In Memoriam Alexander Friedmann, MD (1949-2008)

Alexander Friedmann

It comes as a shock to realize that even in such a comparatively young field as the contemporary field of cultural psychiatry is, we must confront the illness and death of colleagues and friends who have been important contributors to our discipline.

Such has been the case recently.

On March 30th, our good friend and colleague, Alexander Friedmann, died suddenly and unexpectedly, in Vienna.

Alex played a central part in the Vienna Organizing Committee for the highly successful WPA-TPS conference held in Vienna, at the Vienna University Medical School and Hospital, in April, 2006. He was also a key member of the Organizing Committee of the 1st International Conference on Transcultural Psychiatry in the German-speaking Countries, co-sponsored by WPA-TPS and held in Witten Germany, in September 2007.

Before his untimely death, Alex was very actively involved in the planning for the 2nd International Conference on Transcultural Psychiatry in the German-speaking Countries, to be held in Vienna in September 2008.

His enthusiasm, commitment, open-mindedness and good humor will be very much missed by all who knew him and worked with him.

Alex Friedmann was only 59 years old when he died. In addition to many, many friends and colleagues who mourn his loss, he leaves Kitty, twin sons, age 14, and a daughter, age 10.

In January, I worked with Alex on the editing of his bio-sketch, It is included in this memorial tribute to him.

Ron Wintrob, 8 May 2008

A Tribute to Alex Friedmann

I had heard about Alex; that he was a lively, congenial man and a unique one too. I heard that he had been instrumental in helping the Jewish immigrants to Austria from the former Soviet Union adapt themselves to living in Vienna and other places in Austria.

I first met Alex at the WPA-TPS conference in Vienna, in Apr 2006. It was the first TPS conference I had helped organize since becoming chair of the Section in Sep 2005. I was more than a little anxious about how the conference would go: would the facilities be adequate, would there be enough participants, would the atmosphere and ambience of the conference be what I had hoped for?

I needn’t have been so concerned. All those details had been very well organized by Thomas Stompe and the Vienna organizing Committee…that included Alex.

Pauline and I like to attend as many presentations as we can at TPS conferences. Many of the presenters are our friends, and we like to hear them discuss their work. In Vienna, we were eager to hear Alex’s presentation on the cultural integration of Jews from the former Soviet Union, especially those from its Asian regions, ‘Sephardic’ Jews whose cultural traditions were very different from those of the ‘Ashkenzi’ Jews; the group that both my parents had come from, during the centuries that their families had lived in Russia and Poland before they migrated to Canada in the early 20th century.

Alex’s presentation was intensely moving for me and Pauline. I started to tell him that, after his presentation, when I introduced myself. But I couldn’t express it, because I almost immediately became choked up with emotion; not something that usually happens to me in response to a colleague’s presentation. I felt very awkward at becoming so overcome. Alex was warm, sympathetic and generous in his response.

We became close friends from the time of that interchange. We talked a lot during the conference. I learned more about Alex’s contributions to helping rebuild the Vienna and Austrian Jewish communities, and the recognition he was accorded for those efforts by the governments of Vienna and of Austria. I also learned about his own family background, and about his wife and children. He talked about how he had developed his commitments to the Jewish community’s welfare; in Vienna, in Austria, in Israel, in the world.

We kept up our contacts by correspondence. We communicated about plans for the launching of a professional group of German-speaking psychiatrists and other mental health clinicians interested in cultural psychiatry. I was invited, and very honored to participate, at the 1st international conference of transcultural psychiatry in the German-speaking world, held in Witten, Germany, in Sep 2007. Alex played a major role in the conference organizing committee. We had a number of opportunities to spend time together in Witten.

We started making plans to spend time together again in Sep 2008; first at the WPA Congress in Prague, then at the 2nd international conference of transcultural psychiatry in the German-speaking world, to be held in Vienna. Alex would again be playing a major part in the Vienna conference organizing committee.

At the Prague Congress, Alex had agreed to give a presentation on his efforts to help rebuild the Jewish community in Vienna since the 1970s, including his visionary work with the Sephardic Jewish immigrants, at a symposium the Section was sponsoring on the impact of Jewish culture on psychiatry.

Such unique men as Alex come amongst us only rarely. He loved people, he loved what he did as a doctor and as a psychiatrist. He had commitments that were deeply felt for his background, for the Jewish community, for Vienna, for Austria. He loved his family. He loved his friends too. And they returned the affection.

He did things to help other people; his patients, their families, and he did things for students and colleagues who came under his influence. People liked working with Alex because of his warmth, commitment and professional wisdom.

For all that, we thank Alex, and we count ourselves very fortunate to have been with him when he was amongst us.
We will miss him…but we will not forget what he has given to enrich our lives for having known him.

Ron Wintrob Chair, WPA-Transcultural Psychiatry Section

Motivating Deeds after the Trauma

For Alexander Friedmann cross-cultural psychiatry represented more than a scientific field.

All of a sudden, it is too late to confer with Alexander Friedman. His unexpected death on March 30th has made another meeting I had intended to have with him impossible.

I had met him for an interview in Witten, Germany in September, 2007, during the first international congress of transcultural psychiatry in the German-speaking countries.

Dr Friedmann was one of the organizers of that conference. At the time, I had said to myself, this conference is ending, but the theme of the conference is still in the early stages of development – there is therefore no need to hurry to complete the interview with Alex in Witten- we could meet again in Vienna.

The man who had opened my eyes to a new field of expertise had to leave the congress early to get a plane. His presence however, was noticeable right to the end.

Now, in the middle of ongoing preparations for the second international congress of transcultural psychiatry in the German-speaking countries, to be held in Vienna in Sep 2008, and for which he was principally involved in the planning, he has left us forever.

His friends, family and colleagues are only now able to grasp the fact that he has not merely just temporarily left the room, but that he will not be coming back. Although telephone calls and emails do refer to the tragic event, his loss remains “un-graspable” to us. This sentiment will undoubtedly be reflected in many other obituaries and leave a lasting patina on our memories of him.

It is possible for a full life to be reduced to mere landmarks, if set forth in a table: A-levels at the Lycée Français of Vienna in 1967, award of doctorate in1977 and the qualification of medical specialist in psychiatry in 1984, assistant professor and initiator of a social-psychiatric centre in 1990, instructor in psychiatry, lecturing tutor of the Special Outpatient Clinic for Cross-cultural Psychiatry and Migration-related Psychological Disorders, and initiator of the ESRA association 1994, initiator of a vocational education centre combined with a training workshop in 1998. In 1995 and 2000, he was awarded the Decoration of Merit 1st Class of the Republic of Austria and the State of Vienna.

I am able to retrieve a sign of the living Alexander Friedmann in a reflection he wrote on 21 January 2008 for the website of the World Psychiatric Association (https://www.wpa-tps.org/wpa-tps-site/Friedmann-A.htm). Here I can find answers to questions I was tragically denied the opportunity to ask myself.

Friedmann reports that his parents grew up as Austrian citizens in Czernowitz, the prospering capital of the Bucovina District. The local Jewish community was comprised of Orthodox Hassidic Jews, as well as of highly emancipated and assimilated Jews. In terms of religious tolerance, the Jews of Austria were accepted and treated on an equal footing with other Austrian citizens since 1882, and the Jews were loyal citizens of Austria-Hungary. The Empire collapsed with its capitulation at the end WWI. Alex’s parents became Romanian citizens. They married in1942 in Bucharest. Within a short period of time, they fell victim to persecution by the Romanian fascist regime. His mother, prosecuted as a communist and discriminated against as a Jew, was deported to a concentration camp. She was able to survive due to the help of her husband, who went into hiding and supplied forged documents for victims of Nazi persecution.

Their only child, Alexander, was born in Bucharest in 1948. Both parents had somehow survived the Holocaust. They now dreaded Stalinist Romania and fled to Palestine- a saga of its own- to join their Zionist relatives who had been living in Palestine for many years. The mother and the ailing child however, are not able to find peace and gain strength in the newly-founded State of Israel. Alex and his parents re-immigrated to Vienna in 1952. For Alexander, school represented a confluence of French, German and Austrian cultures.

At home he was simply a Jew, with a migration background, while at school he learned to speak six languages. In Austria, as Friedmann recalled the post-WW2 years, the 1950s were no bed of roses for Jews. Anti-Semitism continued to flourish – Austria’s self-surrender to Hitler’s German Reich is denied to the extent of accepting the historical lie that Austria was the Nazis’ first victim.

At age 16, Alexander was arrested as a participant in a rally opposing Neo-Nazis, in 1964:”It was incomprehensible to me, how it could be possible that young Austrians were in denial of the historical reality of WW2 and could maintain the conviction that the Holocaust had never taken place”. In retrospect, Friedmann is convinced that the cornerstone for the decision for a course of study that would enable him to understand people and their psychological roots was embedded that very day.

The final decisive influences upon his career choice are the tensions in the forefront of the Six-Day War, in 1967. The very same week, directly after having successfully concluded the entrance examination for medical studies at Vienna University, he departs for Israel. For the following 10 years he will devote his semester breaks to Israel, working as a farm hand, and at the end of this term, provide medical aid to Bedouin nomads by his ambulance service in the Negev desert. He then concentrates on his medical specialist training in Vienna, the emphasis of which is directed to the fields of social and cultural psychiatry.

Cross-cultural psychiatry is so closely tied in with his own life, his family’s and his Jewish people’s history and experiences, that he never just approaches this field of expertise on an academic discipline. As an assistant professor, he succeeds in establishing an outpatient clinic at the University Hospital, in which people originating from various countries and cultures can find help. According to Friedmann: “Today, many years later, I am convinced that people, even though they may acculturate and lose some of their culturally characteristic features, are very similar when seen from a psychological perspective. They react to and suffer from the same type of illness and the same distressful experiences of life, but they express their anguish using different languages, customs and bodily symptoms.

Friedman also perceives the Jewish Community of Vienna in the light of a changing history. The first Jew mentioned is a medieval era coin maker, who is murdered in the end. In the course of 9 centuries, there is constant change between tolerance and appreciation on one hand, and persecution and casting out on the other. Before the “Anschluss” to Hitler’s Reich, there were 200.000 Jews living in Austria, amongst them acclaimed authors such as Schnitzler and Zweig, physician-psychiatrists such as Freud and Adler, musicians such as Mahler and Schönberg.

Whoever was still alive after 1945 and had come back to Austria, finds his former property plundered and “Aryanized”. Several thousand victims, who had survived the death camps, are now categorised as “displaced persons”, are traumatised, ill, robbed of their roots as well as of their property, and depressed.

In 1970, 85% of all Jews living in Vienna were born outside of Austria. 92 % of all Jews born after 1945 had foreign-born parents, many of whom were refugees from the conflicts in Hungary in 1956, Poland in 1967,and Czechoslovakia in 1968; too exhausted to reach their primary destinations of Israel or USA.

As of 1972, a new wave of immigrants follows, coming from the Asian Soviet Republics – Tajics, Uzbeks, Jews from the Caucasus. They do not speak German, their traditional occupations are not needed or wanted in Austria.

Friedmann experiences how these mostly Sephardic people do not receive a warm welcome by many of the Austrian Ashkenazi Jews: “Initially, the Jewish Community had isolated and rejected these new immigrants”. They imitated the xenophobic behaviour of the majority of the Austrian population. “However, several years later, there was a general surprise about the delinquency of a significant number of young immigrant Jews who belonged to this group of Asian immigrants and had declined into drug consumption and criminality”. The Viennese Jewish community decided to help.

Dr. Friedmann also encounters such ftroubled youth in his clinical practise. Most of them had neither money nor health insurance coverage. The young doctor founds a union of Jewish fellow doctors, whom he persuades to also work free of charge. “This initiative led to my integration into the social organizations of the Jewish Community, which, up to this point of time, I had only perceived as a representative and religious organisation”.

Obviously, being just as creative as helpful, the “mensch” Friedman is elected to leading roles within the Jewish community. He regards it as his task to primarily establish the position of the immigrant Sephardic Jews from Asia within the Viennese Jewish community and subsequently in Austrian society. In the Vienna Jewish Community, opportunities for them to learn German are developed, followed up by vocational integration,and the organisation of housing. Friedmann reports of “their having their first experiences of democracy”, referring to cases in which the local authorities could also be convinced to concede democratic (voting) rights to the newcomers in the Jewish community. 1982 sees the beginning of the construction of a synagogue built according to Sephardic tradition. A school soon follows. Within his own periphery, Friedmann shortly later initiates the interdisciplinary outpatient clinic ESRA for immigrants and traumatised survivors of the Holocaust. “This clinic now treats 1400 patients annually”, the founder sums up and reports of the vocational training school, which has already had a total of 2500 graduates within 9 years. Young people are now better prepared to meet the demands of school and to deal with social turbulence and unemployment.

Friedmann’s summary: “In the year 2007, the Jewish Community has grown to 7500 members. It currently operates three schools, the Vocational Training Centre, two sports clubs and four social facilities for the former Asian Soviet immigrants, who themselves have also established a school of the arts”.

Not without pride, he mentions his own distinctions awarded by the state and adds: “My own standard is based on the fact that there is practically no unemployment and no criminality amongst the members of our community and that psychological barriers (of intra-communal prejudice) have been brought under control”.

It is consequently no surprise that the assistant professor has also directed his attention to other conflict areas in the last few years. Asylum seekers from the former Yugoslavia, the former Soviet Union, the troubled and war-ravaged areas of the Middle East require specialists for psycho-traumatology. With the Association for Cross-cultural Psychiatry in German-speaking countries, Friedmann intended to advance the constructive debate regarding posttraumatic disorders on a trans-European basis. This now remains the task of those he has inspired and motivated.

Klaus Commer, April 4, 2008