False accusations, persecution, abduction, rape, torture, murder, destruction by fire of homes and synagogues and more are not new to the long-suffering Jewish people. What was new last Simchat Torah was that all of these unspeakable catastrophes took place on just one day, October 7, on Israeli soil – thanks to failed and arrogant national leadership that turned a blind eye to substantial early warnings and adopted misplaced “conceptions.”
Because the Jews haven’t had to face such abominable crimes against humanity – including against nine-month-old babies – since the 12-year-long Holocaust in Europe, no one is certain how long it will take, if at all, to heal the physical and emotional wounds and how to help such a wide variety of survivors who have lost loved ones, homes, personal possessions, workplaces, and communities.
The psychologists, psychiatrists, social workers, and other clinicians can suggest and try out a patchwork of therapies. Some victims may never be healed. The calamitous Yom Kippur War, in which Israel was also taken by surprise half a century ago, continues to cause trauma among those who fought and who lost loved ones.
Some victims of Hamas's October 7 massacre may never heal
By the eighth week of the Gaza war against sadistic Hamas terrorists, there has been an increase since September of 30% in those suffering from depression and anxiety. Among men, the increase was 15%, and among women 37% (a difference of 150% between the genders).
There has also been an increase in anxiety and depression among children and seniors. Maccabi Healthcare Services, the second largest of the four public health funds, reported that healing them will be “a major challenge facing the health system.”
Dr. Tali Shmueli, Maccabi’s director of mental health, declared that “the horrifying events of October 7 brought to the general public many feelings of pain, frustration, and deep sadness. Most of the applicants mainly need several therapeutic sessions to acquire basic tools for relaxation and giving emphasis to the existing internal forces, and they turn to the primary medical services for assistance with sedatives.”
Maccabi Director-General Sigal Dadon-Levi added that “the main challenge facing the entire health system at this time is the field of mental health. The events of the war cause a lot of mental damage, including trauma, anxiety, and depression. The psychological response [of Maccabi therapists] that is required in the immediate term and that will be required in the long term is of very different orders of magnitude than what we are familiar with.”
Prof. Merav Roth, a University of Haifa clinical psychologist and a psychoanalyst at the Israel Psychoanalytic Society, a teacher and supervisor both at the society and at the psychotherapy program at Tel Aviv University’s Faculty of Medicine, serves voluntarily on the advisory committee of the Hostages and Missing Families Forum headed by Prof. Hagai Levine. A day after the Hamas incursion, she began to develop tools for psychoanalytic groups to help survivors.
In an interview with The Jerusalem Post, Roth said she had never worked before with freed captives, but she has treated patients for bereavement for many years. “In the past, Israeli soldiers were kidnapped, abducted by terrorists – but not women, children and infants! There is so much trauma to whole families. When they return, they are exposed to what they lost. A mother came back and quickly learned that her husband, brother, and other loved ones were murdered.”
The first thing to do, Roth suggested, is to stress that the world continues to exist, that it hasn’t been destroyed. “They lived for weeks under terrible conditions, some were constantly threatened [with] being murdered, beaten, prevented for hours [from] going to the toilet, served a starvation diet. But now they can be taught that they are dignified people who are being cared for. The love and goodness showered upon them by the whole country are important after nine months of a terribly divided population. The volunteering and caring help balance that with the good. Their belief in humanity must be restored.”
The healing process involves restoring their feeling of control and power. Their needs must be met, said Roth, but they must not be forced. “Each survivor gets a therapist who must not just sit and nod their heads and listen. They [survivors] should be directed to connect themselves to a cause, to remember how they helped others, to describe what they excelled at before October 7 and to whom they are connected, and to build a bridge to the times before they were taken captive.”
It will take years to treat them, she continued. “It doesn’t mean they’ll be fine in a couple of years. They have to be watched; we must prevent suicides, drug abuse, and the like. Some will need sleeping pills or antidepressants. But many will not develop full-fledged post-traumatic stress disorder. We will try to prevent suicide. We are hundreds of volunteer psychiatrists, psychologists, and other therapists for their psychological first aid, and then they will be channeled into state-provided regular treatment [employing] a variety of techniques to reduce anxiety, including cognitive behavioral therapy, eye movement desensitization and reprocessing (EMDR) therapy, moving your eyes a specific way while you process traumatic memories and more.”
Since there have been no studies on what techniques are most effective in healing victims of such an unprecedented event, said Roth, there are concrete plans to conduct research to determine what is most effective for helping each group.
THE TAUB Center for Social Policy Studies in Jerusalem just published a paper that outlines the steps the government should take in order to provide for the needs of the evacuees from the western Negev and the northern settlements.
Prof. John Gal, principal researcher and chairman of the Taub Center’s Welfare Policy Program, outlined the most critical points regarding the civilian evacuation and temporary housing, employment solutions, economic assistance, and support provided to these communities and the absorbing communities, based on his review of the data and information accumulated since the beginning of the war.
The researchers expressed concern about psychological situations such as depression and violence in the family. “As a result of the prolonged absence from their homes, temporary living conditions that are often characterized by crowding and a lack of privacy, and, in many cases, the absence of educational and employment frameworks, risk situations such as depression, anxiety, loneliness, and domestic violence are liable to develop among evacuees.”
Gal stressed that, with time, the chance of this happening increases, even among people with no prior history of these conditions. According to him, the time to deal with these difficult and complex situations that have arisen is now, to help prevent high-risk outcomes in the future. “To this end, the state should allocate the necessary resources to provide material and financial solutions, as well as psychosocial assistance from social workers and other professionals. The lessons learned from those who were housed in ‘COVID hotels’ should be applied – even though the stay in those hotels was much shorter than in the current situation.”
The Taub Center paper warns that a one-size-fits-all policy on the part of the state is not likely to be effective. “It may well increase the feeling of coercion and will constitute an obstacle to rehabilitation. Specific groups in need of special psychological and other assistance include the elderly, individuals with disabilities, single-parent families, large families, immigrants and asylum-seekers, and individuals living in poverty. Another important group, of course, is the families of those who have been murdered, taken hostage, or harmed in some way by Hamas, as well as those who were direct witnesses to the massacre and acts of terror. They are particularly in need of intensive support and assistance for the long term.”
THE INTERNATIONAL Center for the Enhancement of Learning Potential in Jerusalem, headed by Rabbi Dr. Rafi Feuerstein, has dealt mostly with children with disabilities like Down syndrome. But it has a large group of trained professionals and volunteers who are able to treat the elderly as well and felt they couldn’t remain on the sidelines after October 7.
The center was established by his late father, Prof. Reuven Feuerstein, a Romanian-born Israeli clinical, developmental, and cognitive psychologist, known for his theory of intelligence, who won the Israel Prize before his death nine years ago. Believing that mental disabilities conditions are not fixed but, rather, modifiable, he is recognized for his work in developing the theories and applied systems of structural cognitive modifiability, mediated learning experience, cognitive map, deficient cognitive functions, learning propensity assessment device and instrumental enrichment programs.
Escaping from the Nazis and coming to Mandate Palestine in 1945, he taught child survivors of the Holocaust until 1948. The improvements Feuerstein witnessed in victims after they received extra psychological and educational attention made him question current beliefs regarding the stability of intelligence.
His son Rabbi Rafi has spent two decades at the Feuerstein Institute, as a colleague and close disciple of his father. He developed instrumental enrichment basic tools and memory tools for the elderly. He is known as one of the leading experts of Learning Propensity Assessment Device – a dynamic evaluation based on the Feuerstein method used to determine how an individual thinks and learns. The institute is now treating elderly people rescued from Gaza and those of all ages evacuated from destroyed homes or those in dangerous areas in the South and North.
The quality of life of the elderly who were kidnapped and those evacuated from their homes was greatly affected. They lost friends, family, and also their routine, Rafi told the Post in an interview. “Their daily routine has gone wrong; their warm corner of the house is no longer warm; they are far from their friends and their daily activities.
“Studies conducted by the institute and Israeli hospitals in recent years have proved [the Feuerstein Institute technique’s] efficacy in helping older people who are moved to another place and suffer from cognitive problems such as memory and movement.
“Our institute has been engaged for many years in improving memory among adults and special populations in the field of memory and cognition. The government knows how to move survivors and evacuees to hotels, knows how to give them food and a warm bed, but not everything else. Their quality of life was seriously damaged,” he stated.
He sent a special team that voluntarily goes to the hotels of the Dead Sea and in Jerusalem to help those elderly. “The job of our volunteers is to return them to the quality of life they had until October 7 through the cognitive program ‘instrumental enrichment’ that gives older people strategies for organization, planning, and functioning. And by the way, it also gives them a little sense of a routine, even if it’s not in their natural place, the home. Used to a routine of going to the grocery store, studying Torah, preparing food, their lives are now frozen, like a muscle that is not used. They learn again how to return to their routine.”
Evacuated children and youths, including those with special needs, also have to get help.
“One evacuated girl in a hotel said she just wanted to make an omelet. A teen who was sent to ad hoc classes asked: “Why learn history? I am history,” recalled Rabbi Rafi.
The Feuerstein team of caregivers, led by Tamar Zingerman, who heads the memory program, is now caring for elderly people who have lost their homes and their families and are in hotels. “Some even don’t leave their hotel rooms,” she related. “We encourage them to go out. They sit; some tell the same story again and again. They are not demented. We conduct cognitive stimulation, give them a renewed sense of control and of organizing their lives and not being passive.”
Fortunately, concluded Roth, “the human spirit is very strong. People have power and want to be repaired. Kids are still in stages of development, and few suffered any traumas before, so they can usually heal faster. Hundreds of thousands of Holocaust survivors who survived indescribable horrors made aliyah to Israel [or settled in the Diaspora] and had the strength to build new lives, families, educational achievements and professions.”•