PTSD support remains pertinent for Holocaust survivors

Elihu Kover is the vice president of Nazi Victim Services for Selfhelp, Inc., a New York City organization that provides assistance to people who lived through the Holocaust. Founded in 1936 (there were people fleeing Germany for the U.S. before the Holocaust was fully underway), the organization serves about 5,000 New York City Jews each year who wish to stay in their homes and in their communities in spite of what their age and the Holocaust has done to them. For many, that means combating symptoms of late-onset posttraumatic stress disorder that may have lain dormant during their youth and middle age, but is arising in later years because their defense mechanisms lower as their ages grow higher.

The aging process, itself, is fraught with perils,” says Kover, who has been at SelfHelp for 25 years. Noting that every client’s situation is different, Kover says that his clients present a range of issues, many of which may be PSTD reactions.

With the population of U.S. Holocaust survivors now between ages 70 and 80, there’s a growing need for gerontologists – and anyone else who treats aging and elderly patients, for that matter – to be more aware of the symptoms Holocaust survivors may present and the approaches they should use to treat them.

According to Kover, there are some 100,000 to 110,000 survivors in the country and a little more than half live in New York City. “We have a number of clients who have various paranoid symptomology, some almost to an acute level and their issues come out in various ways,” he says. For some, they feel they are being watched all the time or see the Taliban wherever they look; others are able to live independently, but they write volumes of distorted thoughts about the people who are “out to get him.”

“For others, the paranoid reactions are less extreme,” he says. “They’re hesitant to apply for government benefits or to reveal information to the government.”

Another common Holocaust survivor symptom is guilt. People survived the Holocaust and the years after doing things that in today’s world may be judged unfavorably, says Kover, whether it was stealing or cannibalism. “We can’t judge what people did in today’s time,” he says. “People may have done things they may not be proud of and they’ve hidden all these years,” and that he says – along with feelings of ‘why-did-they-die-but-I-didn’t’ – can cause PTSD among the aged.

It’s no surprise that these symptoms surface as survivors get older. “Thoughts come back because they’re not so busy anymore,” says Kover. “They’re not working; they have time to think. It’s a normal stage of life where you look back and evaluate what you did.” But some practitioners think that the actual benefit of late-onset or typical PTSD can be lost if too much focus is placed on the whys and whens of its emergence.

“The idea of PTSD exists for a reason,” says Jonathan Slavin, Ph.D., licensed psychologist for 48 years in Newton, Mass., former director of Tufts University Counseling Center, a lecturer for the department of psychology at Harvard Medical School and a regular consultant with the Israeli Ministry of Health and Defenses. “It’s a defense. [PTSD] is an effort on the part of the mind and brain to allow for something extremely overwhelming. Some symptoms may not be debilitating at all. They may just be an effort… for the mind to heal.”

Slavin has focused much of his life’s work on PTSD trauma in the U.S. and abroad and is well versed in counseling trauma sufferers throughout Europe. “I think for a long time, trauma studies have been about talk-talk-talk” But in recent years, he says, practitioners have been learning that not trying to deal with trauma and setting it aside – going on with life – may be the answer, particularly for Holocaust survivors.

“Maybe they couldn’t talk about it, they couldn’t show their kids,” says Slavin. “I see it as they have put together…a real life in spite of their trauma. It’s not like a covert operation and that trying to put a life together is a happy-go-lucky experience. There are lots of consequences [to that behavior].” But, he says, so is not trying.

Research for a project by SelfHelp Inc. shows that there will be Holocaust survivors in need of services for at least 15 to 20 years, says Kover. To keep up, he says there’s a need to train people in the workplace to work with this unique population.

“You don’t want psychologists and psychiatrists to have to do all the work,” says Kover. “We need to train social workers and staff who work with survivors especially where there are large populations in metropolitan areas.”

“I think all mental health professionals should acquaint themselves,” says Slavin. “It’s as if people think all Holocaust survivors are dead. But that’s not the case. Children, grandchildren are also affected. Practitioners should be aware of people’s histories.”

Synagogues and community groups are providing outlets for parishioners and community members in need. Rabbi David Paskin of Temple Beth Abraham in Canton, Mass., holds a yearly Holocaust remembrance. “The Jewish community definitely rallies around the survivors of the Holocaust; especially recently, as we are losing more and more of them to old age,” says Paskin, who has been at Temple Beth for 15 years.

“Now that I think of it,” he says, “losing our survivors is, itself a trauma for the Jewish community.”