The number of patients receiving psychological treatment at centers near the Gaza border doubled between 2017 and 2019, according to a recent report stating that residents have been living “under constant stress and fear that war is imminent.”
The Hosen (“Resilience” in Hebrew) centers provide psychological support to residents of Gaza border communities. The number of patients rose from 2,385 in 2017, a relatively quiet year, to 4,705 in 2019. Residents lived through three “intense rounds of fighting” in 2018 and 2019 and sporadic shooting in between them, according to the report.
Residents also experienced a new phenomena, namely unprecedentedly loud, violent protests next to the separation barrier and the launching of incendiary balloons.
The rounds of fighting forced residents to make “very sudden transitions from routine to emergency and back, which didn’t allow the necessary space for recuperating and gathering new strength.”
Children were involved in at least 57 percent of the 39,965 treatment sessions provided in the five resilience centers in 2019, the report said. Adults accounted for another 30 percent while 2 percent were seniors. Age was not recorded in 11 percent of the cases.
Sivan Yungerman, a 47-year-old mother of three, started a series of treatments last year with her 10-year-old daughter after she and her family were outside their home on Kibbutz Erez and tried to find shelter after rocket sirens went off.
“The whole situation of people screaming and chaos caused the need for treatment,” Yungerman, a resident of Kibbutz Erez told Haaretz. “There has never been such an incident before. I was also near a shelter, at home, and suddenly found myself in a crazy situation with Iron Dome missiles exploding over my head. I felt a loss of control and realized I needed care.”
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Yungerman also described the period prior to that as full of fears. “There were all kinds of other situations,” she recalled. “Suddenly, a boom you can’t identify. You jump and you don’t know if it’s an alert or a door slam. There was always repression, and then there was the straw that broke the camel’s back. I assume the rocket sirens broke me.”
‘The problems are much more complex’
The Israeli government decided to establish the border centers in 2007 to meet the residents’ psychological needs. Treatment regimens were initially limited to 12 meetings, but later extended to 24, and officials say residents can return for further rounds of treatment.
“During the past two years we’ve seen more people needing over 24 treatments,” said Meirav Vidal, the director of the Eshkol Regional Council’s resilience center. Patients needing more than 24 meetings this year needed recognition from the National Insurance Institute as terror victims with psychological needs, a requirement that was later dropped. The centers also started offering services free of charge in 2008.
Vidal sees the increase as well as the extent of treatment needed as a worrying sign. “We see people arriving with far more complex problems, requiring resources and more profound treatments than we’ve known,” she said.
Vidal said a survey of residents generated worrisome findings, the main one being that 48 percent agreed with the statement “I have no strength to cope with life’s demands.”
“We see burnout, exhaustion and weariness. We’re seeing diluted resources, people saying ‘enough, we’ve no strength left’,” Vidal said.
The centers plan a new survey in 2021, hoping for more encouraging data given that 2020 was calmer than the two years prior. Vidal said the security related incidents in 2018 and 2019 prevented residents from healing. “Emergency situations not only disrupt routine but also your role, what you’re doing, your thought process, your feelings,” she said, adding that emergency situations force people to act differently, but that everyone has to return to themselves afterwards.
Vidal said it takes time to restore balance, to understand the emergency has passed and that it is possible to relax, likening the process to a switch. When you constantly turn it on and off too much, it breaks.
“So, think about this switch in the soul, which you constantly tell: ‘enter emergency mode, leave emergency mode. It wears out. It doesn’t allow the time to regather strength to cope a further time. It erodes the ability to be flexible,” Vidal said.