All of Israel has been experiencing mental trauma since October 7, the most devastating day in the country’s 75-year history, and the most murderous single day for global Jewry since the Holocaust.
Neuroscience tells us that trauma caused by exposure to the horrific events of that Saturday and the stresses of the ensuing war is exhibited in changes to the human brain.
On October 7, some 2,500 Hamas terrorists burst across the border into Israel from the Gaza Strip by land, air, and sea under cover of a deluge of thousands of rockets fired at Israeli towns and cities.
The terrorists killed approximately 1,400 people as they ravaged over 20 southwestern Israeli communities and IDF bases. Entire families were executed in their homes, and over 260 people were slaughtered at an outdoor festival, amid horrific acts of brutality by the terrorists. The vast majority of those killed were civilians — including babies, children, and the elderly.
Hamas also seized some 230 Israeli and foreign national hostages of all ages and is hiding them in Gaza.
According to neuroscience and psychotrauma experts like Tel Aviv University and Ichilov Hospital neuroscientist Prof. Talma Hendler, acute stress like Israelis have been experiencing is caused by hyperactivation of a small region of the brain called the amygdala, which is primarily associated with the limbic system and mediates emotion and memory. The amygdala is a paired structure, with one part on each side of the brain.
This hyperactivation is the reason many Israelis have been walking around in a fog in recent weeks. Some people are experiencing a lack of motivation and inability to concentrate, and as a result, have withdrawn from regular routines and social life. Many complain of sleep disturbances, nightmares, or hypersensitivity to specific sounds. Others are anxious, angry, or can’t stop crying.
“Your amygdala goes into overdrive because you need to recruit all your survival mechanisms to get over the acute threat of trauma and stress,” Hendler explained.
“It’s very detrimental in the long term if the limbic system stays hyperactive and doesn’t go back to its [pre-traumatic event] homeostatic level. The good news is that 80-90 percent of people will, with time, overcome this overactivation of the limbic system. They won’t develop a post-traumatic pathology,” she said.
However, Hendler cautioned that the lowering of the amygdala’s activity does not come naturally. One has to work at it from two directions.
First, one can downregulate the limbic system through relaxation techniques, biofeedback, and various cognitive methods. Equally important, according to Hendler, is activating the mesolimbic system. Also called the positive pathway or reward system, it is about being active and goal-directed.
Bringing ourselves out of our trauma depends on our inner resources — our ability to turn to our family, friends, and community for connection, and to return to regular functioning in terms of work and pastimes.
Many people find that helping others soothes their sense of panic and despair. This is evidenced by the enormous and immediate civic effort to provide rescue and relief to the 200,000 Israelis displaced from their homes in the south and north of the country.
“Keeping [the reward] system up is as important as your ability to downregulate the threat system,” Hendler said.
“The balance between the two systems is critical to recovery and resilience. It’s important to know that resilience is a very active process. A person is not [innately] resilient or not resilient. You need to actually build this muscle like we do muscles in our body. It’s about actively staying healthy despite adversity,” she said.
Some individuals can calm down their limbic systems to pre-trauma levels on their own, while others may seek help from a mental health professional. Unlike in past times of war and national trauma, Israel’s government and healthcare system geared up immediately to provide this support to the hundreds of thousands of Israelis who have asked for it from the Health Ministry, their health maintenance organization, or non-profit mental health organizations.
People whose amygdala and limbic system stay in overdrive even after several weeks or months may end up with post-traumatic stress disorder (PTSD). These individuals essentially stay in an acute trauma state because the threat system in their brains has taken over.
“With post-trauma syndrome, many cues in the environment — even those only slightly related to the actual traumatic event — become a reminder of the trauma because there is a wrong learning of these cues as a potential threat. These stay as potential threats rather than become memories,” Hendler explained.
“These people never get over the acute stress. It becomes engraved in their brain,” she said.
Hendler learned through imaging of the brains of IDF medics who fought in the Second Lebanon War in 2006 that those who had a more activated amygdala before being exposed to traumatic events developed more disturbing symptoms afterward. Hendler’s study was published in 2009 and subsequent studies done by others confirmed her findings.
Other research she conducted on the brains of post-combat soldiers with and without PTSD diagnoses showed that those with PTSD not only had higher levels of activity in their amygdala, but also lower levels of activity in their pre-frontal cortex (the area of the brain responsible for executive function, some aspects of social behavior, working memory, and speech and language).
This has led Hendler to be a proponent of using technology to conduct prompt intervention following psychological trauma. She said it is important for those physiologically predisposed to developing PTSD, but it is also relevant for anyone who is or has been under acute stress.
Hendler developed the technology behind Prism, a product brought to market by GrayMatters Health this year to treat PTSD. Prism is software that works in tandem with a cap fitted with special electrodes worn by the patient. The person engages with a unique interactive audiovisual interface that is meant to help them modulate their brain activity.
“It’s about brain training. You give people the skill to modulate the brain, so even if they’re reactive, they gain some ability to plastically change their brain relatively quickly after the event. The goal is for them not to get stuck in this state of hyper-arousal and hyper-reactivity, which is not good for their brain,” Hendler said.