How the Trauma Takes Its Toll on Us

By Ilan Kutz and Sue Kutz

When Francisco de Goya created his series, "The Black Paintings," he was expressing his despair over human nature and war in 19th century Europe. But his "Duel with Cudgels" might as well have been painted to capture the craziness of the situation in the Middle East today. It depicts two figures inflicting blows on each other while they sink in quicksand.

Life in quicksand has altered the Israeli experience in profound ways. Those directly exposed to violence have suffered physical and emotional injuries that will scar them for life. As mental-health workers, we have treated many victims who have been injured in more than one terror attack. We have tried to help people who have just lost a loved one while still grieving for an earlier victim. We have worked with doctors and nurses who are at risk for secondary traumatization owing to their exposure to so many dead and maimed.

The repeated scenes of violence, funerals and portraits of the dead are putting the population at large at risk of secondary trauma. With each new assault, many of our patients suffer a reactivation of earlier trauma. Others report feelings of great vulnerability because of their familiarity with a victim or their proximity to an attack. A colleague was shocked when her neighborhood cafe, which she had just left, exploded, along with its patrons.

Yet even more demoralizing than terror is the growing realization that there is no solution in sight. "The Situation" is what everyone calls the state we're in. It's a depersonalized term that reflects the feeling that there is no one responsible and no control possible. Like an enigmatic curse or a supernatural vapor, The Situation has come and settled in. In this atmosphere of powerlessness, people oscillate between being oversensitized and being numb.

Israelis, who have long been used to noticing and reporting unattended packages, are now compulsively scanning even those in the hands of any person who might be Palestinian. We have heard of more than one case in which a young dark individual in a heavy coat was tackled under the assumption that he was wearing explosives under his garment. (In at least two cases, the suspicion was confirmed, and many lives were saved.)

Long accustomed to worrying about the danger to their children in the military, Israelis are now worried about the danger to their children in the schools. In fact, class outings have been suspended. One day recently, the mayor of the town of Nahariya shut down all its schools after a warning of an impending terrorist act. In a society characterized by its love of gatherings, even the youngest children know that crowds are to be avoided.

The flip side of all this vigilance is an anesthetized sensibility. Some of our usually well-informed and politically passionate acquaintances have stopped reading newspapers and debating politics. Others respond to the news by assessing any given terror attack by the quantity of dead and injured. ("That one wasn't so bad; only three were killed.") A young mother we know has witnessed this kind of imperviousness in her two sons, ages 4 and 6, who cry, "Terror attack," and joyfully throw their toy cars into the air. There is a numbness too in Israeli attitudes toward the punishment inflicted upon the Palestinian population. Most Israelis operate in denial, either ignoring this human suffering or justifying it with rationalizations such as "They started it."

The combination of vigilance and numbness was illustrated by a local TV channel's decision to run a split screen after a suicide bombing: on one side were body parts and ambulances, on the other a soccer match. That way, no viewer missed any of the action on either front.

In this peculiar fog of distress and uncertainty, everything feels contingent and on hold. Even for those whose jobs have not evaporated along with the tourists and foreign investment, planning ahead has become difficult. People we know talk of moving themselves, or at least their money, abroad. Even short-term planning like that for, say, a weekend trip, feels unusually heavy, as the number of places considered safe is substantially reduced.

In the past, Israelis had a standard answer to the anxious question, "What's going to happen?" "It'll be all right," they would answer. During the Gulf War, while people waited for an incoming missile to fall and then for the all clear to release them from gas masks and taped-up rooms, they spoke to one another on the phone and said, "It'll be all right." Even when the current intifadeh began, people told one another, "It may take time, but it'll be all right." This sentence has been the reassuring mantra-at-the-ready, but it just doesn't feel right anymore.

Ilan Kutz is an Israeli psychiatrist and expert in the treatment of trauma. Sue Kutz is an American-born psychotherapist in private practice in Tel Aviv