Vamık D. Volkan, M.D., DLFAPA, FACPsa.

 
 
 
 
 
 
SYMPTOM FORMATIONS
AND
CHARACTER CHANGES DUE TO UPHEAVALS OF WAR: EXAMPLES FROM CYPRUS
 
 
 

 
 Vamık D. Volkan
 
 
 
 
 
 
 
Presented at the I4th National Scientific Meeting of the Association for the Advancement of Psychotherapy,
May 6-7, 1978, Atlanta, Georgia. Published in American Journal of Psychotherapy, Vol.XXXIII, No.2, pp.239, April 1979.    
 
   
 
 
This article offers a review of the psychoanalytic and psychiatric literature on symptom formation and individual and collective character changes triggered by war or by similarly violent civil upheaval. It is suggested that each such event should be studied by itself since many different circumstances can bring man to acts of aggression. The effects of the war on Cyprus, where group narcissism developed to compensate for hurt, constitute a case example of such focused study.
 
 
 
 
Wars and psychologic insight:
Around the world man continues to kill and maim his fellows for what he rationalizes as some imperative; a recent news item notes the current conduct of 26 wars. It has been calculated that 59 million people were killed between 1920 and 19451 in one form of collective ag­gression or another, and according to the report prepared in 1977, for the Rockefeller Foundation (and four other sponsors) by Ruth Leger Sivard, one out of every six dollars (or a monetary equivalent) was being spent on arms. Military expenditures throughout the world rose from $324 billion in 1975 to $350 billion in 1976, and by 1975 military spend­ing in the developing nations—9 % of the whole in 1960—had doubled. The United States and the Soviet Union together were spend­ing annually $200 billion on arms a few years ago.
 
The impact of such outlay can best be appreciated in comparison with what is being spent for human needs around the world. For example, it costs $14,800 on the average to maintain one soldier, but an average of only $230 each goes for the education of young people from 5 to 19 years of age; and $44 per capita is spent for health. It would ap­pear that what national leaders dramatize as "wars" on such human problems as poverty, energy shortages, and the like are far less well financed than are the death-dealing kinds of war.
 
It is, of course, beyond the competence of a psychoanalyst and psychiatrist such as myself to understand clearly all of the political, eco­nomic, social, historic, anthropological, and other issues that contribute to the present state of affairs. Nonetheless, it seems to me that the psychological issues that help kindle and sustain great conflicts are seldom considered seriously by those responsible for their conduct. Be­cause of this widespread neglect, President Anwar el-Sadat's public declaration during his visit to the Israeli Parliament in November 1977, that there is a "psychological barrier" between Egyptians and Israelis is his­torically significant. It is even more significant that he underlined this Jr statement by saying, "It is this psychological barrier which I described in official statements as constituting 70 % of the whole problem."
 
Since Freud's2 declaration that aggression is an innate, instinctual, and independent disposition of man, psychoanalysts have had a tendency to understand the psychological reasons of every war in the light of this basic genetic formulation. Although it is an inescapable truth that the human race is endowed with aggression, I know of no compelling study undertaken to date to illuminate the many ways in which facets of this instinctual drive interact with other issues in the genesis of wars. The pessimism Freud3 expressed in his reply to Einstein's plea that he find a solution for man's proclivity to armed conflict set up a model for his followers and encouraged them to leave political matters, including declarations and conduct of war, to statesmen. His assertion that it was not profitable to consult an "un­worldly theoretician" on such an urgent human problem went un­challenged. Freud4 had noted earlier the disillusionment about civi­lized values that war brings by its return to barbarism, which has sup­posedly been left behind in the process of evolution but which is ever resurgent in wartime. He held to the ironic conclusion that man's regression to barbaric behavior betrays as illusory his belief that he has ever in fact risen above the barbaric condition, whatever refinements may have led to his confidence about having done so. Nevertheless, Arlow5 suggests that perhaps Freud was more optimistic than he ap­peared, since he considered the "cultural process" to be biologically de­termined. It was Freud's view that as individual development movestoward the ego's reliable mastery of instinctual drives, so does cultural evolution move to strengthen the intellect and the internalization and taming of aggressive impulses. This hoped-for transformation has ob­viously not as yet taken place. 
 
Following the lead of Freud, Ernest Jones6 wryly suggested that it would take "a couple of centuries" of psychoanalytic research before it would be possible to impede wars by psychoanalytic unolerstanding. Re-viewing other psychoanalytic  formulations  about war,  I7 join with Mitscherlich8 in suggesting that psychoanalytic (as well as psychiatric) re­search on the collective aggression of large groups must not be dismissed from consideration; investigation of the psychology of war should not exclude those who are experts in clinical psychologic issues and psychological theories. We should not restrict ourselves to a medical or clinical position; an interdisciplinary approach is clearly indicated. I suggest further that wars should be considered one by one, since, like patients, they may have many apparent similarities but be different one from another in highly significant ways. Such a case-by-case approach is recommended as an aid to understanding not only the psychological de­terminants of any given war but also its impact on the people involved in it. In spite of the dearth of psychiatric and psychoanalytic material on war per se, there are many reports on clinical conditions associated with wars, and on the miseries these entail. An individual's reactions to experience in war—his symptom formations and/or character changes—will depend on the nature of the specific trauma he has un­dergone; his present psychologic makeup; his psychologic foundation, and so on, but, nevertheless, general statements can be made about the impact of war on a group. We can hope for answers to such questions as whether a specific war has increased neurotic symptoms in the involved population, whether it has changed the character of the group in specific ways, and so forth. Over and above the individual or collective misery wars or warlike quarrels bring is an aspect of an attempted "cure." Glover,9 although referring to war as "mass insanity," saw it also as containing a "curative process," holding that just as insanity is itself a dramatic attempt to deal with conflict on the level of the individual, war is an attempt on the collective level to cure some disharmony, however doomed it may be to result in hopeless disintegration. The notion of war as "therapy" can be found in other writings also.7-8-10 It should not be forgotten that some wars have reduced collective aggression; turned passivity into assertion (aggression); and increased group cohesion and group esteem.
 
Atkin,11 a contemporary psychoanalyst, notes that patriotism usually exalts the group in a legitimate, acceptable, rationalized displacement of an individual's narcissism, and that the projected hate component of am­bivalence is similarly engaged. He suggests that a nation's "war institu­tion" is ego-syntonic, and that we cannot expect man to live above his "emotional income." Following this line of thought, I7 have suggested that not only preparing for war, but even waging it, can be ego-syntonic for at least one group of participants, although the challenge or support of this view will require case-by-case study, as mentioned above. It remains true, however, that the study of combined group reactions to any war, and clinical observations of the group processes at work in it seem likely to contribute significantly to the understanding of what its determinants were.
 
This paper reviews the literature on the effects of war on individuals and groups, and gives aspects of the case history of one war—the conflict on Cyprus, the island paradoxically known as the birthplace of Aph­rodite, the Goddess of Love. I propose to examine here the shaping of new characterological modalities shared by the members of a group in­volved in the conflict. Such shared character-trait manifestations can be understood not only from the point of view of the trauma and excite­ment of the war or warlike events themselves, but also from that of past shared cultural and historical events intermingled with the effects of war itself.
 
A review of the literature on war-related psychiatric conditions (neuroses and character changes):
Years ago, Glover9 said that civilized nations are at a disadvantage in war because they lack primitive man's ritualistic control of killing and do not know the "purity" of a rage to punish their enemies. Wars, espe­cially perhaps those in modern times, bring much misery beyond that dealt by bayonets and bullets. Its victims may undergo imprisonment or gross discrimination, and find no sanctuary from war's invasive changes however far they may be from ar.y active "front." Today's reactions to war must consider not only battle, but many kinds of persecution; the fear of annihilation; and the loss of people and places that hitherto shaped life. Even the loss of an enemy presence11-12 heavily invested with psychic expectation can cause psychological dislocation. Wars all cause loss, change, and maladaptation—as well as those adaptations which promise improved conditions—although each will be unique in some particular and hence unique to some extent in its human conse­quences.
 
It is not surprising that when modern psychiatry first addressed itself to the psychiatric symptoms engendered by war it focused on soldiers actually engaged in combat. It was during World War I that Freudian concepts were first applied to soldiers suffering from what was called shell shock, war fatigue, or combat neurosis and blamed at the time on' microstructural organic changes in the nervous system. This war pro­vided a turning point for psychiatry by introducing the concept of possi­ble functional (psychogenic) instead of organic etiology for combat neurosis. Rado13 points to a change in the official viewpoint in the USA Army publication on neuropsychiatry made available in 1929.
 
When Freud14 wrote in 1919, on psychoanalysis and war neurosis he was interested in theory, and sought a unifying hypothesis that would explain both the ordinary neuroses of peacetime living and those caused by war. The ego fears damage in either war or peace; in times of external peace, the individual's enemy is the demanding libido which menaces the ego. Freud, at that point in the development of the psychoanalytic movement, saw in both traumatic neurosis and in the neurosis specifically connected with war an ego defending itself from a danger that threatened from without or was embodied in the shape assumed by the ego itself. He further suggested that the conflict in war neurosis was one between the soldier's old peaceful ego and the belligerent one war required of him, and that this conflict could become acute when the former realized that it must give way to its newly formed and parasitic belligerent double.
 
Freud came to differentiate the so-called war neuroses from psychoneuroses proper, and identified some of their unique qualities. Later, others offered a variety of definitions, and theories to account for them. In 1941, Kardiner15 gave a classical definition of war neuroses among the military, emphasizing that these types of neuroses are persistent or even chronic. Among his patients in a Veterans' Hospital he noted irritability; a proclivity to explosive acts of aggression; a craving for compensation; alterations of self-concept; and dreams unique to this condition. The repetition of unpleasant dreams in traumatic neurosis (including war neurosis) seemed on first glance to contradict the domi­nance of the pleasure principle. This concerned Freud, and in 1920, he16 accounted for it by concluding that when the mental apparatus is flooded as a result of trauma, the pleasure principle is rendered inopera­tive. Primitive modes of functioning, basically aimed at the binding and mastering of stimuli, appear, and the repeating dreams reflect this aim.
 
Rado13 referred to the late posttraumatic period of war neurosis as traumatophobia, holding that trauma originally representing war's threats comes at last to stand for all prospective dangers. The personality falls under a traumatophobic regime in which it reverts to the infantile technique of automatically reaching out for support.
 
The World War II literature contains many observations on the experience of men in combat,17-21 many suggestions for treating combat-zone illnesses, and theoretical formulations. Lidz22-23 wrote, for example, on the significance of repeating nightmares of combat among military patients in the South Pacific. He viewed these nightmares as wish-fulfillment dreams in spite of the accompanying terror—projec­tions of suicidal wishes in the face of a life no longer seen as worth living, the dreamer being in an ambivalent state of fearing but desiring death. Some of the men symptomatic because of combat were studied over time, one being Wexler's24 patient, a man compulsively driven to become a Life Master in bridge. He had had a precariously constructed ego before his combat experience, the trauma of which remained like a foreign body in his psyche. His terrible experiences persisted in his dreams and fantasies as he tried to master them, and bridge became a means of restitution and mastery—a form of combat on a field far less dangerous than that of battle.
 
Only a few studies of  World War II in the psychiatric literature of the mid-1940s refer to the effects of war on non-combatants. War was dif­ferent in the 1940s from the earlier trench warfare. Civilian populations were now heavily at risk from bombing, and civilians might be expected, like soldiers, to show the effects of war trauma. Glover25 and Schmide-berg26 attributed such expectations to reports from the Spanish Civil War, and Schmideberg held that the boasts and threats made by the Germans and the warnings of the pacificists added to them. However, the British response to the blitz showed that mass neurosis was a myth, although neurosis did afflict some individuals. Under wartime condi­tions no accurate assessment of mental illness could be made, and many physical illnesses were no doubt psychosomatic responses to stress.26
 
Some of Schmideberg's analytic patients had begun analysis before the blitz, and she was able to observe that the air raids elicited in them fewer dramatic reactions than might have been expected. She believed that the majority of the people adjusted to "blitz reality" and learned to take the bombing as a hard but unavoidable part of life. Denial was used to deal with danger, and people regressed "to the narcissism of the baby." Activity made a sublimated outlet for aggressiveness, and countered helplessness. The blitz provided ample libidinal sadistic and masochistic satisfaction, and it was a help to identify with those less frightened and to externalize one's terrified parts onto the more timid.
 
Anna Freud and Burlingham27 observed the reactions of children to the bombing of London during World War II. They reported that if the very young children were not separated from their mothers or mother substitutes they were not traumatized by repeated exposure to bombing. The mothers or their substitutes provided a protective envi­ronment for the youngsters and shielded them against the dangers of the world. This in a sense offers proof that the mother performs certain executive functions for the child. The Freud-Burlingham observations showed that under the hazardous conditions that then prevailed the young child reflected the anxiety of an anxious mother, but was not himself anxious if the mother remained calm.
 
War-related stress leading to characterological changes in the mass—changes that were uniformly seen irrespective of differences in the back­ground of individuals composing the mass—was first studied seriously with Nazi concentration camp survivors as subjects. In this instance evidences of war mentality were not confined to the battlefield but appeared in all kinds of persecution and systematic destruction. The psychoanalytic concept of trauma, as reviewed by Furst and others,28 will illuminate our understanding of what it was that happened to the victims of the Nazis.
 
Trauma concerns the effects of a stimulus, usually a sudden, intense, and destructive one, that arises from an external situation (or an internal one concerning an instinctual drive usually in its involvement in separa­tion from a love object to such an object's love.) This overwhelms the ego's ability to mediate divers demanding forces, and induces helpless­ness. It should be understood, however, that constitutional de­terminants, past experience, and the individual's actual condition before, during, and immediately after the infliction of the trauma influence his surrender to helplessness. Traumatic neurosis is characterized by a blocking or reduction of various ego functions; spells of painful affect (anxiety or rage); and sleep disturbances. The trauma is re-experienced in dreams, and its mental representation is repeated in the waking state until mastery can be achieved, often accompanied by psychoneurotic symptoms. Nunberg29 has written about the relation­ship of trauma and character formation. The individual's development of new character traits after undergoing trauma will depend on whether the trauma in question is repeated or averted. Trauma may retard psychosexual development, or when such development has already reached the genital level, it may bring about regression to one of the pregenital phases. Although in either case the ego forms character traits in reaction to the urges of pregenital libido, it will do so gradually in the first instance, and suddenly in the second.
 
The trauma suffered by those held in concentration camps was un­believably severe and continuous. Because the survivors of Hiroshima exhibited remarkably similar changes in personality makeup, one must conclude that sometimes it is the intensity of the trauma that reshapes personality rather than its duration.
 
Friedman30 noted that "through an astonishing oversight" those who rescued the Jews from the camps failed to consider their psychological plight, but believed naively that freedom would end their suffering. He went on to say how incredible this naivete seemed in retrospect. The survivors' need of psychiatric help was evident as soon as they made their way into the free world, and so much was then written about their scars that I cannot cite all the relevant studies here but will refer to only a few written in English. A more detailed review can be found in my book Cyprus—War and Adaptation.7 It is agreed that these survivors had something that could not be classified simply as mere traumatic neurosis. The survivors' clinical picture has elements of traumatic neurosis, but its uniformity and intensity, the specific scars left in the victims' self-representation, and its continuation in the victims' children31 make it unique. I7 describe elsewhere a young Jew who had lived for 18 months in hiding as an infant and who had no conscious memory of this period of his early life, but nevertheless exhibited a character structure similar to that of victims who had been adults when persecuted by the Nazis. He acted like a"living statue," memorializing what had happened to the Jews under Nazi power. The term massive trauma has been applied to something that seems to take precedence over issues of predisposition; when stress is sufficiently powerful it will produce the same psychological disturbance in each individual under its sway and mold his character in a way that is rather uniform among all those exposed to the same crushing experience. Rappaport32 suggests that the regenerative powers of the ego are not limitless, and that the human spirit can be broken beyond repair.
 
Niederland,33-34 who is credited with the term survivor syndrome to describe a wound whose scar becomes imbedded in the characterological makeup of those who suffer from it, saw it among concentration camp victims as containing:
 
1- Anxiety, the most prominent complaint, with its accompaniment of sleep problems including rerun nightmares, and phobias,
 
2- disturbance of cognition and memory (amnesia or hyperamnesia),
 
3- chronic depression and survivors' guilt over having survived what destroyed so many worthy people close to them,
 
4- a tendency to seek isolation, and evidences of injury to object relationships,
 
5- psy­chosomatic conditions, particularly headache or gastrointestinal or car­diovascular disturbances; and,
 
6-  a physical appearance like that of a walking corpse.
 
 
 
Premorbid personality counted for little in the face of traumatization as severe as that of the concentration camps; charac­terological makeup was altered whatever the previous psychologic situa­tion or the postrelease experience. Eitinger's35 comparison of Norwe­gian with Israeli concentration camp inmates challenges while para­doxically proving this conclusion. The Norwegian group, ethnically homogeneous, had been well-nourished and relatively secure before be­ing arrested for defying the Germans. Moreover, when released, they returned home to relatively normal conditions and a homeland in which they were welcomed. Although the Jewishness of the Israelis was what put them in the camps, they came from different nations and, having no homeland awaiting them after their release, were truly isolated. The Norwegians adjusted better to life after being freed, but the fact that even in their group some people suffered from the classic survivor syn­drome may prove that one's state before and after undergoing excessive stress of the kind experienced in a concentration camp does little to modify the outcome.
 
Our understanding of survivor syndrome, originating in the study of concentration camp survivors, is applied today in a general way to those surviving any kind of manmade or natural disaster. Rangell,36 who worked with survivors of the Buffalo Creek disaster, wrote that there is room and time in anyone's psyche for only a limited amount of ideation, memories, and fantasies, with their accompanying affects, and that the crowding to capacity of a survivor's psyche can be expected to age him prematurely.
 
Lifton37 found that the survivors of Hiroshima greatly resembled concentration camp survivors, although the massive trauma there was different in having taken place in one horrifying moment. He saw in their corpselike appearance evidence of "the death imprint," to use his term, which we have come to apply to something the survivors of natural disasters have also,38 and which dominates their characterologic makeup. Refugees from wars or similar upheavals have also attracted psychiatric attention, one example being the studies of the refugees of the Hungarian uprising,39-41 and another, studies of the Cubans who fled to the United States.42 Psychiatrists became interested in brain­washing during the Korean war; Buckman's43 paper on this and on the use of hallucinogens in chemical warfare is an excellent review of these issues. The war in Vietnam brought new papers44-46 on combat psy­chiatry, and Harding and Looney47 studied refugee children from Southeast Asia. Figley48 collected a volume of papers dealing with two million American men and women still living who served in Vietnam, some of whom had been prisoners of war. Some of these papers deal also with long-term consequences of stress experienced in Vietnam. James Willworth noted in Time magazine for July 3, 1978, that perhaps as many as 70 % of those who were prisoners of war in Vietnam are now divorced. In my recent book on Cyprus71 applied the term interim survivors to those who outlive a disaster only to remain in chronic danger. They are like people in whom mingled hope and hopelessness wait for the killing storm they survived to strike again, and I compared them with the survivors of a desperate situation now terminated. I will shortly refer to their shared characterological makeup.
 
The present Cyprus problem:
The character traits shared by interim survivors in Cyprus can be best understood against a historical and sociological background. The American Psychiatric Association established in 1969, the Task Force of Psychiatry in Foreign Affairs, which studied Cyprus in an effort to understand the emotional issues involved in the irreconcilable interethnic differences there. During its seven years of life this task force, which recently evolved into a committee, was provided by the unfolding of events on this Mediterranean island with a laboratory for the study of psychohistory. I was a member of the task force, and am now a member of the committee that succeeded it; a Cypriot Turk born and reared on Cyprus, I had special insight into its work and was able to collect data7 on my many visits to my homeland.
 
Cyprus is smaller than the State of Connecticut. Greeks are in the majority there, but Turks had been living side by side with them, often in mixed villages, for four centuries by the summer of 1974, when military action divided the island for all practical purposes into a northern sector controlled by Turks, and a Greek sector in the south. Although commonly thought of as the present "Cyprus problem," this partition, achieved by violence, is but one manifestation of hostility that smoldered for more than 15 years and that was itself a reflection of an uneasy historic standoff. Two of my earlier papers, in this journal12-49 and elsewhere,7 describe the situation in some detail. A summary will suffice here.
 
The island is strategically situated and was accordingly claimed by one conqueror after another. Mycenaean settlers came in the late Bronze Age, to be followed in turn by Phoenicians, Assyrians, Egyptians, Macedonians, etc. A resurgence of Hellenism occurred during the Byzantine period, and Greek became the official language, Hellenic cul­ture surviving over the centuries even under other rulers, The Ot­toman Turks, seized the island from the Venetians in 1570-71, by send­ing Turks from Anatolia to Cyprus as settlers they introduced another cohesive religious and cultural influence alongside the Hellenic survival. The Turkish administration endured for 300 years until Great Britain took the island over in trust in 1878, through a treaty with the Sultan. After World War I, Turkey formally recognized British rule in Cyprus according to a 1923 treaty, and in the following year Cyprus became a Crown Colony. In I960, the Republic of Cyprus was established and a mini-state formed.
 
Although the Cypriot Greek movement for Enosis—union with Greece—dates back about a hundred years and, as Markides,50 a Greek sociologist born on Cyprus, writes, its origin can be found in "a dream shared by Greeks that someday the Byzantine empire would be restored and all the Greek lands would once again be united into a Greater Greece," the present Cyprus problem can be said to date from 1931, when the British governor's house was burned by Greek Cypriot adherents of Enosis. The drive for Enosis was then suppressed, to sur­face again after World War II, The Cypriot Turkish minority rejected Enosis, desiring Taksim instead, the division of the island between Greeks and Turks.
 
Terrorism prevailed in the mid-1950s, A Greek Cypriot guerrilla group named EOKA was formed to work for Enosis. In 1959, negotia­tions in which Britain, Greece, and Turkey took part led to the establish­ment during the following year of what was called the "reluctant" Re­public of Cyprus, the constitution of which, called "unworkable," divided power between Cypriot Turks and Cypriot Greeks.
 
It is interesting that when the Republic of Cyprus was declared there was no Cypriot nation. Greeks, in the majority, and the minority component of Turks kept their respective nationalistic views—their Greekness and Turkishness. Cyprus was incidentally their birthplace—they were first either Greeks or Turks—and they continued to fly Greek and Turkish flags, the new Cypriot flag appearing only on a few govern­ment buildings.
 
Writing about the formation of new states such as the one attempted on Cyprus, Geertz,51 a contemporary anthropologist, states that they are abnormally susceptible to serious disaffection arising from primordial ties53 persistent in the assumed "givens" of social existence—mainly im­mediate contiguity and kin connection, but also membership by birth in a specific religious community with its own language, and so forth, Geertz suggests that although disaffection based on intellectual, class, or economic differences may threaten to lead to revolution, disaffection that is based on primoridal ties such as race, language, or culture is likely to lead to partition, a redrawing of the very limits of the state and a new definition of its domain.
 
Elsewhere I7 have reviewed what has been written about the social customs of Turks and Greeks, concluding that the attitudes both groups share arise from their child-rearing practices. In the extended family, however it may have been modified in contemporary life, the child grows as an extension of his in group and as its loyal supporter, and comes to think of the outgroup as either "all bad" or "all good" accord­ing to his expectations, but never as one he can embrace or comprehend in all its diversity as he can his own. When he sees the outgroup as "all bad" he uses psychologic maneuvers to keep his distance from it. The fact that the (modified) extended family offers a child "multiple mothers" influences his separation-individuation process in such a way that his mother-images (as well as his own corresponding self-images) are not required to integrate as would be the case in a culture in which the child/mother unit is not influenced by a number of mothering persons. In the type of family organization usual among both Turks and Greeks, the child's frustration with one mothering person makes her "all bad" while a more accommodating "mother"—who may be, in fact, an aunt or grandmother—becomes "all good." The child can cycle from one to another, making each "all good" or "all bad" according to the occasion and with what compliance they respond to his demands. Such a child will as an adult feel the support of his native culture when he views one group outside it as "all good" and another as "all bad." Members of the same group will share the targets upon which they externalize all their unwanted self-object images. A review of the litera­ture on the social attitudes of Greeks and Turks7 shows that they use externalization mechanisms to insure the continued cohesion of their respective national identities, each group externalizing onto the other those aspects of itself it seeks to reject. The small island of Cyprus thus contained a mixture of two cultural groups each of which used externalization extensively and each of which was "other-directed."53 This situation led to taboos as strong as the incest taboo—such as the one against intermarriage—which kept the groups apart; as long as these prevailed the Cypriot Greeks and the Cypriot Turks lived on the same turf without ever really knowing one another in spite of the peaceful ap­pearance of things on the surface. I suggest that the attainment of "freedom" from the British and the establishment of the Cypriot Re­public paradoxically disturbed the psychologic balance between the two groups and led to the exacerbation of tensions. I speak here only of psychologic events, which were, of course, interacting with historic, eco­nomic, and political happenings, but are not on that account any less im­portant.
 
Intercommunal trouble erupted within three years of the establish­ment of the Republic, and after bloodshed in 1963-64, the Turkish population was confined to enclaves and surrounded in turn by the Tur­kish irregular army, UN. soldiers, and Greek soldiers. This confine­ment lasted for 11 years. Twenty-five thousand Cypriot Turks, a fifth of the total Cypriot Turkish population, became refugees and the en­claves were crowded. For the first five years, the Turks were not allowed out of their enclaves, and were in a sense imprisoned, although many simply remained in their homes. Others joined them there; a single home might shelter more than 10 families from time to time. Refugees not fortunate enough to join relatives lived in caves or tents. After five years had passed, Turks were allowed to move from one en­clave to another, and to pass through the Greek sectors as long as they returned to their "ghettos."
 
In 1974, EOKA-B, an organization formed to continue support for the aims of the original EOKA, tried, with the help of the junta then rul­ing Greece, to assassinate the Greek President of Cyprus, and Greeks took up arms against one another on the island. A new man came into power, signalling a speedy declaration of Enosis, but mainland Turkey intervened and used its powers as one of the guarantors of the Republic to enter Cyprus. After fierce battles the island was divided in two; 160,000 Cypriot Greeks were forced into the southern part of the island, and 60,000 Cypriot Turks who had been living in the south went north as voluntary refugees. These moves were the occasion for much social and psychological turmoil. Cyprus is so divided at the present time. The Cypriot Turks have set up a government of their own in spite of political efforts to settle the standoff in some other way.
 
Group narcissism affecting the characterological makeup of its members:
Although war actually broke out on the island in the summer of 1974, hostility had prevailed for about 15 years before its eruption. The situation of the Cypriot Turks after the storms of 1963 and 1964, is uniquely interesting as an example of what I call shared group nar­cissism. This affected to a considerable extent the characterological makeup of the population without reference to individual psychological differences. The Cypriot Turks had succeeded in withstanding the great stress of a period in which many of their kinsmen had lost their lives, but those surviving in the enclaves were at all times fully aware of the possibility of danger in the future. They were alive but not free— interim survivors who had survived bloody days only to face dislocation, severely reduced circumstances, and the loss of loved ones and property. They had been imprisoned after the fighting, but within their own neighborhoods so they could maintain the illusion of normal living, They experienced no full-blown "survivor guilt" as was seen among the survivors of the Naxi camps. They had been since 1963, in danger, the pawns of a situation beyond their control. Punished by an external agency, they could project inner guilt at having survived when their loved ones had not, and were thus saved from painful self-condemna­tion. Nevertheless, they resembled other survivors I have mentioned in having undergone terrible hours that they relived by day in the mind's eye and by night in repeating dreams. The memories of tragic events invaded the psychic space they needed to deal with impending danger and the unquenchable hope of achieving complete freedom and safety. Their hope of help from mainland Turkey had been nourished in vain during the 11 years in which they had been confined in enclaves, and before help came it had become chronic.
 
The period of confinement in the enclaves can be divided into two periods; in the first, which lasted five years the people were virtually prisoners; in the second, the six years that followed, the Greek soldiers were no longer stationed encircling the enclaves, and the Turks were allowed to enter the Greek sectors "freely" and to visit other enclaves. But for all practical purposes they were treated outside their own en­claves as second-class citizens.
 
Careful  examination  of what  was going on during the closely confined five-year period shows an interesting phenomenon, one ap­parently illogical and best understood from the psychologic point of view—the establishment of a shared grandiosity among these deprived people, some of whom were obliged to live in subhuman conditions. There was an inflated group concept—a kind of group narcissism.
 
The tensions they all felt, occasioned by the physical limitations of their daily life, had re-established something very like the traditional extended family, which modernization had generally modified in the di­rection of smaller kinship units. Many family members, and even their friends, were obliged to live together in the crowded enclaves, and such togetherness, along with the deprivations they all shared, strongly reacti­vated the mechanism of externalization of self-and-object images seen as bad and worthless. Such externalizations were supported by projection of aggressive impulses. The end result of such psychological ma­neuvers was the creation of a world outside the walls that confined them—a world populated by enemies and one to be decried. The physical barriers behind which they lived—barbed wire, trenches, actual walls, and piled-up oil drums—took on a psychological meaning that supported the inner perception of the confined that all beyond them was bad and/or worthless, and all confined within them, good and/or gran­diose. The Turks' perception of the Greek world outside the barriers as bad persisted in spite of their intellectual appreciation that the Greeks were, in fact, thriving. Paradoxically, the much more meager world within the enclaves was tinged with grandiosity, which was obviously de­fensive.
 
A grasp of what an individual's narcissistic personality is will help us understand group narcissism. Recent studies54-57 of narcissistic per­sonality organization show that the person with such a personality orga­nization feels himself preeminent, first in power, brilliance, beauty, and so forth, and considers therefore everyone external to himself who does not adore him as beneath contempt. Paradoxically, the intense feeling of grandiosity can coexist with feelings of inferiority and overdependence. The grandiosity, that inflated self-concept, is a defense against and compensation for early frustrating experiences which could not be positively modified for the child by a cold mother, who, neverthe­less, valued a specialness in the child. Modell's57 studies, as well as my own,55-56 show that such persons often have the fantasy of dwelling in­side a glass or plastic bubble in which they create a glorified, albeit lonely, kingdom of their own. This bubble fantasy is actualized by many such patients in an attempt to support the illusion that if their inflated self-concept is put under a cover (inside a wall), so to speak, its stability and cohesiveness can be maintained. It can, thus, be separated (primi­tively split)54-55 from the inferior aspects of the self and objects connected with appropriate feelings. I once knew such a patient who saw himself as Robinson Crusoe with no need for Man Friday; he was unable to sleep at night until he had reactivated this fantasy of being omnipotently alone on his island (bubble.)
 
Although one must acknowledge that the psychologic processes of a group differ in some respects from those of a single individual, a parallel can be seen between the defensive-adaptive constructs of the individual with narcissistic personality organization and those of a group that has been severely traumatized but left with chronic hope of survival. Thus, the walls of the enclaves in Cyprus were symbolically the walls of a plastic bubble within which the Turks created a glorified world of their own in an adaptive defensive maneuver against their helplessness.
 
One manifestation of this group narcissism appeared in a mass hobby; everyone seemed to be raising parakeets in cages. There were hundreds of them in the houses, markets, and public places; one had to step over cages to buy a loaf of bread in the grocery. No one saw this bi­zarre preoccupation as out of the ordinary, and I was reminded of a Turkish proverb that fish living in the water do not know what water is. Elsewhere7-49 I explore the symbolism of these birds and what they meant to their owners. Here I offer only a summary of my formulation, and something about how the mass hobby reflected the group's nar­cissism. Because the Cypriot Turks had waited five years in vain for help from Turkey, they could no longer idealize Turkish leaders who had to limit their concern to political activity. The birds represented their needy parts, and as they cared for them they identified with an abstract savior. Raised in families that represented the Turkish extended family, the birds served not only their owners' denial of their needy selves by giving them a target for externalization, but their grandiosity as well. When the birds sang they were felt to be joyously extolling their caretakers. People confined in enclaves felt free com­pared to birds living in small cages. As long as they could maintain the illusion of being self-sufficient by controlling the savior and the saved (in the small, simple world of their birds) they could be like Robinson Crusoe with no need for a Man Friday (Turks from the mainland.) Their great interest in their bird's fecundity reminds one of "the process of biological regeneration" observed by Williams and Parkes58 in sur­vivors of the Aberfan tragedy in Wales, in which 116 children and 28 adults were lost in an avalanche of coal slurry. Surviving couples in Aberfan who had not lost a child demonstrated an impulse toward "bio­logical regeneration" in a birth rate that rose sharply after the tragedy. Fruitful birds encouraged their owners to believe that Turkish Cypriot stock would not perish but would continue.
 
Myths about a great weapon also supported the people's grandiosity as a defense against their helplessness. Such myths often arise under the pressures of war. Niederland in a personal communication to me speaks of the myth of a secret or uniquely effective weapon believed in by concentration camp survivors he interviewed. The Cypriot Turks believed, as was evident in children's play or adults' unguarded remarks, that there was some special weapon on the mountaintop site of an ancient castle historically associated with heroism and strategically im­portant for the Turks of that time. It was at the highest point under Turkish control. The likelihood of some sort of gun emplacement there provided a kernel of truth for this myth, which envisioned a sym­bolic anal explosion or phallic thrust against the enemy, or a big breast to nurture the helpless people.
 
The grandiosity of the confined Turks coexisted, as might be ex­pected, with their feelings of helplessness and the turning against themselves of their accumulated aggression. For example, the stories told to children at bedtime would begin in the usual way with the trials and tribulations of a hero; but now, instead of the classic triumphant happy ending, there was usually an account of the hero's annihilation or dismemberment.
 
The second phase of life in the enclaves began in the summer of 1968, when the Cypriot Greeks removed the encircling ring of Greek soldiers and allowed the Turks to go from one enclave to another. All interest in the parakeets vanished with the opening of the gates. The ten people I interviewed seven years later with the specific purpose of eliciting memories about the bird hobby had only a dreamlike memory of them. As soon as the Cypriot Turks could visit the world outside their enclaves they could no longer maintain their illusion of grandiosity. The external situation had so changed as to render the symbolism of the wall (a protective bubble) ineffective. Greek sectors glittered with a prosperity that contrasted sadly with the shabby enclaves, and the Turks were not only unable to activate their sadistic wishes toward their op­pressors, but to continue any longer the narcissistic denial of Greek power. They had to be submissive entering a Greek sector. Their humiliation was great, and their self-esteem sadly reduced, as was ap­parent during the six years of "open" enclaves. Old narcissistic defenses had to take new forms; the great weapon became more like a nurturing breast than before, and a huge flag was flown near the castle on a wire stretched between two mountains. The Turks could see this red signal over great distances, and its sight "refueled" them. They obtained some relief from denying the Greeks admission to the enclaves under absolute Turkish control. Whatever the military or political reasons for this, it was psychologically helpful to the interim survivors in handling their shared low self-esteem. In psychoanalytic terms it was an anal retentive measure against the enemy, and it preserved a secret, as it were, causing the enemy to fantasy in frustration what was going on among the Turks, and promoting the Cypriot Turks' faith in their power and the possi­bility of magical repair of their narcissistic injuries. In spite of such bra­vado, the low self-concept of the interim survivors would reappear from behind the various adaptive measures by which they clung to the illusion of power and chronic hope; many people were hypochondriacal, and most habitually used antidepressive or tranquilizing drugs, which could be obtained without prescription. The society had become orally de­pendent on sedation. One could hear the lament "We'll all die off! Within 15 years no Turks will be left on Cyprus!" This was the situation when, in the summer of 1974, war erupted. Troops from mainland Turkey, liberating the Turkish enclaves in the north, divided the island in two. New adjustments were then required.
 
Postwar observations on Cyprus:
My report concerns only the northern sector of the island in which my studies took place, but I can imagine the disastrous effects of events on the thousands of Cypriot Greek refugees fleeing to the south, and the tragedies they faced. Although I am aware of no searching psychologic study of their adjustment, the work of Evdokas and his associates59 is helpful. Evdokas, a psychiatrist, questioned the Greek refugees with the help of other social scientists and made it possible to analyze the manifest content of their replies.
 
The initial response of the Turks liberated after 1974, was shared elation. One Cypriot Turkish psychiatrist told me six months after the event how doctors and patients in his hospital spontaneously joined hands and danced in the yard of the hospital when they first saw the Turkish aircraft from which the paratroopers jumped. The patients, who were mostly schizophrenics, were so overtaken by euphoria that they were without symptoms and seemed for a while to be altogether well. Although such a statement sounds extreme, it is in accord with the fact that "emotional flooding,"55 whether triggered by libido or ag­gression, can cover over other coexistent psychologic states and lead to perceptual change. The feeling of elation was so strong and so freely shared that it seemed to take precedence over the existing, individual characterologic differences. The dominant feeling shared by a popula­tion long victimized glued it together in a new form of group cohesion. Elation was in the service of trying to acknowledge that a great change was occurring. Like the anger that appears after a loss such as the death of a loved one in the service of confirming the reality of the death, ela­tion was needed to confirm change. In that part of the world at the time, I clearly saw the effects of this, which lasted from six to eight months after the war, drawing the Turks in Cyprus and those in Turkey together as brothers and sisters. This manifestation of cohesion was particularly significant in view of the political and economic troubles Turkey was then facing and the fragmentation accomplished by dif­ferences in political party and class.
 
Nonetheless, there was great personal suffering, especially among those who had lost relatives and friends, and those who had been obliged to become refugees in a flight to the north. Postwar adjustment can be expected to require accommodation to change and loss, and to bring into play the psychodynamics of mourning. Symptom formation and alteration in character traits associated with war can best be understood as fixations in one of the phases of mourning; there was a general simi­larity in the responses of different people to the shared external changes. Even the initial elation can be viewed as the initial phase of mourning since it helps people to accommodate to change, but although the elation was confirmed by the Turkish view of all that had happened as ultimately beneficial for the Turks, one cannot forget that elation and depressive feelings are opposite sides of the same coin.
 
A more appropriate process of mourning started once the elation and hyperactivity subsided. I12 have spoken of the mourning of the Cypriot Turks before in this journal, so I will not repeat myself. Here I point out that mourning, whether evoked by the loss of beloved dead or the loss of accustomed enemies and familiar places, was not easily accom­plished by the Cypriot Turks after this war. This may be true of all postwar grieving, but perhaps each war has some unique reason that makes it difficult for those involved in it to grieve. For example, A. and M, Mitscherlich60 wrote about the inability to mourn among the Germans after Hitler's downfall, since they perceived their dead as hav­ing been sacrificed to him. This perception meant that to mourn them would be to acknowledge an alliance with him and all he represented— to be in contact with their own guilt because of implicit association with Nazi crime. The Cypriot Turks could not mourn their dead for quite another reason—they saw them as having died that others might live, in a heroic sacrifice. They glorified and idealized their dead, and it is very hard to "kill" (psychologically) the giants of one's fantasy, although—or perhaps because—it is psychologically useful to "memorialize" them. Many memorials such as statues and tablets were quickly put in place in northern Cyprus, and much of the affect associated with grieving was locked into this stone and bronze.
 
The Cypriot Turks could not easily grieve over the dead or departed Cypriot Greeks, who had been invested with "all bad"-ness as the enemy, but their departure not only removed the real danger connected with their presence, but also the targets of their aggression to which the Turks had so long been accustomed. To mourn over the Greeks was to acknowledge this aggression. Thus the Cypriot Turks kept things that tied them to the Greeks who were now long gone—(linking objects61); and tried in piecemeal fashion to "bargain" for separation from the absent enemy. I often encountered such linking objects even as late as my visit to the island in the summer of 1977, although by then the initial intense investment in them was attenuated. It was never surprising to have the Turkish occupant of a formerly Greek house spontaneously and at some rather inappropriate moment ask if I would like to see something that had belonged to his Greek predecessor. Sometimes this would be a photograph of someone my host had never actually met, but who used to live in his house; whatever it was, it clearly had a highly emotional value in linking the two men together.
 
When the process of mourning is complicated it leads to symptom formation and/or changes in the characterological makeup. The be­reaved individual may, for example, become (defensively) callous about whatever has changed or been lost. When after a war both adversary groups are callous and unable to empathize with one another, it becomes an impossible task to find political as well as social peace. Mack62 uses the term the egoism of victimization to refer to the absence of empathy a national group may exhibit toward the suffering of a traditional enemy even when the condition of the latter is the more grievous. The Greeks and Turks alike were surely afflicted with such egoism of victimization, all of the reasons for which Mack holds are not understood, although severe hurt and grief seem to make it inevitable. He states that third-party intervention is essential if the cycle of repeated war between two ethnic groups caught up in a web of hostility and without empathy after a confrontation is to be interrupted. He warns, however, that third-party nations may exploit such a draw for their own national purposes.
 
A "Living Statute":
Thus far I have referred to collective behavior. It is obvious that in Cyprus, as in any other war-torn place, one would find individuals with psychiatric conditions precipitated by war and its attendant stress but idiosyncratic to the individual rather than to the group to which he belongs. The meaning of the neurotic or psychotic, symptoms or character changes of such a person can be understood only in reference to his psychological makeup and with an assessment of how he internally perceives external events and symbolizes them.
 
In my work on Cyprus, I came to know some individuals I called "liv­ing statues."7 By a twist of fate they were perceived by others as symbols of the collective struggle, and living memorials. What was most important was that they themselves had suffered a change in self-concept in assimilating their role of epitomizing the group struggle. I suspect that every war has had such living statues, but I can only describe those I found among the Cypriot Turks.
 
Case report:
In the spring of 1975, six months after the war in Cyprus, I was asked to see professionally an 11-year-old boy. His name is Savaş, which, in English, means war. His father is a well-known Cypriot Turk­ish poet; since I am identifying him, I cannot disclose all of the particu­lars of his life, but only what I have permission to reveal. His family moved after the war into a vacated Greek house. The discovery of a putrefying body in the adjoining orange grove made Savaş extremely anxious and initiated rather severe obsessive-compulsive symptoms in him. He had been born on December 25, 1963, which is known by the Cypriot Turks as the "Bloody Christmas" that signaled the eruption of interethnic conflict. The father-to-be was away from home that day, having left his pregnant wife and his mother in their mixed village. The two women were captured, the younger being taken to a Greek hospital, where she gave birth to Savaş, who was placed in a crib alongside other Turkish babies in a nursery used also as a morgue for Turkish casualties. A shocked British nurse removed the babies and found room for them elsewhere.
 
The poet father did not know for some time whether his family had survived, but he was reunited with them on the 10th of January, and for the first time saw his son, whom he named War because of the circum­stances of his birth. He then wrote a series of poems called Letters to My Son, Savaş,63 in which he described what was happening when the boy "was opening his eyes on the world." He wrote daily during the months that followed the birth. The poems point to the child as an immortal, or at least a child of destiny. The first tells how the child might have died in the womb without having known the miracle of life. Each begins with an admonition like "Listen well, my son," and speaks of the unique identity of the infant who knew the stench of death with his first breath—an identity as perceived by the father, and by others through the publication of the poems. The volume ends with reference to the statue of Atatürk, the Turkish hero, savior, and first President, which stands in the Cypriot capital city's Turkish sector. The poet turns to it in his fantasy and sees tears in the eyes of Atatürk, who would save the Turks if he still lived.
 
When I first saw the boy War, he remarked that books are usually written only about famous people from the past, like Atatürk, but that one had already been written about him. He seemed to feel that he had been immortalized, and later interviews made it clear that his father and others had from his early childhood unconsciously impressed him with the belief that he was a special symbol of war. As he grew he identified himself with the statue of the hero Atatürk. When, during the war, a stray bullet narrowly missed him as he sat in his room, the self-concept of his having been saved by a "miracle" from dying at birth was reactivated, and his identification with Atatürk was strengthened. As a schoolboy he heard about Atatürk's narrow escape from death at Gallipoli, when shrapnel striking his breast shattered a watch in his pocket without injur­ing him. When the boy had caught the stench of putrefaction in the orange grove, he recalled that he was born to smell death as his father's poern, which had become part of the country's mythology, indicated. All these experiences fostered his belief in himself as a symbol of war and heroism, and contributed to his need to be perfect, although I am fully aware as an analyst that his obsessional neurosis owed much also to problems of his psychosexual development. Although the events dur­ing and after the actual war initiated his neurotic symptoms, he had a character that included the self-image of being a memorial to the strug­gle of his group. One of his revealing symptoms was that he thought his face was like the marble of a statue, and he feared that if he scratched it it would crumble like crumbling stone.
 
I am happy to say that the young man War, who still keeps in touch with me and who is following in his father's footsteps, becoming himself a man of letters, is now without neurotic symptoms. I believe, nonethe­less, that his self-concept of being a memorial to his people persists.
 
Concluding remarks:
The study of clinical conditions in voluntary or involuntary par­ticipants in war—especially those conditions common to the involved masses—is useful in promoting an understanding of the destructive potential of man. The paradox that aggression increases self-esteem cannot be overlooked in any clinical study of the psychology of war perse. The problems of narcissistic hurt and narcissistic defense, handed down from one generation to another as they have been in Cyprus, and their reactivation under certain political, economic, and historical conditions, require further scrutiny. Referring to Freud's2 passing attention to the problem of conflict between one national group and another, Mack62 suggests that Freud himself saw a definite area of narcissism at the heart of the difficulty. The explosive hostility between certain groups arises from long-standing resentment and dislike awakened in each over years of proximity during which individual as well as collective self-images have become fiercely competitive and interaction has been marked by each group's defensive pride and hurtful denigration of the other. Mack states that a group is like an individual in seeing as an enemy any others perceived, rightly or wrongly, as a threat to the survival of the self or self-esteem. The threat need not be one of physical annihilation. We must learn to be sufficiently objective in looking at any war to ac­knowledge that it might be ego-syntonic for at least one of the parties in conflict. Such divisive forces are part of the human condition, whether we want to admit it or not.
 
Summary:
Except for obvious differences in technology, one war may seem like any other in its affect on the quality of life, but each has unique psychological determinants and a unique impact on the human beings involved. A case-by-case interdisciplinary scrutiny is necessary to un­cover the genesis, as well as the psychological influences, of any given conflict, as becomes evident in this report of the 1974 war on Cyprus.
 
 
 
 
 
 
 
 
 
 
REFERENCES:
 
1-  Richardson, L.F. (1960.) The Statistics of Deadly Quarrels. Stevens and Sons, New York.
 
2-  Freud, S. (1930.) Civilization and Its Discontents. In Standard Edition, Vol.21. Hogarth Press, London, 1961, pp.59-145.
 
3-  ______  (1932.) Why War? In Standard Edition, Vol.22. Hogarth Press, London, 1961, pp.197-215.
 
4-  ______  Thoughts for the Times on War and Death (1915.) In Standard Edition, Vol.14. Hogarth Press, London, 1961, pp.273-301.
 
5-  Arlow. J. (1973.) Motivations for Peace. In Psychological Basis of War. (Eds.), Winnik, H.Z., Moses, R., and Ostow, M., Jerusalem Academic Press, Jerusalem,
 pp.193-204.
 
6-  Jones. E. (1915.) War and Individual Psychology. In Essays in Applied Psychoanalysis, Vol.1. International Universities Press, New York, pp.55-76.
 
7-  Volkan, V.D. (1979.) CyprusWar and Adaptation: A Psychoanalytic History of Two Ethnic Groups in Conflict. University Press of Virginia, Charlottesville, VA.
 
8-  Mitscherlich, A. (1971.) Psychoanalysis and the Aggression of  Large Groups. Int. J. Psycko-Anal., 52:161, 9.
 
9-  Glover, E. (1933.) War, Sadism, and Passivism. Allen and Unwin, London.
 
10- Fornari, F. (1966.) The Psychoanalysis of  War. Tr. A. Pfeifer. Indiana University Press, Bloomington, Indiana, 1975.
 
11- Atkin, S. (1971.) Notes on Motivations for War, Toward a Psychoanalytic Social Psychology. Psychoanai Q., 40:549.
 
12- Volkan, V.D. (1977.) Mourning and Adaptation After a War. Am, J.  Psychother.31:561.
 
13-  Rado, S. (1942.) Pathodynamics and Treatment of Traumatic War Neurosis (Traumatophobia.) Psychosom. Med., 4:362,14.      
 
14-  Freud, S. (1919.) Introduction to Psycho-analysis and the War Neuroses. In Standard Edition, Vol.17. Hogarth Press, London, 1955, pp.207-210.
 
15-  Kardiner, A. (1941.) The Traumatic Neuroses of War. Psychosomatic Medicine Monograph II-III. Paul Hoeber, New York.
 
16-  Freud, S. (1920.) Beyond the Pleasure Principle In Standard Edition, Vol.18. Hogarth Press, London, 1961, pp.7-64.
 
17-  Hardcastle, D.N. (1944.) Some Notes on Traumatic Neurosis and Allied Conditions. Int. J.Psycho-Anal., 25:132. 
 
18-  Thorner, H.A. (1946.) The Treatment of Psychoneursosis in the British Army. Int. J. Psycho-Anal., 27:52. 
 
19-  Wagner, P.S. (1946.) Psychiatric Activities During the Normandy Offensive, June 20-August 20, 1944. An Experience with 5,203 Neuropsychiatric Casualties.
Psy­chiatry, 9:341.  
 
20-  Blain, D., and Heath, R.G. (1944.) The Nature and Treatment of Traumatic War Neuroses in Merchant Seamen. Int. J. Psycho-Anal., 25:142.
 
21-  Dreyfuss, D.K. (1949.) Delayed Epileptiform Effects of Traumatic War Neuroses and Freud's Death Instinct Theory. Int. J. Psycho-Anal., 30:75.
 
22-   Lidz.T. (1946.) Nightmares and the Combat Neuroses. Psychiatry, 9:37-49. 
 
23-   ______  (1946.) Psychiatric Casualties from Guadaecanal, A Study of Reactions to Extreme Stress. Psychiatry, 9:193.  
 
24-   Wexler, H, (1972.) The Life Master: A Case of Severe Ego Regression Induced by Combat Experience in World War II. Psychoanal. Study Child, 27:565.
 
25-   Glover, E. (1942.) Notes on the Psychological Effects of War Conditions on the Civilian Population, "The Blitz—1940-41." Int. J. Psycho-Anal., 23:17.  
 
26-   Schmideberg, M. (1942.) Some Observations on Individual Reactions to Air Raids. Int. J. Psycho-Anal., 23:146.
 
27-   Freud, A. and Burlingham, D. (1942.) War and Children. International Universities Press, New York.
 
28-   Furst, S.S., (1967.) (Ed.) Psychic Trauma. Basic Books, New York. 
 
29-   Nunberg, H. (1956.) Character and Neuroses. Inl. J. Psycho-Anal., 37:36. 
 
30-    Friedman, P. (1949.) Some Aspects of Concentration Camp Psychology. Am. J. Psychiatry, 105:601.
 
31-    Sonnenberg, S.M. (Reporter) (1974.) Children of Survivors. J. Am. Psychoanal. Assn., 22:200. 
 
32-    Rappaport, E.P. (1968.) Beyond Traumatic Neurosis. Int. J. Psycho-Anal., 49:719. 
 
33-    Niederland, W.C. (1961.) The Problem of the Survivor. Hillside Hasp.,10:233. 
 
34-   ______ (1968.) Clinical Observations of the "Survivor Syndrome." Int. J. Psycho-Anal., 49:313.
 
35-    Eitinger, L. (1964.) Concentration Camp Survivors in Norway and Israel. Allen and Unwin, London. 
 
36-    Rangell, L. (1976.) Discussion of the Buffalo Creek Disaster: The Course of Psychic Trauma. Am. J. Psychiatry,133:313.
 
37-    Liflon, R.J. (1968.) Death in Life, Survivors of Hiroshima. Random House, New York. 
 
38-    Lifton, R.J., and Olson, E. (1976.) The Human Meaning of Total Disaster, The Buffalo Creek Experience. Psychiatry, 39:1.  
 
39-    Mezey, A.G. (1960.) Personal Background, Immigration, and Mental Disorder in Hungarian Refugees. J. Ment. Sciences, 106:618.
 
40-   ______ (1960.) Psychiatric Illness in Hungarian Refugees. J. Mental Science, 106:628. 
 
41-    Meszaros, A.F. (1961.) Types of Displacement Reactions Among the Post-Revolution Hungarian Immigrants. Can. Psychiatr, Assoc. J., 6:9.
 
42-    Rumbaut, R.D., and Rumbaut, R.G. (1976.) The Family in Exile: Cuban Expatriates in the United States. Am. J. Psychiatry, 133:395.
 
43-    Buckman, J. (1977.) Brainwashing, LSD, and CIA: Historical and Ethical Perspective. Int. J. Soc. Psychiatry, 23:8.
 
44-    Tiffany, W.J. (1967.) Mental Health of Army Troops in Vietnam. Am. J. Psychiatry, 123:1585.
 
45-    Strange, R.E., and Arthur, R.J. (1967.) Hospital Ship Psychiatry In A War Zone. Am. J. Psychiatry, 124:281.
 
46-    Bloch, H.S. (1969.) Army Clinical Psychiatry in the Combat Zone—1967-68. Am. J. Psychiatry, 126:289. 
 
47-    Harding, R.K., and Looney. J.G. (1977.) Problems of Southeast Asian Children in a Refugee Camp. Am. J. Psychiatry, 134:407. 
 
48-    Figley, C.R., (ed.) (1978.) Stress Disorders Among Vietnam Veterans. Brunner/Mazel, New York.
 
49-    Volkan, V.D. (1972.) The  Birds of Cyprus: A  Psychopolitical  Observation. Am. J. Psyckother., 26:378. 
 
50-    Markides, K.C. (1977.) The Rise and Fall of the Cyprus Republic. Yale University Press, New Haven.
 
51-    Geertz. C. (1973.) The Interpretations of Cultures. Basic Books, New York. 
 
52-    Shils, E. (1957.) Primordal, Personal, Sacred, and Civil Ties. Br. J. Sociology, 8:130. 
 
53-   Vassiliou, G., and Vassiliou, V.G. (1970.) On Aspects of Child Rearing in Greece. (Eds.), Anthony, E.J., and Koupernik, C.,  
In The Child and His Family, Vol.1, pp.428-444. Wiley-Interscience, New York.    
 
54-   Kernberg, O.F. (1975.) Borderline Conditions and Pathological Narcissism. Jason Aronson, New York. 
 
55-   Volkan, V.D. (1976.)  Primitive Internalized Object Relations. International Universities Press, New York.
 
56-   ______   (1979.) The "Glass Bubble" of the Narcissistic Patient. In Stable Instability, (Eds.), LeBoit. J. and  Capponi, A. Jason Aronson, New York.
 
57-   Modell, A.H. A Narcissistic Defence against Affects and the Illusion of Self-Sufficiency. Int. Psycho-Anal., 56:275.
 
58-   Williams, R.M., and Parkes, C.M. (1975.) Psychosocial Effects of Disaster: Birth Rate in Aberfan. Brit. Med. J. Vol.2:303-304. 
 
59-   Evdokas, T., Mylona, L., Paschalis, C., et al. (1976.) Refugees of Cyprus, A Representative Socio-Psychological Study. Theo Press, Nicosia, Cyprus. 
 
60-   Mitscherlich, A., and Mkscherlich, M. (1975.) The Inability to Mourn: Principles of Collective Behaviour. Grove Press, New York,
 
62-  Volkan, V.D. (1972.) Linking Objects of Pathological Mourners. Arch. Gen. Psychiatry, 47:215.
 
62.  Mack, J.E. (1978.) Foreword. In Cyprus-War and Adaptation by V.D. Volkan. University Press of Virginia, Charlottesville.
 
63.  Yasin, Ö. (1965.) Oğlum Savaş'a Mektuplar (Letters to My Son Savaş.) Çevre Yayınları, Girne, KKTC. 
 
 
 
 
 
 
 
 
 
 
 
 
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