We know that we will soon have waves of returning war veterans from Iraq and Afghanistan and witness their adjustment coming home and with their family members. We know that there will be massive psychological wounds to these soldiers and those around them.
Clinical psychology came of age after World War II to help returning soldiers. What can we learn from those lessons that will help us with today’s challenges?
Unfortunately, Israel has much to teach us about how to work with war trauma. I have been traveling several times a year to Israel to work with combat soldiers and their families. In the following piece, I describe some of this work and the lessons that can be learned.
- Trauma is never finished.
- The personal connection heals
- Trauma is in the body: mind/body methods.
- Posttraumatic growth comes from building resiliency, creativity, hardiness and courage.
Trauma is never finished
According to Judith Recanati, founder of Natal trauma treatment center in Tel Aviv, Israel was founded on the myth of “Never Again.” Instead of marching silently to the gas chambers, Israel’s founding soldiers were mythically heroic, strong and physical. Even with good pensions and a hero’s welcome. However, soldiers from the 1967 war are still filling Natal’s support groups. Many feel as if their lives are over and they have not found a new purpose for living. The succeeding waves of terrorism at Sderot and other cities in Israel do not strengthen Israel’s citizens; rather, they are becoming more vulnerable or hardened (Serlin, 2008). With waves of terrorism worldwide, how will we face cumulative effects over generations (Paulson and Krippner, 2007)?
The personal connection heals
Before a soldier begins military service, a staff member from the Casualty Division of the Israeli Defense Force establishes contact with the family and maintains this contact throughout the military service and after the soldier has returned home or has been wounded or killed. Widows have yearly retreats and stay connected for years. Every town in Israel has a “House for the Fallen Soldier” that keeps track of names and memorials and hosts events for families. Both Selah and Natal are set up like homes with a kitchen on each floor and welcoming staff. The hotline is staffed by paraprofessionals from the community who are older than 40 and know the callers by their first names. A web of connections provides a support system that holds and helps heal the soldiers, family and community members (Serlin, 2008).
Trauma is in the body
Trauma is the “speechless terror” characterized by frozen affect, memory and speech. Methods that re-awaken numb bodies in a compassionate environment are nonverbal and symbolic and include meditation, imagery, art, music and movement therapies, EMDR, psychodrama and existential therapy (Serlin, 2007a). These are being used effectively in Israel along with cognitive and verbal approaches (Serlin, 2007b).
A war widow working in a group wrote:
“When I’m thinking in a retrospective way, I realize now how detached I was from my body. I used it as a tool in order to walk, talk, but rarely as an expressive tool. Only after the first day, I started to connect to my feelings through my body and my movement. Only through participation could I understand the meaning of it and was able to differentiate and name it. As I moved, I felt a growing amount of energy and power emerging from my body. I started to communicate with movement with some other members of the group.”
Posttraumatic growth comes from building resiliency, creativity, hardiness and courage: Posttraumatic growth refers to the transformative potential inherent in any breakdown (Calhoun and Tedeschi, 1999). It means using methods that foster creativity, build on strengths and establish new narratives of personal identity and hope (Antonovsky, 1979; Frankl, 1959; Maslow, 1962; Pennebaker, 1990; Serlin and Cannon, 2004).
In a group that took place during the war in Lebanon, a participant’s son was called up to the front. She wrote:
“It was a time of war, a time of fear, a time of a lot of anxiety.…We talked about death a lot and I cried a lot and I was invited to tell about my feelings. The group approached me, reaching their hands to me, and we stayed that way for a long time. I started to sing a sad song … and the group sang with me. I felt like a small child, a frightened child but at the same time a child with a protective mother, a containing mother. I could feel the energy flowing into my body. I also felt part of a “oneness” as I felt the energy of the group. I was not alone anymore. First I could feel it physically and then I could process it emotionally. I was never held like this by my mother and it felt so good. It helped me realize once again … the importance of nonverbal communication and also the strength of the group. It gave me hope again.”
The Israeli experience working with trauma can help psychotherapists understand the importance of the ongoing cumulative effects of trauma, the importance of the personal connection, the centrality of mind/body methods and the potential of posttraumatic growth.
Ilene A. Serlin, Ph.D., ADTR, operates Union Street Health Associates Inc., a psychological counseling service in San Francisco. She is also president of the San Francisco Psychological Society. Her website is www.ileneserlin.com and her e-mail is: firstname.lastname@example.org.