In mass terror attacks, psychologists on the heels of EMTs
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In mass terror attacks, psychologists on the heels of EMTs

First responders include trained psychologists and social workers to help witnesses reconnect to reality in the face of trauma

Groups of soldiers receiving psycho-social support following a terror attack on January 8, 2017, on the Haas Promenade in Jerusalem, where a truck rammed into a group of soldiers on a tour. (Melanie Lidman/Times of Israel)
Groups of soldiers receiving psycho-social support following a terror attack on January 8, 2017, on the Haas Promenade in Jerusalem, where a truck rammed into a group of soldiers on a tour. (Melanie Lidman/Times of Israel)

Emergency first responders weren’t the only people speeding towards the terror attack on the Haas Promenade in Jerusalem on Sunday afternoon, in which a truck plowed into a group of soldiers on a tour, killing four and wounding 16. Motorcycle-driving psychologists and social workers are also part of the first wave of emergency responders, providing emotional support for witnesses in the chaotic aftermath of a mass terror attack.

“We provide immediate support and stabilization,” said Miriam Ballin, the director of the psycho-trauma unit for United Hatzalah in Jerusalem. She said the psychologists arrive just moments after the EMTs, especially for attacks that are categorized as a “psychological mass casualty incident,” where there are many witnesses. “Our job is to ground [witnesses] and connect them to reality, discussing what they saw and helping them process it,” she said.

The first step for emotional support is to physically separate the witnesses from the scene, which is usually hectic and overrun with security forces and journalists.

United Hatzalah volunteers trained in psycho-social trauma support help witnesses on January 8, 2017, in the wake of a truck ramming attack in Jerusalem. (Melanie Lidman/Times of Israel)
United Hatzalah volunteers trained in psycho-social trauma support help witnesses on January 8, 2017, in the wake of a truck ramming attack in Jerusalem. (Melanie Lidman/Times of Israel)

Then, like the EMTs, the psychologists use triage to identify witnesses that are confused or in shock.

“Our first step today was to remove a gun from anyone who is in a highly agitated state,” said Ballin. “We give the gun to their superiors, separate them from the group, and give them space to experience what happened. When they have tears and yelling, that’s what we call a normal reaction to an abnormal situation. It shows that people are OK.”

When psychologists and social workers identify a witness in shock, they try to engage the person using as many senses as possible to bring them back to reality. This often means standing directly in front of the person experience shock symptoms, looking them in the eye, and placing a hand on each shoulder, tapping each shoulder alternately.

“This is bilateral stimulation that activates both sides of the brain at once,” said Ballin. “When we touch them back and forth like this, it brings down their agitation.”

Ballin said that dozens of United Hatzalah volunteers provided psycho-social support to more than 50 people in the first hour after the attack.

Social workers with the army utilize the "bilateral stimulation" trauma response method to help calm a witness by applying physical pressure on both sides of their body, after the truck ramming attack on January 8, 2017. (Melanie Lidman/Times of Israel)
Social workers with the army utilize the “bilateral stimulation” trauma response method to help calm a witness by applying physical pressure on both sides of their body, after the truck ramming attack on January 8, 2017. (Melanie Lidman/Times of Israel)

Jerusalem municipality social workers also responded to the scene on Sunday. One social worker from the southern district of Jerusalem said that their primary job is to help witnesses figure out the next step. Sometimes, due to the trauma, they are confused and need help connecting with family members to let them know they’re OK. Other times, concerned family members will arrive at the scene and need emotional support. She noted that since the victims of Sunday’s attack are all soldiers, the army will provide any needed psychological support.

In the immediate aftermath of the attack, more than 200 soldiers who were touring Jerusalem gathered on the grass below the Haas promenade, out of sight from the site of the attack. Psychologists and social workers debriefed large groups of soldiers, who stood in circles with their arms around each other.

An hour after the attack, as the soldiers began to make their way back to the bus, they filed up to the street level, where two of the bodies were still under white ZAKA sheets. Many were crying and had their arms draped around each other. “Don’t look at it! Keep walking! Don’t look at it!” a commander yelled as they walked by.

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