The Historical Psychodynamics of Nazi Health Policy

Review of Geoffrey Campbell Cocks, The State of Health: Illness in Nazi Germany, Oxford: Oxford University Press, 2012, ISBN # 978-019-969567-6, 229 pages, $110.

The Nazis spent a great deal of time and energy assessing the health of German citizens while trying to determine ways to make the volksgemeinshaft healthier. The Third Reich’s preoccupation amounted to an obsession with public health issues and fit neatly into the Nazis’ pseudo-scientific biological ideology of racial supremacy as a kind of psychic counterbalance and complement, the flip side to the various killing programs initiated by the Nazis in Germany and across Europe, each side of the equation complementing and reinforcing the other.

Geoffrey Cocks’ new book on how the Nazis sought to transform Germany into a “health state” (while simultaneously murdering millions) explores this important but little studied subject. He does a masterful job in covering virtually every aspect of the story.

Professor Cocks’ name should be familiar to most psychological historians. His examination of the Goering Institute (Psychotherapy in the Third Reich, 1985, Transaction, 1997) was a breakthrough study. He co-edited the anthology, Psycho/History: Readings in the Method of Psychology, Psychoanalysis, and History (Yale, 1987) and edited Heinz Kohut’s correspondence from 1923 to 1981 (The Curve of Life, 1994). Through the years, he has published several articles in Clio’s Psyche.

Here Cocks takes on the massive project of making sense of nothing less than a comprehensive examination of all aspects of medicine and illness in the 12-year history of the Third Reich. He covers virtually all types of physical and mental illnesses, not just in terms of concepts and theoretical constructs (which might more narrowly qualify as intellectual history), but offers a comprehensive view of actual conditions as well as policies, practices, and outcomes.

Chronologically, he covers the impact of World War I and its aftermath through the interwar years and on down through the years of Nazi conquest to the health consequences of the scarcities and horrific suffering in the latter years of World War II. He includes all geographical regions, covers all categories of people, from women through various social groups, working-class to middle-class, and on to prominent figures in the

Page 372

Nazi leadership, all the while drawing extensively upon an extraordinary array of sources.

The study is based on full understanding of the medical literature and on extensive and superb archival materials scattered across Germany, from Gestapo reports to the many archived annual health reports Cocks mines so successfully. The study also includes creative and convincing references to popular jokes, to relevant films and novels and demonstrates mastery of the primary, secondary, and periodical literature in both German and English, including important essays published in anthologies, all integrated with the relevant up-to-date standard book-length historical studies, from Burleigh to Bessel through Evans to Kershaw.

The book also contains a number of insightful illustrations and photos, and some especially useful reproductions of pharmaceutical advertisements. Extensive footnotes are at the bottom of each page, where they belong.

The study’s potential importance for historians is suggested by the fairly good review it received in a recent issue of The American Historical Review (Vol., 118, No. 1, Feb. 2013), as well as by the fact that the “Communications” section of the next issue of the AHR—a publication which very sparingly publishes letters to the editor—printed an exchange of views between Cocks and his reviewer (AHR, Vol. 118, No. 2, April 2013).

One of the things especially recommending this volume to psychologically oriented historians is Cocks’ thorough mastery of the psychohistorical literature, which he successfully—and courageously— integrates into his traditional historical narrative. One finds ample citations (not mentioned by the AHR reviewer) from the standard studies of Binion, Waite, Redlich, Lifton, and Loewenberg (though one looks for mention of Jay Gonen’s masterful, Roots of Nazi Psychology [Kentucky, 2000]). Cocks makes particularly good use of Klaus Theweleit’s neglected but important two-volume study, Male Fantasies (Minnesota, 1987).

The psychoanalytic side of Cocks’ orientation is suggested by the list in his acknowledgments of an impressive number of psychoanalytic institutes where he made scholarly presentations during the book’s genesis. These include the Association Internationale d’Histoire de Psychoanalyse in Paris, the Deutsche Psychoanalystische Gesellshaft in Berlin, the European Association for the History of Psychiatry in London, the Karl-Abraham Institut (Berlin), and the Michael-Balint-Institut (Hamburg). He cites in the text, uses object relations theory, references

Page 373

Chodorow, Lacan, and Freud and from time to time interweaves psychological and psychoanalytic explanations into his narrative.

The psychological side of things is as crucial and interesting as the historical side, and while many examples could be given of the large number of both kinds of stimulating facts, ideas, and connections present throughout the book, there are far too many to mention in a short review. As but one example, I offer the following illustration.

Cocks notes (p. 117) that women’s “early object relations with their mothers… meant that they too most often possessed an internal desire to mother and were more psychologically open than men to rational capacities and emotional investment in others. Given this, it is not surprising that German women’s reactions to the prospect of war were especially intense and problematic.” Ambivalence and tension were almost inevitable, given the Nazi demand that women produce children to serve as cannon fodder for Hitler’s agenda. “The resultant effect on women’s nerves shows up in the Annual Health Reports,” writes Cocks. This is a necessary corrective to the popular notion that every German leapt enthusiastically into the conflict. It is not surprising that reports noted “nervous disorders had increased considerably during the first months of the war, especially among women,” whom, the reports said, frequently burst into tears when merely being spoken to.

One hesitates to be overly critical of such an outstanding study, yet it is worth mentioning that Cocks’ extensive source material cites none of The Journal of Psychohistory’s relevant articles on Nazism published in its more than 30-year existence, nor any of the relevant pieces on Nazi Germany published in Clio’s Psyche in the last 20 years.

Despite those omissions, Oxford University Press should be commended for publishing a work that so successfully interweaves psychological theories and insights into an extensively researched and readable historical narrative that mentions important psychohistorical studies rarely cited in mainstream narratives. I suspect the book’s $110 price—as well as its excruciatingly small print—will undoubtedly turn many prospective readers away. Nevertheless, historians of Nazi Germany as well as specialists in psychological history can benefit from exploring the many insights and nuances of this rich study.

Page 374