Author: Robert Břešťan, HlidaciPes.org, Czech republic
The war that Russia has unleashed against Ukraine is now in its third year. The number of people, both civilians and soldiers, who are suffering from a whole range of psychological problems continues to grow. Among other things, this can include permanent personality change due to torture and inhumane treatment. It is also 60 years since the groundbreaking work of psychiatrist Leo Eitinger, born in former Czechoslovakia, in which he described the long-term effects and consequences of excessive stress.
People affected by war suffer from a range of psychological problems such as anxiety, depression, panic attacks and sleep problems. Post-traumatic stress disorder, a syndrome suffered by both soldiers and civilians, is widespread and typically occurs in people exposed to torture, who have been through captivity with the imminent possibility of death and other life-threatening situations.
As Jan Vevera, the head of the Psychiatric Clinic at the University Hospital in Pilsen and formerly the chief psychiatrist of the Czech Army, points out, this disorder was well known to military doctors; in the literature it appeared under names such as “soldier’s heart” or shell shock. Less well known, however, were the permanent changes in personality structure that hardship and torture can produce.
It was the Czech-born psychiatrist Leo Eitinger who was instrumental in the recognition of the diagnosis of “Persistent personality changes after a catastrophic experience”, now designated F62.0. He was also at the beginning of the then completely new field of victimology.
This is a field that focuses primarily on the relationship of the victim to the offender and the crime, the consequences of the crime from the victim’s perspective, and the efforts to help the victim. Eitinger himself was one of the victims of Nazi ideology. However, he managed to survive and cope with the horrific experience.
A Brief Moment of a Nice Future
Leo Eitinger was able to use his harsh life experience of imprisonment in the concentration camps of Auschwitz and Buchenwald in his profession. He maintained a scientific distance and demonstrated that the so-called concentration camp syndrome, described shortly after the Second World War, was not – as originally thought – related to the patient’s personality before the illness, but was linked to the cruelty, the length of imprisonment and the specific experiences in the concentration camps.
This year marks the 60th anniversary of his groundbreaking work, a detailed study of Norwegian and Israeli concentration camp survivors. In 1996, the International Society for the Study of Traumatic Stress officially listed it as one of the most important works on trauma.
Leo Eitinger died in Oslo in October 1996, and his legacy is still maintained by the University of Oslo. It awards the annual Lisl and Leo Eitinger Human Rights Prize. In addition to psychiatry, Eitinger, together with his wife, was very active in the public sphere and in the promotion of human rights and the fight against injustice and racism. For this reason, he is also a recipient of the Royal Norwegian Order of St. Olaf.
Norway, also based on the work of Leo Eitinger, became the first country in the world to establish a department of disaster psychiatry. For Leo Eitinger to get this far in life, he needed a good dose of luck. He wasn’t born in the ideal time or place on the planet. As a 1912 graduate, he later lived through the democratic Czechoslovak republic First Republic, and graduated from medical school in Brno in 1937, but if his future still looked promising, he soon found out that he was wrong.
Surviving in the camp hospital
The Eitingers were a Jewish family originally from Halych and Leo, as a Jew, could no longer practice medicine under the new law and order. In the spring of 1939 he began working for a humanitarian organization, the Nansen Foundation, which helped Jews obtain visas and escape abroad. At first he himself did not receive permission to travel, and he was not able to leave until October 1939.
In November of the same year, he found himself in Oslo, Norway, where he first worked as a doctor for Czech refugee children; later he got a job at Kroghstøtten Hospital, then at the psychiatric institution in Rønvik near Bodø. After the German invasion of Norway, everything was different again. Or rather, in many ways as he had recently experienced first-hand in The Protectorate of Bohemia and Moravia (partially-annexed territory of Nazi Germany that was established on March 1939 after the German occupation of the Czech lands).
Eitinger was again stripped of his medical license, went into hiding, took refuge in the Norwegian countryside and worked as a laborer in a sawmill. In March 1942, however, he was arrested. He passed through several prisons in Norway and Germany and, together with other Norwegian prisoners, found himself in the Auschwitz concentration camp on the night of March 2-3, 1943.
There he served as a doctor in the camp hospital, where conditions were at least a little better than for ordinary prisoners. Thanks to that, he managed to survive. One of the patients he helped to keep alive in Auschwitz was the young Romanian Elie Wiesel, later a Nobel Peace Prize laureate, whose nomination for the prize Eitinger later helped to win in Norway.
In January 1945, Eitinger was included in the death march, and in harsh conditions he made his way through Gliwice to the Buchenwald concentration camp, where he lived to see the end of the war. Of the 762 Jews deported from Norway to German concentration camps, only 23 survived, Leo Eitinger being one of them.
A name for psychiatry textbooks
“Eitinger returned to Norway after the war and resumed his psychiatric work. He was mainly concerned with the psychology of war victims. His research laid the foundation for victimology, a field that studies the effects of violence on victims and deals with problems in processing trauma, especially anxiety, intrusive thoughts, frightening dreams, avoidance of trauma-related stimuli, insomnia and substance abuse,” says psychiatrist Jan Vevera.
He is an admirer and promoter of Leo Eitinger’s work; however, as he points out, Eitinger, a famous Czech native, does not even appear in domestic psychiatric textbooks yet. Yet he clearly deserves his place in them.
If only because after the Second World War most research – psychiatric, psychological, sociological and philosophical – focused on the psychology of the aggressor, while the victims stood aside from the main research.
“It was assumed that the psychological problems caused by the trauma of the concentration camps would disappear after a shorter period of time, and if they did not, it was because the disposition to these problems was already in the victims long before the trauma,” Vevera says.
Eitinger radically changed this view. In his studies, he proved that the problems suffered by survivors were unrelated to the patient’s personality before the disease. This represented a breakthrough in understanding the mechanisms of the effects of stress.
“Thanks to these studies, the diagnosis of “Permanent Personality Change After Surviving a Disaster” was created. Leo Eitinger thus contributed to the compensation of war victims and veterans who developed serious psychological problems long after the war,” Vevera points out.
The work of Eitinger and his followers, he says, shows that how we deal with trauma and whether it has long-term consequences is influenced not only by the trauma itself but also by its circumstances: “That is, whether the suffering is perceived as the result of one’s own free decision to participate in the defense of one’s homeland, or whether it is perceived by those affected as the result of an unfortunate coincidence, as in the case of hostages.”
He adds that sustained interest helps victims. This can be in the form of material help; it is also important not to forget the psyche: “But despite media portrayals, how we as Westerners are helping Ukraine is tragically inadequate. I won’t talk about war supplies here, and I’ll stick to psychotherapeutic interventions: for example, ‘schools in peace’, month-long holidays for Ukrainian schools, would help. But we will not find anything like that. And that is wrong.”
