Confessions of a Traumatized Society

"I'm afraid of taking a shower, afraid of leaving the house, of the rockets reaching me. We live opposite a valley. At night the cries of the jackals sound like alarms. I don't dare go out to the balcony to hang the washing. I'm afraid of falling asleep. The thought that an alarm will sound soon makes me nervous. I'm scared I won't make it in time to the shelter. That I'll get caught in the blanket. That I won't find my spectacles."

A young Haifa woman offered this touching description in an anxiety relief workshop run by NATAL (The Israel Trauma Center for Victims of Terror and War), held last Thursday at the Eden Inn in Zichron Ya'akov. For the last three days, she has been situated at a fairly safe distance from the rockets. But as with most of the refugees there, and more so since an alarm sounded in the vicinity of the hotel, she reports of her fears in the present tense - as if she is still in the war zone.

The participants - refugees of the north from Kiryat Shmona, Acre, Nahariya and Haifa - all nodded their heads in sympathy. "My fear is so strong, that I think it is like a stain that will remain", the young woman continued. "I'm afraid that I'll stay scared for the rest of my life."

"Look at us," said a Kiryat Shmona resident sitting to her right. "We are trained. We don't get nervous. It's 30 years now that we are living with this fear."

Mostly women accepted the hotel's invitation to attend the workshop, joined only by one older man. The hosts, Varda Oshpiz and Limor Sofer, discussed the importance of sharing the experience and made it clear that fear was perfectly normal given the circumstances. They asked the participants to demonstrate their coping methods for the group's benefit.

A Kiryat Shmona primary school teacher, a Kibbutz Deganya member whose house was directly hit by a rocket, said she drew courage from her Holocaust survivor mother, who came to Israel and started a new life in the Kibbutz. "I barely rescued this shirt out of the house," pointing to her red shirt, "and a few photo albums covered with holes. I plan to return to Kiryat Shmona and rebuild the house."

The confessional character of the meeting was cut short soon after it began. What do they need anxiety relief for, some women retorted, when they are preoccupied by real existential problems? The hotel stay is limited to a few days. Why, they repeatedly asked, must they return to their homes? And where will they go to? Back to the shelters? To abandoned Kiryat Shmona? What about the government?

5,000 calls a month

One of the women, choked with tears, said she arrived at the hotel as a stow-away, invited by a friend who stayed there. "We were doing fine financially before the war. But now I can't afford staying in the hotel. I need to decide what to buy first with the money I have left: diapers or medicine for my grandchildren. I have two married daughters with children to feed. They don't work at the moment. No one will assist me since I'm not a single parent or eligible for welfare, but I had to escape."

"Where do you live?", the woman's daughter asked Oshpiz, exposing her racked nerves. "Do you know what we're going through? Do you even realize what it is like to sit in the shelter with your kids for a month? I don't approve of what you're doing. What help will it bring me to talk about fears for an hour?"

She opened the floodgates. For a long time the participants mainly unloaded their anger. The complaints and grievances - on the mayor, the government and the media - only increased, and threatened to worsen the already gloomy atmosphere. Tikva, a sanitary worker for the Kiryat Shmona municipality, suddenly stood in the center of the circle, stretched to the height of her small stature, and announced that the mayor would not talk with her on the phone, although she dialed his personal number. "They are abandoning the city's residents", she shouted with tears in her eyes.

The despair peaked when the turn came for the only man in the group to speak. With broad hand gestures, like a prophet of doom, and rising intonations, he began portraying the war as the Gog and Magog war and spread a hallucinatory apocalyptic doctrine. Most of the participants agreed with every word, and as the atmosphere became increasingly surreal, the hosts decided to move on to relaxation exercises.

It appears that the present war is different from its predecessors not only in the anxiety it spreads, but also in the freedom of its victims to speak about it. The increase in calls to mental emergency hotlines reflects this. This past month NATAL received about 5,000 calls, twice as many as last year. ERAN (Emotional First Aid by Telephone) reports a doubling of anxiety-related calls. Sigal Haimov, manager of NATAL's hot-line, gauged the number of hotline callers. She relates the increase of calls to the growing awareness of the anxiety phenomena, as well as the availability of the hotline.

Magen David Adom reported 1,325 shock victims have been hospitalized thus far. The hospitals in the north report an increasing number of casualties who arrive on their own after rocket strikes. After a rocket fell in Wadi Nisnas a week ago, about 50 Israeli Arabs, neighbors from the area and relatives of the injured flooded the Rambam hospital dining room, which was converted to a make-shift emergency room for anxiety patients. According to professor Ehud Klein, head of the psychiatric ward of the hospital, the true number of anxiety victims is hard to estimate, since many of them do not come to the hospitals for treatment.

Following the experience of the intifada, trauma experts came to the understanding that traumatic reactions to difficult scenes and, to a large extent, situations of panic and threats of danger, might set in and become post-traumatic disorders. These disorders condemn victims to an entire life of misery and suffering. As with battle-shock victims, such a reaction is followed by a repeating of the experience: flashbacks, a tendency to either describe the event or repress it, fears during the day and nightmares at night, as well as irregularities in normal bodily rhythms. These irregularities include terrible sensitivity to noise, restlessness and insomnia, or alternatively, staring and disassociation.

First aid is crucial to preventing the trauma from setting in. Recounting the event restores the victim's feeling of control. But some doubt the benefits of "sharing groups" immediately following an event, or after a few days, such as in the workshop. Indeed, some are skeptical of the process, in which each victim tells his version of the event and expresses his feelings about it. Klein, for instance, prefers individual treatment. He says that the overload of information about the threat or about the exposure to danger absorbed from other participants' accounts only increases anxieties.

Physical relaxation

Dr. Ronnie Berger developed the NATAL workshops, and four of his teams have already undergone a month of field work. They move from Arab to Jewish towns as semi volunteers, he says, and instruct professionals on how to relieve stress and anxieties. Berger, a city cowboy type, developed an expertise in treating anxiety victims in disaster-struck areas. Since the attack on the World Trade Center in the United States, he operates as part of the Psychologists Without Borders organization, which he established. Two months ago he returned from Java Indonesia. He has conducted courses and workshops in Hurfeish, Rama, Gish (Gush Halav), Merer and Peki'in, worked with the Haifa train garage workers and the Nahariya shelters, risking his life in the process. He instructs social workers, teams and teachers, and later accompanies them in the field, meeting people in the shelters. In this "fanning-out" method, as he put it, it is possible to treat a greater number of people.

From Berger's perspective, the state of national endurance is not encouraging. The lack of organization in the rear produces tremendous exhaustion. "It's not only that we didn't prepare for this war," he says, "but that people here are still harboring a feeling that the army will be victorious, and when they acknowledge that this mock army of Hezbollah is not so weak, they snap. All the primeval fears about the world seeking our destruction surface, the connection to the Holocaust is subsequently made, and this causes people to sink into despair."

Berger says the Arab population has more complex reactions. "It depends on the village, if its a Muslim, Christian or Druze village. I did not find a lot of sympathy for Hezbollah in the places I visited, but I did meet with terrible anger towards Israel. You have to understand: Their whole concept of threat is new. The danger caught them by surprise. There is also sympathy for relatives in Lebanon, and above all - their fear is very real since they don't have shelters." He says that another factor that makes the work more difficult is that the teams are exposed to the same trauma. The workshops are interrupted by alarms, and the social workers, who are also mothers, break off to see if everyone at home is alright.

The idea behind the workshop is that venting is an important part of stress relief after staying in a shelter for a long period of time. Berger believes in physical activity. He developed a series of rhythmic hand drumming, drumming on the body, breathing exercises, joint-loosening exercises and verbal exercises to release anger.

It seems that Berger and his teams are trying to finger-plug a flood, but is the feeling that half of the country, if not all of it, is suffering from trauma, indeed founded? Studies conducted in the U.S. a year after the World Trade Center attack showed that 10 to 20 percent of New Yorkers have post-traumatic symptoms. However, Professor Zahava Solomon, a leading trauma researcher from Tel Aviv University, was surprised to discover a smaller scale of symptoms, about 9 percent. Her conclusion was that Israelis handle the "situation" fairly well. The question is whether national endurance can also pull through the present war, and how repression affects us as people.