AMCHA the National Israeli Center for Psychosocial Support of Holocaust Survivors and the Second Generation Dr. Natan P.F. Kellermann,
PhD. "For
me, the Holocaust has not ended." A Holocaust survivor.
Thus it seems that Elie Wiesel (1978) was correct in stating that "time does not heal all wounds; there are those that remain painfully open" (p. 222). While Holocaust survivors and their families made every effort to continue their lives without being constantly reminded of the terrible events of the past, traumatic memories kept returning with all their accompanying emotions. As Judith Herman (1992) pointed out in her book Trauma and Recovery; "atrocities refuse to be buried" (p. 1). They keep penetrating the conscious and unconscious minds of the survivors and their offspring until they are properly remembered, mourned and worked through within a safe healing relationship. AMCHA - the National Israeli Center for Psychosocial Support of Survivors of the Holocaust and the Second Generation - is a non-profit organization dedicated to provide such healing. "Amcha" (Hebrew/Yiddish word for 'your people') was the code word that helped Jews identify one another in occupied Europe. It now stands for another kind of support system in Israel, one that tries to give survivors and their children an opportunity to unburden their hearts. Until the establishment of AMCHA in 1987, no other institution had dealt specifically with this subject or exclusively with these clients. Why did it take more than 40 years after the end of the war to establish such an organization? Many reasons may be suggested. First, a new social awareness of the Holocaust began to develop in 1960 after the Eichmann trial in Jerusalem. Having been silent for decades, more survivors than ever were ready to speak out and they started to openly share their memories and their prevailing mental suffering. As younger people grew increasingly curious about their parents' past, asking questions and seeking answers, the legacy of guilt and shame that bequeathed the Holocaust generation was embraced and slowly transposed. With time running out for the ageing Holocaust survivor community, many felt the heavy responsibility of bearing witness and preserving memory. In addition, the psychological effects of transgenerational transmission of Holocaust trauma upon the offspring became more widely acknowledged. Secondly, while survivors seemed to live a normal life and looked healthy from outside, their families knew of their private and largely concealed suffering. Therefore, during the 1980s, there was a sense of urgency to provide emotional support "now or never." The woes of aging, retirement, illness, and death of their spouses created new emotional crises that activated the old trauma. As a result, many started to seek professional help, sometimes for the first time in their lives. Thus, the various psychological needs of this population started to become more acknowledged, as manifested for example by the pioneering paper by Professor Haim Dasberg (1987) on "The psychological distress of Holocaust survivors and offspring in Israel, forty years later." However, services that were heretofore provided were found to be insufficient and largely inadequate. Mental health professionals seemed to avoid this chronic patient population and showed signs of "Holocaust victimophobia" (Dasberg, 1994) as well as various counter-transference responses that reinforced the conspiracy of silence that had prevailed for so many years. A 'Holocaust survivor' may be defined broadly as any Jew who lived under Nazi occupation during the 2nd World War and who was thus threatened by the policy of the 'final solution' but stayed alive. According to this definition, clients eligible for treatment in Amcha include persons with widely different Holocaust experiences. For example, those who were confined to a ghetto, forced labor in work camp and/or incarceration in a concentration camp, in hiding or living under false identities, refugees who left their families behind, those who fought with the partisans, those who were sent away in the 'Kindertransport,' etc. All these people were traumatized in one way or another, either being under constant threat of being killed, having suffered significant losses or having lived under the shadow of Holocaust persecution. With about 350.000 Holocaust survivors living in Israel at the time and when including also their children and their immediate families, a rough estimate of those directly or indirectly affected by the Holocaust would be approximately one million people. Though only a small percentage of these were assumed to be more vulnerable to mental distress, the population at risk still constituted a large number of individuals who were in need of special mental health services hitherto not provided by the existing institutions. Therefore, a group of devoted Holocaust survivors and mental health professionals, led by the late Manfred Klafter founded AMCHA. Being aware of the survivors' distrust of clinical psychiatry, they decided to focus on non-material, psychosocial and largely preventive support rather than on mental health treatment per se. The goal was to provide a framework for mutual aid, memory processing and grief resolution, as well as a place were Holocaust survivors and their families could feel at home and understood. As the Israeli society failed to provide the necessary economic support, most of the funding of Amcha came from foreign government subsidies and donations by friendship groups in various European countries with a small part of the activities paid also by the clients themselves through a system of "fees-for-services". Starting modestly in Jerusalem, AMCHA today (2000) employs about 130 mental health professionals who provide services to over 3300 clients in four major cities (Jerusalem, Tel-Aviv, Haifa and Beer Sheva) as well as in affiliated locations. In 1999 about 2000 of these clients were in some kind of treatment and about 1300 were members in the social clubs. About half of clients in treatment are elderly Holocaust survivors while the rest are child-survivors and children of survivors. AMCHA has become a pioneer in the field of lifelong consequences of post-traumatic stress. Much of its experience and research on the mental health of Holocaust survivors is by and large unique. As a result of this unique experience a rich selection of services are regularly provided by Amcha as presented in Table 1. Table
1. Services provided to all populations of Amcha
Services provided to elderly Holocaust survivors
Services provided to child survivors of the Holocaust
Services provided to the Second Generation
Services provided to the professional community and to third parties
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The
long-term after-effects of Holocaust traumatisation are far-reaching.
More than half a century after the war, the Holocaust continues
to make its presence felt on survivor families and others in a variety
of ways. Like an atom bomb that disperses its radioactive downfall
in distant places, often a long time after the actual explosion,
the Holocaust continues to contaminate everyone who was exposed
to it in one way or another. When retiring from work or experiencing
deteriorating health, terrifying nightmares and flashbacks reappear
in old-age survivors who kept themselves excessively busy in order
to repress their painful memories. Survivors who were children during
the war continue to struggle with their basic insecurities and prolonged
mourning for parents they never knew. The offspring of both these
groups, the so-called 'second generation', gain more awareness of
the repressed pain that they indirectly have absorbed from their
parents. Traces of Holocaust associations may even be found in the
third generation who, in their quest for past roots discover the
prematurely broken branches of their family trees. Finally, relatives,
close friends and caretakers show signs of having been secondarily
traumatised by the plight of the survivors and certain populations
suffer from bystander guilt.