Does trauma linger into Old-Old age? using the holocaust experience as a paradigm

Trauma that lingers from early to very late life poses a special threat to the labile conditions of adaptation while facing imminent frailty and death. This chapter examines long-term effects of trauma in three modes of survival into old-old age: (a) dementia-molded survival, which raises a question as to whether cognitive impairment sensitizes traumatic memories or blunts them, (b) embattled survival, which involves either a chronic confrontation with the past trauma or else its reactivation in the adverse conditions of late life, and (c) robust survival, which maintains the capacity to stay well in the face of age-related challenge as well as past trauma. Coping with past trauma under robust survival typically generates a delicate balance between general resilience and specific vulnerabilities. This chapter dwells on research of old and old-old Holocaust survivors, who provide a paradigm for the special challenge of long-term effects of extreme trauma. LIFETIME TRAUMA AND SURVIVAL IN OLD-OLD AGE A key issue that developmental models need to account for is the combined impact of distal influences, such as adverse events early in life, and proximal influences, such as recent experiences and resources (Martin & Martin, 2002; see Chapter 5). As developmental trajectories become increasingly obscured and labile in old-old age (Baltes, 1997; Poon & Perls, 2007), the interactive effects of distal trauma and proximal age-related experiences are particularly intricate or unpredictable.