Tuesday, November 22, 2016
Elder of Ziyon
Why is
it that, although terrorism and war are not infrequent in Israel, the number of
IDF soldiers suffering
from post-traumatic stress disorder (PTSD) is actually amongst the lowest in militaries
around the world?
In
2013 the Israel Defense Forces Medical Corps Mental Health Department released
a study on PTSD with staggering statistics. For example, following the 2006
Second Lebanon War, 1.5 percent of Israeli soldiers in mandatory service and in
the reserves were diagnosed with PTSD. Some 2.9% of the IDF servicemen who took
part in the military campaign sought psychological help after the war, but were
not diagnosed as suffering from PTSD. In contrast, a U.S. Army Medical Corps
study done in approximately the same time period, found that about 8% of U.S.
soldiers who served in Iraq and Afghanistan had been diagnosed as suffering
from PTSD.
According to the
IDF study, PTSD diagnoses in other militaries worldwide ranged from 2% to 17%
of troops who participated in combat.
How
can this be? Is it special training received in the IDF? Or is it something
else?
Israel
has developed world class expertise in the treatment of trauma but it is not
some special prevention regimen that makes the difference. It isn’t something different in Israeli
soldiers. Our soldiers are people from all backgrounds, from countries around
the world. Yes, their training is not the same as in other armies but much of
it is very similar and the differences are not enough to account for the
statistics.
Israeli
soldiers aren’t different. It is Israel itself that is different.
1)
Experience
Unlike
in the US, there is no person in Israel who is untouched by terrorism or war
and soldiers are an integral part of Israeli society.
The
IDF is a citizens’ army, consisting of our fathers, brothers, husbands,
friends, sisters and daughters. Almost every household has a soldier, if not a
number of soldiers, many of whom have fought in multiple wars. Those who don’t
have a soldier in their own family live next to a household with a soldier. Virtually
every person does reserve duty and /or has colleagues who take leave from work
to go to reserve duty. Israelis pass soldiers on the bus, in the train and in
the store. Even those portions of society that do not enlist (such as Orthodox
Jews) have seen soldiers and had interactions with soldiers. This means that
many Israelis who have not themselves been on a battlefield have secondary
experience with those that have – they have dealt with injuries and death of
friends and family, brothers and sisters.
The
prevalence of terrorism means that there is little separation between the
soldier on the battlefield and the mother in her home, the child walking to
school or the father driving to work. Many Israeli civilians have found
themselves under attack by terrorists with rocks, knives, guns and suicide
bombs. Others have witnessed attacks or seen their aftermath. Others are
related or connected with those who have been in these situations.
The
average Israeli knows or can imagine what a soldier or a victim of terrorism
has experienced. Personal experience creates understanding and compassion for
the pain of others.
2)
History
Israel’s
current generation of 40 to 60 year-olds grew up with Holocaust survivors. They
didn’t understand the survivors or their sometimes-strange behaviors. Some
survivors picked up half-eaten sandwiches that other people had thrown away and
put them in their pockets, just in case. Others were terrified of dogs. Some
clung to their children. Others almost never touched their children. Some were
perfectly normal in the day but screamed in their sleep.
It
took many years for people to understand that these behaviors developed as a
result of the extreme trauma the survivors had experienced. Later on, it was
discovered that trauma could be passed on - that the second generation, the
children of the survivors had developed their own form of trauma related
behaviors.
The
average Israeli knows that terrible experiences alter the psyche and effect
behavior.
3)
Attitude
“What
doesn’t kill you, makes you stronger.”
Israelis
have developed an attitude of “What doesn’t kill you, makes you stronger.” Although
this expression is often said jokingly, regarding small uncomfortable
situations like going to the dentist or telling a child to do something he or
she doesn’t don’t like, it is indicative of a societal mindset. Israeli’s experiences as individuals and as a
nation have taught that terrible things will happen. Some people will die as a
result but those who survive will be stronger because of it. This is the
mindset of resilience.
“Maybe
it’s because of something he experienced.”
A
lawyer I once met was obviously brilliant but also obsessive and prone to
temperamental fits. I was told about him: “Oh yeah, he’s nuts. But maybe it’s
because of something he went through [as a soldier]”. In a single breath, there
was a swift judgement, forgiveness and understanding.
Generally
Israeli society is willing to give people the benefit of the doubt and forgive
unpleasant behaviors if and when they are a result of previously experienced
trauma.
4)
It’s
different when you are fighting for your home
One of
the reasons traumatic events can be scarring is that they often seem completely
random, creating a feeling of helplessness. The soldier may question why his
friend was killed and not him, after all, seconds before, he was standing
exactly where his friend stood when the bomb exploded. The person riding the
earlier bus might question why she left the house earlier that day and wasn’t
on the bus that was blown up in the terror attack – the bus she normally rides
to work. The lack of control over traumatic events that occurred or could occur
in the future is frightening. In Israel, this is tempered with a collective
purpose. Everyone goes to the army for the same reason. Everyone suffers from
terror attacks for the same reason. The individual cannot control what is
happening but at least they know why it’s happening.
It’s one thing to be a soldier fighting in a far-off land because your government decided it’s necessary. It’s very different when you can stand on a hill and see the homes of the people you are defending, possibly even your own home. This doesn’t make the traumatic experience easier but it gives the psyche a way to process it. There is a goal and a purpose, it’s not random - it’s personal.
5)
Love
While
Americans might honor or respect their soldiers, Israelis love their soldiers
passionately. Honor is something you do from far away. Love is up close and
personal.
To
Israelis, soldiers aren’t heroic figures you throw parades for and give medals.
Soldiers are our boys, our girls, our family. You feed them, make sure they are
warm and comfortable. You let them sleep on your shoulder if they fall asleep
next to you on the bus. It doesn’t matter if you never saw them before and
don’t know their name. It doesn’t matter if they come from a different
background than you or have a personality you don’t like. The minute they put
on the uniform they belong to you and you belong to them. Each soldier could be
anyone’s soldier so you do for someone else’s son or daughter exactly what you
would hope someone would do for yours. Our heroes are soldiers that go home and
their mother tells them to take out the trash. No one calls them “Sir.” Rarely
will anyone thank them for their service but everyone will love them.
Relevant
to people everywhere…
My
grandmother always said: “You can learn from anyone. From some you learn what
to do, from others you learn what not to do.” I’m writing this because the
Israeli example is relevant to people everywhere. From it, I hope that others
will learn how to empower themselves.
Today, with the rise in terrorism
worldwide, there is added impetus to understand trauma and PTSD. While one
might be more likely to discover PTSD in soldiers, security forces or rescue
workers, anyone who has been exposed to highly traumatic situations (such as a
terror attack) could also be afflicted with PTSD. Just ask the people who
worked next to the Twin Towers, the children of Beslan, the Bastille Day
revelers in Nice, or pretty much any Israeli citizen.
We don’t have to go even as far as
terrorism and war. Sexual abuse survivors for example, also belong in this
category.
Not everyone who experiences trauma, even
extreme trauma, will later be afflicted with PTSD. In fact, most people will
not. Even so it behooves us all, no matter what our station in life, position
or nationality, to have at least some understanding of trauma and PTSD. Sadly,
this information could suddenly become very relevant.
The
magic words
What can you do to help someone suffering
from trauma or PTSD? You don’t have to have any special qualifications to help.
Amazingly there are magic words that you can say that, if you mean them, can
work wonders. Can you guess what they are?
Trauma manifests itself differently in
different people. One of the most insidious ways that traumatic experiences can
affect the psyche is in alienating the individual from those who care about him
or her. The feeling that “no one can understand me” (which is often true
because only those who have had similar experiences can really understand)
leads to the feeling that “I am alone”.
A person who is suffering needs to find a
way to release their pain. This needs to be done in a way that suites that
individual and needs to happen in a way that they don’t feel judged. Often
times successful therapeutic methods have to do with activities and/or with
animals (who don’t demand explanations). There are many effective methods, as a
bystander you can help someone suffering find the method that suites them but
otherwise that healing is their private journey.
Here’s what you can do:
Address the lie of, “I am alone.” This
thought is poison to the soul and can lead even the strongest individuals on a
downward spiral. The key to the prison this thought creates is astonishingly
simple. All you have to do is mean it.
Use the magic words: “You are not alone.”
Understanding, being there without judging, love… these don’t fix the
problem but they go a long way to making it less severe.
