Life after the atomic bomb

ON AUG. 6 AND 9, 1945, THE U.S. DROPPED atomic bombs--first on Hiroshima and then on Nagasaki--in order to end the war with Japan. This marked the first time in history that weapons of such mass destruction were used against civilians. Within the year, the death toll was about 200,000. Today, there are as many as 400,000 survivors from those bombings.

The atomic explosions inflicted severe physical damage, most obviously, burns from the blast wave and resultant fires and radiation-related diseases from the initial explosion and subsequent fallout. The Radiation Effects Research Foundation noted that early symptoms of exposure to the bombs included fatigue, high fevers, nausea, vomiting, bleeding from the gums, cataracts, and diarrhea. Today, survivors, especially those who were children at the time, run higher risk of developing leukemia and other nonmalignant disorders. In sum, not only did the survivors of the atomic bombs suffer from radiation effects immediately following the event, but have remained at higher risk than the general population for other physical ailments.

In spite of the fact that this massive destruction occurred more than 60 years ago, the psychosocial effects of the experience on the survivors rarely have been studied. One major reason for this is that survivors and their families often were stigmatized by others and feared social rejection if they publicly discussed their experiences. As a result, A-bomb survivors have tended to keep their history a secret.

Setsuko Thurlow was 13 years old when the bomb hit Hiroshima. In 1982, she wrote that the "physical condition [was] beyond description." This inability to put her thoughts and feelings into words continued for weeks: "I remember being stunned by indescribable and undistinguishable feelings and not being able to express them." She goes on to discuss psychic numbing--an inability to feel--that haunts her to this day.

In 1981, researcher Joanne Silberner looked at the continuing psychological problems of survivors. These include refusal to leave one's home, inability to hold down a job, nightmares, depression, and anger. Silberner identified three levels of survivor reactions: denial of memories of the event; the feeling that the person's sole identity was that of a survivor of the bombing; and transcendence. Silberner also notes the psychic numbing caused by the A-bomb.

Psychological scars

The concept of psychic numbing brings us to Robert Lifton, the psychiatrist who coined the term, and who has been studying the effects of the atomic bombings since 1962. Lifton identifies five psychological themes of survivors: overwhelmingly indelible images of grotesque forms of death that color all subsequent experience; guilt for living through the tragedy; psychic numbing; feelings of being entrapped in a world that seems counterfeit and in which they cannot trust others; and the struggle for meaning, a wish to bear witness and have the crimes committed against them acknowledged.

Lifton also delineates three stages that the survivors experienced after the bombings: immediate fears went beyond their own deaths; during the following days and weeks, people who first appeared to be untouched began exhibiting physical symptoms, and many more died, giving the sense that these weapons of mass destruction had poisoned everything; years later, there was an increase in incidences of cancers in victims, as the effects of the Abomb were seen to be endless.

A study by researcher Maya Todeschini focuses on the ways in which the A-bomb affected women within Japanese culture. Todeschini's dissertation, which analyzes life histories of women who were teenagers at the time of the bombings, found that women who suffered radiation illnesses were seen as aggressors and "polluters."

What can research on the psychosocial effects of the Holocaust teach us about the longterm effects of the atomic bomb attacks on Hiroshima and Nagasaki? Holocaust studies demonstrate that the effects of the trauma remain evident today. As early as 1964, William Niederland described the "survivor syndrome" that affected many concentration camp inmates. It includes depression, nightmares, anxiety of renewed persecution, psychosomatic symptoms, survivor guilt, emotional numbing, cognitive and memory disturbances, an inability to verbalize the traumatic experiences, heightened aggression, and a "living corpse" appearance.

Since 1980, after inclusion of post-traumatic stress disorder (PTSD) in the DSM-III, the diagnostic manual of psychological disorders used by mental health professionals, many clinicians and researchers have explored the long-term psychosocial effects of the Holocaust on survivors through this prism. Researchers now speak of post-trauma, even when survivors do not meet the formal criteria for diagnosis of the disorder. Hans Keilson, however, who undertook a longitudinal study on Dutch Jewish war orphans, prefers the concept of "sequential traumatization," to PTSD. Instead of seeing an "event" that has "consequences," trauma is viewed as a lifelong process with sequences. This helps explain why trauma continues, even years after the event, and why victims can develop symptoms at different times after the experience.