Renate Flens, a German woman in her 60s who suffers from depression, tells her psychotherapist that she wants to love her children but just can’t. She and the therapist soon realize that both Flens’s problems may be rooted in her frustration at being unable to allow others to get close to her. After lengthy conversations, they realize something else: a contributing factor may well be the child-rearing teachings of Johanna Haarer, a physician whose books were written during the Nazi era and aimed at raising children to serve the Führer. Flens (a pseudonym) was born after World War II, but Haarer’s books were still popular during her postwar childhood, where many households had a copy of The German Mother and Her First Child—a book that continued to be published for decades (ultimately cleansed of the most objectionable Nazi language). When asked, Flens recalled seeing one of Haarer’s books on her parents’ bookshelf.

Flens’s story, told to me by her therapist, illustrates an issue troubling a number of mental health experts in Germany: Haarer’s ideas may still be harming the emotional health of its citizens. One aspect was particularly pernicious: she urged mothers to ignore their babies’ emotional needs. Infants are hardwired to build an attachment with a primary care giver. The Nazis wanted children who were tough, unemotional and unempathetic and who had weak attachments to others, and they understood that withholding affection would support that goal. If an entire generation is brought up to avoid creating bonds with others, the experts ask, how can members of that generation avoid replicating that tendency in their own children and grandchildren?

“This has long been a question among analysts and attachment researchers but ignored by the general public,” says Klaus Grossmann, a leading researcher in mother-child attachment, now retired from the University of Regensburg. The evidence that Haarer’s teachings are still affecting people today is not definitive. Nevertheless, it is supported by studies of mother-child interactions in Germany, by other research into attachment and by therapists’ anecdotal reports.

Haarer’s Teachings

Haarer was a pulmonologist, who, despite having no pediatric training, was touted as a child-rearing expert by the Nazis (the National Socialists). The recommendations from her book, originally published in 1934, were incorporated into a Reich mothers training program designed to inculcate in all German women the proper rules of infant care. As of April 1943, at least three million German women had gone through this program. In addition, the book was accorded nearly biblical status in nursery schools and child-care centers.

Although children need sensitive physical and emotional contact to build attachments and thrive, Haarer recommended that such care be kept to a minimum, even when carrying a child. This stance is clearly illustrated in the pictures in her books: mothers hold their children so as to have as little contact as possible.

Haarer viewed children, especially babies, as nuisances whose wills needed to be broken. “The child is to be fed, bathed, and dried off; apart from that left completely alone,” she counseled. She recommended that children be isolated for 24 hours after the birth; instead of using “insipid-distorted ‘children’s language,’” the mother should speak to her child only in “sensible German”; and if the child cries, let him cry.

Sleep time was no exception. In The German Mother and Her First Child, Haarer wrote, “It is best if the child is in his own room, where he can be left alone.” If the child starts to cry, it is best to ignore him: “Whatever you do, do not pick the child up from his bed, carry him around, cradle him, stroke him, hold him on your lap, or even nurse him.” Otherwise, “the child will quickly understand that all he needs to do is cry in order to attract a sympathetic soul and become the object of caring. Within a short time, he will demand this service as a right, leave you no peace until he is carried again, cradled, or stroked—and with that a tiny but implacable house tyrant is formed!”

Before publishing The German Mother and Her First Child, which ended up selling 1.2 million copies, Haarer had written articles about infant care. Later titles included Mother, Tell Me about Adolf Hitler!, a fairy-tale-style book that propagated anti-Semitism and anti-Communism in language a child could understand, and another child-rearing manual, Our Little Children. Haarer was imprisoned for a time after Germany’s defeat in 1945 and lost her license to practice medicine. According to two of her daughters, she nonetheless remained an enthusiastic Nazi. She died in 1988.

Modern Consequences

There are many reasons to think that Haarer’s influence persisted long after the war and continues to affect the emotional health of Germans today even though parents no longer rely on her books. Researchers, physicians and psychologists speculate that attachment and emotional deficits may contribute to an array of phenomena of modern life, including the low birth rate, the many people who live alone or are separated, and the widespread phenomena of burnout, depression and emotional illnesses in general. Of course, the causes of these personal and societal issues are many and varied. But the stories of people such as Renate Flens lend credence to the idea that Haarer’s lessons could play a role.

As Flens’s therapist notes, after a time patients may disclose their disgust at their own body and admit to following strict eating rules or to being unable to enter into close relationships—which are all consistent with the outcome of Haarer’s child-rearing regimen. Psychotherapist Hartmut Radebold, formerly of the University of Kassel, tells of a patient who came to him with serious relational and identity problems. One day this man found a thick book at home in which his mother had noted all kinds of information about his first year of life: weight, height, frequency of bowel movements—but not a single word about feelings.

In the laboratory, Grossman, who retired in 2003, continually observed scenes such as this: A baby cries. The mother rushes over toward him but stops in her tracks before reaching him. Although she is only a few feet from her child, she makes no effort to pick him up or console him. “When we asked the mothers why they did this, they invariably stated that they didn’t want to spoil their babies.”

That sentiment, along with sayings like “An Indian feels no pain”—an idiom essentially meaning “Be as stoic as a Native American”—continued to be widespread in postwar Germany and is still heard today.

Research Reveals Harm

Haarer’s recommendations were viewed as modern in the Nazi era and promulgated as if scientifically sound. Studies have since demonstrated that Haarer’s advice is indeed traumatizing.

Ilka Quindeau of the Frankfurt University of Applied Sciences and her colleagues have studied the generation of children born during the war. They initially intended to examine the long-term effects of bombing raids and flight under perilous circumstances. But after the initial interviews, the researchers decided to adjust the study design: so many of their conversations revolved around experiences in the family that the team added a lengthy interview that focused exclusively on those interactions. Ultimately, the investigators concluded that many interviewees exhibited a pattern of unusually strong loyalty toward their parents and that their failure to include mention of conflicts in their descriptions was evidence of “a relational disorder.”

Quindeau has pointed out that Germany is the only country in Europe where what happened to the children of war has been so broadly discussed, despite destruction and bombings having occurred in other countries as well. She has also noted that psychoanalyst Anna Freud found that children with a healthy attachment to their parents were less traumatized by the war than those with a less solid attachment. Putting everything together, Quindeau concludes that the interviews she conducted about bombings and exile had actually uncovered something more than the effects of war: they revealed deep grieving about experiences in the family that were so traumatic they could not be expressed directly.

Direct evidence for Quindeau’s interpretation is hard to come by, however: randomized, controlled experimental studies that examine Haarer’s educational recommendations cannot be conducted for ethical reasons; the probability of doing harm is just too great. Nevertheless, even research that does not explicitly deal with child-rearing in the Third Reich can provide important information, Grossmann says. “All the data we have tell us that if we deny a child sensitive caring during the first one or two years of life, as Johanna Haarer suggests,” you end up with children who have limited emotional and reflective abilities.

Some of the evidence, Grossmann says, comes from a longitudinal study in which 136 Romanian orphans between the ages of six and 31 months were divided into two groups: half remained in the orphanage; the rest were taken in by foster parents. A control group consisted of children from the region who had always lived with their natural parents. Both the children who remained in the orphanage and those who were fostered developed attachment problems. For example, in a 2014 experiment with 89 of the orphans, a stranger came to the door and, without giving a reason, told a child to follow him. Only 3.5 percent of the children in the control group obeyed, whereas 24.1 percent of the children in foster care followed the stranger, and 44.9 percent of the children living in the orphanage did.

“Children like this—who are easily seduced, don’t think and don’t feel—are fodder for a nation bent on war,” says Karl Heinz Brisch, a psychiatrist at the Dr. von Hauner Children’s Hospital at the Ludwig Maximilian University of Munich. “In Johanna Haarer’s view, it is important to deny caring when a child asks for it. But each refusal means rejection,” Grossmann explains. The only means of communication open to a newborn are facial expression and gestures, he adds. If no response is forthcoming, children learn that nothing they try to communicate means anything. Moreover, infants experience existential fear when they are alone and hungry and receive no comfort from their attachment figure. In the worst case, such experiences lead to a form of insecure attachment that makes it difficult to enter into relationships with other people in later life.

Why Mothers Took the Advice

Why did so many mothers follow Haarer’s counterintuitive advice? Radebold, whose research has focused on the generation of children born during the war, notes that Haarer’s views on child-rearing did not appeal to everyone during the 1930s and 1940s but attracted two groups in particular: parents who identified strongly with the Nazi regime and young women who had themselves come from emotionally damaged families (largely as a result of World War I), who had no idea what a good relationship feels like. If, in addition, their husbands were fighting at the front—leaving them to fend for themselves and to feel overburdened and insecure—it may well be imagined that the toughness promoted in Haarer’s books could have been appealing.

Of course, strict child-rearing practices had been commonplace in Prussia well before the Nazis came on the scene. In Grossmann’s opinion, only a culture that already had a tendency for hardness would have been ready to institute such practices on a grand scale. Studies on attachment conducted in the 1970s are consistent with this view. He notes, for example, that in Bielefeld, which is in northern Germany, half of all children were shown to exhibit an insecure attachment; in Regensburg, which is in southern Germany and never came under Prussian influence, less than a third fit that category.

To evaluate how secure the attachment is between a child and a parent, Grossmann and other attachment researchers often use the Strange Situation test, which was developed by psychologist Mary Ainsworth while at Johns Hopkins University in the 1960s. In one version, a parent and toddler enter a room, and the child is placed near some toys. After about 30 seconds the parent sits down in a chair and begins to read a newspaper or magazine. After at most two minutes, the parent is signaled to encourage the child to play. A few minutes later a strange woman enters the room. Initially silent, she begins to talk to the parent and then tries to engage with the child. Shortly thereafter the parent gets up and leaves the room. After a brief period, the parent returns, and the strange person leaves. A few moments later the parent again exits the room, leaving the child behind. After a few minutes the strange woman reenters the room and begins to engage with the child, and then the parent returns as well.

Attachment researchers closely observe the child’s behavior during the entire episode. If the child is upset for a while and cries during the separation but soon calms down, he or she is viewed as securely attached. Children who cannot calm themselves—or who never react to the disappearance of their attachment figure—are assessed as insecurely attached. Grossmann has conducted this test in a number of different cultures. He found that in Germany, in contrast to other Western countries, many parents view it as positive when their children do not respond to their disappearance. The parents perceive this reaction as “independence.”

Like Parent, Like Child

Grossmann’s findings also indicate that when children grow up and begin to have children themselves, they pass their attachment behavior down to the next generation. As part of one of his studies, he and his colleagues used interviews to examine the quality of the attachment that parents had in their own childhood, conducting the study about five years after giving the Strange Situation test to the subjects’ children. In assessing the parents’ responses, the researchers looked not only at what the adults were saying but also at the emotions they exhibited during the interview. For example, they observed whether the parents switched the subject frequently, gave only monosyllabic answers or indulged in overgeneralized praise of their own parents without describing actual situations. The results showed that the attachment quality of the children often mirrored that of their parents. A 2016 meta-analysis published by Marije Verhage of VU University Amsterdam and her colleagues, which analyzed data from 4,819 individuals, confirmed that the quality of attachment is transmitted from generation to generation.

How exactly the negative childhood experiences of parents are transmitted to their own children is still a matter of conjecture. But biological processes appear to be involved. In 2007, for example, Dahlia Ben-Dat Fisher, then at Concordia University in Montreal, and her colleagues found that the children of mothers who had themselves been neglected in childhood regularly exhibited lower levels of the stress hormone cortisol in the morning. The researchers interpret this pattern as a sign of abnormal stress processing.

In 2016 a team led by Tobias Hecker, then at the University of Zurich, compared a group of children in Tanzania who reported having undergone a great deal of physical and mental abuse with children who reported little abuse. Those in the first group had more medical problems as well as an abnormal pattern of methylation (binding by the chemical group CH3) of the gene that codes for the protein proopiomelanocortin. This protein is a precursor for an array of hormones, among them the stress hormone adrenocorticotropin, produced in the pituitary gland. Altered DNA-methylation patterns can affect the amount of protein made from a gene, and this pattern can be passed on from generation to generation. Researchers have observed this phenomenon in animal experiments; in humans, the picture is as yet less clear.

Parents can grapple with their own attachment experiences and try to raise their own children differently. “But,” Grossman says, “in stressful moments, we often fall back on learned, unconscious patterns.” This tendency may be one reason that Haarer’s youngest daughter, Gertrud, decided never to have children herself. In 2012 she publicly confronted her mother’s legacy, writing a book about Johanna Haarer’s life and ideas. Speaking about her own childhood in an interview on Bavarian television, Gertrud Haarer declared, “Apparently it so traumatized me that I thought I could never raise children.”

This article originally appeared in Gehirn&Geist and was reproduced with permission.