitment to work together for a set term.
31. to telephone your therapist between scheduled sessions, in urgent need, and have the call returned within a reasonable time. be taught skills that lessen the risk of retraumatization: (a) containment (reliable temporal/spatial boundaries for recovery work); (b) control of attention and imagery (through trance or other techniques); (c) systematic relaxation
32. to reasonable physical comfort during sessions