After almost 30 days of fighting in the south and the entry of tens of thousands of troops into the Gaza Strip, the Israeli Defense Forces is beginning its “day after” routine. The brigades that fought in Gaza have held their Operation Protective Edge “graduations” and some 30,000 reservists have shed their uniforms and returned home. But for many, this is not the end. “The war may be over, but the internal tumult is just beginning,” said Saar Uzieli, a clinical psychologist who is the head of the clinical unit at Natal, the nonprofit Israel Trauma Center for Victims of Terror and War.
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During the hostilities, the organization’s hotline received some 5,000 calls from residents of southern Israel, worried parents of soldiers and some conscripts and reservists, all seeking someone to listen to their apprehensions. “Some were afraid of going into the Gaza Strip and dying, some might have been afraid to say ‘We’re afraid.’ Some need a place that can contain the fear,” said Gila Sela, the head of Natal’s hotline. “When everyone is such a great hero, you need a place to unwind.”
According to estimates, mental health authorities treated more than 100 soldiers during the fighting for anxiety and post traumatic stress disorder. Those who were treated included soldiers on the front line, those inside Israeli territory and those on the home front. In an interview with Haaretz, Lt. Col. Dr. Ophir Levy, commander of the IDF’s unit for combat stress, declined to say how many troops sought help but said the numbers were relatively small compared to the number of soldiers who took part in the fighting. Some 30 soldiers were treated for anxiety before the ground war even started. These figures were higher than those in recent rounds of fighting in Gaza: 23 such cases during Operation Cast Lead in 2009 and 19 cases during Operation Pillar of Defense in 2012.
IDF mental health officers along with psychiatrists, both in the regular army and reservists, established special teams to handle “combat reaction” in soldiers, considered a precursor to PTSD.
The army says the goal of these mental health teams is to aid the soldiers, among other methods by talking them through their problem, without removing them from the military framework. Troops undergo mental preparation during periods of quiet too, said Levy. “There is a window of opportunity for preventing chronic PTSD. ... Most mental health officers succeed in providing a good response since soldiers remain in the areas of hostilities,” said Levy. Every unit that took part in combat received the support of a mental health officer, who was assigned to the unit in advance.
Immediately after the three-day cease-fire went into effect Tuesday morning, the forces that had been deployed in the Gaza Strip regrouped within Israel, and the mental health teams got their marching orders, Levy said, adding that at that stage combat reaction is a normal response to intensive combat. For that reason the Medical Corps tries to bring in its treatment teams right away for meetings with combat units at the platoon and company levels, especially for units that experienced particularly difficult incidents. These include the Golani Brigade operations in the Gaza City neighborhood of Shujaiyeh, or the activities of the Maglan special forces unit in Khan Yunis. A number of soldiers in these units were diagnosed with PTSD during the fighting, and a few were removed for treatment.
One reserve unit contacted the combat stress unit independently and arranged for a kind of “group therapy” session for its troops with staff from Levy’s unit.
Similar steps were taken during and after the Second Lebanon War in 2006, with follow-up for significant periods after the war. According to figures issued by the IDF Medical Corps in September, 1.5 percent of soldiers who saw combat in that war suffered from PTSD. It is expected the numbers suffering from PTSD, in all its forms, will be similar for Operation Protective Edge.