How do you bandage the wounds you can’t see?
The entire population of Israel is feeling anxiety, experts say, but a small and growing number will have lasting trauma
Debra writes for the JTA, and is a former features writer for The Times of Israel.
Early last week, one of the volunteers manning the helpline for NATAL, the Israeli trauma center for victims of terror and war, received a phone call from an eight-year-old boy. His ten-year-old sister was also on the line.
“Our mom won’t stop shaking,” the siblings told the volunteer on the phone. “We don’t know what to do.”
A few moments earlier, the siblings’ mother had decided to leave their house in Ashdod and make a quick dash to the grocery store. She had only been gone for a few seconds when an air raid siren blared, signaling yet another incoming barrage of rockets. Separated from her children, she panicked and ran home, and together they dashed into the shelter. But even after the siren’s wail died down, she couldn’t collect herself. She began convulsing and hyperventilating – classic signs of a panic attack.
The quick-thinking kids, who had seen NATAL’s phone number on the news, decided to call for help.
“We’ve received thousands of calls since the beginning of the war,” said Orly Gal, NATAL’s executive director. “And you have to understand, every conversation, it’s not like it’s for a minute. It’s a long conversation, to access symptoms, to give breathing exercises and help them calm down, and if need be, to refer for psychological care.” (Citizens can call the helpline free; the number is 1-800-363-363).
NATAL was founded in 1998 to help increase public awareness of the invisible wounds of Israel’s ongoing conflict – the wounds of the mind and soul. Thanks to a huge gift from activist Judith Recanati, the organization operates a multi-tiered system of outreach from a sun-soaked, colorful headquarters in the heart of Tel Aviv. Here, specially-trained volunteers speaking Hebrew, Arabic, English, Turkish and French man the 24-hour hotline. Groups of bereaved wives, children and siblings meet for support and intake. Staff members, buoyed by a donation from the Steven Spielberg Shoah Foundation, collect and compile video testimonies of former IDF prisoners of war, following the same model used to compile the stories of survivors of the Holocaust.
In addition, NATAL sponsors mobile units – teams of trained staff members who visit homebound sufferers of trauma and mental illness, both to check in and offer a bit of love and support, but also to monitor progress and ensure that further care isn’t needed.
“You don’t see trauma and post-trauma. It’s a hidden wound,” Gal says. “The problem for Israel, for our soldiers, is it’s so hard to prove to the IDF and the Defense Minister and social services. A lot of people who come to us say they wish they would have lost a hand rather than have PTSD. Because it’s really hard.”
The Israeli government is still calling the events in Gaza an operation, but for the homefront, it long ago spiraled into a war. The bloody toll in Gaza is horrifying; the loss, destruction and fear sowed among Israeli civilians is shattering. Every day brings more stories of fallen soldiers, their lives snuffed out in an instant of fire and utter injustice. Among the sunflower groves and sheep pastures near the Gaza border, a shovel’s scratching sound twists its way into dreams; in the coffee shops and boutiques of Tel Aviv, pedestrians jump or freeze at the wailing, siren-like sound of each passing motorcycle. The citizens of Israel know that their bodies are protected by the Iron Dome and by a military determined to finish the job. But what about their minds?
“Everyone in Israel, to a certain extent, has anxiety right now, and a reaction to what’s going on,” said Ariella Perry, a clinical therapist and social worker. Perry, who lives in the settlement of Efrat with her husband and four children, works for a major health insurance company in Jerusalem. Since the outbreak of the conflict, she has also spent evenings on call for another help hotline, routinely taking calls from terrified Israelis and helping parse out their symptoms and refer them to further care. “It’s on everybody’s mind, everybody’s talking about it.”
Perry estimated that while the entire population of Israel is feeling the strain of war, about 15 percent of Israeli citizens have what is classified as trauma. That group veers heavily toward people who live down south, where the rocket fire has been relentless, and toward children, many of whom are showing their symptoms through regressive behavior like bedwetting and refusing to sleep alone.
Trauma is the immediate emotional response to a deeply disturbing event. For trauma to become post-trauma, better known today as post-traumatic stress disorder, or PTSD, symptoms must persist 30 days after the event has passed.
Perry estimated that only about eight or nine percent of that traumatized 15% of the population will continue to suffer so far after the conclusion of this war, and be diagnosed with PTSD. But as the hostilities continue and ceasefire after ceasefire crumbles into an explosion of rocket fire and squandered opportunity, it remains far too early to tell.
“The most difficult thing for people right now is the feeling of a loss of control,” Perry explained. “You think, ‘I built this beautiful home, and this is going to be my safe space, and now there are rockets falling on my home?’ Your whole sense of security falls apart.”
For a country where war is as much a cycle as the changing seasons, one of the most common things psychologists like Perry see at times like this are the resurgence of dark feelings people thought they had long tucked away.
“I have a lot of young adults coming to my clinic now, men and women in their 30s who were eight or nine years old during the first Gulf War, and they are saying that suddenly they feel the same way they did during that war,” Perry said. “This is the closest thing that Israel has had to the Gulf War, with sirens all over Israel, the uncertainty, not knowing if you are going to have to pull over while driving on the highway.”
For kids who are feeling anxiety and stress, Perry urged parents to try and maintain a sense of control. Explain the situation to your children, she said – hiding the truth from them and telling them that the sirens and explosions are something other than what they really are is only going to make them feel more disconnected. But keep the explanations short and simple.
“Don’t tell your children that soldiers are dying, but you should tell them that yes, there is something going on down south, the soldiers are going in to protect us. And try to give them activities where they are in control. It can be as simple as helping cut a salad, but let your child feel a sense of pride that he was able to do something and succeed at it,” she said.
For parents or adults, she said, it’s very important to keep in mind that in a time where nothing is normal, it’s normal to feel off.
“It’s legitimate to feel this way. It’s OK,” she said. “In extreme cases where they describe more severe symptoms I ask them to go consult with a family doctor, and in more extreme cases to go to a psychiatrist.”
At NATAL, Gal said resources are absolutely pushed – the organization operates on a budget of NIS 14.5 million ($4.24 million), 85% of which comes entirely from donations – but it’s also crucial to remember to help not only the average citizens, but the ones who work on the front lines of both physical and emotional trauma.
“This time around, a lot of kids are crying. They are crying, and shouting, and it’s hard to hear. And then you look at your volunteers who answer the phone calls, and you realize you have to also help the helpers,” Gal said. “So that’s what we are doing. We have supervision and we support them and we know that when this war finishes, please God, we will do a lot to continue to help and support them.”
When the war does end and Israel’s counselors and therapists take stock of the extent of the emotional damage, Perry believes that Israeli citizens will nevertheless prove themselves to be above the curve.
“On the whole, the response of Israelis is a bit of anomaly,” she said. “The fear of terror is in our DNA. We know how to rally, how to brush it off and continue moving. But if you feel something, it’s important to let it be legitimate. There’s no one way to react to this. And if you need help, it’s not a sign of weakness. It’s a sign of strength that you need help and you go and get it.”
