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Category Archives: grief

Understanding Trauma and its Effects: Holocaust Memorial Day

Group understanding trauma and suffering at Auschwitz-Birkenau concentration camp to remember the Holocaust and educate themselves with a group tour of the area, seen through barbed wire.

Understanding trauma through a visit to a concentration camp: how many of us try to process the horrors of the Holocaust.

27th January is Holocaust Memorial Day – a chance to remember the estimated 11 million people (six million of them Jews) who lost their lives in the Holocaust, and future genocides. In understanding trauma that survivors live with, we as a society demand history doesn’t repeat itself, and we acknowledge those affected.

This date was picked as the official memorial day back in 2000, by governments from around the world, stating that ‘we value the sacrifices of those who have risked their lives to protect or rescue victims, as a touchstone of the human capacity for good in the face of evil’.

But how did Holocaust survivors deal with the psychological trauma in 1945, and how do we begin understanding trauma like this in 2018?

Being told to forget

When most survivors returned home, or began new lives in other cities or countries after liberation, they faced negative reactions from neighbours, friends and colleagues. Hostility, silence and indifference were all common, because nothing like the Holocaust had ever happened before, where certain groups (including Jewish and Polish people, gypsies and gay men and women) were systematically targeted. Though camp conditions were reported worldwide before and after liberation, trials were delayed and took a long time, and many perpetrators escaped punishment. Every time war criminals were brought to justice – some only in the last decade – survivors faced trauma triggers.

Victims were either told to forget about their experiences, or they decided to repress the memories as a coping strategy, ploughing their attention into normal life and trying not to think about the past. This is not something psychologists, or indeed psychiatrists, would suggest today. In order to recover from trauma, and process it, patients use talking therapy with psychologists, and treatments such as EMDR would be recommended for those suffering from PTSD (Post-Traumatic Stress Disorder).

Early studies of Holocaust survivors

In 1950, survivors in Israeli refugee camps were found by sociologist Judith Shuval to be more ‘pessimistic’ than control subjects, and also ‘hard’: hardened to the setbacks they encountered. By the late 1960s, more research emerged on the psychological impact of surviving the Holocaust, and terms like ‘survivor syndrome’ were coined (by psychiatrist William G. Niederland, who studied 800 cases in 1964). For many survivors, symptoms of what we’d now call PTSD didn’t emerge until years afterwards; technically, when symptoms emerge at least six months after the traumatic event, this is late-onset PTSD.

Jewish people in Nazi-occupied Europe who weren’t in concentration camps but were hidden in plain sight (in children’s homes, convents or strangers’ homes), became resistance fighters, or fled abroad – perhaps on Kindertransport – had different experiences, but still faced emotional distress. We still call them Holocaust survivors, because they are. They lost many relatives, friends and neighbours, and had no community to return to after the war. Anti-Semitism didn’t die with the Nazis, either; the remaining Jews scattered across Europe faced stigma in the decades afterwards. Despite the distress those in hiding suffered, it wasn’t until 1983 that any researchers (Shanan and Shahar) included them in scientific studies, and we began understanding trauma for those who survived in different circumstances.

Mother clutching baby's hand in monochrome photo suggesting mother and child bond

Genetic science and psychological assessments both suggest parental trauma can affect children, even decades later. Understanding trauma.

Understanding trauma in a second generation

Helen Epstein, the daughter of two Holocaust survivors, published a ground-breaking book in 1979. Children of the Holocaust: Conversations with Sons and Daughters of Survivors suggested that these children had inherited fears and anxiety because of their parents’ suffering. A mixture of learned behaviour in the family unit, and having no outlet to discuss their concerns, meant survivors’ children faced their own specific challenges. Epstein’s book struck a chord with people all over the world. It reminds us that trauma doesn’t end with the patient, but can affect those around them.

Furthermore, there’s science to back up her theory. Scientific American reported in 2015 that children of Holocaust survivors have different stress hormone profiles to their peers. The survivors themselves had lower levels of cortisol, and younger survivors had less of an enzyme that processes cortisol, freeing their bodies to focus on storing glucose (essential during starvation); this seems fairly logical. But the stress hormone profile of their children features high levels of cortisol – perhaps compensating for their parents – and a greater predisposition to PTSD than their peers.

Long-lasting effects of trauma

In 2010, the American Psychological Association summarised decades of research which showed that Holocaust survivors still had symptoms of PTSD and that they reported poorer wellbeing than peers who hadn’t been Holocaust victims. Many of these survivors won’t have had early psychological intervention; as we discussed earlier, they may have been discouraged from talking about what happened, or they may have tried to repress their memories and refused to reflect on the past, as a coping mechanism, not understanding trauma within themselves. Whatever their family circumstances, they often battle loneliness and isolation, but meeting fellow survivors can help increase their sense of community.

Sadly, other genocides followed the Holocaust. In the decades since, we’ve seen groups persecuted across the world – for example, in Bosnia, Cambodia, Rwanda, Sudan, and the current actions against Rohingya Muslims in Myanmar. That’s sadly why Holocaust Memorial Day doesn’t just remember past horrors, but what’s going on right now in the world, affecting vulnerable men, women and children. Understanding trauma in 2018 is much easier than in 1945, but survivors of more modern atrocities won’t necessarily have access to better treatment, or any therapy at all. Here in the UK, we are also fighting for Syrian refugees to be given trauma assessments and treatment to process the horrors they’ve seen (the war in Syria is on the verge of being categorised as genocide), as they adjust to starting again thousands of miles from home.

This Holocaust Memorial Day, we pay tribute to all those who’ve experienced the trauma of genocide, and their families, and wish them well in their ongoing recovery.

Written by guest contributor and mental health campaigner Polly Allen, for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).

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Coping with Christmas After the Death of a Loved One

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Coping with Christmas after the death of a loved one is always very painful.  Pain is often made worse because everybody else appears to be happy at this time  of year.

While Christmas will be painful, there are a few things that can make the process a little easier.

It is important to recognise that sadness will come and go throughout the festive period. This is inevitable, grieving is the price we pay for love. You can and will get through it.

These practical steps for coping with Christmas after bereavement may help.

1) Plan for Christmas day: get out pen and paper or the iPad, and jot down things you might like to do if you were not feeling quite as sad

List simple things. Maybe you always wanted to drink Bucks Fizz in bed, but never could because your partner was teetotal, or perhaps you always wanted to walk in the country on Christmas morning rather than go to church. Now is the time to please yourself – don’t feel guilty, just do it.

In making new memories and new habits, you are building a future for yourself in small but tangible ways. And don’t forget to include the quiet time between Christmas and New Year, which many people can find difficult. Think about what you’ve always wanted to use that time for.

2) Anticipate the parts of the actual day when you are likely to feel worse

Once you can recognise where the major deep pits lie, you will be able to draw up a plan to be doing other activities at those especially vulnerable times. If you recognise that your dip in mood occurs after lunch, why not go for a walk, have a sleep or try and master a hobby?

Don’t be afraid to rip up the rule book to get through Christmas. Just because you’ve always done things a certain way, doesn’t mean they have to remain that way forever. If a particular tradition or ritual feels too upsetting to revive this year, attempt a new one. Swap the Queen’s Speech for a card game, or the post-lunch walk for a Boxing Day morning walk instead.

3) Create a ritual that honours the past but sows the seeds of hope for the future

Perhaps that might be to gather winter foliage from the country to make a seasonal wreath and then laying it at your partners resting place.  Afterwards, why not meet up with a son, daughter or grandchild to do something different together? Have some mulled wine, treat them to a meal, watch them ice skate, have a flutter on the horses.

It is not important what the activity is – the importance is found in developing new rituals. Why not create a ritual you can carry out and extend every year forward?

4) Buy yourself a present

Wrap it nicely and pamper yourself, whatever the budget. Don’t pick something practical with little personal meaning, such as a new iron.

Choose something you have always wanted but never dared to buy. If you can’t afford to be extravagant, buy something that works towards your dream – a Theatre Token, to help save for a theatre trip, or a pair of walking boots, to prepare for an exotic walking holiday at some point in the future. Open your present on Christmas Day, and immerse yourself in it.

5) Make an emergency ration pack

An emergency ration pack is a small parcel made up of items that will lift your spirit even in your darkest moments. The idea is that you take time to select items that comfort or cheer you. When sadness hits, you won’t feel like seeking out things that raise your mood, so be prepared, and have the ration pack ready before you need it.

A typical ration pack might include chocolate, bath oils, a favourite DVD, a magazine, notebook, a novel and a painting set. The items don’t have to be expensive or wildly exciting, but they keep you occupied in difficult times.

6) Accept invitations

You may not want to go out, and that’s fine, but try and be gracious. Accept the odd invitation, as it will help you realise that life goes on. When you’re struggling, set a time limit: tell yourself you’ll go to Christmas drinks for an hour, and then see how you feel. Could you stay half an hour longer? Don’t forget to enlist friends and family to help, too.

Socialising does not mean you have stopped grieving or have forgotten your partner.  It does mean that you are courageously choosing to walk on for yourself while honouring your past life.

7) Count your blessings

Remember, you are lucky to be here: you have your health, and the ability to choose to move forward. You are able to feel your pain, but this in itself means you will also feel joy again. Many are not so lucky.

You may find it helpful to talk to other people who have recently lost a loved one. Track down a support group near you, or consult bereavement charities, to find a network of like-minded people who may be further along in their journey with grief, and can remind you of the happier times to come.

8) Be kind to yourself: use mindfulness

Don’t be harsh on yourself when you feel sad. Feelings of sadness will pass. Feeling broken and like life has ended is part of the grieving process. Allow yourself to experience your emotions without dulling them with excessive alcohol or drug use.

If you are unable to take any of these steps and are thinking that you can’t go on, it is essential that you seek help.  Counselling or psychotherapy may help you to adjust to your situation. It may also allow you to recognise that, despite your current feelings of sadness, you do have the chance of a positive future ahead of you.

If things become too much before you have arranged psychotherapy, dial 111 (for NHS help in a non-emergency), 999 (in an emergency) or talk to the Samaritans, night or day, including over the Christmas period, on 116 123.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk). 

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