Message From Michael Blumenfield, MD.

President of the American Academy of Psychoanalysis and Dynamic Psychiatry

I am very pleased to begin my two year term as President of AAPDP. Cesar Alfonso has done an outstanding job during his presidency by both expanding the membership and unifying our organization. During this time we have seen an increase in our membership especially among our younger colleagues. The success of the Teichner Scholar Program and the establishment of the Scott Schwartz Award have been two very important highlights of the past two years. We have also seen the successful passing of the torch from one great editor of our journal, Doug Ingram, to another great editor, Richard Friedman, who will be assisted by his outstanding co-editor Jennifer Downey. Just as significant has been the changing of our journal name to Psychodynamic Psychiatry, which will widen our connection with the body of psychiatrists who share our interests in psychoanalytic and psychodynamic theory and therapy. In addition, our Forum magazine under the able editorship of Jerry Perman continues to provide interesting articles about our members and our organization as well as creative pieces on a variety of pertinent subjects.

We all know that there are evolving changes in the delivery of mental health care. Many psychiatrists who value a psychoanalytic and psychodynamic perspective frequently find themselves in settings where they don’t have a chance to discuss these concepts and case formulations with colleagues. While applying these skills in various settings related to psychopharmacology, C/L psychiatry, short term therapy, inpatient hospitals etc , they are often isolated from colleagues who have a psychodynamic background. Even those psychiatrists who do long term therapy need a home to share their interest in their work and that home is the Academy of Psychoanalysis and Dynamic Psychiatry.

Now is the time to surge our membership. I am proposing that over the next two years each member invite at least one new colleague to join AAPDP each year. I believe that we could double our membership in the next two years, which would allow us to expand our programs and activities. Not only should we be inviting our junior colleagues (residents, medical students and early career psychiatrists) to join but we should also offer our seasoned colleagues an opportunity to join AAPDP. I have been pleasantly surprised to see some of my old friends and colleagues quite receptive to being invited to join our organization. I know that many of you will be glad to chat by phone with a perspective new member in order to be the second sponsor needed to join, as Membership Chair Jerry Perman, Past President Cesar Alfonso and I have done this past year. The membership application is easily accessed from our website (AAPDP.org) or from our office.

As we engage in a membership drive, we need to highlight the benefits of membership as well as expanding them. I have already mentioned our publications, which include this Academy Newsletter. Whether or not you were able to attend our recent annual meeting in Philadelphia, I hope you appreciate the outstanding program that was put together by Kim Best and Gene Della Badia. I have asked overall Program Chair Eugenio Rothe to serve a second term and I have appointed Mary Ann Cohen to lead the efforts in putting together the 2013 San Francisco meeting. Already there is a great program committee planning this meeting with the theme, Psychodynamics: Essential to the Issue of Suicide and Other Challenges to Modern Day Psychiatry.  We have a mentorship program for our younger members and also have Grand a Rounds Program, which helps identify speakers for programs throughout the country. I have appointed Deborah Cabaniss as the new Chair of the Education Committee. I am looking forward to our organization exploring the possibility of developing Special Interest Groups that can meet at our annual meeting or online during the year, Peer Supervision Groups, and also exploring how we can interface with long distance learning and the social media. I have appointed President-Elect David Lopez as Chair of the Public Relations Committee and Mims Cohen will continue as Chair of our Web & Electronics Committee.  Our website looks great and we will continue to build on it (AAPDP.org).

Being a medical organization, we have always been very close to the American Psychiatric Association. We have an outstanding Representative to the APA Assembly in the person of Eric Plakun who was a candidate for Assembly Recorder this past May. The Academy is an Allied Organization of the APA and some of our members are on various APA committees. We also continue to interact with our colleagues in other specialty organizations, which many AAPDP members also join and vice versa. We organize and plan various joint panels at their meetings and at our own annual meeting.

The world we know is getting flatter all the time. In the past few years, we have been expanding our international interactions. Joan and Matt Tolchin have established a close relationship with OFIFER (Italian Psychoanalytic Group), Cesar Alfonso led a study tour to Thailand and has been invited back for a second time. Several of our members are teaching in the CAPA program (Chinese American Psychoanalytic Alliance) via telepsychiatry on the Internet. There have been yearly CAPA tours to China on which several of us have participated in lecturing and sightseeing. Dr. Elise Snyder, the remarkable founder and leader of CAPA continues to recruit teachers and supervisors from AAPDP for CAPA. We also anticipate expanding our connection with the World Psychiatric Association (WPA). Last year our Executive Council accepted the recommendation of our International Task Force and lowered the dues for international members making it more feasible for our international colleagues to join AAPDP. We hope to develop further connections with our international colleagues, which can include hospitality arrangements, joint panels and presentations at various international meetings. I have appointed Sylvia Olarte as Chair of our new International Task Force.

I will be communicating with all of you on a regular basis about new developments in AAPDP. Please be sure that we have your correct email address. I also need and want your ideas for AAPDP. Please write or call me anytime.

Best regards.

Michael Blumenfield, M.D.

President- American Academy of Psychoanalysis and Dynamic Psychiatry

Tel: 818 564-4207

Email: mblumenfield@aol.com

The Spinoza Problem: A Novel: by Irvin D. Yalom-  Irvin Yalom is a prominent psychiatrist who is now Professor Emeritus at Stanford Medical School He is a well published author who is known for his outstanding books on group therapy. He also has written books about case histories and relationships, which have been very well received by the public including Love’s Executioner and Staring At the Sun, which addresses death and dying. In addition he has authored a few novels including When Nietzsche Wept and this latest book published in February 2012, The Spinoza Problem.

This very readable novel will be particularly engrossing to those who have some acquaintance with the philosophy of Spinoza or have chosen to put aside any literal understanding of the bible and question the traditional belief in God. It also will have great appeal to readers who are always drawn to trying to get further insight into how anti-Semitism and Hitler were able to flourish in post World War I Germany leading to the rise of Nazism and World War II.

Yalom acknowledges that he always had been fascinated with Spinoza but could never find a way to write about him since very little was known about his personal and inner life. In the foreword of this book he describes a circumstance, which stimulated an idea, which then allowed him to imagine this novel.

The story starts off by introducing the reader to Baruch Spinoza (nicknamed Benito), a brilliant Talmudic student in Holland and Alfred Rosenberg a student in Germany who runs for President of his College class by making an anti-Semitic speech which gets him called on the carpet by two of the faculty, one of whom is Jewish. Each chapter alternates by following the lives of one of these two young men. Spinoza who lived in the 17^th century in Holland becomes ex-communicated by his well-known Rabbi because of his heretic views of the bible and his refusal to accept a belief in God, rejecting both ideas as superstitions. Rosenberg lives in the 20^th century and experiences the aftermath of Germany’s humiliating defeat in World War I, becomes a writer and an editor, meets a young Adolph Hitler whom he idolizes and ultimately serves. Although they lived nearly 300 years apart, their connection through Spinoza’s writings resulted in nagging questions which Rosenberg pondered most of his life. These may have unconsciously challenged his deeply held anti-Semitic beliefs. On another level the examination of Spinoza’s deconstruction of a religion based philosophy founded on myths and superstitions highlights the flaws of the deeply held views of Hitler and so many of his followers.

Yalom offers this book as completely factual except for the personal life and inner thoughts of each of the protagonists and the connection that he imagines between the two. There are however some reasons that Yalom has for believing that Rosenberg could have been bothered by the problem that some earlier great German minds valued the writings of “Spinoza the Jew.”   The real lives of both men are well known.  This includes the details of the ex-communication of Spinoza from his Jewish community and the actual writings of Spinoza. Rosenberg’s life and ultimate death by hanging as a war criminal have been well documented and his views were widely disseminated, as he was an editor of a prominent Nazi newspaper as well as holding other important positions under Hitler.

There are records that show that Rosenberg did spend some time hospitalized in a Psychiatric Clinic during his Nazi years. Yalom creates therapy sessions between Rosenberg and a made up German psychiatrist who is not sympathetic to his vision. Yalom obviously does this, as he imagined the method in which he would approach Rosenberg if he were his psychiatrist.

Another made up character is Franco who is depicted as a friend and follower of Spinoza, who believes that Judaism should be changed from the inside rather than completely discarded in place of a new philosophical view of God as Nature, which was Spinoza’s view. This character becomes a Rabbi and plans to leave Europe and come to the New World and found a new religion. In the epilog of the book Yalom suggests that he was making a reference to Mordecai Kaplan a 20^th century pioneer of modernized and secularized Judaism known as the Reconstruction movement in the U.S. (although Kaplan’s trajectory was somewhat different than the character in the book).

Also in the epilog of the book Yalom quotes the wisdom that, History is fiction that happens. Fiction is history that might have happened.

This novel successfully weaves the two together in a stimulating, thought provoking and quite enjoyable novel.

Case #2

A senior psychoanalyst  is supervising a junior colleague who is treating the  following case. The patient is a single 36 year old dental hygienist living in Manhattan who is in her second year of three times / week psychoanalysis. She entered treatment because of difficulty trusting men which has been related to an inconsistent and insensitive father who shared with the patient the fact that he was cheating on her mother. The therapy has been going well and the patient has made progress in her ability to accept interpretations, have her own insight and utilize insight through her understanding of the transference.

The patient came into a recent session a little anxious and perplexed. She related the following incident . The other day after coming home from work she  rode up in the elevator with a young man a few years younger than her  who lives across the hall from her with whom she has a causal acquaintance. She believes he has a minor position in the union and always viewed him as trying to act like a wannabe tough guy but “a nice kid.”  He was pacing back and forth and seemed scared and she asked if everything was Ok. He asked her if she had a beer or a drink. She invited him and gave him a beer. She distinctively heard him say half to himself, “ I can’t believe I helped put someone to sleep.” When she asked him what did he say, he said it was nothing. They chatted about incidental things and he thanked her for her time and left. She wondered if that were something serious like someone being killed but then became scared and changed the subject and got into talking about her family, dreams and other things that were all continuation of issues she had been recently talking about. The therapist didn’t see any direct or indirect references to this subject in the next two sessions leading up to the  supervisory session.

Does the supervisor  have any obligation to either to suggest  or urge his supervisee  to try to influence the patient to report this information to the authorities and  is the therapist or the supervisor  obligated to do so.? What are clinical and therapeutic implications for the therapist  to spontaneously bring up this incident if the patient is not talking about it ? 

Response from invited discussant Sheldon Frank. M.D.  Dr. Frank is a child and adult psychiatrist practicing in South Florida.

The implications from this patient’s statement about her neighbor are not clear. Legally, there doesn’t appear to be enough factual information to warrant any kind of report by the therapist. Therapeutically, it is warranted that the anxiety around the interchange be brought up to the patient for examination / reaction on her part. The result could be, for instance more (or less) of a hint by the neighbor as to possible criminal activities and/or plans; and perhaps  even a conflict within the patient as to whether she needs to contact the authorities.

Response from invited discussant Myron L. Glucksman, M.D. Dr. Glucksman is a psychiatrist and psychoanalyst practicing in Redding Connecticut and New York City. He is a Clinical Professor at N. Y. Medical College and a training analyst at the Psychoanalytic Institute at N. Y. Medical College.

 Other comments received about this case :

 It seems quite clear that the patient has been told about a murder. If the therapist is denying this, he or she will not be able to understand any conflicts that the patient has in dealing with this information. Learning about a serious crime by a person who is likely to commit other such crimes does ethically obligate the therapist and the patient to notify the authorities. If you hesitate in doing this, is it because of the nature of the murder.? If it were immediately after 9/11 and the neighbor indicated that he was involved in the planning of that crime, would that push the therapist and the patient to action ? Does the ethical rule apply only to multiple murders? Of course, notifying the authorities could endanger the life of the patient and the therapist (and maybe even the supervisor) . Even if the information was given anonymously to the police, once they started investigating the neighbor, the hit man and his boss could soon figure out the only person who was told about the “putting to sleep” was the therapist. He or she could be eliminated or “made to talk ” and tell that the the other person that was told was the supervisor .  Then they both could be put to sleep.  So maybe it is best to just deal with the therapeutic implications of this interchange between the neighbor and the patient  as well as the interchange between the patient  and the therapist.  It must be significant that the patient and her father shared a big secret (that of the father’s affairs). Now circumstances have occurred where the patient and the therapist are sharing a special secret . Understanding this may move the therapy forward in a productive manner.  Dr. A (name withheld by request )

Comments are welcome in the comment section below and will be added to this blog.

Case #1

The patient is a 26 year old young women who came into therapy because she was depressed about her inability to complete things. She had started college twice and dropped out and as a adolescent she came home from sleep away camp twice. Her goal was to go to nursing school some day in the future. She had many friends but had trouble keeping a boyfriend, She was attractive but was somewhat inhibited and only on occasion would allow herself to have sexual relations which she would enjoy. Her parents were divorced when she was 6 years old. Her father is a physician would visit her periodically as a child and when she was older she would visit him and his new wife . She always felt close to them and their two children. Her own mother was an alcoholic and when she was younger her behavior was quite erratic. At time she was physically abused by being slapped around. Other times she would have to take care of mother by making food for her and sometimes would even stay home from school . Despite poor attendance she got good grades. She herself does not drink or take drugs. She shows no evidence of a major depression or psychotic symptoms. She is often moody but doesn’t appear to have hypomania. She becomes angry when she is disappointed. As a preadolescent she saw several therapists and she had 2 or 3 brief trials of therapy in the past 3 years including several weeks of a trial on an SSRI which she didn’t feel made any difference. She is currently in treatment with psychodynamically oriented psychiatrist who has decided not use medication at present. She has been coming for 4 months 2x/week ( Tuesday and Friday). She says this is the first time she is making progress in therapy as she feels she can talk freely and is not being judged.

During her last session on a Friday very close to the end of session, she said , Whatever we say here is completely confidential, isn’t it?” The therapist replied, “Why do you ask this question ?” The patient then went on , “ You know that baby sitting job that I have been doing every Saturday nite for Mr. and Mrs. Woodman my neighbor’s 15 month child.?” Well last week the kid was a real problem. He was whinning all the time and wouldn’t listen to me. The final straw was that he spit on me. I lost it and slapped him real hard across the face. His face got really red and swollen. I put some ice on it. I will never do that again.” The therapist, was stunned and before she could say anything, the patient said , “Well, I know my time is up” and got up and left.

Should the therapist do anything with this information. Is the therapist required to notify anybody? What are the legal and therapeutic implications ?

Response from invited discussant Myron L. Glucksman, M.D. Dr. Glucksman is a psychiatrist and psychoanalyst practicing in Redding Connecticut and New York City. He is a Clinical Professor at N. Y. Medical College and a training analyst at the Psychoanalytic Institute at N. Y. Medical College.

In my opinion, the therapist has no legal obligation to report the slapping incident because, so far, it is an isolated episode and apparently did not result in a serious injury to the child. The therapist should explore the patient’s feelings about her behavior; in particular, her angry feelings when she feels disappointed. I suspect that her anger is, in part, connected to her feelings of rejection and abandonment by her alcoholic mother. Evidently, she was not adequately nurtured as a child, and was exploited by both her parents in regard to having to take care of her mother. As a babysitter, she again finds herself in a similar position and becomes enraged when the child spits on her – re-stimulating feelings of rejection and humiliation. However, I believe the therapist should warn her of the legal consequences of similar abusive behavior toward the child or others in the future.

Response from invited discussant Sheldon Frank. M.D.

Dr. Frank is a child and adult psychiatrist practicing in South Florida.

There is no doubt that the information must be reported to the state child protective services immediately, with, of course, communication to the patient that this is being done. The legal and ethical mandates are clear, regardless of effects on the therapy. The therapy may perhaps be unaffected or strengthened–though not necessarily. Certainly a therapeutic relationship which covers up a reportable abusive act and denies the possibility of future risk to this child or other children being cared for by the patient does not help her in the long run. The outburst of violence on her part was so impulsive, so over-reactive to the baby’s acting like a baby, that even her sincere conviction that she won’t do it again is suspect. In addition to dynamic interpretation, the patient might benefit from other psychiatric treatment tools. Her life pattern, her complaint about not finishing things, and, perhaps, this outburst, may reveal adult ADHD (a continuation of childhood ADHD). (One can’t say from the data in this case, but ADHD children are much more likely to be slapped, neglected, and/or abused than other children.) A trial on stimulant medications is a safe and effective way both of confirming the diagnosis and treating. Alternatively, a search for mood swings and bipolarity might establish a mood-based origin of her action, and a mood stabilizer could help her self-control. We child psychiatrists often confront these diagnostic alternatives, and usually opt to test first the ADHD possibility because of the rapid onset and cleaner side effect profile of stimulant medications.

Since the account came out at the end of the session a day before the next baby-sitting engagement, there is a quandary as to how and when communicating the report mandate to the patient is handled. Some state laws require a report within 24 hours of receiving the information–which is defined as information containing the suspicion of abuse/ neglect. (It is the agency’s job, not the therapist’s, to distinguish between abuse and, say physical discipline.) Hopefully, the child protective agency would act promptly. Professionals have the right to anonymous reporting, so the agency would not tell the patient the source of the report–it could have come, after all, from the child’s parents. Still, the chance of the therapeutic relationship being damaged is greater if the therapist waits until the Tuesday session to deal with this complication. If I were the therapist, I would call the patient and ask her to return the same day to continue the session, and use that extra time (? without extra charge) to communicate to her the necessity of reporting. The therapist didn’t answer directly the patient’s question on confidentiality; if pressed, he could have reminded her that the only exceptions were situations in which there was the danger of harm to herself or others.

Initial comments from readers of this blog :

Well, when you said “dilemma” you meant it. In the first case, it weighs the betrayal of trust of a confidential relationship for someone who appears to be genuinely interested in changing her anger responses, against the safety of a very young child from abuse. My response given the details here would be to file a CPS report, and talk to the patient about the legal reasons why that had to be filed in a candid way and trying to help her see the situation through several points of view. Though it would be tragic if the therapeutic relationship were not strong enough to withstand this, a child’s safety must take precedence.- Heather Fretwell

Responses and opinions from any readers of this blog are welcome and will be added as comments. The second case will be discussed in a future blog

These vignettes are based on real cases which I have  either been involved with as the therapist or as  the supervisor or I have read about them or have been told about them by a colleague. Some details may have been changed to protect confidentiality.

All the cases are at least 10 years old. Readers of this blog are welcome to express their opinion about the cases. We all recognize that in a real clinical situations, there would be much more information available about the patient which might help in making a decision.

In a future blog, I will present further discussion about these two cases.

Case #1

The   patient is a  26 year old young women who came into therapy because  she was depressed about her inability to complete things. She had started college twice and dropped out and as a adolescent she came home from sleep away camp twice. Her goal was to go to nursing school some day in the future. She had many friends but had trouble keeping a boyfriend, She was attractive but was somewhat inhibited and only on occasion would allow herself to have sexual relations which she would enjoy. Her parents  were divorced when she was 6 years old. Her father is a physician would visit her periodically as a child  and when she  was older she would visit him and  his new wife . She always felt close to them and their two children. Her own mother was an alcoholic and when she was younger her behavior was quite erratic. At time she was physically abused by being slapped around. Other times she would have to take care of mother by making food for her and sometimes would even stay home from school . Despite poor attendance she got good grades. She herself does not drink or take drugs.  She shows no evidence of a major depression or psychotic symptoms. She is often moody but doesn’t appear to have hypomania. She becomes angry when she is disappointed. As a preadolescent she saw several therapists and  she had 2 or 3 brief trials of therapy in the past 3 years  including several weeks of a trial on an SSRI which she didn’t feel made any difference. She is currently in treatment with psychodynamically  oriented psychiatrist who has decided not use medication at present.  She has been coming for 4 months 2x/week ( Tuesday and Friday).   She says this is the first time she is making progress in therapy as she feels she can talk freely and is not being judged.

During her last session on a Friday very close to the end of session, she said , Whatever we say here is completely confidential, isn’t it?” The therapist replied, “Why do you ask this question ?”  The patient then went on , “ You know that baby sitting job that I have been doing every Saturday nite for Mr. and Mrs. Woodman my neighbor’s   15 month child.?” Well last week the kid was a real problem. He was whinning all the time and wouldn’t listen to me. The final straw was that he spit on me. I lost it  and slapped him    real hard across the face. His face got really red and swollen. I put some ice on it. I will never do that again.” The therapist, was stunned and before she could say anything, the patient said , “Well, I know my time is up” and got up and left.

Should the therapist do anything with this information. Is the therapist required to notify anybody? What are the  legal  and therapeutic implications ?

Case #2

A senior therapist  is supervising the following case. The patient is a single 36 year old dental hygienist living in Manhattan who is in her second year of three times / week psychoanalysis. She entered treatment because of difficulty trusting men which has been related to an inconsistent and insensitive father who shared with the patient the fact that he was cheating on her mother. The therapy has been going well and the patient has made progress in her ability to accept interpretations, have her own insight and utilize insight through her understanding of the transference.

The patient came into a recent session a little anxious and perplexed. She related the following incident . The other day after coming home from work she  rode up in the elevator with a young man a few years younger than her  who lives across the hall from her with whom she has a causal acquaintance. She believes he has a minor position in the union and always viewed him as trying to act like a wannabe tough guy but “a nice kid.”  He was pacing back and forth and seemed scared and she asked if everything was Ok. He asked her if she had a beer or a drink. She invited him and gave him a beer. She distinctively heard him say half to himself, “ I can’t believe I helped put someone to sleep.” When she asked him what did he say, he said it was nothing. They chatted about incidental things and he thanked her for her time and left. She wondered if that were something serious like someone being killed but then became scared and changed the subject and got into talking about her family, dreams and other things that were all continuation of issues she had been recently talking about. The therapist didn’t see any direct or indirect references to this subject in the next two sessions leading up to the  supervisory session.

Does the supervisor t have any obligation to either to suggest  or urge his supervisee  to try to influence the patient to report this information to the authorities and  is the therapist or the supervisor  obligated to do so.? What are clinical and therapeutic implications for the therapist  to spontaneously bring up this incident if the patient is not talking about it ? 

8-14 million Americans suffer from depression each year. As many as two out of ten Americans will have at least one episode of major depression during their life times.

20% of ailments for which Americans seek a doctor’s care are related to anxiety disorders such as panic attack, that interfere with their ability to live normal lives.

About 12-15  million children under the age of 18 suffer from mental disorders such as autism, depression and hyperactivity.

In all 1.5 million Americans suffer from schizophrenia disorders and 300,000 new cases occur each year

13 million Americans suffer from alcohol abuse or dependency and another 12.6 million suffer form drug abuse or dependence.

Nearly 1/4 of the elderly who are labeled senile actually suffer some form of mental illness that can be effectively  treated.

The cost of work related mental health problems to businesses is very high. Almost 3  billion dollars and an estimated 50 million working days are lost each year.

What are implications of these and other similar statistics to your life? What are implications to our health care system? What is the meaning to the mental health professions?

Dr. Ricardo Dolmetsch

Stem Cell Possiblities in Autism Research

Dr. Thomas R. Insel

Dr. Ricardo Dolmetsch from Stanford University  and his colleagues have generated stem cells from children with autism allowing them to study how the brain develops in children with Autism Spectrum Disorder (ASD). The motivations for this research occurred when a child with autism spectrum was born to Dr. Dolmetsch and his wife . In a video  interview with With Dr. Thomas Insel, director of the National Institute of Mental Health, he described how this event led to change in the direction of the  research that he had previously been doing.

Stem cells can be made from skin cells or blood cells. The stem cell has the capacity to make any cell in the body including brain cells. Dr. Dometsch explained how he has been able to take skin cells from his own child with autistm and make little pieces of brain which can be analyzed as to their development and function. One of preliminary findings is that some autistic children are making too many cells that produce dopamine, a chemical that transmits signals to various cells in the brain and nervous system. This provides a potential target for future therapeutic research. To see a video clip of this interview please go to:   http://www.nimh.nih.gov/media/video/dolmetsch.shtml

Increased Incidence of Autism Spectrum in Children

In an earlier interview, Dr. Insel interviewed Dr. Peter Bearman, Professor of Sociology at Columbia University, on his research into the prevalence of autism. It is s quite remarkable that in the past several years the prevalence has increased from 1 in 1500 births to 1 in 150 births.  If one just looks at Autism Spectrum, the prevalence may be 1 in 100 births. Some of these statistics may be due to the fact that there has been a change in the diagnostic critieria which would include more children to fit into this diagnosis. This may account for ¼ of this

Dr. Peter Bearman

increase. Another important discovery which may influence these statistics is the discovery that there are certain relatively small geographic areas called  “spatial clustering” where there is an apparent very high incidence of the diagnosis of ASD. This raises the possibility of some toxic agent in this area. There also is the consideration that such an increase incidence is due person to person education and awareness which allows for cases of ASD not to be missed and therefore a higher reported rate. One other factor which may account for the increased incidence in the diagnosis of autism and ASD is the fact that people are having children at a later age. It has been postulated that increased parental age leads to mutations which are associated with this condition. To see a video clip of this interview please go to : http://www.nimh.nih.gov/media/video/bearman.shtml

Repetitive Behaviors in Adults with Autism Spectrum Disorders Significantly Lessen With Antidepressant Treatment

In News release from the American Psychiatric Assoication dated 12/2/11 it was reported that a .12-week study showed that the antidepressant fluoxetine produced a greater decrease in repetitive behaviors and more overall improvement than placebo in adults with autism spectrum disorders. The study by Eric Hollander, M.D., of the Albert Einstein College of Medicine and Montefiore Medical Center and colleagues from Mt. Sinai School of Medicine represents the first large-scale, double-blind, placebo-controlled trial of fluoxetine in adults that targeted changes in the core domain

Dr. Eric Hollander

of repetitive behaviors as well as overall functioning. Overall improvement in autistic symptoms occurred in 35% of individuals receiving fluoxetine and none of those receiving placebo. Half of the individuals in the fluoxetine group experienced substantial improvement in their repetitive behaviors (versus 8% of those receiving placebo). Previous trials of treatments for these disorders have mostly tested interventions for children. An earlier high-profile trial of another antidepressant, citalopram, did not reduce repetitive behaviors in children with autism spectrum disorders.

Although treatments for common characteristics have been studied, Dr. Hollander notes, “Research on medications for the core features of autism spectrum disorders is still in the early stages, and successful treatments could greatly improve the daily lives of patients and their families. The full study will be published in a future edition of the American Journal of Psychiatry

Dr. Thomas Kirsch **

Dr. B: Can you comment on the relationship between Freud and Jung as depicted in this movie?

Dr. Kirsch : I thought that David Cronenberg’s portrayal of the relationship between Freud and Jung was fair, showing the strengths and weaknesses of both characters. Jung’s initial enthusiasm for Freud and his theories, as well as his reservations about ubiquity of the sexual origin of neurosis, are well portrayed.  Freud is seen as sympathetic to Jung’s countertransference to Sabina Spielrein — a highly probable response, given what we know of their early relationship.  The movie shows the historical beginning of the study of the countertransference dimension of psychoanalysis as seen through the relationships between Freud, Jung and Sabina Spielrein.The scene on the boat going from Bremen to New York was an especially good rendition of the spirit of Jung’s account of the incident, if not the details. In the movie Jung tells his dreams to Freud, but Freud does not reciprocate.  Actually, according to Jung in Memories, Dreams, Reflections, Freud did tell a dream, but refused to offer his associations . Jung asked why. ‘He said, “But I cannot risk my authority!” At that moment he lost it altogether.’

Dr. B: Jung is shown to believe in premonitions, telepathy and perhaps other non scientific unprovable ideas. In what way is this a fair or unfair representation of his theories?

Dr. Kirsch: I find this question biased towards a  misinterpretation of Jung’s openness to investigating phenomena as his belief in them, rather than seeing it as a representation of his forward-thinking attitude toward of the scientific method; the latter is the way it was accurately set forth in the movie. Famous physicists like Nobel prize-winning physicist Wolfgang Pauli and other equally prestigious scientists have shown a great interest in these parapsychological phenomena. The areas of parapsychology, synchronicity, chaos theory, and subjects related to these fields have received an increasing amount of attention by scientists from a number of fields, including psychoanalysis in recent years. A recent issue of Psychiatric Annals (Vol 41, #12, December, 2011) is entirely devoted to the subject of meaningful coincidences and Jung’s concept of synchronicity, a central part of his study of the archetypal layer of the psyche. In a late scene in the movie, the meeting in Freud’s study when the loud crack resounded, was an apt portrayal of Jung’s interest in what he saw as the exteriorization of psychic tension. Freud refused to find any psychological meaning in the phenomenon. My understanding is that, historically,  Freud was not interested in such phenomena. Furthermore, Jung’s interest in parapsychology has been used by psychoanalysis to cast suspicion upon Jung’s credibility, thus demonstrating that Jung was “unscientific” and truly a “mystic”.  I think the movie portrayed the differences between Freud and Jung on that subject accurately and sympathetically.

Dr.B: Do you believe that Jung had a sexual affair with his patient Sabina Spielrein and if so, should this influence the judgment of Jung’s contributions to psychoanalysis?

Dr. Kirsch: I have no idea whether Jung had a sexual affair with Sabina Spielrein. This is a subject which has been written about extensively .   Zvi Lothane, a psychoanalyst and historian, wrote of his conviction that they had a sexual affair in his earlier papers.  In a later paper he reversed his opinion. Let me give a personal vignette from my experiences around this subject. In 1983 I attended a public lecture by Bruno Bettelheim at the Stanford University Medical School. His subject was the Mistranslation Of Freud, but instead he spoke, to an audience who had no access to documented facts, about the still unpublished correspondence between Sabina Spielrein, Freud and Jung, A Secret Symmetry by Aldo Carotenuto (published the following year.) Bettelheim was emphatic that Jung and Sabina Spielrein had had a sexual affair . In the discussion. I asked him how he could be so sure, and he became characteristically offensive toward my challenge of his view of the truth.  In fact, I was familiar with the researches of Carotenuto and knew about the correspondence he had been offered from the basement of the Psychological Institute where Sabina Spielrein had been working prior to returning to Russia..  It is interesting that Spielrein had left all of her papers behind when she returned to Russia in 1919.

Whatever the truth, it is unfair that we should judge Jung’s contributions on the basis of his relationship to Sabina Spielrein.  Jung was only 29 year old in 1904, just at the start of a long career in a still unformed field of study, depth psychology.  To the movie’s credit, it treats Jung sympathetically in this respect. If the full truth is admitted, in the early days of psychoanalysis there were many such sexual liaisons.  Ernst Falzaeder, a psychoanalytic historian, has mapped out the various sexual liaisons between early psychoanalysts and their patients.  It is a remarkably long list. Many of those patients themselves became psychoanalysts. If Jung did have a sexual relationship with Spielrein, his was one among many.

Furthermore, Jung knew about the close relationship between Freud and his sister-in –law, Minna Bernays.  I myself have seen the signature of Freud where he signed himself and Minna into the guestbook of the Hotel Schweizerhof in Majola, Switzerland as husband and wife.  This is highly suggestive, yet Freud loyalists have long protested that this proves nothing about the nature of their relationship.  Jung in an interview with Kurt Eissler for the Library of Congress to be released in 2013, does not expressly say that they had an affair, but he does report that both he and his wife Emma had observed, when they visited Freud for the first time in Vienna in 1907, that Minna  was au courant with Freud’s ideas (in contrast to her sister Martha) and that she looked at Freud adoringly.

There is no question that Jung and Sabina Spielrein had a mutually erotic transference/countertransference relationship. From this distance in time it is going to be very difficult if not impossible to ascertain to what extent it was acted upon.  But is that the most important question to ask?  This was the beginning of psychoanalysis, and we know that Breuer had left the field because of this issue.  The fact is that Sabina Spielrein was helped by Jung’s psychoanalytic treatment of her and that Jung encouraged her aspirations, demonstrating his respect for her.  That she became a physician, a psychiatrist, and an early member of Freud’s psychoanalytic group in Vienna surely demonstrates that his good influence was not misplaced.  The movie also highlights her role in broadening Freud’s libido theory. Her influence on Freud’s theory of the death instinct is documented in a seldom cited footnote in Freud’s Beyond the Pleasure Principle.

Dr. B: How will a movie such as this one or the play by Christopher Hampton, upon which it is based, influence the legacy of Jung?

Dr. Kirsch:I have heard from some of my colleagues that they are disappointed by the portrayal of Jung in the movie. On the basis of this, as well as its sensational trailers, I was prepared to not like the portrayal of Jung.  Certainly the spanking episode is over the top.  The role of Otto Gross, and the fact that Jung and Gross were engaged in a mutual analysis, was one of the strongest historical, as well as dramatically pivotal, aspects of the film.  Gottfried Heuer, a Jungian analyst in London and the president of the Otto Gross society, believes that Otto Gross influenced Jung deeply in 1908 toward greater sexual freedom.

Unfortunately, there is a glaring error at the end of the movie.  When Sabina asks if Jung is involved with another patient, Jung says yes, and furthermore tells her that Toni Wolff is half-Jewish.  That is a complete fabrication!  Toni Wolff comes from one of the oldest Christian families in Switzerland.  Her family tree can be traced back to the beginnings of the Swiss Confederation in the twelfth and thirteenth century.  Christopher Hampton was told of his error before his play The Talking Cure opened in London, but he chose to leave Toni Wolff as half Jewish, and to perpetuate the error in his film version.  Furthermore, many prominent psychoanalytic historians have taken Hampton’s  drama as a statement of fact!  Diedre Bair has documented Toni Wolff’s genealogy on page 713, note 27, in her biographical work, Jung.

I was especially taken by their rendition of Jung’s plea to Spielrein for a reciprocation of the caring patience he had shown toward her in her own state of terrible inner conflict.  This is a faithful rendering of his state of confusion, as documented in their published correspondence, as well as alluded to by Jung in MDR and demonstrated in his Red Book, although this is generally regarded in part as his emotional reaction to the ending of his relationship with Freud.

Dr. B: Did you enjoy this movie and would you recommend it to others?

Dr. Kirsch: I did enjoy the movie.    I thought that both Jung and Freud were well represented and I especially found myself liking the Jung of Michael Fassbender.  The role of Sabina Spielrien was superbly played in all its dramatic potential by Keira Knightly.  The one person who was not well represented was Emma Jung.  She was a much more earthy and powerful person than the haughty, frail creature see in the movie.  That was a real disappointment, because nothing I have heard about Emma Jung was represented, either by the role or by  the actor Sarah Gadon.

I certainly would recommend others to see this movie with the caveats I have raised.  Overall, I found myself admiring and empathizing with David Cronenberg’s portrayal of Sabina Spielrein and both Freud and Jung.  I hope that mine is a more widespread reaction.  If so, it may mark a shift in public awareness of Jung’s value as a pioneer and major contributor to our knowledge of the psyche.

The misrepresentation of Toni Wolff, though, poses a major problem, especially because of the later accusations against Jung for his alleged anti-Semitism. When portrayed as having begun yet one more intimate relationship with a (half) Jewish woman, when he is already widely seen as anti-Semitic, Jung the man comes across as a character lacking integrity.  As the repetition of Hampton’s error by prominent psychoanalytic historians proves, drama can wield a powerful influence over even the most scholarly of minds.

** Thomas Kirsch M.D. is a graduate of Yale Medical School, the residency program in psychiatry at Stanford and the CG Jung Insitute of San Francisco. He is Past President of  the Jung Institute of San Francisco, past vice-president and president of the International Association for Analytical Psychology. He has written numerous chapters in books on Analytical Psychology and is  Co-editor of the Jungian Section in the  International  Encyclopedia of Psychoanalysis, Psychology,and Neurology. He also is author of The Jungians, a social history of the Jungian movement and is co-editor of book: Initiation: The Reality of an Archetype. Dr. Kirsch has written  numerous book reviews and is a well known  lecturer on Jungian subjects. Most recently he has written the preface of a publication of the  correspondence between his father , Dr. James Kirsch who was a psychoanalyst  and Jung titled C.G. Jung/James Kirsch Correspondence, published by Routledge, London 2011. ( There are 150 letters between the two men.) Dr. Thomas Kirsch is in private practice in Palo Alto, California.

I would  would like to thank Dr. Kirsch for answering these questions for PsychiatryTalk-MB

It is reproduced below. As always your comments are invited. In two weeks my next blog will feature an interview about this movie with Dr. Thomas Kirsch a Jungian analyst.

A Dangerous Method

As people who have some some acquaintance with  psychoanalytic theory and it’s history, we were drawn to want to see this movie. The psychiatrist among the two of us found it a more enjoyable experience although we both found many deficiencies in the movie. This movie, directed by David Cronenberg, with a screenplay by Christopher Hampton which came from a book by John Kerr, of course is based on real people and highlights the break between Sigmund Freud and Carl Gustav Jung who at one time Freud had thought would be his heir apparent to the psychoanalytic movement. The movie starts off in the early 1900s as a young women, Sabina Spielrein (Keira Knightley) is involuntarily brought to the Burgholzi, a  psychiatric hospital in Zurich, Switzerland, run by the famed Eugen Bleuler. Her exaggerated mannerisms and dramatic presentation suggests the type of “hysterical” patients who were known to be hospitalized in those days. Jung (Michael Fassbender) becomes her psychiatrist at the hospital and begins to use the new psychoanalytic method which Sigmund Freud (Viggo Mortensen) in Vienna has advocated. He ultimately is shown  becoming drawn into a sadomachistic sexual romantic affair with her. Jung travels to Vienna and meets with Freud several times in which they discuss theoretical issues as well as this patient. Over time Freud is depicted as becoming disenchanted with his previously highly regarded younger colleague. The reasons for this rift would appear to be Jung’s willingness to go beyond Freud’s concept of sexuality and psychic determinism and bring in such ideas as the supernatural, premonitions, telepathy, religion and many others that were not explained in much detail in the movie. In fact, the more well known ideas of Jung about the collective unconscious , symbolism and dream analysis were not very well clarified.

Carl Gustav Jung

Freud appeared to be concerned that any significant deviation from his main thesis and what he believed was the scientific method might be a reason for his theories to fail to gain wide acceptance. As best we can determine, in reality the actual affair between Jung and Speilrein was suspected, but historically it was  not universally agreed that it had actually occurred. In this movie it is shown that  Speilrein wrote to Freud and told him of her affair after Jung rejected her. Freud did not believe her and she subsequently is depicted as convincing Jung to acknowledge the affair to Freud who then gave this as an additional reason for cutting his ties with Jung. Once again Freud is very concerned about the appearance of his analytic movement and such behavior as an affair with one’s patient  at that time as well as at present would be highly unethical. The nature of the affair and the meaning of their attraction to each other is really a key part of this movie, whether it actually happened or not. The characters in their dialogue state that Jung, who is shown being torn by the relationship, views attraction to his patient to be  on the “dark side” and that with his wife on the “loving” side.  Yet he declares his undying  love for Spelrein and is bereft by her leaving him. We are not provided with real insight inot this relationship nor any significant understanding of Jung’s conflict. The film also does not do enough to explicate Jung’s ideas and their influence on Spielrein. While we more often proclaim that a movie should have been tightened up and shortened we believe this film needed a clearer illustration of the ideas that this story was supposed to be  about.  The acting in the film was very strong. The atmosphere of Freud’s office, the streets , people’s dress, horse drawn vehicles and early motor cars made it a wonderful period piece. But alas, as much as we were interested to learn about these people, we felt we came up short in our understanding as well as in caring about them.

Coming Soon : Q & A  About This Movie with Dr. Thomas Kirsch

The next PsychiatryTalk blog will feature a  special interview with  Dr. Thomas Kirsch, a psychoanalyst  and leading expert on Dr. Jung. In it Dr. Kirsch will discuss how well it depicted the various people in the movie as well as Jung’s theories.

I have read many books about the holocaust, have seen many movies about this subject and have visited various holocaust museums throughout the world.  As a psychiatrist, I have treated a few holocaust survivors and many more children of holocaust survivors. I was therefore surprised how impacted I was by reading this book which consisted  first person stories of 52 holocaust survivors most of whom were born between 1926 and 1938.

I became aware of this book  when a good friend of mine John Glass who is one of the 52 authors, showed me a copy of the book and told me about the project behind it. Each author is a member of the Child Survivors of the Holocaust, Los Angeles Organization that was founded in 1983.  Dr. Sarah Moskovitz and Dr. Florabel Kinsler organized the largest international group of child survivors with a membership of more than five hundred people. In the introduction to this book, Marie Kaufman President of the Los Angeles child survivors group and Chair of the Editorial Committee that put together the book noted that many of the authors have given oral testimony  to museums  and to the Shoah Visual History Foundation. But in the fifteen to twenty years since they have done so, they have become aware that for many reasons they have left part of their story untold. This book gave them opportunity to disclose secrets never divulged before.

As one reads this book and digest the  narrative which is recounting horrific early childhood memories, you cannot help but consider whether these are true memories. Could they be screen memories, retrospective memories based on things they were told and learned at a later age? In the course of psychotherapy and psychoanalysis we  often help patients reconstruct early childhood memories and feelings. The accuracy of the actual memory may not be as important as the meaning. I do believe that the memories reported in this book do ring to be quite true. I also would suggest a simple exercise before you read this book. Reflect back on your three or four earliest memories. Sometimes it will be helpful to choose a key event which you can easily date such as the birth of a  sibling, a  death or tragedy or famous event such as the assassination of JFK or Martin Luther King or the  landing on the moon, a particular grade school teacher etc. Often the event that you recall will have some negative or conflictual quality. My own earliest memory is when my mother left me alone  in our apartment for a few minutes to do an errand and brought me back a chocolate bar. When I discussed this memory with her many years later, she was astounded that I exactly recalled the events and she was able to date it when I was less that three years old. I recalled being under the care of an aunt during the time that my sister was born and my disappointment that a cousin has seen her first. I was less than 5 years old .   I also recalled my first day of kindergarden , when I was a  few months older than 5. While each of these memories had some anxiety and conflict, they were minuscule compared to the intensity of experiences of being taken away from one’s parents, hiding for prolonged periods of time, starving and witnessing and being threatened with death and destruction, all of which were common place in the 53 stories of this book.

There is another important dynamic which inhibited many of the child survivors from publicly telling their story . Many were hidden children who often had to assume non Jewish identities, sometimes having  several different gentile names and personas over time,  as young children during the war . Each time it was impressed upon them that under no circumstances were they to reveal their Jewish identity as this could mean death to them and their adopted families. So even after they were liberated, reunited with any surviving families and were beginning new lives in the United States, many still would not readily talk about their Jewish identity especially with strangers

It is very difficult to understand the experience that these children had where a  normal childhood was transformed almost overnight when Kristalnacht occurred in Germany, or when the Germans took over in Poland and issued the new regulations for Jews or similar events that happened in France, Hungry, Italy, Holland  and any other places conquered by the Nazi’s. They moved from their comfortable apartments or homes to the Ghetto where they were jammed into one room with extended families and strangers. In anticipation of this situation or in response to it many of their parents who suspected even worst was to come  made a decision  to send their children into hiding with non-Jewish families. In most of the cases the parents could not be hidden with their children. Childhood separation from parents is a very meaningful experience, usually traumatic with the possibility of lasting yearning, resentment, with a wide range of fantasies. This becomes colored by the subsequent events which might include loving or rejecting the adoptive parental figures  as well as being torn away from one such family as you are moved to another one.  The fate of their own Jewish  parents was often death as was that of most of the their original  families and friends. While many of the  child survivors intellectually came to understand that the decision to try to hide them allowed them to live, the full emotional understanding of this generous act on the part of their parents did  not come to them until many years later. It was often when their own children born in a safe environment were now the age at which they had been  put into hiding by their own parents, did they appreciate the sacrifice that was made for them. For some this realization did not occur until they had grandchildren who are at the age that they were hidden .

It is important to note that the trials and tribulations for many of these child survivors did not cease with their liberation from concentration camps or from their places of hiding.In some situations there was persecution by the Russians who liberated them or continued anti-Semitism when they tried to return to their home town. There were hard times often relieved by the many  organizations and people who tried to help them reunite with any exisiting  families. There were painful discoveries of what happened to missing family members. There was also  long waits for visas to new countries , travels across the ocean, learning new languages and adapting to a new culture

As was the case of many survivors who were adults during the holocaust, these child survivors  spent many years trying to forget and not to look back.  Their parents who survived or adoptive parents and relatives often did not believe that the experiences which they had as children made a lasting impression on them. They were building a new a life and did not want their own children haunted by such terrible events. As they moved on to a “normal life” in the United States the child survivors themselves thought that their memories and experiences were quite unique and as mentioned above were not inclined to talk about them. Many report an amazingly dramatic unburdening feeling when they attended their first meeting of child survivors. The intensity of that feeling and the realization that so many other children had gone through similar events was life affirming and literally changed the course of the lives.

It is noteworthy that so many of the child survivors have gone on to have very productive lives. Perhaps because they themselves have been helped by strangers (many of whom have been recognized in Yad Vashem  as the ‘righteous gentiles”  or “righteous among nations”) they have chosen a helping profession themselves. It seems to me that a high percentage have gone on to be social workers, therapists  and teachers. Some report moving into these fields after a successful career in business. Others have become artists and poets expressing their feelings and experiences in their work. There were numerous poems  as part of the narratives.

Many of the child survivors did not talk about the past for most of their lives   and for many it has only been in their twilight years that most have  felt an obligation to tell their stories or record  a first hand account that will exist for future generations. A good number of the authors of this book   have devoted many hours to teaching about the holocaust in schools and museum  and giving lectures in various settings. These activities and the writing of the chapter for this book as well as other publications that some of them have done appears to have been therapeutic for them.

The authors  tried their best to be sincere and honest in sharing all these events and their past and present feelings about what they have been through. For  most there is a triumph for having survived and for being responsible for the presence of so many wonderful people that they have nurtured and supported in their subsequent  lives  For some of people there is still an ever present wound or bewilderment and pain which stretches from their childhood to their later years. They are still trying to figure out why and how the events of their childhood  could have happened. For all there is the satisfaction of having told the story of what really happened  so those who were deprived of their lives will not be forgotten 

This was not an easy book to read. While I read it in linear fashion over a two week period and did not intersperse with other books perhaps that might not be the best way to read it. For some it might be best to consume it in small doses .  I suspect that some readers will appreciate the value of the book but will put it aside and may not complete it.

I realize also that I may not have captured the essence of the experience of the authors in this review. I would like to give you a few random excerpts although I hope over time you will read the complete version of each of these  52 stories as they all deserve to be remembered:

Lea- Born 1938 I was placed through the Dutch underground with a Christian family. There were many other children. Suddenly the family was betrayed. The underground took all the children away to new hiding places. On of my first memories was of being on a train with other boys and girls…. I  was taken to family of farmers in the small town of Horst by two men dressed in police uniforms. My clothes were torn and I had sores all over my body.  The men said that they ha d smuggled me out of some detention center but I have never been able to find out what happened to me.

Jack- Born 1926- The ghetto was organized  into factories of every possible trade and all the  the production was for the German military…My father could not get employment…When I saw my dad for the last time he was forty one years old…In July 1944 we were transported in cattle cars to Auschwitz-Birkenau. I was with my mother…(We) went through a selection conducted by Dr. Mengele. My mother was sent to the other side. Now sixty four years later, I can still see her walking hunched over, as if she know where she was going. I’m still haunted by this picute and I know that I will for the rest of my life. How do I reconcile the fact that my children are now older than my parents were when they were murdered.?

Lya- Born 1936- When I was seven and she (sister) was four we both went into hiding with different families. The thought never occurred to me that this would be the last time I’d ever see my parents. They never knew where we ended up…In 1946 my sister and I were sent live with  Parents Number 5 in Denmark…I was a very difficult teenager. Obstinate, opinionated, aggressive. I was sent out of class many times. It was sheer anger- a way of expressing myself to the world…My husband ( also a survivor) wasn’t interested in talking about his experiences and for the longest time I didn’t think that mine really countered. …I started dealing with my past in 1993, I was fifty six…. That’s when I first shared my story ( in a group ) about  losing my parents, grandparents, being separated from my sister and being in hiding with strangers. After that night, I became more aware of my own feelings. I could justify them. They were real and they weren’t something nonexistent.

Peter- Born 1936- In 1940 when I was four years old I was no longer permitted to attend my pre-school nor to attend any other school. From my earliest memories, I had to wear a yellow star with the word “Jude” on my jackets and shirts…People looked at us in disgust and were often rude to my mother when she shopped for food…Only 32 out of the 100 Jews transported in the cattle car I was in survived the Holocaust. I lived in the children’s barracks (in Terezin)…We slept in bunk beds on straw and had only a thin blanket. There was only cold water to wash ourselves in the summer and harsh winters…There was small piece of bread in the morning with some brown water they called “coffee” and for supper a watery soup with  an occasional small potato. We were half starved yet we were expected to work…(After the war)I lived my teenage years as a laborer, farm hand truck driver across the US. …By the age of 33 I had completed high school, graduated from San Diego State University and received a graduate degree in  Global Management.   … I have seven grandchildren.

Robert- Born 1935- When I was four years old our lives changed forever, The Gestapo came to our apartment and told us to take just a little luggage and follow them. They sent us by train to the Polish border. The poles would not let us in and Germans would not take us back…We traveled around Poland living as gentiles with an assumed name….The family that hid me decided to put me in the attic in the house. Many times they forgot to take care of me and did not feed me. …After the uprising failed the Germans planned eliminate the city’s population.. Everyone was loaded upon trains, which were headed to Auschwitz. …We knew we were going to be killed…My mother noticed that one of the cars had an opening on top. The train stopped about 100 yards from the Auschwitz concentration camp. My step father Emil lifted me up over the open car and I was able to open the train car door…In February 1947 we took a boat to America and settled with our extended family in Pittsburgh. I quickly learned English and graduated from Carnegie Mellon University in 1957 with degree in electrical engineering. …Over the years I have spoken about the holocaust to thousands of middle and high school children.

Erika- Born 1928- At the time of my birth my parents (in Hungary) owned two kosher restaurants.  I went to school unitl the age of fourteen when the anti Jewish Hungarian government closed the Jewish schools. Anti-Semetism forced many Jewish owned businesses to close or be taken over by non-Jews. Most of my uncles had been taken to forced labor camps in early 1940-42…I was deported to Auschwitz with my mother. We were lucky and escaped the selection. …On the day the Soviet liberators entered our camp they raped many women and wanted us to work for them. …I was helped tremendously by breaking the silence and talking about my experiences. Confronting my losses and acknowledging the effects of the traumatic times in my life have helped me to recover psychologically. However I still have problems such as fear of authority, anxiety about the health of my family, about separation  and the fear of loss.

For more information or to order this book go to www.childsurvivorsla.org