Factors influencing the evaluation of psychological and psychosomatic reactions in survivors of the Nazi persecution.

Since the termination of World War II, Psychiatry has been challenged with the difficult task of the evaluation of the survivors of the Nazi persecution. The psychiatric sequelae of this era reflect direct connection between the different clinical manifestations and syndromes and the conglomeration of manifold physical and psychological traumas to which the survivors have been exposed, often during a prolonged period of time lasting through several years. The present paper examines the important but somehow neglected, and often intentionally avoided, issue: namely, the review of the problems and reactions which psychiatrists, dealing with the medical examination of survivors for the purpose of reparations' evaluation, may encounter. The confrontation of the different views of psychiatric experts may frequently be complicated by deep-seated emotional issues, related to their identity. The evaluation becomes even more complex when Israeli and German experts review each others' findings. The study summarizes the different psychological mechanisms involved in the process of evaluation. Pitfalls related to inadequate use of mechanisms of defence are pointed out and suggestions for the proper ways of co-operation in the establishment of proper psychiatric and psychosomatic diagnosis are presented.