Post-Traumatic Stress and Post-Traumatic Growth in Israel
By: Paula Levin
On 6 October 2023, Adir* was a loving husband and father of four. On the afternoon of 7 October, he joined his commando unit and remained on active duty for 487 days, fighting Hamas and Hezbollah in hand-to-hand combat. When he returned home, his children barely remembered him. He struggled to tell his wife what he had seen and experienced, and decided to move forward and put the war behind him. After lashing out violently in his sleep on two occasions, he now sleeps alone, waking every morning at 3am, unable to fall back asleep until dawn. Getting out of bed each day feels like climbing Kilimanjaro.
Kobi* is 24 years old and weighs 51 kilos. He struggles to eat, to watch television, or to do any of the normal things he used to enjoy. Ordinary moments feel meaningless since burying 17 friends. Regular life feels as though it is happening in slow motion, while he remains behind a solid wall of glass, separated from everything that once felt familiar and safe.
Tomer** is a 20-year-old sniper who couldn’t sleep, and suffered flashbacks, panic attacks and episodes of rage after going home on leave. Before returning to Gaza he decided to confide in a mental health officer. “Before my first appointment, I checked a thousand times to make sure no one knew I was there, that there’d be no record… I told her how I felt, and she said something that changed everything: ‘These are PTSD symptoms.’ That was the first time I heard that phrase applied to me. I’d heard it about other people. To be honest, I had kind of made fun of it. I thought PTSD was a choice – whether or not you let yourself fall apart. I thought it was people making excuses, a way of getting out of the war. It then suddenly hit me too. All at once, everything came crashing down.”
Adir, Kobi and Tomer are just three stories behind Israel’s record-high incidence of Post-Traumatic Stress Disorder. 60% of Israel’s 22 300 war-wounded are also being treated for post-trauma – an increase of 180% – while 78% of suicides in 2024 were combat veterans. The numbers suggest a country in the grip of an unprecedented mental health crisis. Yet alongside Israel’s increase in PTSD is another phenomenon: its under-30 population has been voted the second happiest in the world. What lies behind these polar opposite figures?
Liza Kramer is a Ra’anana-based psychotherapist whose outlook on Israel’s PTSD statistics is hopeful. “This is the first time we, as Israeli society, are really talking about it. Already in 2014, after Operation Protective Edge, we saw a great deal of PTSD, but it was not part of the public conversation. Mothers were talking about it and raising concerns, but it did not receive the attention it needed. In 2014, our boys did not feel sufficiently prepared for the Gaza invasion. The terror tunnels were a huge surprise and the results were devastating. Since then, we have actually come a long way as a culture. The army has now built an infrastructure to deal with PTSD. It is now seen and treated as a brain injury. Trauma debriefing is now standard procedure after missions, and this is important in building a sense of chronology into the event, which helps to move it into memory and prevent flashbacks. Trauma is a physical, visceral experience. It happens in the nervous system, and treatment must address the nervous system,” says Kramer.
The IDF’s MAGEN (Hebrew for “shield”) programme was created to address trauma. According to their website: “Soldiers learn how to support each other in the event of one of their squad members emotionally breaking down. IDF soldiers attend lectures and talks with psychologists and mental health experts. This provides them with the tools to avoid post-traumatic stress before it develops. After every operation, a team of mental health officers arrives at the scene to provide emotional assistance to the soldiers. Those in need are then given further attention at the hospital and in their unit. The goal is to get the soldiers back on track and to help them overcome the trauma they have experienced.” Israel is at the forefront of trauma research and treatment, including treatment with psychedelics at the Combat Veterans Psychedelic Research Clinic at Emek Medical Centre, but the need still exceeds its capacity.
Kramer also points out that countless Israelis are dealing with traumatic grief – people who have lost loved ones in tragic circumstances. “As a society we are carrying an enormous weight of grief, and many people are experiencing low mood or depression, are ‘checked out’ and on edge. Their bodies and minds are hyperaroused, experiencing panic attacks and fear of further panic attacks. And for those serving in the reserves, and their families, for those with sons in Lebanon or Gaza, there is no ‘post’ in PTSD. We are all still living with the threat of war with Iran and with low-grade anxiety,” she explains.
“You will not find a more hopeful country on earth.”
“The experience of trauma is connected to our experience of control,” Kramer explains. “It is not about the event but our reaction to the event. Someone I know fought on 7 October and saw the most horrific scenes, but he told me: ‘We went in like cowboys, we did everything we could. I feel like we were heroes.’ How October 7th affected people very much depends on who they were on October 6th. Were they already living with a highly activated nervous system because of childhood trauma? What was their life experience before the war? What was their interpretation of who they were – someone to whom life happens, or someone with personal agency? Resilience is not a state of calm in the face of trauma; it is the feeling of ‘I can work with what I am experiencing. I have people I can rely on.’ This is where Israel as a country is truly exceptional. Israel scores highest in the world in post-traumatic growth. You will not find a more hopeful country on earth. Yes, our mental health services are lacking, but that is to be expected – October 7th and the war were unprecedented. It is just as important to acknowledge the resilience and to build on it as it is to treat the trauma. I see many teenagers and children in my practice, and their sense of meaning and purpose is pervasive. The pictures of fallen soldiers and returned hostages that are displayed in schools and across the country are not a source of trauma but a message that every person is special and unique. No one is just a number. We live in a society whose very foundation is that every person matters – and that is why we moved heaven and earth to bring every soldier and hostage home. It is something we can be very proud of. We may struggle with pain and trauma for a long time, but the goal is to reach a point where the trauma comes in waves that do not drown or overwhelm us. We learn to float and move forward with them.”
“We learn to float and move forward with them.”
Saul and Shevi Jassinowsky have witnessed trauma transform into resilience countless times over the past 13 years through their involvement with Brothers for Life (Achim LeChaim), an organisation dedicated to helping injured soldiers. One delegation brought to South Africa included a combat medic suffering from severe PTSD, eleven of whose friends had died in his arms. Despite three years of treatment, he had developed a stammer, lost his job and his girlfriend. At the end of a week-long trip to Johannesburg, he agreed to do an interview on Chai FM – and for the first time in years, his stammer was gone. His mother later telephoned the South African host family saying, “I sent a stranger to South Africa. I got my son back.”
After October 7th, on a trip to Israel run by the JNF, Saul – who is Vice Chairman – wondered what could be done to support survivors, returning hostages and their families, as well as bereaved families. A chance meeting with Ronit Belleli, and collaboration with the JNF and the Base, has resulted in 15 remarkable trips to South Africa and counting – with Alon Ohel, Guy Gilboa-Dalal and Evyatar David due to visit soon. “Coming to South Africa has been transformational for them. In Israel, everyone has been through trauma of some kind – no one is considered special in that regard. Serving in the IDF also comes with this myth of impenetrability. Getting injured or suffering PTSD shatters that myth, but they feel this need to put on a brave face. Coming here, they can let their guard down. They also realise there is an entire Jewish world out there rooting for them, filled with love, compassion and gratitude for the soldiers’ service. They see an entire community supporting them at the very bottom of Africa, and they realise they do not need to carry the weight of the trauma alone. We are carrying it with them,” says Saul.
“When we take them around Johannesburg and they see the yellow ribbons on the trees, they are visibly moved and genuinely surprised,” says Shevi. “It is like a giant hug from Africa. But the best part is taking them to Kruger Park. You can literally see them exhale for the first time in a very long time. They find a sense of safety that they thought they had lost. For example, former hostage Amit Soussana had never spoken about her ordeal in Gaza. It was at the end of an eight-hour game drive that she opened up and broke down. That night, for the first time, she was able to fall asleep without a sleeping pill. Since then, she has become a powerful voice for women sexually assaulted by Hamas. She found her voice again right here in South Africa.”
“It is something that happened to them – it does not define them.”
“In some ways PTSD is worse than a physical injury. You can see physical wounds, and you are treated with tenderness and care,” says Saul. “We recently hosted a soldier with a prosthetic arm with a hook on the end, and my four-year-old son Izzi was in awe. He said to us, ‘Do you know that we have a real superhero here!’” adds Shevi. “But psychological wounds go under the radar,” Saul continues. “On these trips, October 7th survivors and victims of terror engage with their pain, and in the process they discover that they are more than their pain. It is something that happened to them – it does not define them. Perhaps that is the secret of trauma becoming resilience. First it needs to be acknowledged, grasped and grappled with, and only then can it become something one can translate into service. We have seen this so many times with people who have come here simply to heal, with no expectation that they do any public speaking. We hosted Tal and Adi Shoham, a couple who were taken hostage with their children and separated. Tal was held for 505 days. They came to South Africa for a safe space in which to be normal people. Tal wanted to advocate for Israel, but Adi had never shared her story – not even with Tal. At the end of their trip, Tal was on stage and Adi decided on the spot to speak as well. The trip and the love she received from the community gave her that safe space for the first time.”
Saul believes that we, as the Jewish diaspora, can use our resources to help heal the collective trauma of the past two and a half years. “Like a mother whose hug is so comforting, our love, respect and pride is our greatest resource. For the sake of the survivors and the soldiers, and for our children who have borne witness to this enormous trauma, it is time to move forward from suffering to resilience,” he says. As a Base Community member and lay leader at the JNF, amongst other organisations, Saul is spearheading a national chesed campaign in memory of Kfir and Ariel Bibas called the Bibas Family Youth Impact Challenge. “We encourage families to direct love, memory and courage into acts of kindness – to translate their trauma into acts of service and light for our community.”
Kobi and Adir would also dearly love to bounce back resiliently from their trauma. They would do anything to return to who they were on 6 October. They are learning, however, that there is no bouncing back – and even if there were, the only way to bounce is forward: to face and mourn the greatest loss of all – the loss of who they were. Only then can they discover and embrace who they might become. Tomer is further along his journey to recovery and writes: “I am a Jewish kid who grew up in Israel, became a soldier and fought in a war for my people. I have realised that despite the cost, despite the pain – I would not have done anything differently.”
*Stories are true. Names and some identifying details have been changed.
**Read Tomer’s full PTSD account, “Diary of a Sniper”, on ynetnews.com
