Psychodynamics of the Survivor Syndrome*

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Abstract
The purpose of this study is to explore some of the psychodynamics of concentration camp survivors. There is growing evidence that in reactions due to extreme environmental stress we are dealing with a condition akin to psychosis or a borderline state. The chronicity of the condition, the clinical symptoms observed and poor response to treatment support the hypothesis that severe trauma results in unmodifiable ego changes. Two related ego alterations are discussed, namely, ego exhaustion and changes in the ego-superego boundary as a result of overwhelming guilt and shame. Ego exhaustion seen here is similar to that encountered in aging. In the aged continued losses and anatomical and physiological decline prevents reparation. Restitution in the concentration camp survivor is difficult because of the continuing ego-superego conflict. A case is presented and problems encountered in the treatment of survivors are briefly outlined. Further longitudinal studies and particularly reports of long-term treatment of survivors would help us gain further insight into the problems of massive traumatization.

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