Visible wounds of invisible repression: A perspective on the importance of investigating the biological and psychological impact of political repression.

Abstract

Objective: Exposure to psychological trauma is a well-accepted risk factor for the development of mental and somatic diseases. However, chronic stressors not fulfilling the criteria of traumatic experience can have similarly adverse health consequences. While the harmful impact of chronic stressors is generally recognized among researchers, there is a lack of acknowledgment within clinical, political, and societal entities. This becomes evident in the experiences of victims of political repression in the former German Democratic Republic (GDR), an authoritarian state in East Germany. Repression in the GDR included covert measures, such as "Zersetzung" (engl: disintegration), consisting of wiretapping, spreading rumors, or provoking failure in professional and social domains. It aimed to systematically undermine the psychosocial integrity of individuals, inducing anxiety, social isolation, and confusion. Method: This article integrates findings on repression in the GDR with existing trauma and chronic stress literature. Results: "Zersetzung" shares key features with severe psychosocial chronic stressors. Like trauma, experiencing "Zersetzung" likely dysregulated the biological stress systems, thereby predisposing victims to the health consequences they frequently experience to the present day. Conclusion: Certain severe chronic stressors, such as "Zersetzung," do not appear to differ in their negative health consequences from Criterion A traumatic events. Identifying the biological and psychological impact of political repression techniques is essential, not only for public acknowledgment, and proper health care of victims of GDR repression, but also for those individuals suffering from similar repression methods today. Clinical Impact StatementThis article argues that the health consequences of political repression methods aiming to undermine an individual's psychosocial integrity arise from stress system alterations. We focus on methods of "Zersetzung," common in the German Democratic Republic. Understanding the circumstances under which "Zersetzung" occurred and revealing its psychobiological associations are crucial in understanding the lasting impact of psychosocially stressful repression. This knowledge should be considered in the compensation, rehabilitation, and health care for former, current, and future victims of political repression.

Specific challenges of researching stress in the context of quiet political repression

“…The mechanisms used in quiet political repression are rooted in the induction of severe and chronic psychosocial stress in target individuals [ 12 ]. Stress is commonly defined as an organism's response to a perceived threat to its homeostasis (internal equilibrium) through either internal or external adverse forces termed stressors [ 19 ].…”

“…The above described core mechanisms of psychosocial stress are inherent to the covert repression techniques of the former authoritarian regime of the GDR [ 12 ]. Aim of these techniques was to silence (perceived) political opponents by causing life crises, inflicting psychological strain, and undermining self-worth [ 13 ], thereby fostering fear, panic, and confusion, and targeting the psychosocial integrity of victims.…”

“…By these means, political opponents can be deprived of valuable resources, such as time, money, security or allies [ [7] , [8] , [9] , [10] , [11] ]. Quiet repression aims to create ongoing feelings of uncontrollability, social threat, and uncertainty – which form the core elements of psychosocial stress [ 12 ].…”

“…We here expand on the importance of investigating the psychobiological consequences of quiet repression [ 12 ], while highlighting the challenges therein. Beginning with an overview of the stress response and the classification of quiet repression as a prototypic chronic psychosocial stressor, we present the most frequently applied research methods to capture stress.…”