Michael Ermann

Bio: Michael Ermann is an academic researcher from Ludwig Maximilian University of Munich. The author has contributed to research in topics: Psychoanalytic theory & World War II. The author has an hindex of 8, co-authored 41 publications receiving 210 citations.

Sixty years later: post-traumatic stress symptoms and current psychopathology in former German children of World War II

Abstract: Background: The aim of the study was to determine the amount of trauma impact, post-traumatic stress symptoms and current psychopathological distress in a sample of former German children of World War II.Methods: 93 participants were recruited through the local press, and assessed using the modified Post-traumatic Diagnostic Scale (PDS) and the Symptom Checklist (SCL-90-R).Results: Subjects reported a high qualitative and quantitative degree of trauma exposure. 13.8% reported PTSD-related symptoms after the war, and 10.8% reported current symptoms. PTSD symptoms after World War II were significantly correlated with current psychopathological distress.Conclusions: In line with other studies, our data document a high degree of trauma exposure during warchildhood. In comparison with other studies on PTSD in warchildren, there is a persisting high prevalence of war-associated PTSD symptoms in this sample. Despite some methodological limitations, our data underline the urgent need for further studies on the ageing group of former children of World War II.

Wir Kriegskinder@@@Children of World War II?60 Years After

Abstract: ZusammenfassungAnnähernd sechs Jahrzehnte nach dem Kriegsende ist in den letzten Jahren ein Interesse am Schicksal der Generation von nichtjüdischen Deutschen erwacht, die im Zweiten Weltkrieg geboren wurden. Die Gründe für das lang dauernde Wegschauen vom frühen Schicksal dieser Kriegskinder, zumindest in der psychoanalytischen Literatur, wird vor allem in Schuldgefühlen als Folge des Holocaust und in der Gefahr gesehen, Unvergleichbares miteinander zu vergleichen. Dieser Gefahr bewusst, beschreibt der Autor Aspekte des Selbsterlebens und des Verhaltens der Kriegskindgenerationen. Er vertritt die Auffassung, dass die schuldbedingte Unfähigkeit der Erwachsenen zu trauern (Mitscherlich) transgenerational bei den Kriegskindern zu einem inneren Verbot führte, selbst zu fühlen. Dieses bewirkte in den Kriegskindgenerationen eine Pervertierung des Denkens, indem die grauenvollen Erfahrungen zur Normalität erklärt wurden. Hinzu kamen Überlebensschuld und Schuldgefühle über den traumabedingten eigenen Hass. Der Autor beschreibt eine Kriegskindidentität. Diese zeigt sich in einem Mangel an Selbsteinfühlung und Gefühlsferne in Bezug auf eigene Empfindungen. Sie äußert sich in einer gewissen Rücksichtslosigkeit gegenüber sich selbst, einer bestimmten Zähigkeit durchs Leben zu gehen, einer Unauffälligkeit des Funktionierens und in sozialer Angepasstheit. Sie beruht auf einer Fremdheit gegenüber sich selbst, die bewirkt, dass die Betroffenen sich auch gegenüber anderen fremd fühlen und ihnen auch fremd bleiben. In der Behandlung besteht der entscheidende Schritt darin, dass Kriegskinder beginnen, sich als Traumatisierte anzuerkennen, ihre Verleugnung aufzugeben und eine positive, bejahende Kriegskindidentität zu erwerben. Im Wesentlichen bedeutet das, die Fähigkeit zu entwickeln, sich in sich selbst empathisch hineinzuversetzen, mit sich mitzufühlen und Verständnis für sich zu erwerben. Der Weg dahin führt durch Trauer über versäumte Lebenschancen und wird begleitet von der Gefahr, die Behandlung abzubrechen, als wäre alles gar nicht so schlimm.AbstractRoughly six decades after the end of World War II an interest in the destiny of the generations of non-Jewish Germans born during the war has arisen during the last few years. The reason for the long-lasting ignorance toward the early destiny of these war-children, at least in psychoanalytic literature, is supposed to lie in feelings of guilt as a consequence of Holocaust, and in the danger to compare incomparable destinies with each other. Conscious of that danger, the author describes these war-generations in regard to some aspects of their self experience and behaviour. He holds the opinion that the inability of the adults to mourn (Mitscherlich), based on guilt, transgenerationally led with the war-children to an inner ban of feeling themselves. This caused a perversion of the thinking in the war-baby generations by gruesome experiences being declared the normality. Survivor’s guilt and guilt felt over trauma-induced self-hatred were additional psychodynamic factors, all together leading to what he calls “war-children identity”. It is characterized by a lack of self understanding and a distance to the own feelings, a certain toughness in coping with one’s life, and social adaptation. It is based on a strangeness to oneself which results in feeling strange also to others and remaining indeed a stranger to them. The decisive step in psychoanalytic therapy implies that war-children start to accept themselves as traumatized, to give up their denial and to acquire a positive war-children identity. This essentially means to develop the ability to be concerned of oneself, to feel empathy for oneself and to gain self-esteem. The way is leading through mourning over missed life chances and is accompanied continuously by the danger to break off therapy as if everything were not that bad at all.

[Psychological complaints, interpersonal problems, quality of life and sense of coherence in former German warchildren].

Abstract: Recently there is a growing psychotraumatological interest in late life effects in former German warchildren. The following article focusses on kind and amount of trauma and psychopathology (Symptom Check List 90-R; SCL-90-R) in elderly people, who have grown up during World War II. By means of psychometric self-reports we assessed their current interpersonal problems (Inventory of Interpersonal Problems; IIP), the quality of life (SF-36 Health Survey) and their sense of coherence (Antonovsky's Sense of coherence-Scale; SOC). Compared to norms from the general population and from "healthy controls", respectively, former German warchildren showed a higher psychopathological distress. They showed an interpersonal pattern of lower expressive/dominant in favour of enlarged passive and caring behaviour. The psychosocial dimension of quality of life was reduced, in contrast to the somatic scales. The former warchildren showed an increased sense of coherence, especially in the dimension of "meaningfulness". We discuss our findings in the light of the current scientifical knowledge and highlight possible future prospects to develop the warchildhood debate from the clinical and scientifical point of view.

Identität, Identitätsdiffusion, Identitätsstörung

Abstract: Identitat ereignet sich im Ubergangsraum zwischen dem Einzelnen und der Gesellschaft. Dabei bedeutet Identitat, dass der Einzelne das Empfinden hat, ein einmaliges Wesen sowie ein Wesen mit Vergangenheit und Zukunft zu sein, sich von anderen zu unterscheiden, in vielem anderen aber auch ahnlich zu sein und viel mit anderen zu teilen. Dieses Empfinden der Koharenz und Kontinuitat im Kontext der sozialen Bezogenheit pragt das Leben. Dabei wird zwischen Uridentitat, personlicher und aktueller Identitat unterschieden. Fur ihre Entwicklung spielen vorsprachliche interpersonelle Prozesse die entscheidende Rolle. Wenn die Balance kippt, die das Identitatsgefuhl aufrechterhalt, dann entstehen Storungen der Identitat, die das Befinden speziell in sozialen Kontakten nachhaltig beeintrachtigen. Es entsteht eine Identitatsdiffusion. Je nach Verwurzelung wird klinisch zwischen einer phasenspezifischen Identitatskrise, einer entwicklungsbedingten Identitatsstorung und einer reaktiven Identitatsstorung unterschieden.

Children of Nazi Germany 60 years on

Abstract: Defence against shock, feelings of guilt, and shame about German atrocities during National Socialism (NS) have dominated the public discourse in Germany for decades. Mitscherlich and Mitscherlich have talked about the inability to mourn due to the involvement of most German families in Nazi terror. The research projects “Childhood in War” at the University of Munich and “War Children and their Flight” at the Hamburg DPG Institute are studying the long-term implications of a childhood during World War II and the Nazi period. In most cases, the personal development of the “war children” was affected – in the case of psychoanalysts, their psychoanalytic socialisation and current professional practice as well. The transgenerational transmission forms an NS introject in the personality. Due to their parents’ lack of empathy, war children are unconsciously looking for a containment of their unbearable feelings in their childhood. Psychoanalysis (including training analysis) becomes a stage where the a...

Effectiveness of Long-term Psychodynamic Psychotherapy : A Meta-analysis. Commentary

Abstract: Context The place of long-term psychodynamic psychotherapy (LTPP) within psychiatry is controversial. Convincing outcome research for LTPP has been lacking. Objective To examine the effects of LTPP, especially in complex mental disorders, ie, patients with personality disorders, chronic mental disorders, multiple mental disorders, and complex depressive and anxiety disorders (ie, associated with chronic course and/or multiple mental disorders), by performing a meta-analysis. Data Sources Studies of LTPP published between January 1, 1960, and May 31, 2008, were identified by a computerized search using MEDLINE, PsyclNFO, and Current Contents, supplemented by contact with experts in the field. Study Selection Only studies that used individual psychodynamic psychotherapy lasting for at least a year, or 50 sessions; had a prospective design; and reported reliable outcome measures were included. Randomized controlled trials (RCTs) and observational studies were considered. Twenty-three studies involving a total of 1053 patients were included (11 RCTs and 12 observational studies). Data Extraction Information on study characteristics and treatment outcome was extracted by 2 independent raters. Effect sizes were calculated for overall effectiveness, target problems, general psychiatric symptoms, personality functioning, and social functioning. To examine the stability of outcome, effect sizes were calculated separately for end-of-therapy and follow-up assessment. Results According to comparative analyses of controlled trials, LTPP showed significantly higher outcomes in overall effectiveness, target problems, and personality functioning than shorter forms of psychotherapy. With regard to overall effectiveness, a between-group effect size of1.8 (95% confidence interval [Cl], 0.7-3.4) indicated that after treatment with LTPP patients with complex mental disorders on average were better off than 96% of the patients in the comparison groups (P= .002). According to subgroup analyses, LTPP yielded significant, large, and stable within-group effect sizes across various and particularly complex mental disorders (range, 0.78-1.98). Conclusions There is evidence that LTPP is an effective treatment for complex mental disorders. Further research should address the outcome of LTPP in specific mental disorders and should include cost-effectiveness analyses.

Totem and Taboo

Abstract: Freud’s interest in the origins of guilt came relatively late in his work, as he himself acknowledged (1933). It was only after his major clinical accounts had been written that Freud undertook a study of the origins of guilt in Totem and Taboo. In his clinical papers, as well as in his books on dreams and jokes, “disgust, shame, and morality” were simply the counterforces against which sexual longings (libido) contended. Moreover, the origin of these counterforces was at first located in the sexual instincts themselves (see Chapter 4) as sublimations and reaction formations of the sexual instincts. Hostility arose out of frustrated libido; sublimations and reaction formations of hostility (although in the service of the “ego-instincts”) also made use of the energy of the sexual instincts to deflect them into social and moral purposes. In this account, libido theory is the centerpiece of the explanation. Our path might have been easier if Freud had indeed regarded his libido theory as a theory of the emotions (as he said he did in Group Psychology, 1921, p. 90). If one permits libido to stand for the attachment emotions, the origin of hostility and morality in a single source becomes a viable hypothesis. Morality is the affective-cognitive outcome of attachment. Threatened attachment, which first evokes protest aimed at the caretaker—“other,” is then transformed, mainly by identification, into states of shame and guilt that aim at maintaining the attachment.

Family violence, war, and natural disasters: A study of the effect of extreme stress on children's mental health in Sri Lanka

Abstract: The consequences of war violence and natural disasters on the mental health of children as well as on family dynamics remain poorly understood. Aim of the present investigation was to establish the prevalence and predictors of traumatic stress related to war, family violence and the recent Tsunami experience in children living in a region affected by a long-lasting violent conflict. In addition, the study looked at whether higher levels of war violence would be related to higher levels of violence within the family and whether this would result in higher rates of psychological problems in the affected children. 296 Tamil school children in Sri Lanka's North-Eastern provinces were randomly selected for the survey. Diagnostic interviews were carried out by extensively trained local Master level counselors. PTSD symptoms were established by means of a validated Tamil version of the UCLA PTSD Index. Additionally, participants completed a detailed checklist of event types related to organized and family violence. 82.4% of the children had experienced at least one war-related event. 95.6% reported at least one aversive experience out of the family violence spectrum. The consequences are reflected in a 30.4% PTSD and a 19.6% Major Depression prevalence. Linear regression analyses showed that fathers' alcohol intake and previous exposure to war were significantly linked to the amount of maltreatment reported by the child. A clear dose-effect relationship between exposure to various stressful experiences and PTSD was found in the examined children. Data argue for a relationship between war violence and violent behavior inflicted on children in their families. Both of these factors, together with the experience of the recent Tsunami, resulted as significant predictors of PTSD in children, thus highlighting the detrimental effect that the experience of cumulative stress can have on children's mental health.