Post-7/10 trauma: ‘Suddenly they are flooded with pain’

People in Israel aren’t really talking about post-trauma. Instead, they have spent the nearly six months since 7 October living in a constant state of trauma

The Simchat Torah massacre was like a giant boulder being thrown into a pond, creating waves of distress that keep on being felt.

Hit by the first wave were the victims and survivors of the attacks – from the kibbutzim, the Nova Festival, and the towns of the Gaza envelope.

The next trauma layer consists of everyone who has spent the past six months living out of a suitcase, including about 200,000 people evacuated both from the border with Gaza and the northern border with Lebanon. None of them has any idea when they will return to their homes – if they have homes to return to.

And then there are the families with serving IDF members; almost everyone is swallowed up in this layer. Almost 600 soldiers have been killed, either on 7 October or in the ensuing fighting. Every day brings tragic news about another young person killed.

The layers continue; everyone has seen the videos, everyone is experiencing life at war, everyone has had the ground beneath them – the idea of Israel’s strength and that finally Jews could be protected – stolen away.

Meanwhile, on the other side of this awful conflict, the scenes of horror and destruction in Gaza continue to shock and dismay.

Perhaps it is little wonder that Israelis are turning to drugs and other substances, both legal and illegal, in record numbers.

“Here in Israel, we haven’t even started to recover,” says Shauli Lev-Ran, a professor of psychiatry at Tel Aviv university and co-founder of a charity, Israel Centre on Addiction. “People are struggling with acute trauma. And because of what is happening we have seen an alarming increase in the use of addictive substances.

“Everyone is struggling differently. Some have insomnia, others have acute anxiety. Some have developed depression. Many of them have become hot-tempered. And they are turning to addictive substances in order to alleviate some of that but while they can help in the short term, the worry is that they can aggravate the situation in the long term.

“What we are seeing is a cycle of more stress, more anxiety, more depression, more use of addictive substances. If you look of alcohol, for example, this can cause an aggravation of depression so some people are living in a vicious cycle.”

According to figures compiled by the centre in December, one out of three women was reporting substantial post-traumatic stress symptoms such as having difficulty falling asleep, having violent nightmares, being startled by loud noises. One out of five people had substantially increased their use of addictive substances since the war started.

One of the most astonishing figures was on the use of sleeping pills with one million Israelis requiring them to fall asleep. “Sleeping pills are the number one substance which is being abused right now,” says Shauli. “There is also a 200 percent increase in the use of prescription sedatives, anti-anxiety and sleep medications and that is what we know about and doesn’t take into account the people who are taking them from parents and siblings.”

Just behind sleeping pills is an increase in the amount of alcohol being drunk and use of cannabis. “The closer people were to the trauma, the higher those figures were,” adds Shauli. “For example, the people from the Gaza Envelope are most acutely affected by the trauma and 50 percent of them reported a significant increase in the use of addictive substances.”

As a society highly knowledgeable about both trauma and psychology, there have been attempts to stem some of this pain. But that has not stopped what Shauli describes as a “second wave” or spike in trauma. The causes are twofold: first there is the continued uncertainty and a general feeling of helplessness, and second is the return of soldiers, many of them young conscripts, from the frontline.

For the first time therapists were on the frontline with the IDF in an attempt to stem the problem of PTSD. But it has only done so much. “There were 800 mental professionals attached to each unit meaning that everyone had someone they could speak to,” says Shauli.

“That means the risk of PTSD was reduced substantially during the war. But things have started to fall apart as they have returned home and they aren’t with their unit any more. All of a sudden, they have time on their hands and they are flooded with pain.”

The ICA is doing what it can. It is working closely with schools from the Gaza envelope region and is focusing in on the survivors from Kfar Aza, one of the most badly affected of the kibbutzim. But the problem as Shauli sees it is that there simply not enough bodies on the ground to help. “It feels impossible to get to everybody – there aren’t enough therapists to go around and we need a lot more money in the public mental health system.”

They are doing what they can – training, assessing, and carrying out targeted therapy – but there is perhaps no surprise that it feels like a drop in the ocean. “We are just having to allocate our resources as wisely as we can,” says Shauli sadly.

• For more information about the ICA and to donate, visit: ica.org.il/en