There wasn't a name for the syndrome before the 1960s, when psychologists started recognizing a condition among patients who all happened to be Holocaust survivors. It came to be known as "survivor guilt."
The affliction also affects those who have endured war, natural disasters, the suicide of a loved one, epidemics and even employment layoffs. Eli Nussbaum, recently named among the top pediatric pulmonologists, is keenly aware of the circumstances surrounding this subset of post-traumatic stress disorder.
"I am a consequence of the Holocaust - both of my parents lost their families during those years," says Nussbaum, author of The Promise (www.elinussbaum.com), a novel that begins in Poland on the eve of World War II and follows three generations through the aftermath.
He is among the group known as the "Second Generation" - children born to survivors anxiously trying to rebuild the families they'd lost. Nussbaum was born in Poland to a man who'd lost his first wife and four children, and a woman who lost her first husband and child, during the Nazi's genocidal regime.
"Because of my family background, I am intimately aware of life's fragility and how a devastating experience can affect a person emotionally," he says. "As a Second Generation, I too was shaped by my parents' trauma. While being raised by survivors made some of us more resilient and better able to adapt and cope, it made others distrustful of outsiders and always on the defense."
For anyone profoundly affected by loss, he says, it's worth the effort to work at transitioning from guilt to appreciation of the gift that is their life. He offers these tips:
• Seek treatment early: The sooner counseling is provided, the more preventable or manageable guilt may be. Early methods may recognize a survivor's feelings and eventually offer alternative perspectives. The hope is to get the survivor to see the loss of colleagues, friends or family as the result of misfortune that has nothing to do with personal culpability.
• Watch for delayed reactions - even years later: No two individuals are identical, and some survivors do not show symptoms until long after a traumatic event. If you or a loved one has experienced a life-altering change or loss and later develop problems such as clinical depression or a prevalent sense of self-blame, be aware they may be rooted in past trauma and share that information with a counselor. Other problems that could be signs of survivor guilt: nightmares, unpredictable emotional response and anxiety.• Don't turn to drugs or alcohol to cope with uncomfortable feelings: Many people suffering post-traumatic stress-related disorders try to self-medicate or somehow will themselves into a better mental state. Drug addiction is often the result, which is why those who suspect a problem should seek professional help. One-on-one therapy, as well as group talk and possibly doctor-prescribed medications are frequently used to help survivors move past guilt.
"Whether people are dealing with the loss of life from combat, or an accident, or suicide, they may not consider themselves 'victims.' So they don't seek help," Nussbaum says. "They may also feel that no one has been through the same experience.
"That's why it is important to be surrounded by loved ones who can offer love, support and perhaps the perspective to seek professional help."
Because their families were gone, many Holocaust survivors did not have that option, which Nussbaum says made the writing of his novel that much more imperative.
"Only they can know just what it was like - but suffering is a universal experience to which we can all relate," he says. "Life can get better, and the story of my parents, and the fortune in my life, is proof of that."
About Eliezer Nussbaum, M.D.
Eliezer Nussbaum, M.D., was born in Katowice, Poland. He is a professor of Clinical Pediatrics Step VII at the University of California and Chief of Pediatric Pulmonary Medicine and Medical Director of Pediatric Pulmonary and Cystic Fibrosis Center at Memorial Miller Children's Hospital of Long Beach. He has authored two novels, three non-fiction books and more than 150 scientific publications, and was named among the top U.S. doctors by US News and World Report in 2011-12.
