[Psychological sequelae of persecution. The survivor syndrome]

In the present decennium, the fifth after the end of the Nazi holocaust, the psychological sequelae in the survivors are far from being overcome, and this chapter of psychiatry is not yet closed. The clinical symptomatology of the survivor's syndrome had only gradually been described during a period of about 20 postwar years. Among the particularities of what survivors experienced were their being outlawed, discrimination, defamation, total absence of rights, loss of individuality, life threatening over a long period, being uprooted, the fact of little number of survivors in one's family and elsewhere, lack of grave for the victims, loss of language, culture and home and many others. Characteristics of the survivor's syndrome are continuing anxiety of being persecuted, struggle against memory, tension feeling, rumination over past, low self esteem, irritability, feeling of survivor's guilt, lack of initiative, retreat in apathy, unability of gaiety and to enjoy the pleasures of life, and return of the persecution in dreams among others. Discussions on care and treatment for the aging survivors now is still vivid in many countries. As a consequence of the holocaust experience remains our knowledge that even a fully built up and equilibrated personality can completely be altered, if circumstances are forcing. Further on it has become more clear that there is a transmission if in altered form of the personality changes to at least the second and third generations. In spite of its many difficulties and setbacks psychiatric help is possible, so that there has developed psychiatry of the persecuted as a new branch of psychiatry.