Probably anyone reading this article already knows about the brutal tragedy, the surprise invasion of Israel by Hamas terrorists.
Of course, it is an event that will continue to unwind over time as Israel and the world responds.
The barbarity, cruelty and war crimes are no surprise to psychiatry. Freud discussed and wrote about our aggressive potential and even death wish. Of course, the Torah, Shakespeare and others also knew of our deadly potential. Jewish ethical principles are devoted to life, a moral life.
There is no question of the immediate psychological harm that includes the shock, the anxiety, the losses, the rage, the second-guessing, the harming hubris, and the uncertainty of the future. Nevertheless, the traumatic aspects are likely to be the most important to consider because they can emerge quickly, slowly, delayed, and counterintuitively. Moreover, when such trauma is caused by fellow humans, the psychological ramifications are worse than if by natural causes like earthquakes.
We all will have our own unique reactions. My wife and I have some paradoxical and unrealistic regret about funding the artistic painting of a bomb shelter for my 75th birthday. Security from bombs in a bomb shelter turned into a death trap from high-powered guns in some such shelters. Of course, we would do it again, but this reminds us of the law of unintended consequences.
My other direct connection was my sister and brother-in-law arriving in Israel the day before the attack for a wedding. The next day we contacted them holed up in a stairwell in Tel Aviv. Most fortunately, they were able to then get to the airport and a flight to London.
Like throwing a large rock into water, trauma always ripples out in its repercussions. The biggest impact is most likely in close exposure to trauma, such as in Israel and consequently in Gaza. Nevertheless, that depends on individual vulnerability and triggers to past traumas. Moreover, if far away, given our online connectivity, what we call secondary trauma will be common. We psychiatrists who treat a lot of patients suffering with PTSD always end up with some trauma reactions such as emotional numbness, startle responses, and nightmares.
Fortunately, there are ways to not only recover from such trauma, but to come out psychologically stronger, what we call post-traumatic growth and increased resilience. Needed to achieve that are 3 components.
The first is support from loved ones and others. Best for that is a unified community of support, for example the Community Solidarity Gathering for Israel held on Oct. 9, with comforting security.
Second is the need to talk about one’s reactions rather than the natural tendency to want to forget the horror, but forgetting can come back to haunt you later. This necessity includes children who will inevitably hear about this tragedy. Talk to them about their reactions and provide realistic reassurance. Most important nowadays is support for students in college, where counter-protests supporting Palestinians and blaming Israel are already occurring. For the elderly, triggers to the Holocaust will be common and hence the need for them to be able to ventilate about their connection. For all of us, we have to prepare for another rise in antisemitism as Israel gets blamed for the event and their counter-invasion.
Third is a renewed vision of the future. We still have the unique co-occurrence of a still-strong Israel and a strong diaspora. However, collectively, whatever has been done to reduce antisemitism and anti-Zionism has been proven to be inadequate. Innovation and better understanding of the causes are necessary, if not reinvention in responding to antisemitism once again. Personally, each of us will want to do what we can to help the cause, whether that be financial, our professional expertise, political action, or just showing up with our comforting personal presence and compassion for the innocent anywhere. Helping others always brings personal satisfaction.
No one wants trauma to be able to get stronger, but once it happens, it is worth fighting for rather than staying in despair. Certainly, the Jewish people have proven repeatedly over history that we can bounce back stronger after we mourn and bewail the losses.
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H. Steven (Hillel) Moffic, MD, is a Wisconsin psychiatrist, and among his numerous accolades, he will accept the 2024 Abraham Halpern Humanitarian Award, at the annual meeting of the American Psychiatric Association in New York in May.
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