The Problem With Expecting Traumatized Israeli Troops to Move On

Expecting soldiers with PTSD to head toward healing in a linear way isn't only a mistaken approach – it’s also cruel

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Israeli soldiers prepare for combat in the Gaza Strip during 2014's Operation Protective Edge.
Israeli soldiers prepare for combat in the Gaza Strip during 2014's Operation Protective Edge. Credit: AFP
Nitzan Rothem
Nitzan Rothem

Seven years have passed since Operation Protective Edge in the Gaza Strip, but that war still haunts Israeli society, refusing closure. During the past year, three events overlapped to underline the open and ongoing status of Israel’s wars: the state of emergency accompanying the coronavirus pandemic, last May’s operation in Gaza and the self-immolation of Itzik Saidian.

A couple of years after Operation Protective Edge, Saidian went to Romania for group therapy, together with his combat comrades from the 2014 battle in Shujaiyeh, a neighborhood in Gaza City. They were accompanied by therapists from the “B’shvil Hamahar” (“On the Path to Tomorrow”) program and by a team from the documentary TV program “Uvda” (Fact). The resultant episode was broadcast in the spring of 2018, close to Memorial Day. Its title – “To Triumph over Shujaiyeh” – presents a chronological line. It tells a story with a clear beginning – the battle in July 2014 – and a happy ending: Thanks to the group therapy, the veterans can carry on with their lives. In Operation Protective Edge, they were regular-service soldiers who entered Gaza with insufficient protection, came under heavy fire and lost friends.

The call to keep on into tomorrow did not help Saidian and may even have caused him distress. His difficulty is hinted at in the raw material that didn’t survive the editing process of “Uvda,” and was broadcast only after he set himself ablaze. In these shots Saidian sports a fine beard, his shoulders are slightly hunched, his rhythm of speech is slow. Someone, possibly the therapist, asks him, “What needs to happen so that you can move forward?”

Saidian doesn’t look at the camera, his answer is convoluted: “Until not long ago I would have told you that… that I am waiting for a war that… that I will be able to go in again. As if to settle accounts.” He tries a different answer: “But what needs to happen… bottom line – to come to terms with myself. There is nothing for us to lean on, nothing that can console us, just to come to terms with it.” Saidian uses the words of consolation that surround him, but cancels out the effectiveness of the two possibilities of closure: to fight the enemy one more time, or to take personal responsibility for himself. His response ended up on the cutting-room floor.

The trap of the lines

The social message that was aimed at Saidian, and which is aimed at other discharged soldiers – the anticipation of progress – is related to the limited way in which we perceive reality. That perception is based on one central image: lines. We think of lines that go in one direction – the wind comes from the southeast, the buildings on the street are numbered in ascending order, and so too with the sequence of our life. Sometimes the line is cyclical, sometimes it moves toward a peak: Dessert arrives at the end of the meal, evolution is moving toward human advancement, and the big battle hastens a war’s end. The idea of a peak organizes personal and social life in a manner that instills meaning and satisfaction, and obligates us to think of time as a passage that leads toward the future.

The examples above are not mine, nor is the underlying thesis they demonstrate. They come from Dorothy Lee, one of America’s first anthropologists. In an article published 70 years ago, Lee (1905-1975) argued that the line is not reality, but only a representation of reality. Think of the phrase, “breaking the line of thought.” Lee mentions this phrase to show that we imagine straight lines, even when the human experience is different. After all, our thoughts elude a linear framework, experiences and times can leap about in them in surprising ways.

According to Lee, Western culture has transformed the line into an ultimate truth. Time moves in a line, and the line is right and good. The line delineates order for us, suggests a process, posits hierarchies and enshrines causal relations. Lee notes that we have even invented machines that replicate the imagined lines, like the electrocardiograph, which depicts the activity of the heart muscle by means of a line.

Lee’s diverse examples stir two questions: What are we missing out on in reality because our perception is line-dependent? And, how is it possible to think in a different way? To answer those questions, Lee discusses the Trobriand Islanders, a culture that, she writes, does not think in terms of lines, processes and peaks.

Saidian. Felt that “there is nothing for us to lean on.”

In Lee’s interpretation of their culture, the residents of the Trobriand islands, which are today part of Papua New Guinea, have no need to create a historical story about themselves, and they have no words or grammar that distinguishes between past and present. In their perception, the unripe apple and the ripe one are two different fruits, and not one apple that has changed with time.

Back to childhood

There is, however, no need to venture to tribal cultures for inspiration. The limitations of our use of lines are apparent, for example, in the way we understand the nature of both war and the mental suffering it entails.

We imagine lines and we also imagine their movement: backward or forward. To these lines we add and instill opposite valuations. Movement forward is what’s needed, toward improvement, fulfillment, summit; movement backward is pathological and atrophied, and so too is movement in a loop, a flat line that moves in a circle, trapping a soldier who does not succeed in moving forward.

But what needs to happen… bottom line – to come to terms with myself. There is nothing for us to lean on, nothing that can console us, just to come to terms with it.

Saidian

The image of the suffering soldier is of someone who can’t hold onto a job, can’t hold on to a relationship, can’t hold on to emotions – and all because he is not moving correctly on the time axis. The dark past erupts into their present and repeatedly sabotages it. The behavioral expression of this suffering manifests in two opposite reactions: withdrawal, on the one hand, and an outburst, on the other. Both are cataloged as post-traumatic responses, along with such diverse emotions as fear, guilt, shame and helplessness.

In 1980, when post-traumatic stress disorder (PTSD) was first included in the “Diagnostic and Statistical Manual of Mental Disorders” (the DSM, published by the American Psychiatric Association), it was the only disorder that was not based solely on a list of difficulties, such as sleeplessness and loss of appetite. Instead of symptoms, the rationale for the new diagnosis lay in the cause of the illness: the argument that shell shock stems from an exceptionally stressful event, namely from a specifiable source. The explanation was political: A powerful lobby of Vietnam War veterans succeeded for the first time in introducing into the DSM a disorder that is marked by a concrete etiology (a causal factor), and not by a list of complaints that could in any case be found in already existing disorders such as anxiety and depression. The Vietnam veterans called into question the establishment of the diagnostic manual as a catalog that is faithful to all schools of psychological thought, and gave priority to psychodynamic interpretations.

But why was it that a particular soldier was affected so seriously, and not other soldiers who participated in the same battle? The attempt to answer that question introduced childhood into the portrayal of PTSD. A routine therapeutic suggestion is that the soldier was vulnerable from the outset because of an unusual childhood experience. Cultural representations fortify this problematic hypothesis, as viewers of the Israeli television series (later shown on Netflix) “When Heroes Fly” know. Viewers (though not readers of the novel on which the show was based) learned that the “original” wound of Aviv, the Israeli army veteran, is not the loss of his commander in the Second Lebanon War, but his childhood exposure to the death of his father – and that this is the central event that needs to be dealt with and recovered from.

Discharged soldiers who take part in discussion circles search for childhood traumas, even though officially a psychiatric diagnosis can be obtained only on the basis of a military cause. Moreover, if applicants for government compensation find failings in their family and their childhood, the Defense Ministry can claim that the cause of the mental disorder does not lie in combat alone. If so, the ministry can approve a reduced compensation, as happened to Saidian. He was granted a 25-percent disability compensation, based on the opinion of a psychiatrist representing the Defense Ministry, who attributed half of his suffering to his childhood. And, it bears noting, the compensation arena is not just a bureaucratic and economic battle. The soldier’s request for financial assistance involves two elements: receiving formal recognition of one’s suffering, and acknowledgment of the social and military context of the suffering.

The idea that there is a childhood factor behind suffering succeeded in striking roots because talking about one’s parents is a component of many psychological methods. Paradoxically, it is not only the traumatic event but also the psychodynamic language that encourages suffering soldiers to move in reverse on the temporal axis, to seek relief by delving into their family past. From this point of view, being tagged as post-traumatic narrows a veterans’ experience, prompting them to think that they came from a defective family, as compared to other families.

Illustration by Daniella Shuhman

Discharged soldiers embark on a journey of searching for problems in their past, though their suffering is occurring in the present. It is not trauma they are dealing with, but a protracted, ongoing suffering. Sometimes, the combat enters their here-and-now concretely, in the form of bad dreams at night and vivid memories during the day. Although psychological labeling views these phenomena as “dissociation” – mental disruption – the fact is that the nightmares and the flashbacks, the heart palpitations and the difficulty in breathing, the crying, the aggression, the shivers from heat and cold – all occur in the present. The diversity of these manifestations undercut a basic Western convention: the truth and the value that we place in lines in general, and in the time line in particular.

The physical torment and the hopeless thoughts are liable to become more acute in periods of military hostilities, such as those Israeli society experienced last May. As such, to Dorothy Lee’s doubt about the exclusivity of the lineal perception, it’s essential to add another variable: the state of war today is not lineal or binary. The Israeli-Palestinian conflict broke the causal connection between war and peace. The military operations are only ostensibly weighed in decisive terms – as a “lethal” movement toward victory or defeat, and as a process of success or failure.

If society and state are not moving from war to peace, why should the soldiers move? After all, the Israeli-Palestinian conflict is also mired in incidents of arbitrary death, lethal shelling and frightening alarms. The Palestinian and Israeli publics, certainly those who live in the Gaza Strip, and, in the “Gaza envelope” within Israel, are not moving ahead toward a life of tranquility, and IDF veterans can still receive an emergency call-up order for a future military operation.

From this perspective, claims of PTSD are flourishing today because they personify the form of contemporary warfare. Like the protracted conflict in Gaza, PTSD also presents as occasionally eruptions of covert and underground suffering. It strikes both soldiers and civilians, even children, and thus mediates the fact that the ongoing conflict has shattered the boundaries between criminal activity and combat, and between front and rear. The continuing conflict – like the standard image of PTSD – moves in waves, in rounds, in devastating loops.

Palestinians and Israelis are not moving ahead toward a life of tranquility. If society isn't moving from war to peace, why should the soldiers move forward?

The loop as personal failure

The public goal of the talk about PTSD not only reflects a concern for those who apply for help. It also sustains a political motivation to validate the importance of the chronological axis of time, precisely in a period of continuing disasters. These disasters encompass endless conflicts, along with concerns about the climate crisis and the spread of epidemics. These ongoing situations show that the message “to progress” is not compatible with “the situation,” with “public health” and with “public security.” Nor is it compatible with many other human experiences. To understand the Israeli oxymoron of an “ongoing emergency routine,” it’s necessary to breach the limitations of linear perception.

But instead of shaking off this approach, we insist on framing the suffering in linear mold, consoling ourselves that “time will do its work.” There is cruelty in the social imperative to confine emotions in time. A discharged soldier who is suffering because of his army service might feel that he disappointed his loved ones and disappointed himself. He has not allowed time, family, friends or professionals to help him rehabilitate his “resilience.”

The feeling of failure is an outcome of lineal thinking. As Dorothy Lee wrote: “If the undertaking is of value in itself, a point good in itself, and not because it leads to something, then failure has no symbolic meaning… But failure is devastating in our culture, because it is not failure of the undertaking alone; it is the moving, becoming, lineally conceived self which has failed.”

In the case of Saidian, adoption of the language of lines intensified the sense of failure that this soldier took on himself: loss of friends in battle, confronting the bureaucracy, healing from the trauma; everyone else is returning to normal life, and he alone is moving in the wrong direction, whether by lagging behind or being stuck in flat loops.

U.S. Army soldier in Mosul, Iraq, April 22, 2009. Credit: AP

Yet even though PTSD diagnoses miss a considerable portion of soldiers’ experiences, they are on the rise in Western armed forces. Complaints about post-trauma have become a widespread way to express distress, which attracts budgets and gets PR. The anthropologist Allan Young, who was the first to criticize the connection between PTSD and linear time, attributes the success of the diagnosis to the simplicity of the explanation. Young studied the American story of guilt-ridden soldiers who, for example, played football with body parts of Vietcong troops. With official recognition of their trauma, their guilt was shared by the U.S. government and public.

Another reason for the popularity of PTSD is communalism. An anthropological study of combat troops who fought in Iraq and Afghanistan demonstrated that the traumatic suffering they underwent became a significant part of their biography. The desire to obtain recognition as PTSD victims gives the applicants a common language, legitimacy to express acute emotions and a feeling that they are part of a community of discharged soldiers.

PTSD complaints have become so routine that the diagnosis seems to be drowning in itself. It’s the scenario of banality: The phenomenon is affecting growing numbers of publics, with a frequency that could sabotage the welfare of soldiers who wish to have their pain recognized as unusual suffering stemming from social circumstances.

Preferring the pocket

A veteran who is suffering because of his army service might feel that he disappointed his loved ones and disappointed himself. He has not allowed time, family, friends or professionals to help him recover.

In the protracted context of the Israeli-Palestinian conflict, 19-year-old Itzik Saidian went into battle in Gaza, flew to Romania to seek recovery, and negotiated with the Defense Ministry, in hope of finding a solution. However, his ongoing experiences – both the suffering and the attempts to cope – collided with the linear approach of the bureaucracy and the treatment. He stood at the entrance to the ministry’s rehabilitation unit, to give outward expression to his inner pain, demonstrating that the suffering was not his alone.

Protracted warfare plays a significant role in Saidian’s tragedy, but it is also offers an opportunity to think about therapy for veterans that is not based on chronological conventions, but tries to express other experiences of time. How shall we recognize suffering that is not time-bound? What can be done in place of dragging the suffering into childhood and clinging to the idea of progress as success? And how do we create a community of discharged soldiers and of their families that is not based principally on joint suffering?

A different type of therapy, more anthropological in character, allows for the possibility of talking with soldiers about mental suffering not as stuck and despairing traumatic movement toward the past, but as a present expression of loss and insecurity. Such a dialogue would not make do with the standard assumptions about the influence of psyche, parents, army, immigration, society and the unending conflict. Rather, therapy would try to understand non-chronological and nonlinear experiences as well, and to clarify their rhythms. Understanding of that sort could help soldiers and the public comport themselves in a world in which ongoing situations are becoming increasingly frequent.

“Moebius Anthropology,” the recent book of essays by the anthropologist Don Handelman enables us to be liberated from the limitations of linear perceptions. Handelman thinks of pockets as a way to grasp the depth of relationships. Put your hand into your pocket, that surplus of textile in our pants. The fingers wriggle down more deeply, and you can pull the inside of the textile out, thus eliminating the distinction between inside and outside, between psyche and society. Lacking flat dimensions, the pocket invites us to fill with content. Its form is at odds with the loop, which flattens the experience of the soldier and his relationships, and it is at odds with the line, which obligates thinking in terms of process and purpose, progress and regression.

It’s worthwhile to enter with the soldiers and veterans into their “pocket,” which is also our pocket. To observe together the twists and the instability, without ignoring the fact that no pants – the protracted armed conflicts – are sewn according to a linear model.

Dr. Nitzan Rothem’s book “Suicide in Uniform: Choice, Duty and Guilt in Israeli Society” (Hebrew), was published by Tel Aviv University Press.

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