Life Review Therapy for Holocaust Survivors: Two Systematic Case Studies

• Published in: Psychotherapy (Chicago, Ill.) Ill.), 2022-12, Vol.59 (4), p.521-532
• Main Authors: Zimmermann, Sarah, van der Hal, Elisheva, Auerbach, Martin, Brom, Danny, Ben-Ezra, Liron, Tischler, Randy, Cassif-Weissberg, Liora, Nof, Reut, Forstmeier, Simon
• Format: Article
• Language: English
• Subjects: Aged; Anxiety; Female; Holocaust - psychology; Holocaust Survivors; Human; Humans; Life Review; Male; Narrative Therapy; Older Adulthood; Posttraumatic Stress Disorder; Psychotherapy - methods; Reminiscence; Stress Disorders, Post-Traumatic - psychology; Stress Disorders, Post-Traumatic - therapy; Survivors - psychology; Trauma
• ISSN: 0033-3204; 1939-1536
• DOI: 10.1037/pst0000419

Having reached the last phase of their lives, many Holocaust survivors (HS) experience an increase in vulnerability. Despite their remarkable ability to adapt, the process of aging presents them with new challenges, often leading to an increased need for therapy. This is made all the more difficult by the fact that there is little research on trauma therapy in old age. To date, no randomized controlled study has been carried out to examine the effectiveness of psychotherapy in HS. The present case studies report the implementation of life review therapy (LRT-HS) undertaken with two female HS with symptoms of post-traumatic stress disorder (PTSD). The mixed-methods approach sheds light to their individual therapy courses and potential mechanisms of change. Both therapies took place in the context of a randomized controlled study evaluating the efficacy of LRT-HS. This integrative, narrative therapy approach answers the natural need of elderly people to look back on their lives. Patients received about 20 sessions of LRT-HS, including a structured life review, narrative exposure, as well as cognitive and behavioral elements. Patient 1 showed reliable to clinically significant improvements on several quantitative symptom levels and with consistent qualitative findings (e.g., semistructured therapist interview). Symptoms of Patient 2 remained mostly unchanged, while life satisfaction and posttraumatic growth reliably improved and qualitative measures pointed to a reduction of suffering. The studies illustrate that reminiscence can be used in adaptive ways even after the experience of massive traumatization. The coexistence of resilience and vulnerability, complex individual symptom profiles, and influencing factors are discussed. Clinical Impact Statement Question: The present study provides deeper insight into the application of life review therapy (LRT) with two Holocaust survivors. LRT includes a structured life review, narrative exposure as well as cognitive and behavioral elements and thereby answers the age-specific and trauma-specific needs of the client. Findings and Meaning: The therapy approach can improve well-being even after the experience of massive traumatization. Next Steps: Future research on this topic might include the further exploration of influencing factors (e.g., personality traits and individual symptom profiles) and supplemental settings (e.g., group; systemic; LRT for descendants).