This is one of a series of excerpts from older articles put online by John Ray as a public service. The articles concerned are in general otherwise available only by special request to a University or other major library.


Penthouse, January, 1979.

The Psychiatric Holocaust


Good German doctors provided both the theory and the techniques for Hitler's extermination of the Jews: they murdered hundreds of thousands of mental patients BEFORE the Nazis built the death camps.

Most of us have wondered, "How could the Germans have murdered millions of Jews in such a callous and systematic fashion?" We have read what the history books and the popularised best-sellers have said about the German mentality and Hitler's rise to power but somehow a piece of the puzzle has been missing. We have continued to ask ourselves "What went on that permitted such ghastly, inhuman practices?

As a psychiatrist, I was astounded and shocked when I came upon the missing piece of the puzzle. German psychiatry played the single most important rule in developing the ideology and practice of mass sterilization and mass murder. Without the support of English and American psychiatry, Hitler's racial programs might never have become so acceptable, and without the active efforts of German psychiatry, the extermination program would never have got off the ground.

German psychiatry was responsible for developing the idea of mass sterilization and mass murder, and German psychiatry systematically murdered 100,000 or more patients as a prelude to Hitler's extermination program - everything from the first extermination centres to the gas chambers and crematoriums. German psychiatry actually carried out the first wide-scale murder of the Jews and then trained the SS killers who later took over the task from them.


I had been researching the role of psychiatry in Nazi Germany for more than a year when my findings were made real to me through photographs of a psychiatric extermination centre provided by New York publisher Robert E. Abrams. Twenty-five years earlier, Abrams had been a young American soldier in Munich, working as a public relations officer. The war had been over in Abrams's sector for more than three months on that particular day in July 1945, and Abrams hardly expected to find himself confronted with a psychiatric crime of such hideous proportions that to this day it remains largely hidden from the public.

Without advance notice, a German army physician appeared at Abrams's office door. Abrams invited him in and asked him his business. The physician had been a front-line medical officer in the war - a man devoted to saving German lives - and on his return to his home town of Kaufbeuren, he had discovered that German psychiatrists were killing mental patients in the local state mental hospital. The doctor was so appalled that he now turned to his former enemy to stop German psychiatrists from waging their private war against German mental patients.

Abrams and another soldier picked up automatic weapons and sped in a jeep to Kaufbeuren. They were about to liberate a state mental hospital from its doctors.

On arrival in the town, Abrams could see the facility standing on a hill in the distance, looking like every other state mental hospital in the world -- large old buildings suitable for the most economical incarceration of great numbers of inmates. Abrams asked some of the children in the street what went on up there, and they replied, "Oh, that's where they kill people."

The children were right. Abrams found that the mental hospital was a death camp complete with a crematorium and three ovens. His photographs confirm scenes indistinguishable from those in the horrifying newsreels depicting the liberation of concentration camps - dead and dying skeletal figures and crematorium ovens. As in liberated concentration camps, the records had been destroyed, but what remained showed a death rate of 25 percent during the prior year, some by poisoning and others by slow death through starvation on "scientific diets". The dead included 100 children, who were murdered during the eighteen months prior to Abram's arrival.....

But whereas the deaths in the concentration camps had ended with the Allied victory, the self-righteous psychiatrists had continued their grim task of murder after the end of the war. After all, they reasoned, "euthanasia" was not a wartime policy of Hitler but a medical policy of organised psychiatry. The patients were being killed for their own good as well as for the good of the community....

Abrams stresses that the psychiatrist who showed him through the "hospital" showed no remorse. He was a "good German" rather than a Nazi. He continued to exert his authority by shoving patients aside during the tour, until Abrams intervened and told the patients that they no longer had to submit to him.

Records uncovered by Abrams at the hospital confirm that the extermination had begun as a part of a national psychiatric program before Hitler took on the systematic murder of the Jews. Hundreds of patients had been shipped off to psychiatric extermination centres prior to the end of 1941, when the national program was largely abandoned and local state mental hospitals took over "the action" on their own.


The psychiatric extermination program was not a hidden, secret shame of psychiatry - at least, not at the start. It was organised by leading professors of psychiatry and directors of mental hospitals through a series of national meetings and workshops. So-called euthanasia forms were circulated to individual hospitals, and final approval of each death was then given in Berlin by a committee of the nation's outstanding psychiatrists. By January 1940 patients were being shipped to six special extermination centres staffed by psychiatrists. In late 1941, public outrage and lack of enthusiasm from Hitler pushed the program underground, but between 100,000 and 200,000 German mental patients had been killed. From then on, individual institutions, such as that at Kaufbeuren, continued to act on their own, even admitting new patients for the purpose of murdering them. At the end of the war, many large institutions were entirely empty, and estimates from various war-crime tribunals, including Nuremberg, estimate the number of dead to be between 250,000 and 300,000, mostly inmates of psychiatric hospitals and homes for the retarded...

Psychiatrist Frederic Wertham, by no means a radical critic of his profession, deserves the credit for being the first to describe the role of psychiatry in Nazi Germany: ... "The tragedy is that the psychiatrists did not have to have an order. They acted on their own. They were not carrying out a death sentence pronounced by somebody else. They were the legislators who laid down the rules for deciding who was to die; they were the administrators who worked out the procedures, provided the patients and the places, and decided the methods of killing; they pronounced a sentence of life or death in each individual case; they were the executioners who carried the sentences out or -- without being coerced to do so -- surrendered their patients to be killed in other institutions; they supervised and often watched the slow deaths..."



While Alexander, Ivy, Wertham, and others have recognised the practical role played by psychiatry in aiding and abetting the exterminations, few physicians have been willing to face the ideological role played by psychiatry in justifying the sterilisation and murder programs. A thorough historical analysis would require a review of eugenics - the use of genetic theory to support political practices aimed at controlling the hereditary traits of the population. Here I can point to only a few key figures in psychiatry whose promotion of eugenic sterilization and euthanasia paved the way for Hitler's ideological development.

The first book that advocated the systematic, scientific extermination of a class of people for racial, "hygienic" purposes was published before Hitler put pen to paper and wrote Mein Kampf. It was The Destruction of Life Devoid of Value, co-authored by psychiatrist Alfred Hoche and lawyer Karl Binding in 1920. Hoche was one of Germany's most prestigious professors of psychiatry, and his book supported the view that many psychiatric patients were "mentally dead" and only "partial" Germans in their existence. He called for medical murder to relieve their suffering, to purify the race, and to save the state money. Not only did Hitler read Hoche, but also, after he took power, he lent his name to advertisements for Hoche's books.

Another psychiatrist, Ernst Rudin, was also a leading figure in German psychiatry before Hitler's regime. As professor of psychiatry at Munich and director of the Department of Heredity at the Kaiser Wilhelm Institute, he was the world's most renowned eugenic psychiatrist. As a visiting dignitary to the United States in 1930, Rudin was praised by leaders at the eugenically oriented Carnegie Foundation. When the Kaiser Wilhelm Institute nearly collapsed for lack of funds shortly before Hitler's takeover, a large grant from the Rockefeller Foundation saved Rudin's work.

Without modifying his already racist, eugenic ideas, Rudin went on to become the chief architect of Hitler's racial-hygiene legislation and was lauded on his sixty-fifth birthday by Hitler's minister of the interior, Wilhelm Frick, who called him "the indefatigable champion of racial hygiene and meritorious pioneer of the racial-hygiene measures of the Third Reich." At the end of the war, this hero of psychiatry had to flee from the outraged families of murdered mental patients.


The tie between Hitler and the eugenic psychiatrists was so close that much of Mein Kampf is literally indistinguishable in language and in tone from the major international journals and psychiatric textbooks of the time. To quote from a few of many such passages in Mein Kampf:

"To demand that defective people be prevented from propagating equally defective offspring is a demand for the clearest reason and, if systematically executed, represents the most humane act of mankind ..."

"Those who are physically and mentally unhealthy and unworthy must not perpetuate their ;suffering in the bodies of their children ..."

"A prevention of the faculty and opportunity to procreate on the part of the physically degenerate and the mentally sick ... would not only free humanity from an immeasurable misfortune but would lead to a recovery which today seems scarcely conceivable."

Hitler received support from psychiatrists and social scientists around the world after he took power. Many articles in the world's leading medical journals monitored and heaped praise on Hitler's eugenic legislation and policies.

These are the same policies that Mitscherlich, the German medical representative at Nuremberg, described as "the starting point for the line of development that inexorably led to enforced 'mercy death' for the incurably insane, on the one hand, and, during the war, on the other, to plans for exterminating races declared to be inferior - Poles, Russians, Jews, and Gypsies."

Leo Alexander, the psychiatrist who accepted responsibility for investigating psychiatric atrocities at the War Crimes Tribunal, was himself among those who had lent his support to Hitler's sterilization laws. He was one of several well-known authors of Eugenical Sterilization, an official report to the American Neurological Association, funded by the Carnegie Foundation.

Speaking of Hitler's two-year-old legislation for involuntary sterilization, Alexander and his co-authors confirm my observation that "it is fair to state that the Sterilization Act is not a product of Hitler's regime, in that its main tenets were proposed and considered several years earlier, before the Nazi regime took possession of Germany." They go on to praise the legislation as conforming "closely with the present knowledge of medical eugenics."

American encouragement of Hitler's psychiatric-eugenic programs went far beyond moral support. In the years prior to Germany's Sterilization Act, the state of California systematically sterilized 15,000 psychiatric inmates and became the world's chief experimental area for eugenics.


American psychiatrists did not stop at supporting sterilization. In July 1942, when Germany's medical-murder program was known to leaders in American psychiatry, the official journal of the American Psychiatric Association published two articles debating a final solution for America's retarded. In the journal's lead article, originally delivered at the annual meeting of the association, Foster Kennedy advocated legislation that would permit the killing of incurably retarded five-year-old children, "the utterly unfit," to relieve them of "the agony of living" and to save their parents from expense and mental anguish. "So the place for euthanasia, I believe, is for the completely hopeless defective: nature's mistake, something we hustle out of sight, which should never be seen at all."

In rebuttal, Leo Kanner, a well-known child psychiatrist, came out against euthanasia but in favour of sterilization. Then, in an unsigned commentary entitled "Euthanasia," the two articles are compared. The editors of the Journal of the American Psychiatric Association do not raise the ethical issue of murder. The word 'kill' is not used. Instead we hear about "disposal by euthanasia", "merciful passage from life", "a method of disposal", and even facetiously, "a lethal finis to the painful chapter". But the editors were aware that, with or without euphemisms, the American public might respond with outrage and many parents with "guilt". So the editors of this august psychiatric journal suggested both a public educational campaign to overcome resistance to medical murder and psychiatric interventions to relieve parental guilt.



Below is more of what Dr. Wertham said:

"In 1941 a commission of five went to the concentration camp Dachau to select prisoners to be transferred to Mauthausen to be killed. All five men were psychiatrists, and their chief was a professor of psychiatry of the University of Berlin."


Wertham, F. (1966) "A Sign for Cain: An Exploration of Human Violence", London

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