Nazi euthanasia (Aktion T4)

Domain XVI · Historical, discredited & harmful · Philipp Bouhler, Karl Brandt · 1939 · Germany (Berlin)

What it is

This is not a therapy. It was a secret state programme of murder. Under National Socialism, doctors, nurses and administrators selected and killed disabled children and adults in institutions in Germany, Austria and occupied territories from 1939 to 1945. The word "euthanasia" was used as a…

Format

• Session number and length follow the client's needs and the setting; the phases below are a working structure, not a protocol.
• Safety, stabilisation and pacing. Goal: build capacity to approach painful material without overwhelm, and agree how history will be brought in (who reads records, when, with what support). Move on when the client can approach and step back from the material in session.

Who practises it, and how they are trained or regulated

• January 1940 to August 1941: Aktion T4. Registration forms disguised as statistical surveys were sent to hospitals, psychiatric institutions and care homes; panels of three medical assessors, many of them well regarded, decided on the basis of the forms who would be killed. People were transported to six killing centres: Brandenburg an der Havel, Grafeneck, Bernburg, Sonnenstein (Pirna), Hartheim near Linz, and…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Pressure to stay silent; retaliation. Working: the concern is formally recorded and acted on.
• Rupture; escalation; your own anger. Working: the client engages with the facts, even if views remain.
• Graphic imagery that retraumatises; performance pressure. Working: new feeling or meaning becomes available.
• Overwhelm when the absence becomes visible; pace and pause. Working: the client speaks about the relative more freely.
• Assuming the history is the main problem when the client came for something else. Working: a shared, client-owned goal.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.