This book has a mission. The authors seek to describe the effects of the Holocaust on child survivors, "not as historians but as psychoanalysts who wanted to know what happened to the human psyche." The book was written as part of a project in which 1,500 survivors were interviewed, but the summary of those interviews is deferred, and the book itself is informed by interview vignettes. Life histories can give soul and meaning to events that are hard to imagine and put them into perspective for those of us who have not endured these most extreme traumata.

There are themes considered here in an innovative way that are quite absent from other psychiatric discussions of the Holocaust. The role of the Holocaust in identity formation is particularly well considered, and there is a chapter segment on genocide and the assault on Jewish identity of children that is particularly informative. Identity distortion and fragmentation are described for the most fundamental components of identity, including gender identity and the sense of wholeness of the body and its parts, in the case of very young children.

Many children survived through being hidden; numerous components of their identities became fragmented and then reformed with greater or lesser degrees of success. The best-known example of this (not included in the present study) remains the Archbishop of Paris, a Jewish boy given over to the Catholic Church for safekeeping, who experienced a profound conversion at the age of 14 and would not return to his religion of origin afterward. The stories recounted here are more prosaic but have a more believable quality. Children of latency age found comfort in the Polish Catholic culture and religion, even as they were aware that they were the hated Jewish Christ-killers. Adolescents remained in Poland and married into abusive relationships they later left. One striking story was that of a woman born in 1928 who was able to give an interview only after psychotherapy. She had been able to ingratiate herself with numerous Polish, German, and Russian people to whom she was exposed and who were generally playing oppressive roles during these times. Doing this, she helped several members of her family to survive. Yet when her mother and sister went to the United States in 1946, she would not join them. She returned to Poland and married into an abusive relationship. When she eventually left with her children and reunited with her mother and family, she was rejected for having left her faith. Her children felt they belonged to none of the cultures from which they came. The authors describe the phenomenon of survivors who grew up feeling they could find a haven only among Gentiles as a widespread one, and it is understandable.

A related identity fragmentation is described as a hidden knowledge of being Jewish. The knowledge of her Jewish identity by the current Secretary of State, Madeleine Albright, has become a public issue in recent times. Although she is not a Holocaust survivor herself, her story is more understandable after reading this book. Within a family, multigenerational deception and denial about facts that very obviously determined the family’s destiny can take place. Usually this is accompanied by the hope that this will be protective in some manner, but it also can result in lacunae and instability of identity and of integration in the generation thus "protected."

As worthy as their enterprise is, it is hard to say that the authors have succeeded in it. The almost exclusive use of the psychoanalytic metaphor in conveying and interpreting the material they deal with makes for heavy reading. Real lives are being described here, but by and large the descriptions lack the raw power of cases described in other volumes on psychiatric problems and treatment of Holocaust victims, and they certainly do not have the power of fictional descriptions.

Exclusive reliance on psychoanalytic interpretation also results in striking omissions of scholarship. Although the Holocaust is unique in many respects, there is an entire literature on the effects of abuse on children and adolescents and posttraumatic stress disorder that is largely ignored. There is also much that has been written on the psychiatric sequelae of exposure to the Holocaust and psychotherapy on surviving victims (a particularly compelling account is contained in Charney’s Holding On to Humanity(1)). This literature is referred to, but in a most meager manner.

No critical discussion or consideration is offered of alternatives to the perspectives of the authors and the procedures they have followed. Toward the end of the book, there is a chapter on the "integrative" effects of the interview on the people who participated. But what about people for whom healing has failed, where the trauma cannot be integrated and engaging these memories serves only to reawaken the unhealed trauma?

For those of us treating adult victims of severe childhood abuse, including Holocaust survivors, this is a valuable book. I expect that many readers will have similar critical reactions to this volume but, like me, will find it a worthwhile addition to our knowledge of this most horrible of evils that humans have inflicted on other humans.