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A Narrative Approach to Working with Aging Holocaust Survivors and Their Families Inside the Institution


Susan Barron, MSW, RSW, Toronto, Canada
Renee Climans, MSW, RSW, Toronto, Canada

Baycrest Centre for Geriatric Care, in Toronto, Canada, is an internationally recognized institution providing geriatric health care, research and education. It provides a full range of inpatient, outpatient, residential and community-based programs for the elderly. As social workers at Baycrest, we have the honour and privilege of working with a group of older people who have a wealth of wisdom and experiences to share. Many of these persons are Holocaust survivors. Each person has a unique story to tell. We have changed as a result of being a privileged audience to their stories. We can learn so much from their recounting. A narrative approach provides a set of ideas, which might be helpful in working with ageing Holocaust survivors and their families inside the institution.

Ageing involves many changes that can include physical, emotional and cognitive losses. For aging Holocaust survivors and their families, coping with such issues can be further complicated by their past difficult experiences. A narrative frame provides a paradigm shift away from a pathologizing approach to viewing survivors and their offspring. It takes the focus away from the individual and positions the survivor and the events that they endured within a social and historical contextual view. Some of the hallmark features of this approach face unique challenges when applied to this population. These will be reviewed.

Within an institutional setting it is easy to lose sight of the person with individualized human needs, values, desires, emotions and beliefs, regardless of their physical and cognitive well being. The knowledge that behaviour has meaning is particularly significant in better understanding the behaviours of our residents who survived the atrocities of the Holocaust. For instance, one cognitively impaired woman, a survivor became particularly agitated at bath time. One might surmise that memory of the showers or gas chambers were influencing her at such times. Another female survivor would wrap up food and hoard it in her room, a behaviour learned when starvation and a paucity of food were part of her lived experiences during her days in the concentration camp.

Implications for care and treatment and future plans are numerous. Consideration must be given to all life experiences when establishing any type of Care Plan. Generalizations must not be made simply in relationship to membership in one particular group. In an article on the Transgenerational Effects of Japanese Internment, Nagata (1991) maintains that simply suggesting that therapists know more about the culture of a client is inadequate since such recommendations often fails to specify treatment procedures to consider within group heterogeneity among ethnic clients.


Narrative inquiry may be utilized as a method for eliciting advanced health care directives. One proposed scheme is the use of a personal value journal, which serves as a basis from which future decisions can be obtained (Grundstein- Amado( 1992). For families, decision making is significantly impacted by one's Holocaust experiences


Salient Features of A Narrative Approach

By engaging in a narrative approach to working with Holocaust survivors and their families, the social worker can help survivors in their search for continuity and meaning, as well as contribute to maintaining a strong sense of self and of well-being during old age. For many survivors, the ability to tell their stories, can be a powerful coping tool. For families, the transmission of such stories can provide a sense of continuity or connection to previous generations. When the person's present circumstances are viewed within their historical context, the search for meaning can be enhanced. The presentation of the stories of some of our residents and their family members will highlight our discussion.

In our conversations with these persons, what is said, the content, or the facts are far less significant than the process of how it is said and the underlying meaning. Kelley (1996) remarks that history is not a collection of facts to be remembered, but is created in the telling. Michael White (1991) has proposed the analogy of lives as texts, suggesting that each telling and retelling of a story create a story, which is more richly described. Henry Greenspan (1992) applies this notion of lives as texts in the life histories of Holocaust survivors and describes how survivors "make a story" out of what is "not a story".

A post-modern view of the world posits that there are no essential truths and that all lived experiences are socially constructed. Any attempts to deconstruct survivors' stories of their experiences during the Holocaust must be carefully considered. The Holocaust as an experience of mass genocide is unique. It may be helpful to view the survivors' experiences as part of the spectrum of trauma literature. When considering what is essential and what is constructed, Schwartz (1998) argues that there are some essential aspects of experience. Similarly, Harari (1995) states that Holocaust survivors are not just telling a story. They are also bearing witness, and providing testimony. There is not a plurality of meanings or multiple perspectives of equal validity for the telling of their stories. As cited in Harari, "There are no metaphors for Auschwitz and Auschwitz is not a metaphor for anything else."

Therefore, clinicians must not try to change or soften the events when working with Holocaust survivors and their families. Langer (1991) implores us to help focus on the bull's eye and not try to avoid it. Therapists may assist such persons to reconstruct meaning out of their suffering by exploring the influence and meaning that their Holocaust experiences had on their lives. For children of survivors, fragmented stories are often transmitted leading to incomplete stories and understanding. One daughter described meaning in her situation. Faced with the reality that her mother was dying, she shared how hard it was to lose her. Without having had grandparents she had no prior experiences with grief and loss. Young (1988) reviews how historical memory, understanding and meaning are constructed in Holocaust narrative.

The concept of "preferred view", of how events affect a person's view of themselves and others is a basic tenet of the narrative approach. Questions that encourage choice; invite possibilities and elicit preferences, listening to their intentions, hopes and dreams allows us to connect with people who have survived the Holocaust. The goal of our clinical work is to help people act in line with their preferences. While the way people see themselves can change over the life span, for many survivors there is a clear distinction between how they viewed themselves before and after the war. The war and their Holocaust experiences clearly interrupted their lives and in many of their stories the picture of the person then and now emerges. Our role as clinicians becomes one of helping to bridge this gap. Moreover, for many survivors that we work with inside the institution, many characteristics that enabled them to survive the war are still evident in their current ways of coping with institutionalization and illness. They are the same people.


One Person's Story

Let me tell you the story of Mrs. B, an 80-year-old Holocaust survivor. She was widowed just prior to her placement. She has two children. The eldest daughter lives out of town with her husband and two college age sons. Mrs. B cared for her other child, a son, for forty years, after he was seriously injured in an accident as a youngster. For several months following her admission, Mrs. B suffered from severe sleep disturbance and headaches. Recurrent nightmares, tiredness and fatigue were frequently reported. Over time she was able to modify and rebuild her life within the structure, supervision and support inside the institution. Family support was also a key factor in her ability to overcome her difficulties. Many different professionals were involved in this process. One of the authors will review some of the clinical work with Mrs. B.

Our relationship has developed collaboratively. It has been based on mutual respect and trust. Together, we have created stories of her life experiences. We have sought ways of describing how Mrs. B has viewed herself and others before, during and after the Holocaust, as well as prior to and following institutionalization. I have not pretended to be the expert. Rather, I have remained curious. I have invited stories of change and encouraged possibilities. For instance, Mrs. B describes herself before coming to Baycrest as rarely being able to step into a store. She remembers not being able to pay for things. She says she could not concentrate. She describes the cells in her head as having been dead. Following her admission she provided words such as wood and hollow to describe how her head felt. Mrs. B's version of her story is as follows: "I came here (Baycrest Centre) and I was in a deep hole. Everyone here has helped to bring me out from that hole".

Through her telling, Mrs. B clearly expressed how she preferred to view herself. It was very important to her to be seen by herself and others as a mensch, a human being, helpful to herself and others. Our work together has focussed on finding ways to enable her to act in line with this view. No longer encumbered by her care giving responsibilities, she takes pride in her found independence. She has noted that she has been through too much in her life not to appreciate everything she has here at Baycrest.

Utilizing pictures in her room has allowed us to capture the influence of those lost either during or after the war. Despite their physical absence, they might still be viewed as having a significant presence in her life. We explore their imagined reactions. Pointing to her late husband's picture on the wall she was asked what he would want her to be doing now. She responded that he would want her to be busy doing things, and he would want her to be happy. Similarly, a picture of her grandfather, sitting on her dresser leads to another story. Associations with some of the great Rabbis in Europe are noted. She states that she may be a little person, but she comes from a big family. The notions of legacy and continuity are powerful.

 

Transmitting the Stories: Finding New Meaning
When understanding the thoughts, emotions and behaviours of our elderly residents, we must always remember that aging, illness and institutionalization are key life transitions and considered occasions for stories.

Storytelling is a vital way of finding new direction in life and new meaning to traumatic life events, such as the Holocaust. Illness and institutionalization are also considered interruptions in life as they disrupt a sense of expectations in life and one's self-image. Social workers may enable clients to story and retell so that resources and strengths used during the Holocaust in order to survive may be identified and drawn upon once again in order to overcome recent traumatic life events. This may elicit positive self-image as well as important life values. In this way, one is not only able to hold on onto the person they were, but also the person they have become, thereby acknowledging one's own reflection and creating a vital connection as well as resolution and closure to one's difficult past.

The following story of Holocaust survivors Batia Malamud and her daughter Faigie Libman illustrates how the telling of their life story influenced their identification, commitments and future. Here are some excerpts from their story as originally told by Sam Olbaum (1999) in The Jerusalem Post. The full story is so shocking, so beyond belief, that Faigie now devotes her life to revealing what happened, honouring her mother's superhuman deeds by recounting them to an incredulous generation. For the many young people who have heard her speak, it is only the eyewitness account that makes the Holocaust imaginable. . . How many of the Second Generation do not understand their parents, who would not, could not put into words the terrible things done to them. How many survivors suffer still; how little of it we, of the freeborn generation, can comprehend. What a tragedy- for Batia Schmidt, for us- that we could not bestow upon her the respect and honour she had earned, even until the day she died, on Yom Kippur, aged 86. This old woman,. . ., was the greatest hero we ever met. And we never knew.

In Faigie's story, she demonstrates that it was resources and strengths such as independence, control, determination and belief that enabled her mother, Batia Malamud, to ensure her own and her daughter Faige's survival. It was these characteristics, identified and drawn upon through storying that allowed Batia and Faige to live with dignity, hope and eventually peace throughout their lives and throughout Batia's life within the institution. It was Batia Malamud who showed Faige the courage to recount the memories of the traumatic Holocaust events in order to create meaning in their lives. Through the re-telling, Anne Adelman (1995) states that they were able "to repair the broken chain of familial, cultural and spiritual history. Narrating the legacy of the Holocaust becomes a quest for mastery and redemption and simultaneously a way to assimilate and transform tragic memory".

Together Batia and Faigie, through their exchange of memories, according to Adelman, were able to "weave a shared narrative that became restorative" not only for them but also for future generations to come.

And even after Batia Malamud passed away in the fall of 1998, Faige continues to tell the stories of their traumatic past to her children and grandchildren in order to fulfill her most important wish to herself. That is, to enhance the memory and purpose of their lives and invest hope and belief in the future, while always maintaining a link to the past … to create a memorable legacy of family unity and strength for generations to come.

According to Faigie, her mother, is the "hero" of her life and of her stories. Now Faige ensures her mother's legacy through her stories, through her ongoing presence at Baycrest and through the ongoing opportunities in which she participates for public speaking on this very subject. These opportunities are now Faige's way of focusing on the presence of her mother rather than the loss itself and ensure that she remains an important part of her inner world thereby allowing and giving permission to the continuity of memories and life legacies.

The dominant story has been to view Holocaust survivors and their families as showing similar characteristics of posttraumatic stress in terms of personality variables such as mood, affect and ability to cope with their situations. This paper has discussed how a narrative approach might provide a lens through which to view these persons in a more productive frame. Within this view, many authours have recently focussed on the strengths, resiliency, resourcefulness and capabilities of survivors. Suedfeld, Krell et al (1997), Sadavoy (1997), Bar-Tur & Levy-Shiff (1994). Possibilities for self-healing, validation of the self and advocacy through the telling and making current generations aware of their stories exist for many 1st and 2nd generation survivors. A narrative approach provides a way for such persons to move forward in their efforts to take control over the influences of their Holocaust experiences.


In the words spoken by one survivor to others entering the concentration camp as cited in Des Pres (1976) :
"I have not told you of our experiences to harrow you, but to strengthen you . . . . Now you may decide if you are justified in despairing."

 

REFERENCES

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Des Pres, T. The Survivor : An Anatomy of Life in The Death Camps. New York: Oxford University Press.

Greenspan, Henry. (1992). Lives as Texts: Symptoms as Modes of Recounting in the Life Histories of Holocaust Survivors. In G. C. Rosenwald & R.L.Ochberg (Eds.), Storied Lives: The Cultural Politics of Self-Understanding. Connecticut: Yale University Press.

Grundstein-Amado, R. (1992). Narrative Inquiry: A Method for Eliciting Advance Health Care Directives. Human Medicine. 8 (1), 31-39.


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