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Irina Koll
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Irina Koll
2014
Approved by:
______________________________________________________________________________
Donald Schultz, PhD, Chairperson
Program Faculty, The Chicago School of Professional Psychology
______________________________________________________________________________
Sean Sterling, PhD, Member
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iii
Acknowledgements
I wish to thank my esteemed professors, colleagues, and friends for their continued
I wish to extend my warm and sincere thanks to my parents for their love, motivation,
And above all, I wish to thank my wonderful and supportive partner, who has helped me
through the thick and the thin to accomplish this journey. Without him, I dont think I would
iv
Abstract
Because the worlds adult population over the age of 60 will double from 605 million to 2 billion
between 2000 and 2050, it is becoming increasingly important to understand this older adult
population as well as the social, economic, and psychological implications this has for various
families and society. Identifying and implementing therapeutic interventions that help maximize
the capacity for better living and functioning for older adults may help to prolong their lives. Past
research has identified that survivors of the Holocaust have suffered long lasting psychological,
physical, mental, and social impairments that have affected their level of functioning in lifelong
situations. However, this study has sought to use a qualitative approach to understand the
adaptive and resilient coping strategies among older adults. It was hypothesized that studying
Holocaust survivors adaptive coping experiences may provide unique and relevant information
about trauma, resilience, and adaptation that can provide further guidance with working with
WWII veterans, Holocaust survivors, and survivors of genocides; and that it might to lead to
improving older adults quality of life. The results of this study show that there are various
significant adaptive coping strategies among older adults including, but not limited to,
psychological inner strengths, external factors including social and peer support, healthy
freedom, and the impact of medicinal and medical advancements that have contributed to their
Table of Contents
Copyright.ii
Signature Pageiii
Acknowledgements.iv
Abstract....v
List of Tables..ix
Problem Statement...3
Purpose Statement3
Research Questions..4
Application of Results..4
Theoretical Framework5
Definition of Terms..6
Chapter Overview8
Theoretical Perspective..28
Problem Statement 34
Research Plan.35
Participants.35
Instrumentation..36
Data Processing..36
Ethical Assurances.37
Analysis.38
Participants.39
Findings.40
Theme Presentations..41
Summary48
Resilience...49
Implication of Results54
Cultural Influence..57
Limitations.58
vii
Recommendations..59
Conclusion.59
References..61
viii
List of Tables
ix
The Holocaust refers to the persecution and murder of approximately six million Jews by
the Nazi regime during World War II, solely because of their cultural, social, ethnic, and
The atrocities of the Nazis against Jews during the war eliminated Jewish communities almost
entirely. The victims suffered inhumane conditions in concentration camps, where they endured
continuous threats to life, life-threatening diseases, depersonalization, and loss of many if not all
of their significant others. Aside from concentration camps, many other Jews were living in
hiding and evacuation under false identities, in fear of discovery, spending months and years in
primitive and inhumane conditions (Barel et al., 2010; Cohen, 1991; Van der Hal-Van Raalte,
In addition, these childhood survivors survived the horrors of persecution, death, and
losses, separation from their family, neglect, and extreme famine and starvation during their first
and most critical developmental years (Van der Hal-Van Raalte et al., 2007). These childhood
survivors had to endure feelings of helplessness and hopelessness as they were confronted from
the earliest age with their parents struggle to escape annihilation without the fundamental basic
protection and safety they so desperately needed. Much of these childrens sole survival was
entrusted to the care of strangers once they were separated from their parents. After the war was
over, those who survived had to further face separations as they were reclaimed by their
estranged parents from the caretakers or came to the devastating realization that their family did
not survive. Also, many parents were too weak and mentally exhausted after the war to be able to
take proper care of their children (Van der Hal-Van Raalte et al., 2007). Recently orphaned child
1
survivors after the Holocaust had to deal with adjustment and were confronted with the havoc the
Holocaust had wrought on their family, social, psychological, and cultural structures (Van der
Hal-Van Raalte et al., 2007). Furthermore, they also had to readjust to their lives, now dealing
with postwar symptoms of trauma, grief and losses, cultural and identity displacement, related
medical and physical conditions, emotional and personality problems and survival guilt.
that survivors have suffered long lasting psychological, physical, mental, and social impairments
that have affected their level of functioning in most life situations (Landau & Litwin, 2000).
However, what is surprising is how there are a large number of elderly Holocaust survivors who
have been able to become well-adjusted individuals (Landau & Litwin, 2000). These survivors
have managed to cope with their traumatic experiences in older age as they are now facing new
As Holocaust survivors face old age, many conditions can reactivate their feelings of the
past associated with trauma they endured in childhood (Cohen, 1991). Institutional care and
placement in nursing homes may bring up feelings of dislocation within unfamiliar surroundings.
A hospitalization experience may associate a survivor with parallel experience while being in a
concentration camp (Cohen, 1991, p. 227). Cohen (1991) also stated that physical deterioration,
illness, and loss of bodily functioning may conjure up feelings of helplessness that these
survivors suffered under the regime of the Nazis. Also, as the childhood survivors now face older
age, the transition of aging can mean significant physical, mental, social, and mental change.
Furthermore, this life role transition stage can mean losses and bereavement, loneliness,
institutional care, caregiver distress, separation from adult children, memory impairment and
2
many other factors associated with old age. Cohen stated that, for the survivor, aging may be
seen as a traumatic experience in its self; however, research has indicated that despite the
transitioning into late adulthood, older survivors have shown the capacity for strength and
further insight needs to be shed on what these strengths may be (Cohen, 1991, p. 231).
Problem Statement
question that they have dealt with horrific trauma and suffering. Little is known about their
adaptive coping mechanisms dealing with trauma in old age. What are their primary positive
coping mechanisms? There is a lack of research on aging Holocaust survivors and their coping
Purpose Statement
The purpose of this phenomenological study will be to explore the lived subjective
experiences of positive coping strategies among aging Holocaust survivors with recurrent
trauma. Recurrent trauma is defined as any new stressors, distress, or mental illnesses that have
contributed to the recurrent traumatic event(s). This can be a medical condition (e.g., recurrent
cancer, stroke etc.), any cognitive disorders (dementia or Alzheimers disease), or anxiety or
mood disorders. The participants in this study are European female and male Holocaust survivors
Research Questions
1. What are the lived subjective experiences of Holocaust survivors now in older age?
2. How does the previous experience (surviving the Holocaust) relate to current
3. What mechanisms do these individuals (report) have helped them to cope with their
4. How did these mechanisms help these individuals deal with their trauma during old
age?
Application of Results
The knowledge about the adaptation and coping of aging Holocaust survivors years after
the Holocaust may provide a further guide with working with survivors of other genocides.
In addition, studying Holocaust survivors experiences may provide unique and relevant
information about trauma, resilience, and adaptation. Its position as the most extreme form of
widely experienced trauma makes it useful for the study of resiliency characteristics across
Theoretical Framework
Existentialism. A human beings paramount struggle is with existence and the ultimate
concerns of the human condition with its emphasis on death, freedom, isolation, and
meaninglessness (Yalom, 1980). Individuals search for some meaning to their lives while
establishing a sense of being, an authenticity that recognizes their ultimate uniqueness while
remaining true to themselves (Corsini & Wedding, 2008). The psychotherapist assists individuals
in accepting their feelings rather than trying to change them as if there is something wrong.
Existential psychotherapy also adheres to the principle that individuals are responsible for
who they are and what they becomeone cannot blame God, parents, teachers, employers or
circumstances (Corsini & Wedding, 2008). The existential psychotherapist is not overly
concerned with the clients past but instead, with the choices to be made in the present and
future.
testimonies might be a beneficial approach since it would address their lived subjective
experiences through the here and now. Zimberoff and Hartman stated, The effective therapist
must empower the client to make clear choices, and then acknowledge and honor those choices,
setting aside his/her own agenda for that clients therapeutic experience or outcome (2003). In
this case, the therapist would interpret and acknowledge what choices the patient has made to
adapting to the pain and suffering they are currently enduring. In addition, the
interpreter/interviewer will honor those choices without changing the outcome of their lived
experience.
Definition of Terms
Holocaust: The current study will explore the Holocaust that took place between 1939
Holocaust survivors: Survivors of the Holocaust who endured pain and suffering in
Recurrent trauma: Recurrent trauma is defined as any new trauma that the aging
Holocaust survivor is facing in the present day. These could be psychosocial stressors such as
inadequate social support, discord with family or caregiver, insufficient financial resources,
Other factors could be distress caused by mental illnesses that have contributed to the
limitations, mood disorders (major depression, grief, etc.) and anxiety disorders as associated
with older age. Medical conditions or physical impairments could be contributing factors to new
trauma (e.g., recurrent cancer, partial blindness, stroke, nutritional deficits, sleep disturbance
etc.).
Trauma: Psychological and physical trauma inflicted by Nazis regime against Jewish
Chapter 2 will review recent literature involving World War II Holocaust survivors and
the trauma associated with their suffering. Chapter 3 will explore how the study was conducted
6
through objectives and their rationales, research plan, participants, instrumentation, data
processing, and ethical assurances. Chapter 4 will examine the facts obtained from the current
study. Chapter 5 will examine the interpretation of the presenting results, what was and wasnt
Chapter Overview
This chapter will review the literature involving World War II Holocaust survivors and
the trauma associated with their suffering. The ultimate objective is to explore the lived
subjective experience of primary positive coping strategies among aging Holocaust survivors
with recurrent trauma. The first theme examined will be the original theory of trauma and it will
trauma. The second theme is an exploration in looking at the survivors trauma after the
Holocaust. A distinction in literature will be made between the current research on productive
resilient functioning after trauma and research on deterioration after exposure to trauma. This
theme will provide a demonstration to evidence how there is a shortening of research on adaptive
and positive functioning after trauma with aging Holocaust survivors. The third theme is coping
strategies associated with physical and psychological abuse or trauma. This will provide a
broadening view on how people cope after surviving psychological and physical distress.
Ultimately, this will help the researcher gain perspective on what the current research shows
regarding positive coping strategies among survivors of trauma in aging. The fourth theme is an
existential approach to interpret and analyze the lived subjective experience of aged Holocaust
including Viktor Frankl, will be reviewed and discussed. In summary, the following sections will
provide a background and context for what the researcher will conduct for this dissertation.
Research on the original theory of trauma. The following section will review the
original theory of trauma. Understanding the phenomenology of trauma will ultimately give way
to conceptualizing and appreciating how Holocaust survivors survived the traumatic experience.
Exploring trauma literature can give insight to the depth of the traumatic experience from
The traditional basis of psychological trauma research is the work of Sigmund Freud.
Reisner (2003) stated that Freuds earliest definition of trauma is any impression which the
reaction becomes a psychical trauma (as cited in Freud & Breuer, 1893, p. 154). Furthermore,
Freud saw trauma as a foreign body to the mind that would leave a residue which would
continue to have its effects long after the event in the form of hysterical symptoms, leading
Freud to conclude that hysterics suffer from reminiscences (Reisner, 2003). Later on,
according to Reisner (2003), Freud stated that an experience was traumatic because it was
overwhelming to the dominant mass of ideas constituting the ego (Freud & Breuer, 1893, p.
116). Freuds theory was that trauma was the result of an interaction of self and environment, a
crisis of experience and meaning, and not solely on the result of an environmental impingement
on the weakened ego (Reisner, 2003). In Freuds view, it leaves human beings to face the
problem that what we call trauma is, in a sense, not trauma but life, and that we are who we are
because of the opportunities that trauma gives us, that we exist as humans to make the most of
our difficulties, not to sustain the fantasy that it is desirable, or even possible, to undo them
(Reisner, 2003).
Huopainen (2002) stated that Breuer and Freud (1893, pp. 56) classified single and
cumulative traumatic experiences: In the case of common hysteria, it not infrequently happens
that, instead of a single, major trauma, we find a number of partial traumas forming a group of
provoking causes. According to Huopainen (2002), Freud stated that the problem is not so
much caused by a specific event, but rather by the effect of such an event, which continues after
the moment of the event itself (as cited in Freud & Breuer, 1893). Freuds contribution to the
field gave evidence that one has to pay attention to the quality of childhood attachment
relationships to understand the current integrative capacity of the patient's ego (Huopainen,
2002). In addition, (as cited in Breuer & Freud, 1893) Freud correctly assumed that hysterical
symptoms and fantasies can be caused by any unprocessed traumatic experiences (Huopainen,
2002).
Huopainen also stated that based on early work, it can be concluded that a child can
undergo trauma by observing violence between his parents, by hostile divorce proceedings or by
the untreated emotional consequences of his mother's miscarriage or other loss of child (2002).
Also, a child can be traumatized by physical abuse, a parents existing dissociative disorder or
As stated by Freud, Among solutions to universal traumas the one most adversely
separateness, which also influences ones solutions to the Oedipus complex and ones way of
relating to sexuality and to death (Huopainen, 2002, p. 98). This type of separateness is
necessary to the childs stage of development to instill normal emotional development and
events the child will initially go into archaic hysteria due to insufficient help to self-regulation
10
by the adult, affects are too powerful traumatizing for the childs mind to endure. Thus, the child
is forced to foreclose the affects from his/her mind instantaneously, so that hardly any
experiential knowledge of them remains in the mind (2002, p. 98). Ultimately this archaic
hysteria will have long lasting consequences on the childs developmental and psychosocial
ability to be able to cope with possible recurrent traumatic experiences in his or her later life
(Huopianen, 2002).
Krystal (1978), psychoanalytically studying the child, offered more insight regarding a
childs traumatic state. Krystal (1978) stated that what we observe in the direct aftereffects of
severe childhood trauma in adults is a lifelong dread of the return of the traumatic state and an
expectation of it (Retrieved January 10, 2011). Also, emotions are often experienced as what he
termed as trauma screens and that there is a fear of one's emotions and an impairment of
affect tolerance (Krystal, 1978). Krystal also argued that among these disturbances there is also
The author also writes about the prevention of severe childhood trauma. Krystal stated,
that regarding the childs traumatization, the mother can be properly described as functioning as
a temporary stimulus barrier or protective shield. Furthermore, Krystal argued that a mothers
ability to prevent childhood psychic trauma is much less than we would wish and this
biotrauma is an inevitable development. Krystal stated, Our need to deny this helplessness in
preventing the traumatic experiences in our children inclines us to deny their occurrence and to
talk about the silent nature of childhood trauma (1978). Krystals theory implies that without
the mother acting as protective shield the child may become distressed and unable to bear the
effects of the traumatic event. This can, in theory, give evidence to show the impact of the
11
distress on the Holocaust child survivor who may not have had any parental and nurturing
The author also offers an interesting perspective about the transition from childhood
trauma into adult trauma and how the adult may cope with trauma in the current day. Krystal
pointed out that in some psychotic states it can be concluded that adults can come close to the
degree of horror and overwhelmed state as we can assume the child goes through in regards to
the traumatic state (1978). Krystal added, In states of prolonged torture and other externally and
internally caused panic states which combine suffering with total helplessness and reach the
catatonoid states, the existence of a traumatic state frequently cannot be questioned (1978).
However, the author argued, there are significant differences during the adult and child traumatic
state. One of the factors that Krystal pointed out that accounts for this difference is the structure
of the adult psyche. Krystal stated that the adult psyche contains all the resources for trauma
prevention, which is referred to as the stimulus barrier (1978). Krystal notes that in the adult
traumatic state the observing ego is retained and that this implies that the self-observing
functions develop. These traumatic experiences and states can be utilized for the development of
trauma signals which are the ultimate emergency response mobilizing alarm which may
function later as trauma prevention (1978). Krystal concluded that these trauma signals can
mobilize a persons defenses, or they may be involved in obtaining help from others.
Krystal also assesses the subjective experience in the adults traumatic state. The author
states that in the psychoanalytic literature, trauma is referred to as feeling of helplessness in the
of helplessness, ranging from numbness to an emotional storm in affects and behavior (Krystal,
1978). In addition, Krystal included the disorganization of feelings, thoughts and behavior, as
12
well as physical symptoms that reflect the automatic dysfunction. This state is what the author
termed as the adult type of psychic trauma as distinguished from the infantile one.
To conclude Krystals attributing theories, the author postulated that the major difference
between the infantile and adult form of psychic trauma is its relationship to affects. Krystal
pointed out that it is the overwhelming of the ego, the surrender in total helplessness and
hopelessness, and the progression to the catatonoid state that makes a situation traumatic
(1978). The traumatic state can neither be equated with nor understood by the intense affects,
which may initiate it. This may be what Krystal referenced as to what Eissler (as cited in Eissler,
1966, p. 26) was referring to when he said: Anxiety cannot traumatize the psychic apparatus,
any more than the defense mechanism can Krystal illustrated that the statement holds true only
It can be noted, as pointed out in the studies, that separateness from the mother or
maternal contact can cause a state of helplessness, fear and distress on the child when the child
undergoes trauma or a trauma-like state. Weakened and strained ego, attachment from the self,
impairment of affect, absence of trauma signals and unprocessed traumatic experiences can all
hinder a persons ability to handle the effects of trauma. To assess trauma more generally to a
population, further exploration needs to be shed on the effects (of living after surviving the
traumatic experience) the Holocaust. The following section will explore Holocaust literature.
The following section will explore what researchers have studied regarding the effects of living
13
after Holocaust trauma. The current literature of victims of the Holocaust has focused on the
Many studies focus on the negative effects of the Holocaust, but few ask whether
survivors have been able subsequently to reconstruct their lives or why they have been able to do
so (Lee, 1988, p. 71). Lee agreed with the current researcher that there are few studies that have
looked into the adaptive capabilities of Holocaust victims. Such coping strategies that Lee (1988)
found during her study were what she called reservoir of inner psychic strength. These
mechanisms as Lee pointed out were creative use of fantasy, recollecting experiences of warmth
and love, and identifying the self with a group. Lee (1988, p. 92) concluded, Although studies
that have focused on the detrimental effects of the Holocaust have been instructive, it would be
helpful for more researchers to study the positive aspects of the lives of the victims of the
Holocaust. The author went on to conclude that as Holocaust survivors are getting older there is
still much more to explore and understand about the ongoing process of massive trauma and
Although Lees study (1988) supports the current researchers focus of topic, it does have
a few limitations. First, the study was done almost 23 years ago, and it does not state how old
were the Holocaust survivors who participated in the study although it gave evidence to the fact
that they were married with children. This is an important factor because the current study is
focusing on aging holocaust survivors who are 80 years old and older. Second, the author used
participants from certain parts of the world, not from a specific region or community. This type
of demographic could be difficult to examine if testing and comparing adaption and adjustment
to current communities since the participants are from varies communities and speak different
languages. Thirdly, the interview section consisted of questionnaires and did not focus solely on
14
interviews. And lastly, the author of the research was a survivor herself so this could have
created research bias and counter-transference issues that may have affected concluding data.
Sigal (1998) looked at varies studies in the literature regarding children who have
survived the World War II Holocaust. Sigal found that recent studies of children who have
distress, witness to horror, and emotional disturbance were now in their mid-adult stages and
married, served in the military, and portrayed no psychological and physical distress. Sigal stated
that in this type of resilience, these children showed adaptability and assertiveness, and they were
appealing to adults. The author stated that these types of coping mechanisms were established by
children who were adopted after they survived the Holocaust and found resilient coping
strategies among them. Children have varying capacities to deal with potentially traumatic
conditions and that these strengths enable them, when provided with a healthier environment, to
surmount the damaging influences of earlier development insults (as cited in Kadushin, 1976, p.
199). It is important to point out that even though this study is a compilation of studies that
provides a positive research component in studying Holocaust survivors resilience it does not
specify and examine the current Holocaust survivors coping strategies in aging.
Suedfelds (2003) study was another investigation looking at specific and general
Jewish respondents who were safe from Nazi persecution. The author found that survivors
mentioned a significantly higher amount of external factors (help from others and luck) of
survival than internal factors (psychological inner strength). The study found that survivors
15
were more likely to mention help from others: social support generally, help from family
members and friends, and help from Gentiles (Suedfeld, 2003, p. 137). Another category that
half of the survivors mentioned were luck, fate, chance, or God which the author noted
compatible with previous research. This study illustrated many interesting and positive findings
to the Holocaust research although it did have some limitations. As the author pointed out,
Recruiting respondents at survivor gatherings results in data from people who are sufficiently
healthy (mentally and physically), energetic, interested, and financially secure to attend such
lectures, social events, and informal discussions. Only those who have the time and motivation
take the trouble to fill out questionnaires, especially those that like the ASQ require the
respondent to follow a relatively long and complicated procedure (Suedfeld, 2003, p. 137).
Studies on deterioration after the Holocaust. There have many studies done on
Holocaust survivors and the effects of their traumatic experiences. One author has dedicated the
Ayalons (2005) study looked at the challenges associated with studying Holocaust
survivors resilience. The study found that while there is enough research about survivors
trauma or posttraumatic stress disorder, there is by far a lack of research done on their healthy
and productive life. In addition, the study went on to explore that by studying those who were
studying the pathological aspects associated with trauma, because it provides information about
the adaptive nature of human beings Ayalon (2005, p. 349). It is important to note that this
study represents a framework of what needs to be addressed and studied in the research realm
16
within this population, because there is a lack of research done on coping mechanisms among
Furthermore, the study mentioned that psychiatrists conducted the majority of research
that was done on the Holocaust survivors, thus giving evidence that survivors who sought
psychiatric help were the most primary used subjects since they were the most easily accessible
for research purposes. Another contributing factor is that some of the research on resilience and
adaptation was based on case studies or qualitative interviews that were often combined with
personal experiences of the authors and there was a minimal attempt to systematically identify
factors associated with resilience (Ayalon, 2005, p. 353). Therefore, as the study pointed out,
coping style, social context, and cultural background of Holocaust survivors is also lacking and
needed in the research realm (Ayalon, 2005). All of these contributing factors show evidence that
there have not been sufficient data on aging Holocaust survivors adaptation mechanisms to
There is a tendency in the literature to focus on victims of trauma and how they have
been able to cope with their psychological distress as soon as the World War II was over. Such
studies in the literature are limiting because the population from which they are drawn tends to
be only adolescents and young adults. This type of research does not identify adaptive coping
survivors of the Holocaust examined coping strategies that survivors relied on. The study found
that the major coping strategies used in the immediate postwar period were social support,
community with other survivors, revenge, and the pursuit of justice (Goldenberg, 2009).
17
However, this study was solely about adolescents and their immediate coping strategies dealing
with their current trauma after the Holocaust was over. Also, even though this study had a
nonclinical sample, it consisted of people who were willing to talk about their experiences, and it
is therefore biased on the healthier end of the continuum of the Holocaust survivor
(Goldenberg, 2009). In addition, this study is based on showing accounts given 50 years after the
actual events, so detailed description of their immediate coping methods may not be as accurate
as one might hope it to be. This study once again evidenced that there is data lacking among
aging Holocaust survivors who now are facing with recurrent trauma, leaving the same
pondering question to the researcher: What are their current coping strategies?
Another leaning, in the literature, is to look for and to find psychological and
physiological disturbances and to focus on these solely. The assumption as speculated in the
research is that most Holocaust survivors who are now facing old age have psychologically and
physically deteriorated. The majority of work in the literature has been negative in the sense that
they stress on the fact that survivors have not been able to cope with their hardships and trauma
exposure during young adulthood negatively affects physical aging, faster deterioration in health
parameters, and shorter survival (p. 470). This studys primarily goal was to focus on survivors
In addition, the study used a sample of people from the European decent including those
who had left Europe before the outbreak of Word War II in 1939, so their trauma was only
associated through family, friends and their community. Since some of subjects from the study
were not closely associated with direct trauma from the Nazis regime, it is difficult to speculate
18
about the exposure of their trauma. However, researchers of the study evidenced that survivors
who have reached their eighth decade are the most fit, adaptable, and most resilient of Holocaust
survivors. Also, the study found no evidence to support its hypothesis that delayed effects of the
trauma of the Holocaust negatively influence physical health and mortality (Stessman et al.,
2008). This study attributed positive findings to the field; however, it failed to look into what are
In the Shmotkin, Blumstein, and Modan (2003) study, researchers focused on tracing
long-term effects of early trauma in Holocaust survivors in a sample of the Israeli Jewish
population. Survivors were compared with European descent groups that had immigrated either
before World War II or after (these subjects had Holocaust-related life histories but did not
consider themselves survivors). The researchers hypotheses were that Holocaust survivors
would fare worse than comparative participants Shmotkin et al. (2003). Once again, this study
explores the relationship associated with Holocaust survivors and their distress as well as their
inability to effectively cope with their pain, a decade after the war, and psychological and
cognitive limitations. This study does not explore any positive adaptive skills among aging
Holocaust survivors.
Van der Hal-Van Raalte et al. (2007) investigated how trauma during childhood affects
the wellbeing of older Holocaust survivors. The authors hypothesized that older child survivors
who were born before the war would show more physical health complaints and psychosocial
issues. The authors also looked into the present functioning between survivors who lost either
one parent or both during the war verse who have survived the war. And lastly, the authors
looked at postwar circumstances, how the child survivors were able to care for themselves
after going through Holocaust trauma. Their results indicated young child survivors of Nazi
19
persecution who experienced unsatisfactory quality of care immediately after the Holocaust
show a lack of wellbeing in their sixties and seventies. Loss of parents as a result of
persecution, age of the survivors (being born before or during the war), and having
autobiographic memories of the war period did not significantly affect survivors present sense
of wellbeing Van der Hal-Van Raalte et al. (2007, pp. 517518). The researchers implied that
inadequate care given to children who survived during the Holocaust, regardless of absence of
parents, led to emotional distress and psychosocial problems. The authors focused solely on
childcare arrangements after Holocaust liberation and its impact on survivors later stages of
life. This study gave attention to the immediate need of after trauma care to decrease early
childhood trauma. However, the researchers did not examine survivors adaptive life strategies
and coping mechanisms in old age after going through childhood trauma. Once again the
literature focused on the negative implications of the Holocaust survivor, including their
hardships.
Other studies, including Barel et al. (2010), implied that Holocaust survivors who have
reached old age have more psychosocial and physical distress when compared to the same age
groups who have not undergone any trauma associated with World War II. The authors noted
that the Holocaust literature provides evidence that many survivors did demonstrate resilience
and even manifestations of growth. Still, we found that Holocaust survivors displayed lower
levels of general adaptation than did their counterparts (Barel et al., 2010, p. 691).
Lis-Turlejska, Plichta, Luszczynska, and Benight (2008) explored the effects of World
War II on the psychological and social functioning of Jewish Holocaust survivors and non-
Jewish survivors (Polish) 60 years after the war was over. The authors found that posttraumatic
stress disorder was higher for Jewish survivors than for non-Jewish survivors. Interestingly, the
20
authors found no differences between the two counterparts for depression and social isolation.
There was a significant finding about parental loss during the war for Holocaust survivors as it
attributed to global decrement of wellbeing (Lis-Turlejska et al., 2008). The authors went on to
say that a traumatic loss at the time of war could be related to higher risks of failure during future
recovery processes and that those survivors who has lost a parent or parents had elevated PTSD
severity regardless of being Jewish or non- Jewish. A limitation of study is that the authors only
looked at two categories including parental loss and nationality. Although this study may provide
insight into some important long term psychological and social functioning factors after
survivors experienced war related hardships, it still fails to address positive attributing coping
Other studies in the Holocaust literature as mentioned by Cohen (1991) have argued that
aging for a Holocaust survivor is a traumatic crisis. Cohen argued that reaching old age for
and burdens. The author states these circumstances remind survivors of what they went through
during the Holocaust. The author implied that when survivors reach old age and experience
physical deterioration, illness, job loss, and hospitalization they re-experience the humiliation,
degradation, and feelings of helplessness suffered under the Nazis (Cohen, 1991, p. 227). The
author also went on to say that Holocaust survivors never attribute to successful grieving
processes because of their inability to experience their own emotions. In addition, the author
stated that there is unresolved grief, mourning, and strained relations among survivors and their
families and children in the current day. Although this study focused on the negative aspects of
Holocaust survivors hardships in the old age, the author did agree with the current study that the
21
literature has tended to focus on the trauma-related aspects of survivors and not on their coping
Landau and Litwin (2000) compared an analysis of Holocaust survivors age 75 and over
with those who did not experience the Holocaust. The authors found that fifty years after the
Holocaust, the women survivors are seen to have greater health-related difficulties and poorer
self-rated health, and men survivors are seen to report much higher rates of posttraumatic stress
disorder (Landau & Litwin, 2000, p. 482). Although the findings of this study attributed
positive findings to the field about Holocaust trauma and survivors psychological wellbeing in
aging, it did have its limitations. The authors study population was limited only to elderly
Israelis from European sociocultural background. Also, the gender population is biased, having
had a decreased participation of elder women. And lastly, the study was taken from a clinical
As mentioned before, most of the work done on Holocaust survivors has been done on
clinical populations or those with problems who have sought professional help. Most survivors
have not sought professional help and research among this population has been limited. The
current study will examine Holocaust survivors who were in hiding or incarcerated during Nazis
occupation during their early childhood, but who did not undergo any professional and
therapeutic treatment following their traumatic experiences. The next section will be exploring
22
The following section will examine coping strategies associated with physical and
psychological abuse or trauma. It is important to review studies on victims of trauma and how
they have coped with their experiences because they can provide insight of the survivors
experiences. Littleton, Horsley, Siji, and Nelson (2007) identified two primary adaptive and
maladaptive strategies when dealing with trauma. According to the researchers, coping strategies
Problem-focused coping strategies directly address the problem causing distress and include
seeking information about the stressor, making a plan of action, and concentrating on the next
emotional distress associated with the stressor and includes disengaging from emotions related to
the stressor, seeking emotional support, and venting emotions (Littleton et al., 2007, p. 977).
Strategies that are regarded as the more adaptive mechanisms are approach strategies
since the focus is on the stressor itself or ones reaction to it and some examples include planning
to resolve the stressor and seeking emotional support and information about the stressor
(Littleton et al. 2007). Littleton et al. (2007) describe avoidance strategies as focused on avoiding
the stressor or ones reaction to it and examples include denying that the stressor exists,
withdrawing from others, and disengaging from ones thoughts and feelings regarding the
stressor. This study assessed through meta-analysis the association between strategies used to
cope with traumatic events and psychological distress. Furthermore, the study assessed the
relationship between approach and avoidance coping strategies and distress following two
commonly studied classes of traumatic events: interpersonal violence and severe injury, and
23
among three types of distress: depression, posttraumatic stress symptoms (PTS), and general
The researchers results supported their hypothesis that there is a clear and consistent
association between reliance on avoidance strategies to cope with trauma and psychological
distress (Littleton et al., 2007, p. 985). The study predicted that the reliance on avoidance
coping strategies is a maladaptive coping method. As a result, the researchers speculated that
some individuals are incapable of learning effective coping strategies and experience increasing
vulnerability to distress following stressful events (Littleton et al., 2007). In addition, according
to the researchers, this could occur because these individuals remain to use unsuccessful coping
strategies while at the same time experience a decline in the amount of energy they have to
devote to coping because they have multiple unresolved stressors as a result of the physical and
cognitive changes associated with the aging process (Littleton et al., 2007, p.985). Lastly, the
researchers found that as the duration of the trauma increased, as did the association between
reliance on approach coping and experiencing less distress. Littleton et al. assessed this by
attributing to the notion that an individual may have to cycle through using approach
strategies multiples times before these strategies result in the individual either resolving the
stressor or reducing its effects to a manageable level (2007, p. 985). Although the limitations to
this study are that the pattern of results may not be generalized to other forms of trauma, this
study has examined theories that are relevant to the current studys orientation and has suggested
valuable information regarding how a survivor may have coped in the past and current day with
Kahana, Kahana, Harel, and Rosner (1988) stated that coping as a response to the
disequilibrium of a stressful state, has been viewed as the successful reduction of stress
24
(reestablishment of homeostasis) thereby identifying coping behavior as only those actions that
produced the desired results (p. 57). The authors, basing their research on Holocaust survivors
from concentration camps, identified five aspects of extreme stress that involve manmade
There are limiting opportunities to remove or act upon the stressor environment 4) No
predictable end to the experience 5) There appears to be meaningless and without a rational
explanation for the pain and suffering associated with the experience (Kahana et al., 1988, p. 59).
The authors argued that during the Holocaust, survivors adapted to escaping harm as a coping
mechanism during their traumatic period. The authors further stated that usually in a lesser
therefore the victims of the Holocaust or extreme trauma had altered coping strategies.
As noticed in the literature from other studies, the authors pointed out that the majority of
research has focused on the negative psychosocial sequelae of trauma and medical and
psychiatric literature has been on populations with extreme trauma in only the clinical setting
(Kanaha et al., 1988). The authors also stated that not all victims of extreme stress have
developed posttraumatic stress disorder and to the same degree or intensity of the trauma.
Furthermore, Kanaha et al. (1988) found from their research, which investigated 300 Holocaust
survivors and compared them to controls, the survivors indicated remarkable intactness despite
the trauma they suffered. The authors also pointed that Holocaust survivors who are now facing
old age may have problems associated with illness, bereavement, disability and retirement. In
addition, they may begin to reminisce about earlier points in their lives including their trauma
because older age can be argued as a time of life meaning and life review (Kahana et al., 1988).
25
However, the authors concluded that for some survivors who were able to cope and
implement adaptive coping strategies during their traumatic experiences might use those
adaptive coping mechanisms during the aging process. This study pointed out useful and
necessary framework that benefits the current studys researcher. The study also had its
limitations regarding the fact that the authors only studied coping strategies among Holocaust
survivors that were in concentration camps and not generalized to other survivors who may have
Nagata, Yuzuru, and Takeshita (1998) explored coping and resilience across generations
among Japanese Americans and the World War II Internment. The authors found that despite
numerous traumas and hardships, most former internees have gone on to lead productive lives.
Resilience has been defined as the capacity for successful adaptation, positive functioning, or
competence despite high-risk status, chronic stress, or following prolonged or severe trauma
(Nagata et al., 1998). The authors explored what cultural and societal factors helped to instill
positive coping and resilience among second-generation Japanese Americans (Nisei) who lived
in the camps, and third-generation Japanese Americans (Sansei) born after the war. Some of
studys research questions included: How did internees cope with stressors during the war? How
have they remained resilient? In what ways have their coping strategies and perspectives on the
The authors pointed out that internees underwent many traumatic experiences including
anti-Japanese sentiment, war hysteria, inadequate medical care, freezing climate, physical and
psychological stressors, familial disintegration, and feelings of humiliation and self blame
(Nagata et al., 1998). As provided in their research, the authors implied that most of the Japanese
internees held strongly onto their Japanese values including gaman (perseverance), a sense of
26
gaman, the ability to endure or persevere under adverse conditions, had strongly influenced
their response to their internment (Nagata et al., 1998). In addition, the authors found that the
attitude of shikata ga-nai (it cannot be helped) helped to maintain a cultural framework from
which the internees were able to cope with the physical hardships and trauma they endured.
Another resourceful coping method among the internees was strong familial commitment and
this was a critical force that helped Japanese Americans to cope with their hardships and
wartime events. In terms of the effects of resilience over after the war, the authors found that
most of the children internees (Nisei) had intact coping abilities, learning to endure hardships,
resourcefulness, strong family support, and an emphasis on education encouraged the Nisei to
actively reestablish their lives and not dwell on the past (Nagata et al., 1998, Retrieved February
16, 2011 EBSCOhost). The authors concluded that resilience may act as an evolving force that
happens over decades and be affected by socio-historical and structural forces. In addition,
as noted by the authors, Resilience is also renegotiated across the lifespan. For some Nisei,
renegotiation occurred as they moved from a stance of silence and emotional internalization
American value of speaking out for justice (Nagata et al., 1998, Retrieved February 16, 2011
EBSCOhost). This study sheds light on the topic of resiliency, adaptive coping mechanisms, and
cultural values that promoted resourceful tools for victims of trauma. All of the studies
mentioned in this section presented various ineffective and effective coping strategies used to
27
Theoretical Perspective
The following section will explore the current topic through the perspective of an
existential approach. Testimonies and the life experiences of existentialist Victor Frankl will be
discussed. It is important to note that not only was Frankl a Holocaust survivor, he also wrote
about his life experience in the concentration camp through the lens of a psychologist (Frankl
1984; Lee, 1985). His testimonies and theories can give meaningful insight to how a survivor
internalized and conceptualized his own survival experience (Lee, 1985; Pytell, 2007). In
addition, this section will explore looking at trauma through an existential approach.
Pytell (2007) noted that Frankls vision of psychotherapy had moved from Freudians
view of psychology to a focus on issues of will, responsibility, and the spiritual dimension of
man. A spiritualized existentialism is what Frankl called his new theory to come to terms with
his own camp experience, (Pytell, 2007). Frankl relied on his understanding of psychology to
objectify his experience and, as the author pointed out, he was able to distance himself from the
absurdity and chaos of the moment and analyze his situations. Its important to note that many
victims of the Holocaust were not professional psychologists, and many endured much worse
than Frankl. In comparison, there are many who have survived worse and lived successful lives
(Pytell, 2007).
Pytell (2007) noted that Frankl was able to work through his personal trauma by
minimizing the horrors of the camp. Frankls theory was to connect the prisoners first
psychological state of shock and then detachment to the second phase of apathy. This transition
was caused by current reality that was seen as intolerable and there was no future to look forward
to (Pytell, 2007). To overcome this issue of apathy and loss of hope, Frankl turned to his
spiritualized height psychology as a solution to apathy and despair and relied on a strategy of
28
attitude adjustment (Pytell, 2007). Pytell claimed that Frankl believed that in these extreme
Pytel (2007) illustrated this by quoting Frankl, Fundamentally any man can, even under
such circumstances, decide what will become of himmentally and spiritually. He may retain
dignity even in a concentration camp. [Also] If there is meaning in life at all, then there must be
meaning in suffering. Here lie the opportunities of attaining the moral values that a difficult
situation may afford him. And this decides whether he is worthy of his sufferings or not (Frankl,
1984, p. 7576). According to Pytell, Frankls existentialist attitude was derived from his height
psychology apparently, which helped him find meaning in the oppressive and dehumanized
situation of the concentration camp (2007). Also, Pytell noted that Frankl turned to a spiritual
moments, (2007). For example, Frankls spiritualized version helped him resolve the psychic
turmoil caused by, among other things, the knowledge of how his mother died (Pytell, 2007).
Lee (1985) described Frankl as having the ability to look back to more favorable times
and hold onto the peaceful memory of something soothing from the past. The author described
Frankls abilities as survival techniques to adjust to the camp life during the Holocaust. Lee
suggested that according to Frankl, people who refused to believe that they could survive and
fantasize about happier times were more likely to die during camp (1985). Lee also implied
that based on Frankls testimony, The only possible freedom prisoners could possibly
experience was the freedom to choose his or her attitude toward the circumstances that were to
In Mans Search for Meaning Frankl writes, Everything can be taken from a man but
one thing: the last of the human freedomsto choose ones attitude in any given set of
29
circumstances, to choose ones own way (1963, p. 104). Lee also illustrated how important it
was for Frankl to hold onto meaningfulness and have the capacity to retreat into his inner world.
By doing this, Lee suggested that Frankl was able to have inspirited and was able to produce a
will to live.
Jacobsen (2006) explores looking at trauma and crisis through an existential perspective.
The author described that, existentially, crises are part of being alive. Jacobsen noted that
perspective if one can only cope with the smooth and the well controlled, then there is no room
left for the human being (2006, p. 42). Jacobsen identified with Bollnows theory that crises
are events that due to their critical and dangerous nature stand out from the continuous flow of
life in generalcrisis need not necessarily lead to disaster. The experience of living through the
crisis may involve the overcoming of danger, experiences of relief and, on a deeper level,
cleansing, the elimination of old issues of conflict and the attainment of a new and higher level
of stabilization (2006, p. 42). Bollnow saw crisis as a potential cleansing of the individual and
this type of crisis is a crucial aspect to ones continued direction of development (Jacobsen,
2006).
Jacobsen identified crisis as having three dimensions: loss, adversity, and opening-of-
existence. During a crisis there can be a loss in which something or someone is missed. The
reaction to this loss is grief and through grieving, according to Jacobsen, one either regains what
was lost or comes to terms with the loss. Ultimately, Jacobsen described that in this process the
joy of life is gradually restored (2006). Jacobsen stated that when one person loses another
person or a cherished object, he or she also loses the relationship to that other person or thing. In
connection with the death of a spouse or a close friend, Jacobsen implied that the death of a
30
loved one is loss of existence and the death of a loved one is a piece of ones own death, (2006).
According to Jacobsen, Human beings are able to accommodate these constant losses yet still
grow and be vital and active, precisely because of their basic openness to the world (2006, p.
45).
In crisis as adversity, Jacobsen described that people cannot change given conditions, but
individuals can decide how they wish to tackle their handicap, illnesses, shortcomings or
adversity in general (2006, p. 45). Jacobsen believes that individuals cannot change certain facts
about how they look, what they have lost etc., but need to accept them as their basis, or his or
her existential ground (2006). The author also implied that if an individual does not accept
them, he or she will live on false premises. In addition, Jacobsen pointed out that people are
thrown into existence, and that each individual is thrown into his or her own existential situation.
To exist is in effect to immerse oneself fully in ones real situation. The answer to the adversity
of life is thus to accept ones facticity and to act on that basis Jacobsen (2006 p. 46).
personal turning point by offering a new life possibility. Jacobsen speculated that during crisis
and disruption, the individual could find an opportunity to look at what life is really about.
Jacobsen illustrated this concept by Yaloms four basic existential concerns: (1) death (we live
now, but one day we are going to die); (2) freedom (we structure our lives ourselves, but out of
emptiness); (3) isolation (we are born and die alone, but we need other people and a sense of
community); and (4) meaninglessness (we seek and construct life meaning, but in a universe
without meaning). According to Yalom, To be struck by a crisis is a disruptive but also fertile
opportunity to find ones position in relation to these four and other basic existential dilemmas
Jacobsen concluded that survivors of an accident related crisis activate their four
existential concerns as mentioned by Yalom. Jacobsen also pointed out that crisis serves as an
important path to development because during a crisis life is lived with particular intensity and
in this process a person should have a chance to take your existence upon yourself (2006).
Jacobsen concluded that even though crisis is and can be painful it is also a chance to
feel the world. In addition, This is a chance to find oneself, clarify ones position on this earth,
to take over ones own life Jacobsen (2006, p. 52). Jacobsens theories help explore, through an
existential approach, how a suffering individual who has undergone crisis can see their crisis as a
turning point, and an opening opportunity for new life development. Looking at these theories
can assist the current researcher in the possibility of understanding the primary adaptive coping
strategies among aging Holocaust survivors. In addition, the current researcher is interested in
perspective.
In the Review of Literature section, studies on Holocaust survivors have been cited and
found that most of the work that has been done on this population has been on the negative
effects of trauma in regards to the victims of the Holocaust. Whats missing in the literature is
not the need to understand the potential benefits that come from coping strategies among aging
Holocaust survivors, but actual nonclinical, positive and primary coping strategies derived from
aging survivors testimonies. The Holocaust experience is a unique experience that is different
from other types of trauma, and therefore can provide valuable information about trauma and
resilience. As cited in the literature review, most of the research on the Holocaust has been from
32
a psychiatric, pathological, and clinical viewpoint. In addition, most of the work on the
Holocaust experience has been guided by psychoanalytic and psychodynamic theories; therefore,
Holocaust survivors are entering old age, which is causing new questions to emerge about
how best they can be cared for. Studying Holocaust adaptive experiences can provide unique and
relevant information about trauma, resilience, and adaption that can provide further guide with
working with survivors of other genocides. There is an important need to understand and
document the Holocausts survival efforts now that they have entered their final stages of life.
The review of literature is intended to institute a foundation for the current study which will
focus on aging Holocaust survivors who endured childhood and adolescent trauma, and how
have their primary adaptive coping strategies in the current day been able to help them in their
placement in society as they face old age. The next chapter, Methodology, will explore how the
33
The following methodology chapter will include Objectives and their Rationales,
Research Plan, Participants, Instrumentation, Data Processing, Ethical Assurances and a Chapter
Summary.
Problem Statement
question that they have dealt with horrific trauma and suffering. Little is known about their
positive coping mechanisms dealing with trauma in old age. What are their primary positive
coping mechanisms? There is a lack of research done on aging Holocaust survivors and their
What are the lived subjective experiences of Holocaust Survivors now in older age?
This project seeks to understand what are the positive coping strategies among Holocaust
survivors who are now facing old age; to explore what coping strategies have survivors have
used in the last two decades to cope with their trauma; and to explore how the previous
experience (surviving the Holocaust) relates to the current life transitioning among older adults
in the community.
Rationale. All objectives of the current study are contributing factors to explore and
understand the subjective lived experiences of aging Holocaust survivors to help therapists treat
Holocaust survivors. Studying Holocaust survivors adaptive experiences can provide unique and
34
relevant information about trauma, resilience, and adaptation that can provide further guidance
Research Plan
The researcher will establish contact with the San Fernando Community Senior Day
Centers and the program director to request permission to speak with the participants. Once
permission is granted, the researcher will recruit participants who meet the criteria of the study
and who would like to volunteer for interviews. Once the participants have been identified, an
informed consent will be provided before the interviews stating the length of the interview and
the researchers contact information. The initial interview will be held at the participants Day
Center.
Participants
The subjects will consist of eight Jewish female and male survivors who lived during
(19391945) World War II Holocaust. At the time of World War II, the subjects age ranged
from 1318 years. All subjects will be from the origin of country under the former U.S.S.R.,
which would now be anywhere from Eastern Europe (Poland, Belarus, Ukraine, Eastern Russia
Lithuania, Latvia, Estonia, Hungary, Romania, Moldova, Croatia, Czech Republic, and Serbia).
The subjects will be selected from a convenient sample from the San Fernando Valley
35
Instrumentation
Questionnaire items will be open-ended to promote unrestricted response, flexibility depth and
clarification to derive the participants phenomenological experience. All subjects will be given
standard instructions to describe their experiences during World War II, long-term effects of the
Holocaust and their current lives. The interview will explore concepts regarding positive coping
strategies among aging Holocaust survivors. An example question will be: How does it feel to
The initial interview will be audio taped, translated from Russian, and immediately
transcribed. For transcription of the responses to interview questions refer to Appendix B. All
subjects will be informed and assured of their right to refuse to respond to any particular
Data Processing
Qualitative data processing will be analyzed and interpreted by the interviewer. The
classical content analysis and keywords-in-context qualitative data analysis tools. Constant
comparison involves developing themes in the research data. In classical content analysis, the
researcher will count the number of times each theme is used to understand the frequency of each
theme. In keywords-in context data analysis, the researcher will identify keywords that are
Ethical Assurances
Due to the sensitive nature of the current study, the researcher will adhere to all
guidelines to ensure ethical considerations and privacy rights of all subjects. The subjects will be
assured and informed that they have the right to refuse to answer any questions and can terminate
the interview if they feel uncomfortable or unwilling to continue. Every caution will be taken to
psychologists and code of conduct, the researcher will inform participants about (1) the purpose
of the research, expected duration, and procedures; (2) their right to decline to participate and to
withdraw from the research once participation has begun; (3) the foreseeable consequences of
declining or withdrawing; (4) reasonably foreseeable factors that may be expected to influence
their willingness to participate such as potential risks, discomfort, or adverse effects; (5) any
prospective research benefits; (6) limits of confidentiality; (7) incentives for participation; and
(8) whom to contact for questions about the research and research participants' rights (American
Because the nature of the study may elicit strong emotions and feelings, a referral for a
licensed psychologist will be available to consult with any participant who feels that he or she
may need the support. Dr. Dmitry Tuller will be available for one free consultation and any
In this chapter the researcher described the Research Plan, Participants, Instrumentation,
Data processing and Ethical Assurances. The next chapter will be Analysis and Results.
37
The aim of the research was to understand the positive coping strategies among
Holocaust Survivors who are now facing old age. By interviewing older adults aged 86 and
older, the researcher wanted to gain a better understanding of how surviving the Holocaust and
the atrocities of WWII relate to the current life transitioning among older adults in the
community.
The interviewer gathered information about participants gender, age, country of origin,
and relationship status. The participants were asked to complete face-to-face interviews with the
interviewer surrounding their experience during WWII. All face-to-face interviews were
conducted at the approved Adult Day Center in a confidential private room. Each interview
lasted approximately 1.5 hours. The researcher reminded the participants that the interview
process may elicit strong emotions but is a safe and comfortable environment. Since the
participants are from a specific culture and background, the researcher conducted interviews in a
respectful, sensitive, and carefully paced manner. In addition, prior to the interviews, the
researcher reminded the participants that they have the right to refuse to answer any questions
and can terminate the interview at any time if they feel uncomfortable or unwilling to continue.
Analysis
to maintain anonymity, confidentiality, and a method to refer to the participant throughout the
discussion of findings. Researcher reread transcripts and evaluated documentation and notes
taken during participants interviews to identify any patterns of themes within the context of
responses.
38
Using qualitative processing, researcher counted the number of times each theme is used
to understand the frequency of each theme. Next, researcher identified keywords that are
frequently used as commonalities among each theme. Through interpretation and qualitative
processing, researcher was able to identify emerging themes and patterns that developed within
Participants
Five of the eight of the participants were female and three were male; all participants
were between the ages of 8797. All eight of the participants identified themselves as Jewish
Caucasians from the former U.S.S.R. Participants were three couples and two female widows
39
Findings
structured interviews attempted to answer and explore the following objectives and rationale: (1)
To understand what are the positive coping strategies among Holocaust survivors who are now
facing old age; (2) To explore what coping strategies have survivors used in the last two decades
to cope with their trauma; and (3) To explore how the previous experience (surviving the
Holocaust) relates to the current life transitioning in older adults in the community.
As outlined in Appendix A the research questions that the interviews attempted to answer
were: (Q1) Tell me about your experience during World War II? (Q2) How have you learned to
cope or deal with your WWII experience (e.g., Holocaust)? (Q3) How does it feel to be a
survivor? (Q4) What do you think are some of your strengths, which have gotten you to where
you are now? (Q5) How have you handled the experience of living past the Holocaust now in
older age? (Q6) Now that you are facing older age, how has surviving the Holocaust aided you?
(Q7) Can you name some of your specific coping strategies? (Q8) When you feel overwhelmed,
what do you do to make yourself feel better? (Q9) Have you at any time since your Holocaust
experience received any professional psychiatric/psychological help? (Q10) How did you feel
talking about the Holocaust with me? Bonus question (Q11) Anything additional about yourself
Because the interview questionnaire elicited many responses, themes that emerged from
the questionnaire related to the researchers objectives were considered in five themes. The five
themes and descriptions of themes are presented below. Theme results from participants are
presented in Table 2.
40
Resilience X X X X X X X X
Interpersonal/family relationships X X X X X X X
Theme Presentations
Resilience. One theme that emerged from most participants had to do with their ability to
be able to recover from their misfortunes (e.g., atrocities of WWII, famine, loss, pain, etc.) and
adjust into the world. This form of resilience can be illustrated by the following quotes from the
participants:
Participant 1: The heart lived on, Im not the same but still strong. Ive survived
the unthinkable because I was able to bounce back and keep going. Many of my
comrades died along the way, but my spirit was strong.
Participant 2: What was I supposed to do? There was nothing to do but keep
going. Nobody had the time to stop and think about what had really happened. My
God gave me the will to adjust, wed, bear my children, make it to America and
live.
Participant 3: The Holocaust was one of the worst times in my life. But its very
simple: life went on. Older age did plague me and weigh me down, diseases only
41
occurred naturally and worry increased. But I have survived. You learn to go on
because you have to.
Participant 4: You build resiliency and learn to forget the bad. If you dont fight
the will to live then you die (or died back then). Everything is here (points around
her) thats the point. Nothing will be like the Holocaust. Thus, everything is all
ready better in life. My family, my life, my home, is all here and THAT is life.
Participant 5: You yourself can choose what happens to you. I chose to move on
and adjust. I chose to live.
Participant 7: Maybe it was Gods plan or my inner will that helped through such
trauma and pain. Or maybe I was destined to survive so I can born my family and
contribute to this world. Regardless I credit my survival to some form of
resiliency.
Participant 8: Its always been a coping method of mine, to turn negative things
into positive. I am alive today because I take care of myself, worry little and I am
a determined person.
Strong maternal influence. A second theme that arose throughout the interviews was
the discussion of how a maternal figure influenced participants strengths and resiliency during
WWII. Many participants reported that most men over the age of seventeen had to fight in the
Russian army against the Nazi regime, which left many of the women behind. Participants recall
how their mothers strengths kept them alive. This form of a strong maternal influence was
Participant 2: My father was killed in the war. My mother was my only family in
the four years that we hid from the Nazis. Every day I thought I would die but my
mother stayed by my side and became my shield. She somehow believed in
freedom and even though my young mind couldnt understand it, her strength
saved me. I owe everything to her and the kind people who hid us all those years.
42
Participant 5: If the Germans captured you, you were dead. If you were a man
over the age of 17 you went to fight in the Russian army against the German
Nazis. It didnt matter if you were Jewish or Christian or whatever. You had to go
fight. Many people were being murdered in the front (Russian army) or by the
Germans. My father left to fight and never returned.
My mother was the only thing that saved me. I recall how hard she worked to
make sure I was alive. I remember her looking so old. As if the war had aged her
beyond her years. I remember wanting to help her. I think I got my strength and
will from her.
Since I was in the hierarchy of being the oldest, I was used to taking care of
people. Being the CEO of cooking, cleaning, everyone was dependent on me.
Thats how I go forward in life. Expectations set on myself. This is what I think
my mother has instilled in me.
Freedom from oppression. A third theme that emerged was in regards to the freedom
of life, liberty, and the pursuit of happiness. The following quote reflects participants
43
perception of what freedom in the United States has meant to them. Many participants reported
being religiously oppressed, prosecuted, denied access to healthcare, and limited jobs due to their
religious affiliation and the anti-Semitism that plagued them in the many regions of the former
U.S.S.R. Participants described that their immigration to the United States was for a better
quality of living, medical advancements, and unlimited opportunities for everyone in their
Participant 3: I have had heart surgery, few bypasses and a pacemaker. America
literally has saved me. Russia didnt have these medical advancements or
procedures. I am alive today because I have had these advancements in medicine.
In Russia, rarely people lived longer than 60-65. And I cant believe I even lived
passed 80.
Participant 6: Many people think after the Holocaust it became easier for us
(Jews) but on the contrary anti-Semitism was at it highest. Besides sparse food
and limited opportunities, you had people who hated you for no other reason but
your last name. So many hid who they really were. It was the Nazis all over again.
You couldnt read the great literatures or listen to the music you wanted to.
Communism took over everything whole. My family and I did everything in our
power to try to get out of Russia and it would take 11 years to find our freedom.
44
We are destined from the day we were born to the day we die. We all have a
destiny. My destiny was to have been married, to meet my husband, for my
grandchildren to be alive and to be living right here in United States. And for this
freedom I am so grateful. Its the reason I stand beside you today.
Participant 7: It was unbearable to leave Israel, my home for so many years. But
my adult children persisted for a long time for me to come to my senses. I needed
the medical technology that only United States had so I did what many had to do I
suppose. I came here and because of that I bought many years to my life. But I
dont think I will ever get over how hard it was to leave my country, and I left
many countries to be here.
importance of interpersonal and familial relationships. Participants reflected about their views on
marriage, family, and social relationships as an aid to their resiliency and adaptive coping
Participant 1: Since all my family members were killed by the Nazi regime, my
marriage and children from this marriage are the only family I know of.
Socialization with peers and other relatable people like me have been important to
me. I used to socialize much more but I am still a cheerful and happy
person.(Recites poem and sings song to the researcher.)
Participant 2: As a mother my only goal was to help my child grow and be happy
despite the world in which he was created. I love my son and grandchildren and
them having a good life has been my motivation to live.
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Participant 5: My motto has been since I came to this country to work honestly
and respectfully. Be part of the community, respect thy neighbor, always be
positivethings will be better. Make good connections with people. My family
will be happy and free people. My familys future and happiness is what kept me
going strong.
In Russia I always feared a war, always looking over my back. But now in
America, I didnt feel so afraid so I was ready to make a better living for myself
by making friends and providing for my family. Family is the number one most
important thing in the world.
Participant 6: The most important thing that has helped me is familial support.
Seeing my daughters and granddaughters to succeed means everything to me.
Success in healthy aging. Lastly many participants described specific elements that have
contributed to their success in aging and coping with past and present traumatic experiences.
Participants recalled the importance of leisure activities, socialization, family support, positive
mottos, patience, determination, cultural/religious beliefs, past adaptive coping strategies, and
present positive coping styles. The following quotes below support this theme.
Participant 1: I attribute physical strength as the reason for my long life. Like my
father and fathers before him, I too possess a strong spirit (points to his chest).
Comparing to some of my counterparts, many of my peers have dementia and are
losing their (minds).
You cannot get depressed or feel bad. I am not afraid to die. I am not afraid of
tomorrow. Never been afraid of death. You have to stay strong, do what you love
and live. Those that were afraid and complained all the time, all perished a long
long time agoWhat doesnt kill you makes you stronger.
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Since people saved my life during hiding from the Nazis, I always loved to help
people and be around people.
I used to socialize more before my physical pains, however now I just see
caregivers, family and my husband.
I believe having good nutrition, medications I need, and support of familyis all
contributing factors to my success in aging and surpassing many of my peers.
Participant 4: My motto was always to see the good in things. I believe I have a
strong will. Determination and being patient was something I learned to possess
quickly in time of trauma and pain.
Participant 5: I think because I was used to living poor, I was adapted to living
poor during the war with everything sparse around. So that adaptation definitely
saved me.
When young, when youre not as old, youre not as predisposed to the emotional
trauma because your mind cant imagine what really is going on. Only until later
you begin to intellectualize what happened to so many people. Life and death
wasnt a concept when youre a young mind so you just get through things
easier.
I have always prided myself in being mentally and physically strong. I had
endurance. I learned patience and stayed positive and healthy. I was determined
about everything. Quit smoking? Yes, I did. I learned that if I put my mind to
something I could do it. Thats my biggest strength and coping mechanism. Mind
over matter is a motto of mine as well.
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I have worked very long hours and exhausted my body; therefore, I am plagued
with many ailments. But I am content and grateful for what I have here and my
family is happy and healthy.
I have lived a long life because I have always been eager to learn. I am fluent in
five languages, have lived around the world thus been exposed to many cultures,
beliefs and various ways of living.
Participant 8: I have learned that there are negative forces (e.g., people, nature
disasters, wars etc.) that may strike you down but you have to carry on no matter
what. Find positive people, surround them around you. Find a job you love, I
loved helping people. Do your prayers and commit to God. Draw, paint, eat
healthy, exercise, socializelike I do. All these things make you a better person
and part of the community.
Summary
In this qualitative study, participants shared their overall subjective experiences during
and post WWII. Through the semi-structured interviews with eight older adults, the researcher
was able to obtain themes related to these experiences. The research themes that emerged
pertaining to these experiences are described in the following chapter, Discussion of Results.
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This study examined the positive coping strategies of World War II (WWII) Holocaust
survivors. A phenomenological qualitative study was conducted to explore and uncover themes
from the testimonies of Holocaust survivors who are now facing old age. The importance of
studying adaptive coping experiences can provide unique and relevant information about trauma,
resilience, and adaptation that can provide further guidance with working with survivors of
genocides and related traumatic experiences. The following research questions guided the study:
1. What are the lived subjective experiences of Holocaust survivors in older age?
b. To explore what coping strategies survivors have used in the last two decades
The results of the research study demonstrated that there are specific styles of adaptation,
resilience and lifelong adaptive coping strategies within the older population of trauma survivors.
The participants were able to report lifelong coping mechanisms that have aided them in times of
and psychosocial stressors. The following are five themes derived from the findings.
Resilience
The first research theme explored resilience as a coping mechanism among the older
adult population. The majority of the older adults described having a strong inner mechanism or
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organism that guided them throughout their traumatic and distressing experiences. The
participants reported that this inner strength and type of attitude was an adaptive method of their
choice to keep on living despite the many horrors surrounding them. This attitude can be
supported by Frankls own survival techniques, as illustrated by his observation that the only
possible freedom prisoners could possibly experience was the freedom to choose his or her
attitude toward the circumstances that were to somehow be endured (Lee, 1985, p. 93). Many
participants described that in a time of horror and despair, they had a will to live and the
alternative method would have been death. As Frankl stated, Everything can be taken from a
man but one thing: the last of the human freedomsto choose ones attitude in any given set of
circumstances, to choose ones own way. This was found to be an adaptive attitude related to
the participants own coping styles (1963, p. 104). An example of resilience was demonstrated in
participants comments:
You build resiliency and learn to forget the bad. If you dont fight the will to live
then you die (or died back then). Everything is here (points around her), thats the
point. Nothing will be like the Holocaust.
You yourself can choose what happens to you. I chose to move on and adjust. I
chose to live.
Results pertaining to the second research theme revealed that a majority of participants
had a strong maternal influence that aided them during their traumatic experiences. Many
participants described having a characteristically strong mother who contributed to their ability
to adapt and cope with their distressing experiences during and after WWII. Participants
testimonies demonstrated that there is a strong correlation of healthy attachment styles from a
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findings demonstrated that participants with healthy and adaptive maternal influences during
childhood and adolescence contributed to participants long-term resiliency and capacity to cope
psychosocial functioning. Similar findings in the literature supports the current researchers
findings as illustrated in the work of Huopainen (2002), Krystal (1978), and Freud (1893-1895)
that indicate that, without the maternal figure acting as protective shield, the child can become
distressed and unable to bear the effects of the traumatic event, thus giving evidence to show the
impact of the distress on the Holocaust child survivor who may not have had any parental and
nurturing contact during WWII. Examples of strong maternal influence can be illustrated by
participants comments:
Everyday I thought I would die but my mother stayed by my side and became
my shield. I owe everything to her and the kind people who hid us all those
years.
My mother was the only thing that saved me. I recall how hard she worked to
make sure I was alive. I think I got my strength and will from her.
The third research theme surrounded the influence of older adults experiences of
freedom from oppression. The majority of participants reported being religiously persecuted and
frequently exposed to prolonged anti-Semitism in their former country of origin. Older adults
reported that they no longer had respect nor received equal rights as a person during their life in
former Russia. The results demonstrated that participants felt that they were not part of the
51
community and in some cases felt not human as they described their psychological and
Most of the adults who immigrated to the United States experienced freedom of religious
environment, and part of a specific group and community. Older adults who reported belonging
to a community or group free from religious oppression indicated that this belonging contributed
to their adaptive coping strategies. Research demonstrating the importance of being able to
identify the self with a group of people or community for the aging Holocaust survivor has been
limited in the current literature. The results demonstrated that older adults who were able to
belong to a group of people and community without discrimination and religious persecution
were able to transition and adapt healthier long-term coping strategies despite earlier childhood
comments:
Many people think after the Holocaust it became easier for us (Jews) but on the
contrary anti-Semitism was at it highest. Besides sparse food and limited
opportunities, you had people who hated you for no other reason but your last
name. So many hid who they really were. It was the Nazis all over again. My
family and I did everything in our power to try to get out of Russia and it would
take 11 years to find our freedom.
I needed the medical technology that only United States had so I did what many
had to do I suppose. I came here and because of that I bought many years to my
life.
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The fourth research theme discussed the importance and benefits of interpersonal and
familial relationships. Participants reflected on the significance of marriage, family, and social
relationships as an aid to their resiliency and adaptive coping strengths. Older adults described
identified how social and interpersonal support brought purpose and meaning to their quality of
life. In addition, many participants reported their inner psychological strength and motivation to
succeed in life was for the well being of their children and family. These results can be supported
in various findings in the literature including Sigal (1998) and Suedfelds (2003) studies
identifying adaptive coping strategies of Holocaust survivors and the positive influence of
external factors of help from others, social support, and familial environmental factors. An
participants comments:
Since all my family members were killed by the Nazi regime, my marriage and
children from this marriage are the only family I know of.
Ive survived a stroke and have had many psychological battles to deal with. But
having family around me gives me happiness and strength. Family is the most
important thing to me and always will be.
But now in America, I didnt feel so afraid so I was ready to make a better living
for myself by making friends and providing for my family. Family is the number
one most important thing in the world.
Lastly, the fifth research theme explored what are the overall adaptive strengths that
enabled participants to cope with the varying traumatic conditions from their past to the present
53
as they have faced older age. Most participants reported that witnessing horror, emotional
disturbances and malnourishment did not significantly impact their psychosocial and emotional
development, but in fact, contributed to their strength and resiliency. This type of strength can be
witnessed throughout participants lives as they now adapt to their own aging illnesses and
Many participants reported that surviving past traumatic conditions gave them the
capacity to deal with existing distressing and painful experiences. Nietzsches popular phrase
whatever doesnt kill you, makes you stronger, supports the existential belief that was found in
the participants describing an inner psychological model that influenced their adaptive
functioning through their adversity. Similar references to participants resiliency and coping
strengths can be noted in Yaloms (1989) existential theories and Jacobsens existential working
model of dealing with trauma. Jacobsens (2006) theories influenced by Yalom support
participants existential positions of how the suffering individual through adversity and crisis
emerges stronger and that even though crisis is and can be painful it is also a chance to feel the
world. In addition, Jacobsen stated that this is a chance to find oneself, clarify ones position on
this earth, to take over ones own life (2006, p. 52). Jacobsens theories give further guidance,
through an existential approach, as to how suffering individuals (like many of the participants in
the study) who have undergone crisis can see their crisis as a turning point, and an opening
opportunity for new life development. This is evidenced in participants testimonies that
expressed the importance of moving forward through hardship by restoring and rebuilding their
lives. All participants after WWII finished their education, married, and started a family. The
54
results of the study gave evidence that all participants wanted a better future for themselves and
Kahana et al. (1988) further support current findings, stating that not all victims of
extreme stress have developed posttraumatic stress disorder and some survivors who were able
to cope and implement adaptive coping strategies during their traumatic experiences might use
those adaptive coping mechanisms during the aging process. Similarly, findings from Nagata et
al. (1998) support resilient coping strategies among Japanese child trauma survivors. The authors
concluded that these child survivors had intact coping abilities, resourcefulness, strong family
support, did not dwell on the past, and exhibited resilience across the lifespan.
In addition to psychological strengths, older adults reported that leisure activities such as
cooking, gardening, board games, socializing with peers, drawing and other related recreational
activities have contributed to their positive attitude and adaptive coping strategies. Some older
adults described coping in aging as finding a meaning to life including spirituality and
exploring a sense of purpose, education, and creative outlets. It was clear in the results that the
quality of their life is a result of various factors associated with inner psychological strengths,
adaptation, and familial and healthy environmental factors. Examples of success to healthy aging
You cannot get depressed or feel bad. You have to stay strong, do what you love
and live. Those that were afraid and complained all the time, all perished a long
long time agowhat doesnt kill you makes you stronger.
I believe having good nutrition, medications I need, and support of familyis all
contributing factors to my success in aging and surpassing many of my peers.
I have always prided myself in being mentally and physically strong. I had
endurance. I learned patience and stayed positive and healthy. I was determined
about everything. I learned that if I put my mind to something I could do it. Thats
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my biggest strength and coping mechanism. Mind over matter is a motto of mine
as well.
I had an adaptation to tolerate pain. I have struggled through all my life. But all
my struggling has helped me overcome my obstacles to this day. It has shaped me
into who I am today. Its an inner resiliency that words cannot explain.
adaptive coping strategies among aged survivors of various traumas suffered during WWII
holocaust. There is limited research in the importance of adaptive coping strategies in the older
adult population. Most research findings, as the literature suggests, have focused on the
psychological and physical distress of childhood trauma post WWII Holocaust. Past research
studies have focused on the negative effects of trauma in regards to the victims of the Holocaust.
Research has been from a psychiatric, pathological, clinical viewpoint and mostly been guided
by psychoanalytic theories.
This study explored the psychological aspects, through nonclinical testimonies derived
from aging survivors experiences of resiliency, adaption and positive coping strategies among
As mentioned previously, survivors of WWII are now entering older age, which is
causing new questions to emerge about how best they can be cared for. Studying Holocaust
survivors adaptive coping experiences can provide unique and relevant information about
trauma, resilience and adaptation that can provide further guidance with working with WWII
veterans, Holocaust survivors, and survivors of genocides. As baby boomers reach older age, and
the population of older adults outnumber other age groups, it is important for mental health
56
professionals to practice effective therapeutic interventions related to working with older adults
with trauma.
Identifying and implementing therapeutic interventions that help maximize the capacity
for better living and functioning for older adults may prolong their lives. Further, this
researchers results can assist the older adults family, friends, and caregivers regarding how to
preserve areas of functioning for the aged adult. In addition, studying lifelong coping strategies
among older adults can assist the mental health professional, social worker, and counselor in
identifying early warning signs of children with trauma and provide necessary tools to manage
symptoms of distress (e.g., anxiety, depression, PTSD, fear, guilt, shame, environmental
stressors, loss/separation, anger, worry and feelings of helplessness) to improve daily functioning
external factors including social and peer support, healthy environment and surroundings,
Cultural Influence
lived subjective experiences, as she is of the same cultural and religious background of
participants from the former U.S.S.R. Further, researchers own family has a history related to
experiences during WWII and the devastating aftermath of the war was an exceptionally difficult
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and moving process that further contributed to the researchers own passion and interest in the
proposed topic.
demonstrating empathy and understanding of the sensitive material presented by the participants
testimonies. Furthermore, researcher was more attuned and motivated to explore, interpret and
Limitations
This qualitative study was limited to eight participants and all the participants are from an
Eastern European background, residing in Los Angeles. Out of these eight participants, three
were male. As a result, the generalizability of the results to other older adults is limited. Some
transference was exhibited throughout the interview processes as participants mentioned that the
researcher reminded them of their daughter and/or granddaughter. Thus, some may have
generated answers that they believed would show them in a more favorable or less favorable
light toward the researcher. Each participant provided self-reported information, which may also
have impacted the results, as they may not have responded in a completely honest manner. Due
to the nature of the study and the personal connection to the topic, it should be noted that the
researcher might have developed countertransferences toward the participants and their lived
subjective experiences. Also, even though researcher is fluent in the participants language, due
to language differences, some dialogue may have been lost in translation when transcribed.
Additionally, the interpretation of the data may pose a limitation, in that the coding and origin of
the themes from the interviews was performed from the perspective of the researcher.
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Recommendations
This researcher found several implications for future research such as:
1. A study that includes a larger sample size that incorporates more input from the older
adult participants.
2. Psychological and physical evaluation of an older adult to assess for cognitive and
3. A study that incorporates the experiences of participants adult children to explore the
4. A comparative study between older adults who were exposed to trauma in childhood
5. A study that includes other religious and cultural populations who have endured
Furthermore, the results of this study raise implications for psychological and
professionals in working with trauma with older adults of various ethnic backgrounds.
Conclusion
According to the United States Census Bureau, there were 40.3 million people in the U.S
who were over the age of 65 and that this was the highest increase in older population in 2010.
Between the years 2000 and 2010, the total population of older adults increased from 281.4
million to 308.7 million, further indicating that this is the fastest growing age group in the
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In addition, between the years 2000 and 2050, the proportion of the worlds adult population
over the age of 60 will double from about 605 million to 2 billion over the same period (World
Health Organization, 2012). It is becoming increasingly important to understand this older adult
population as well as the implications that population aging has for various families, and social,
This research study provided results that can help create new areas of research and
formulate further understanding of the importance of adaptive coping strategies when dealing
This study has shown that there are various significant adaptive coping strategies among
older adults including, but not limited to, psychological inner strengths, external factors
including social and peer support, healthy environmental surroundings, belonging to a specific
As research has shown, there is a growing need for the aging population that are
limited mobility and other physical or mental health problems). There is also an increase in
care for older adults in home nursing, community and assisted living, residential care and
long stays in hospitals due to psychological and physical deterioration. Programs and
resources involved that can limit the impact of these stressors on older adults and result in a
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How have you learned to cope or deal with your WWII experience (e.g., Holocaust)?
What do you think are some of your strengths, which have gotten you to where you
are now?
How have you handled the experience of living past the Holocaust now in older age?
Now that you are facing older age, how has surviving the Holocaust aided you?
When you feel overwhelmed, what do you do to make yourself feel better?
Have you at any time since your Holocaust experience received any professional
psychiatric/psychological help?
How did you feel talking about the Holocaust with me?
11th (bonus question) Anything additional about yourself or experience that you
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Consent
Subject
The research project and the procedures have been explained to me. I agree to participate
in this study. My participation is voluntary and I do not have to sign this form if I do not
want to be part of this research project. I will receive a copy of this consent form for my
records.
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