Early trauma can have life-long consequences

Young survivors of the holocaust have often been told from their early years that they 'survived the war well' and that 'they are lucky not to be able to remember that awful time.'

They then often do not connect problems that they have in the present day, now that they are 60 or older, with early traumatisation. While the link is definitely there, as Elisheva Van der Hal-Van Raalte has demonstrated. On 16 May she hopes to obtain her doctorate based on empirical research into the consequences of war traumas in early childhood on the present-day well-being of holocaust survivors. Van der Hal: 'Early trauma can have life-long consequences.'

Van der Hal, herself a war child, worked for 20 years as psychotherapist with survivors of the holocaust. She often observed a relationship between the present-day well-being of her clients and their childhood war-time experiences. 'I want to use doctoral research to find empirical support for my clinical observations,' she says. Participants in the research were 203 war survivors, born between 1935 and 1944 in European countries occupied by the Nazis, and who now live in Israel. Van der Hal asked them to complete a questionnaire giviing her information on the circumstances under which they had lived in the early years after the war. She assessed their present psychological functioning by measuring the production of the stress hormone cortisol.

What did she discover? ‘The youngest survivors in particular, those born between 1941 and 1944, experience negative consequences in later life as a result of their childhood deprivations. This group missed the safe and protected pre-war situation. Children were born into families which were torn apart completely by the terror of the Nazi regime. During the first years of their childhood they did not experience the security and protection which is so important for healthy development.'

For many holocaust survivors the trauma did not stop when the war came to an end. Post-war care often left a great deal to be desired. This, too, was not without its consequences for war children, as Van der Hal's research has demonstrated. 'Survivors who experienced poor or inadequate post-war care now have more physical, psychosocial and emotional problems. My research shows how important it is that young war victims are given proper support.'

In terms of the after-care of war children it is not enough to support only the children. Van der Hal emphasises that the parents or carers have to be included in the support plan. ‘After the Second World War, parents, like children, were severely affected by the consequences of the war. As a result, they were not always emotionally available for their equally traumatised children. After a disaster or a genocide it is therefore important that parents, too, receive support, so that they can provide adequate care for their children.'

Those who have been traumatised can benefit from outside help, but they can also protect themselves against psychological problems. Van de Hal: 'I have based my research on the salutogenic model of the American Israeli Aaron Antonovsky. This poses the question: 'Why do you continue to be healthy', as opposed to the pathogenic model which is based on the question: 'Why do you become sick'. A positive attitude to life seems to protect holocaust survivors against post-traumatic stress disorders, in spite of the terrors they have experienced.' According to Van der Hal, this finding can be translated into guidelines for the psychotherapeutic treatment of trauma sufferers. 'Help them to develop a more positive attitude to life, focused on a healthy ways of handling problems of stress.'

One limitation of her research which Van der Hal mentions is the selectivity of her survey group. 'Future research should focus on the later consequences of early war traumatisation among Jewish survivors who live outside Israel, among the youngest survivors of the Japanese occupation, and among children of resistance fighters.' She ends on a positive and hopeful note: 'My research has generated greater insight into how young children can become permanently traumatised. But what is more important is that the results also show how you can try to prevent this in present-day instances of genocide.'

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