The Toll Gaza's War Takes on Mental Health

We want Israel to win, but thoughts of wounded Palestinians keep us up at night. We blame Hamas, but know they were Israeli shells. What’s driving us mad and how do we cope? This British psychiatrist explains.

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An Israeli Merkava tank rolls back from the Gaza Strip to an army base at the Israeli-Gaza border as the sun sets on August 3, 2014.
An Israeli Merkava tank rolls back from the Gaza Strip to an army base at the Israeli-Gaza border as the sun sets on August 3, 2014.Credit: AFP

Messages come throughout the night: “Doctor, are you awake?”

“I can’t sleep.”

“I can’t stop thinking about the war in Gaza.”

“I’m worried about my cousin in the IDF.”

“I just had a baby, and I can’t get the images of Palestinian babies being pulled out of the rubble in Gaza out of my head.”

As a consultant psychiatrist working on Harley Street and at hospitals around London, I tell my friends, family and patients that they are not suffering from nervous breakdowns, that their labile moods are normal for now, for these are not normal times. Anti-Semitic rallies have been sweeping through Europe - the likes of which my generation have only read about in books - and we as Jews are being called Nazis whilst people march in the streets of Paris with “Death to the Jews” on placards. Is it any wonder my phone is ringing constantly?

The arguments between friends on Twitter and Facebook cause genuine anger and unease.

“I just couldn’t persuade them that Israel is just defending itself!”

“I told them that I can still be a Jew and not wish to see Palestinian civilians die. Can’t I?”

I am shocked that they even ask me but the malignant nature of some virulent debates online has made people question what they know to be true: that they are peaceful, caring people.

“Of course you can,” I say, as if she needed permission or reassurance that such an obvious statement was true.

She is exasperated and tells me she has been vomiting from the stress.

“I was up all night commenting and posting to Facebook in defense of Israel. I didn't make it to work the next day.”

Long-term friendships are savaged because emotions are so intense on both sides at the moment. Every anti-Israel video posted by a colleague or friend on social media results in a rapidly severed online friendship, which leads to sadness and newly acquired melancholic symptoms.

I remind them of what Freud said: “We are never so defenseless against suffering as when we love.”

But it’s not just their love for Israel that is keeping them up at night, spiking their cortisol levels and blood pressure as they appeal to friends over social media that Israel has no interest in killing civilians or collective punishment of Palestinians. It’s their love for people of all faiths that is responsible for their current inability to function in the day and their anhedonia (the inability to experience joy or pleasure).

“I feel so guilty as a Jew, as if I am betraying Israel when I say I want this war to stop, but I can’t take it anymore seeing dead women and children and homes obliterated.”

“How can we just sit back as Jews and not feel something for other human beings that have nowhere to go and are being paid by Hamas to stay in schools and hospitals as human shields?!”

I nod, and I can see the pain in their eyes. I can see how much this war means to everyone.

The social psychologist Leon Festinger’s theory of cognitive dissonance refers to when people are excessively stressed because they are holding onto two contradictory ideas at the same time.

Festinger suggested that when people are split in their emotions, they will do anything to reduce this feeling of unease and avoid reading or seeing more information, but that’s not possible. News channels run the images of ambulances and explosions in Gaza and Israeli funerals around the clock. There is no peace to be found.

It’s daytime now and I sit in my medical clinic and patients talk of how they have not been able to sleep all week, their concern ongoing for Israel and their families, the images they have seen of rockets arcing over the Negev toward loved ones in Be’er Sheva and Tel Aviv repeating in their mind, and the news of soldiers dying daily.

As much as I want to offer my patients relief from their burdens, there are no straightforward answers here, no panacea for their emotions. I can’t prescribe my patients a pill to make their dissonance dissolve, for it is wholly at odds with our beliefs that as Jews we would not wish for the prospect of life and goodwill toward others that are suffering. For Israel to win this war we wish Hamas destruction as they wish ours, but we struggle internally with the knowledge this will mean death to hundreds, if not thousands, of civilians.

“Why can’t I stop thinking about this?” My patient puts her head in her hands in exasperation. “I am so angry that the world has turned against us. They don’t understand!”

“It’s because these thoughts are ego-dystonic.” I suggest.

“What’s that? She looks up at me inquisitively.

“It means that the thoughts and dreams you are having are in conflict with your own image of yourself. And that is making you sick.”

“The image of myself? Don’t you think the whole of Israel is ego-dystonic?”

We tell ourselves this is necessary for us to live; others must suffer, no matter the numbers, for the sake of our own security. This irrational thought takes center stage and rational thought is sidelined as we cling to religious beliefs and turn to our leaders, who tell us that this is a war of the enemy’s making.

We are sorry but this is necessary evil against evil. We watch videos on Facebook that tell us we are right and they are wrong. We re-tweet pro-Israel bloggers’s comments and our feelings of uncertainty and morality dissipate. But yet we can’t sleep at night nor think straight by day.

And therein lies the question: For our mental health and for our love of Israel, must we embrace cognitive dissonance?

Dr Mark Silvert is a medical director and consultant psychiatrist at The BlueTree Clinic, London.

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