Alexander Friedmann, M.D.

Memorial Tribute

Since 1975 I have been part of the staff of Vienna's University Hospital and since 1990 I have been Assistant Professor of Psychiatry at the Medical University of Vienna and a staff psychiatrist there. I have been teaching transcultural psychiatry to medical students and trainees in psychiatry since 1994.

I am myself the product of several cultures: Like my parents, I am an Ashkenazi Jew, although, as a result of a liberal education, not very observant.

Family background and upbringing

My parents were born and grew up as Austrian citizens, living in Czernowitz, the prosperous capital city of Bukovina, the eastern region of the Austro-Hungarian empire, which was a German speaking city at the dawn of the 20th century. Czernowitz had a sizable Jewish population during the years that preceded WWI. The Jewish community of Czernowitz in those years was comprised in part of Hassidic orthodox Jews and in part of highly emancipated and assimilated Jews. Especially after the proclamation of the Decrees of Tolerance in 1781and 1782, the Jews had become very loyal citizens of the Austro-Hungarian empire and dedicated to Emperor Franz Joseph I., who ruled from 1848 until his death in 1916.

After the capitulation of Austria in WWI, the Austro-Hungarian empire was dismantled, the republics of Czechoslovakia and Hungary were established, and large territories of the empire became part of other countries - Galicia of Poland, Croatia and Bosnia-Herzegovina of Yugoslavia, and Bukovina became part of Rumania. Thus, my parents became Rumanian citizens during their adolescent years. The prosperity of Czernowitz, renamed Çernau?i, declined under Rumanian rule. Many of its Jewish inhabitants decided to leave and settled in the Rumanian capital of Bucharest, where better economic possibilities were to be found. My parents met in Bucharest and were married there in 1942. My father, who was a printer by profession, became the owner of one of the biggest printing companies in Bucharest.

Soon after their marriage, my parents became victims of the fascist takeover in Rumania. In 1942, my mother was deported with her family to a Rumanian concentration camp; officially charged with being communists, but unofficially because the Rumanian fascists were intensely antagonistic toward Jews. She survived, with the help of my father, who was hiding in the Bucharest underground, living in a cellar where he printed false documents for other victims of the persecution. Nevertheless, had my parents not left their home city of Czernowitz, they would probably have shared the fate of Czernowitz's Jewish population, which was deported to Siberia when the Soviets occupied the city in WWII, or they would have been exterminated by the Nazis.

At the end of WWII and of the genocide of the Jews of occupied Europe, my family had survived the Holocaust. Since both of my parents' families had been Zionists during the pre-war years, most of their family members had emigrated to Palestine before WWII. I was born in Bucharest in 1948, the only child of my parents. As Rumania became a Stalinist country, my parents, unwilling to live under another dictatorship, determined to emigrate, even if they had to leave their belongings behind. Although emigration was not allowed in those days, they were able to take advantage of the incompetence of the bureaucracy; my father was able to get official approval to accompany my uncle to Austria for medical treatment, and my mother was given permission to visit her mother in the new state of Israel. My parents had applied for exit visas in different districts of Bucharest.

That is how I came to live from 1949 to 1952 in Israel; a country of WWII survivors hardly able to feed its population and subjected to frequent attacks from the armies of surrounding countries. My traumatized mother could not cope with that kind of stress, and I was a fragile and underdeveloped child repeatedly getting sick. As a consequence, my parents decided to return to Europe and to make a life for themselves in Vienna, the city their families had considered as their capital until 1918. My parents enrolled me in the Lycée Français de Vienne, a school run by the French government, where I was educated in the French language and exposed as much to French cultural influences as I was to Austrian and German culture. At home, I was simply Jewish. My personal migration history and my school career ultimately enabled me to be able to speak six languages.

Even though my family was living in Austria, they always spoke of their intention to go back to Israel one day, but that never happened. However, Austria was not an easy place for Jews to live in the 1950s. The antisemitic tradition persisted, combined with the stubborn denial of the collaboration of a huge part of the Austrian population with the Nazis before and during WWII. There was also a great deal of popular support for the nationalistic narrative that Austria had been the first victim of Nazi German persecution and invasion. Support for this misreading of Austrian history created a climate of uneasiness and, for many, of fear among Jews living in Austria at that time.

My first direct confrontation with manifest antisemitism occurred in 1964: nineteen years after the liberation of Mauthausen, a Nazi extermination camp in Austria where 120,000 people had been murdered, more than 60.000 of them Jews. It was at a neo-Nazi rally in the center of Vienna. In response, antifascists staged a counter-demonstration. Between both groups, there were about 3000 people. Fighting broke out between opposing groups. Many participants of both sides were arrested, including me, a 16 year old boy at that time. During the afternoon I had to spend in a cell, together with others of both sides, intense political discussions occurred. I wondered how it was possible that young Austrians could deny the historical reality of WWII, convince themselves that the Holocaust had never happened, and remain stubbornly loyal to Hitler's propaganda. I simply could not understand. I tried to understand that type of mass madness and its historical and cultural roots. Looking back, I believe it was my experience of that afternoon that shaped my decision to orient my later studies toward understanding humans and their psychological roots.

Medical school and training in psychiatry

I consider the events of 1967 to be the triggers of my professional life, as well as shaping my life as a Jew living in Austria: In that year, I finished secondary school and started to study medicine. During the week I took my final exams in medical school, the 'six-day war' started in Israel. All my cousins were soldiers in the Israeli army and involved in fierce fighting. My parents were very fearful, questioning the future of the Jewish people, and of the security of the small Jewish community in Vienna.

Those days made me think about the sense and the responsibilities of my own life as a human being and as a Jew. I decided to leave for Israel immediately after my last exam and arrived while the war was still going on. That summer, I was a volunteer agricultural worker on a kibbutz, where I met other volunteers from all over the world. From then on, I would spend my summer vacations during the next ten years as a volunteer at kibbutzim in Israel. In the summer of 1977, after my graduation as a medical doctor, I volunteered in an outpatient clinic in the Negev desert, designed to provide medical services to the region's Bedouin population. After that, I spent five weeks living with a nomadic Bedouin clan.

In the autumn of the same year, I started my training at the Department of Psychiatry of the Medical University in Vienna, where I completed my training six years later and was subsequently appointed Assistant Professor of Psychiatry there in 1990. During my training, I spent one year in internal medicine, six months in neurology and one year in child neuropsychiatry. Throughout those years in training, I never lost my interest in psychological differences due to acculturative stress, so, quite logically, my orientation was always toward social and cultural psychiatry.

Ultimately I was given the assignment to inaugurate and develop an outpatient service for transcultural psychiatry within the Department of Psychiatry, which I have directed ever since then. During the fourteen years I have been director of the transcultural psychiatry clinic at the university hospital, I have been able to focus the clinic's efforts on treating people of foreign descent and different cultural groups. Today, many years later, I am convinced, that humans, although culturally different, are psychologically similar, reacting to and suffering from the same type of illnesses and stressful life events, but using different language and body signals to communicate their distress.

Involvement in the rebuilding of the Jewish community of Vienna

Throughout my adult life, I have spent part of my free time helping to rebuild the Jewish community of Vienna1), that had been decimated by WWII. I have felt an abiding responsibility, as a child of survivors of the Holocaust, not to let the world's bigots succeed in their wish to eradicate the Jews of Europe.

In order to understand the context, it is helpful to review the history of the Jewish community of Austria. The first Jew in the territory of Austria was mentioned in the 11th century. He was the master of the court mint. It is known that he was murdered. In the following nine centuries, there were times when the Jews in Austria were tolerated and prospered, and other times when they were persecuted, driven out of the country or killed. Until the 19th century, Jews never enjoyed equal civil and religious rights.

It was the oldest son of the Austrian empress Maria Theresa, Emperor Joseph II, who promulgated the radically progressive "Edicts of Tolerance" in the late 18th century, giving non-Catholics; that is, Protestants, Eastern Orthodox Christians and Jews, judicial and civil quasi-equality. The result was an impressive expansion of the Austro-Hungarian empire's economy, industry, sciences, social welfare system and the arts and humanities, until the eve of WWI.

The Jewish population of Austria reached almost 200.000 before WWII. Most of the Jews of Austria lived in Vienna, although there were some in the Austrian provinces and in smaller cities. Most of them were highly integrated, and some had become very prominent citizens, such as the novelists Arthur Schnitzler and Stefan Zweig, the physicians Sigmund Freud and Alfred Adler, the musicians Bruno Walter, Gustav Mahler and Arnold Schoenberg, and theater and cinema figures such as Peter Lorre and Billy Wilder. Others were well-known political figures of their time. Several were Nobel prize winners. Nonetheless, all of them were forced to leave the country and those who did not do so in time were murdered by the Nazis.

When the nightmare years of WWII ended and the Republic of Austria was re-established in 1945, there was practically nothing left of the Austrian Jewish community. Some Austrian Jews came back to find the community looted, their material possessions plundered, their houses and apartments "aryanized" and the Austrian government unwilling to consider providing restitution or compensation for their losses. The Jewish community was reduced to 10.000 people, of whom only a few thousand had lived in Vienna pre-1938. Thousands were "DPs" (displaced persons), survivors of the Nazi death camps. It was a traumatized population, sick, rootless and depressed. In the post-WWII years, most Jews living in Vienna were refugees and DP's from Poland, Rumania, Hungary and Czechoslovakia. By 1970, 85% of the Jews living in Vienna had been born outside Austria, and 92% of the Jews born after WWII had non-Austrian parents. In the 1970s, the Jewish community included a large number of older people and a small number of children. For fifty years after WWII the Jewish community of Vienna experienced declining numbers. After 1945, there was little to attract Jews to live in Austria. The Jewish community consisted largely of refugees from rebellious communist countries (from Hungary after 1956, from Poland after 1967, from Czechoslovakia after 1968); refugees too exhausted to cope with continuing their migration to Israel, USA or other countries that had agreed to accept them.

Beginning in 1972, a new wave of transient and permanent migrants came to Austria; Jews from USSR, most of them in transit to Israel and some to the United States. From this inflow of 250.000 people, 3000 chose to stay in Austria. Most of them came from Tajikistan, Uzbekistan, the Caucasus region (Chechnya, Dagestan, Azerbaijan and Georgia). They were very culturally foreign to Austria: they did not speak German, they looked Asian, their occupational skills were not transferable to Austria, they were Sephardic rather than Ashkenazi Jews with very different religious rituals and customs, their families were patriarchal and authoritarian, they were poor and sick. On the other hand they had a lot of children.

At first, the Jewish community isolated and rejected these new immigrants, imitating the xenophobic behavior of the majority of the Austrian population. But a few years later, stunned by the arrest of a substantial number of youngsters belonging to this immigrant group who had slipped into drug use and criminality, the established Jewish community of Vienna decided it had to do something to help.

The problem had already come to my attention, since some of the immigrants were brought to the University Hospital where I was on duty. Most of these immigrants were poor and had no health insurance. To cope with that problem, I inaugurated a Union of Jewish Physicians that not only brought together a number of Jewish doctors, but got them to agree to treat these people 'gratis'. With that initiative, I became involved in the social welfare of the Jewish community, which I had until then considered as only a representative and religious organization.

Two years later, in 1983, I was elected to the governing council of the Jewish community and in 1989 became director of its social welfare division. I was convinced that it was my obligation to help the immigrants to integrate; first in the Jewish community, then in Austrian society, and that should be done by giving them respect and recognition, To accomplish this objective of the new immigrants' cultural integration in Austria, the Jewish community needed to initiate programs for their education, job training and housing. My friends and I were able to convince the leadership of our community that there was no alternative, and that we, the Jewish community, would ultimately benefit from the successful adaptation of these young people in Austrian society. It was necessary for us to get the approval of the leadership of the Jewish community, since a major financial commitment was needed to develop the services to be offered to the new immigrants. In the beginning, we concentrated on offering free German language courses and on giving financial aid to those who had not yet found adequate jobs. In 1980, we were able to change the community bylaws, offering voting rights to the new immigrants and helping them to develop their own communal organizations. By doing so, we gave them practical training in democratic governance, something they had not known in the pre-migration countries where they had grown up.

In 1982, we started construction of a synagogue built in the Sefardic tradition. At the same time, our community by then had enough children to inaugurate a Jewish school. Soon afterwards, I created a multi-professional outpatient clinic (ESRA2)) for immigrants from the former Soviet Union and for traumatized survivors of the Holocaust. That clinic now has 1400 patient visits/year. In addition to the Jewish school, we now have a vocational school (JBBZ3)) for youngsters at risk of school dropout, social turmoil, unemployment, substance use problems and delinquent behavior. That school has had 2500 graduates in the 9 years it has been in operation. By 2007, the Jewish community of Vienna has grown to 7500 members. The community now operates three schools, the vocational training center JBBZ, two sports clubs and four social clubs for the former immigrants, as well as an arts school run by them.

In recognition of these accomplishments, the Republic of Austria and the City of Vienna have honored me in 1995 and 2000 by awarding me Golden Crosses of Merit. But my own measure of success is the fact that there is practically no unemployment and no criminality among the members of our community and that psychological disability has been brought under control.

In the last few years, we have witnessed the first marriages between children of our original Ashkenazi Jews and children of immigrants from the former USSR. These ex-Soviet Jews now hold 6 of the 24-person governing council positions in the Jewish community. In 2005, the mayor of the city of Vienna hosted a celebration for the thirtieth anniversary of the establishment of the ex-Soviet Jewish community of Vienna, at the City Hall; an event nobody could have imagined 30 years earlier.

Current professional activities

During the last ten years, having almost daily clinical experience with asylum seekers from the former Yugoslavia, the former Soviet Union (mainly: Chechnya, Armenia and Georgia) and from countries like Iran, Iraq and Syria, I have specialized in psychotraumatology (PTSD). Together with friends and colleagues, I participated in the founding of the "Austrian Society for general and special Psychotraumatology" (ÖGASP). I am in currently the director of its scientific committee.

In 2006 and 2007, I participated in organizing congresses of the societies for transcultural psychiatry in the German speaking countries 4 and will do so again in September 2008. Our goal is to create a trans-European society to promote research in the field, to develop training of future medical doctors in cultural diversity and to have some influence on policy of the European countries in dealing with migrants.

1) www.ikg-wien.at
2) www.esra.at
3) www.jbbz.at
4) www.transkulturellepsychiatrie.de
e-mail: alexander.friedmann@meduniwien.ac.at

January 21, 2008