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Friday, August 15, 2008 | return to: international


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Israel makes strides in dealing with post-traumatic stress

by dina kraft, jta

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The talk often turned to blood.

"The smell of blood, that's what stays with you," Tom Shechter, 22, says matter-of-factly at a group therapy session for Israeli soldiers suffering from post-traumatic stress disorder.

Shechter, a combat medic, was badly injured during the Second Lebanon War, which ended two years ago this week. He was setting up a field hospital in an empty school building in a Lebanese village when he was hit by a Hezbollah missile.

This group and dozens of others like it that treat reservists and active-duty soldiers suffering from post-traumatic stress disorder, or PTSD, are a reminder of one of the least visible but most painful scars of the 2006 war.

But the groups are a sign of progress the Jewish state has made in reducing the stigma traditionally associated with PTSD in Israeli society, where military service is mandatory and everyone either has fought in a war or knows someone who did.

Public service announcements on the radio urge war veterans who suffer from trauma symptoms — they include difficulty sleeping and concentrating, and problems interacting with family and friends — to seek help.

"Today it is no longer treated as something to be ashamed of," says Miri Shalit, a psychologist who supervises the rehabilitation department at the Defense Ministry. "You can see the difference, for example, from the Yom Kippur War [in 1973] — it took people years to seek help."

Shalit credits a new, more cognitive therapeutic approach for the better success rates in treating PTSD: The Israel Defense Forces now trains combat officers to work with their soldiers in the aftermath of attacks or difficult incidents as part of an effort to prevent cases from developing into PTSD. The concept, based on years of research conducted in Israel and abroad, is to debrief as soon as possible after the traumatic event in a safe place away from the battlefield.

During the debriefing, the soldiers can review the facts of the incident together, and share their thoughts and feelings. They can understand that it's normal to have intense reactions to traumatic situations — called "acute stress reaction" — and at first suffer from symptoms such as insomnia and moodiness.

The problem occurs when the symptoms do not subside and prevent one from functioning normally.

Research shows that about 10 percent of those exposed to traumatic events suffer from PTSD. Combat soldiers tend to have a lower occurrence in part because they are trained to deal with stressful battlefield situations.

But, as Shechter attests, even soldiers cannot fully be ready for the traumas of the battlefield.

"You cannot fully prepare yourself," he says. "An incident will always come as a surprise."

As Shechter lay wounded in an Israeli hospital with shrapnel injuries to his stomach, head and hand, he refused help from an army psychologist. But two months after returning home, Shechter knew things weren't right. He found himself waking suddenly in the middle of the night, unable to fall back asleep. He was haunted by flashbacks.

After undergoing individual and group therapy at the defense ministry, Shechter says he's starting to feel improvement.

"It was good to be able to feel like I could unburden myself, to talk," Shechter says.


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