How do you deal with the trauma of the deadliest day Jews have experienced since the Holocaust?
This was the question Israeli trauma experts faced in the wake of Oct. 7, 2023, when over 1,200 Israelis were killed and some 250 taken captive in Hamas’s attack on Israel.
The massive attack by terrorists immediately was followed by additional traumas: The displacement of tens of thousands of Israelis from their homes in the conflict zones. The subsequent war, which has left hundreds more soldiers dead and thousands wounded. Emotional scarring on a national scale.
At the Hebrew University of Jerusalem, some of Israel’s foremost trauma experts set to work to design new clinical approaches and train therapists to deal with these traumas.
“These experiences are beyond anything we have seen,” said Professor Asher Ben-Arieh, dean of the university’s Paul Baerwald School of Social Work and Social Welfare and CEO of the Haruv Institute for the Study of Child Maltreatment, noting that some children were taken hostage and witnessed their parents’ murder or kidnapping. “The tools we have used until now are not sufficient. We need new solutions and new ideas for how to treat these traumas.”
Ben-Arieh estimates that 25% to 50% of those who experienced trauma were likely to develop problems such as post-traumatic stress disorder (PTSD), depression, anxiety, complex grief, or difficulties in marital, social, or occupational adjustments.
To meet these new needs, Hebrew University’s Israel Center for Addiction and Mental Health set about to launch the Institute for Traumatic Stress and Recovery to create a multidisciplinary, academic-clinical hub to address trauma-related research, training, prevention, treatment, and resilience promotion.
The Institute for Traumatic Stress and Recovery aims to give therapists and trauma survivors evidence-based practices and technologies, accessible via Israel’s public health system, to enhance the healing and recovery of Israelis grappling with the enormity of these traumas. The institute will conduct research, train therapists in new evidence-based practices, and provide patient-centered, comprehensive, coordinated care.
“This proactive approach will not only enhance the capacity for timely and effective trauma intervention, but also contribute to a more informed and resilient community as a whole,” said Hebrew University psychology professor Jonathan Huppert, who is involved in the project.
“Trauma manifests in many ways and can be different for different people,” Huppert said. “Not everyone has PTSD. Some have stress, grief, coping, the effects of being evacuated. Since Oct. 7 people are more stressed in general. They may experience more negative thinking, trouble sleeping, more physical aches and pains, muscle tension. Things may set them off more easily.”
Many experts in the field say it long has been clear that Israel needs to improve its overall approach to mental health. There has been insufficient training of mental health professionals using evidence-based best practices treating trauma, a lack of integration between research and practice, and a lack of awareness among the public at large about the impacts of collective traumatic stress.
The events of Oct. 7 drew attention to those problems while adding the urgent need for new approaches to trauma specific to this historical event.
The new institute, which will offer a rare combination of research with clinical practice, training, and advocacy, has raised 25% of its budget so far and is actively seeking support for the remainder.
“We need enough money to have a stable center to think out of the box,” Ben-Arieh said. “And we need it urgently. We’re not even post trauma. We are not past this. It’s still happening.”
After the shock of the initial Hamas attack, Ben-Arieh and his colleague Ofrit Shapira Berman, a Hebrew University professor who specializes in treating adult survivors of complex childhood trauma, joined an October 7 National Task Force to care for children who were abducted.
Working with Israel’s Ministry of Social Services and other governmental bodies, the task force trained the security services who first greeted the abducted children upon their release in late November 2023 to ensure the children would not be retraumatized in the process of their release. They also worked with their parents.
Ben-Arieh and his colleagues understood early on there were no existing protocols on how to treat child hostages and that they were entering uncharted territory. The task force prepared by watching documentaries about the girls kidnapped by Boko Haram terrorists in Nigeria and spoke with soldiers who had been held in captivity. Ben-Arieh acknowledges that even this was insufficient, and the team is constantly adjusting and updating procedures as they continue to work with the children. While hoping that this sort of devastating event is never repeated, the task force is establishing pioneering procedures and research that could be used in the future around the world.
The task force identified six groups of children at high risk since Oct. 7: child hostages; those who witnessed severe violence and murders; newly orphaned children; children who lost a parent, sibling, or other relatives; children whose friends or peers were killed or kidnapped; and children displaced from their homes.
“There is a deep issue of betrayal in childhood trauma,” said Ben-Arieh. “In these cases, these events often happened in places that their parents said were the safest in the world. Parents could not save their children. Or they had to choose. We have new forms of trauma that we don’t understand.”
He added, “We need to change the field.”
By Elana Sztokman
