'You know when rocket is coming; virus could be right here'

Virus presents new mental health challenges, even for battle-hardened Israelis

Experts warn that resilience learned in times of terror may not be enough to equip people emotionally for the new reality

Nathan Jeffay is The Times of Israel's health and science correspondent

Workers wearing protective clothes disinfect a synagogue in Bat Yam, on March 18, 2020, as part of measures to prevent the spread of the Coronavirus. (Flash90)
Workers wearing protective clothes disinfect a synagogue in Bat Yam, on March 18, 2020, as part of measures to prevent the spread of the Coronavirus. (Flash90)

While Israel may be accustomed to ongoing threats on the lives of its citizens, mental health professionals are warning that resilience learned in times of terror hasn’t equipped people emotionally for the current coronavirus pandemic.

Sally Ross-Bihari of Enosh, the Israeli Mental Health Association, told The Times of Israel Wednesday that while people have become used to terror attacks they have no idea what to expect from the COVID-19 crisis.

“One of the most difficult situations is uncertainty,” said Ross-Bihari, director of Enosh’s center for professional excellence.

“Even in Sderot where rocket attacks have been going on for years and people know the drill — they fire and we fire and there’s a ceasefire — but in this case we don’t know what will happen, and there is uncertainty.”

Sally Ross Bihari (Courtesy)

She elaborated: “The uncertainty of the situation and changes that are happening make it different than the times we know with bombs and missiles. Knowing that every day there will be new guidelines is an unfamiliar situation.”

Uncertainty is further increased because “you see coronavirus behaves in different ways in different countries,” she said.

In Sderot, residents said that the need to take shelter during periods of rocket fire from the Hamas-run Gaza Strip has made them familiar with the drill of staying home, but not with the current uncertainty.

Illustrative: Israeli children run to a bomb shelter during a Color Red alarm warning of incoming rockets from the Gaza Strip, January 8, 2009. (Anna Kaplan/ Flash90/File)

Batya Katar, 59, clearly remembers the day 12 years ago when her late mother’s home was hit by a Kassam rocket, and has led protests against what she considers the intolerable impact of rockets. But she finds the coronavirus threat “much” harder to handle, and said that it is a “serious psychological challenge” for her town’s famously hardy residents.

In a telephone interview, she said: “When there is a Kassam coming at you, there’s a red alert and you go in to the safe room, but you don’t get this with coronavirus. No one knows who has it and who doesn’t or exactly how you get infected.

“You know a Kassam is on its way. And you have the Iron Dome. But with this, it could be next to you.”

Tal Toren, Sderot municipality CEO (Courtesy)

Tal Toren, director of the Sderot municipality, echoed Katar, saying, “Emergency situations we know, we don’t know this.”

“It’s something else completely,” he added. “We know how to deal with what we’re used to, like anyone, but coronavirus is something totally unfamiliar.”

In Beersheba, also in the range of Gaza rockets, clinical social worker Rachel Gang is being approached by new clients — even though she can’t see them face-to-face. “It’s very difficult for people to psychologically process these events,” she said by telephone, adding that “many clients are prepared for rocket and war-like time but this is a new experience.”

People take cover during a rocket warning siren in Sderot, southern Israel, November 12, 2019. (AP Photo/Tsafrir Abayov)

Gang commented: “If you compare the disruption of routine by rockets it’s similar. Apart from that, preparing from rocket fire doesn’t prepare us for what is happening now, because it’s an unknown situation.”

She said that the sense of unpredictability isn’t just hard to absorb, but also prevents people from employing some normal coping strategies, such as trying to combat disruption to life by following routines, or in exceptional times, setting new routines.

“I encourage people facing anxiety or mental health challenges to develop routines but with the current changing restrictions it’s very hard to create routine,” she admitted.

An Israeli firefighter wearing protective clothes disinfects a bus station in the ultra-Orthodox town of Kiryat Ye’arim (Telz-Stone), on March 18, 2020, after seventeen of the city’s residents were found to have coronavirus. (Yonatan Sindel/Flash90

Ross-Bihari said that as well as sowing uncertainty, the coronavirus crisis has caused emotional instability by prompting the government’s order for people across Israel to stay at home, and eliminated many normal support structures, nationally, locally and in families. “Community support is very big in Israel, but now we don’t have it in familiar form,” she said.

Ross-Bihari suggested that when comparing terrorism and coronavirus responses, “the similarity is being able to go through stressful times and handle stressful situations. But even the most basic thing of being able to get help from say grandparents, which we do during rockets, is now unavailable. Plus, normally we rely on neighbors and friends, we get together, but now are told to keep our distance.”

Passengers on the light rail in Jerusalem, March 17, 2020. (Yossi Zamir/Flash90)

Some mental health professionals are optimistic that, especially as people become more used to the coronavirus threat, emotional resources built up during terror threats will help Israelis to manage. Judith Spanglet, a trauma expert who works in Israeli communities near the Gaza border, predicted that “those who have practice building their resilience will find that very helpful.”

“People can say if we can handle Hamas and Islamic Jihad we can handle this, and just like we stay in sheltered rooms we’ll stay in our buildings,” she said.

Ross-Bihari told The Times of Israel that while many Israelis will find coping strategies, large numbers will face emotional and mental health struggles, and she expects that the current spike in calls on Enosh’s switchboard is “the tip of the iceberg.”

“This is just the beginning,” she said, “but in a few weeks there will be erosion of the resilience and we will see more people reaching out, especially as they are stressed after being home with kids, and feeling strain in relationships.”

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