A writer who is also a clinical psychologist describes the horror stories Israelis are telling themselves after October 7.
The notion that a story could save someone’s life has always struck me as a pathos-laden cliché. Not that I underestimate the written word: As a child, I discovered that stories were the ultimate escape. The world outside was dreary and gray, but in my notebook, stray cats could talk and unpopular girls could fly. When I grew up and became a writer, stories were how I brought to life the worlds I was not brave enough to step into because they were too seductive—or too frightening. But I’d never considered that the same tools used by writers to create imaginary stories could be useful for people trying to survive an unimaginable reality. And then came the war, which taught me otherwise.
In early October, I was hard at work on a new novel. Immediately after Hamas’s attack on Israel, I saved the file, knowing I would not be revisiting it for weeks. In addition to being a writer, I have a day job as a clinical psychologist, and Shalvata, the psychiatric hospital in Hod Hasharon, near Tel Aviv, where I work, declared a state of emergency. The massacre in the kibbutzim along Israel’s southern border had left victims’ relatives in a state of shock. Terrorists had infiltrated homes and murdered children in front of their parents and siblings. Families had spent hours upon hours in bomb shelters and safe rooms, fearing rockets and men with guns. Partiers at an outdoor rave were attacked; a few hid for hours under their friends’ bodies while others fled into the desert. Hundreds of families were informed that their loved ones had been kidnapped or declared missing, plunging them into intolerable uncertainty, and tens of thousands of civilians were forced to evacuate the region and abandon their homes.
These people required mental-health care, and time was of the essence. In emergency medicine, the “golden hour” refers to the period of time immediately following an acute injury, when medical intervention can dramatically increase survival odds. The later the intervention, the greater the risk of complications. The situation is similar when it comes to mental health: The sooner the intervention, the higher the chances of helping the patient process the events and prevent post-traumatic stress disorder.
Mental-health care cannot erase trauma. Therapists do not have the capacity to change reality. We cannot bring back these people’s children who were burned before their eyes, or their friends who were shot, or their wives and girlfriends who were raped and murdered. But we can help them live with the pain. The goal of a terrorist attack is not just to kill as many people as possible—the goal is to murder the souls of those left alive. A survivor who suffers flashbacks is doomed to relive the massacre over and over again. A survivor who feels guilty because he was not able to save his wife is locked in the prison of his own mind. But although the trauma itself is unalterable, research shows that flashbacks, guilt, and other symptoms of PTSD can be alleviated by constructing a therapeutic narrative. This is not fiction; this is life itself. The facts are horrific, but the way they are told can make a difference.
Read: ‘The whole country has PTSD’
The traumatic event itself is a moment of shock and voicelessness, and so its treatment requires the opposite: A wordless experience is turned into an event that can be described and named. In the weeks I spent talking with refugees and survivors of the Hamas attack, I discovered that the way we cope with trauma is closely connected to our ability to turn a chaotic reality into a well-constructed story. It is a horror story, a story that should never have happened, but once it has occurred, the only way to contend with it is to be able to tell the story from beginning to end, recounting the details and creating meaning.
At first there are no words at all. Only silence, trembling, weeping. The trauma is an attack on the very capacity for thought. Restoring the ability to form thoughts occurs when we begin to give names, to put the events into words. We sit with these people and we try to fill the blank page, to turn what was imprinted on the body into something that can be uttered. This is the initial transition from physiological symptoms—sweating, pounding heart—to descriptions. Very slowly, the words begin to come, and when they do, the paralysis and silence sometimes turn into a disordered, unstoppable flow. Many survivors tell their story in present tense, as though it were occurring here and now, and when you look at them you understand that, from their perspective, it really is occurring at this very moment: Present reality is collapsing into the past. Nowhere is safe.
We intervene to shift the survivor from present tense to past tense, from “I’m running away” to “You ran away,” from “I’m hiding” to “You hid.” In this way, we remind her that the event is over, and we patch the chronology back together. Just as fairy tales begin with “Once upon a time” and end with “The end,” this twisted story must also have a time frame to delineate it. When the mental continuum is frayed, past and present dissolve into each other. Psychic reality becomes indistinguishable from external reality, and the victim suffers intrusive memories and uncontrollable flashbacks. We therefore ask our patients not to stop mid-story, but to reach the point at which the event ended and declare its termination. The trauma turns from being an occurrence they experience repeatedly in an eternal present tense to a painful memory of a past event. When the mind can once again differentiate between past and present, it can hopefully find some degree of comfort, alongside the pain and loss. In order to create meaning and hope in life after the event, the survivor must first internalize that the event really is over.
Establishing a coherent, time-delineated story is an essential stage, but it is not enough. There are stories that heal us, and stories that haunt us. “When the terrorists came, I hid in the closet,” one boy testified. “I sat there frozen for hours, without moving. I can’t believe I didn’t do anything.” Feelings of helplessness and passivity intensify the sense of vulnerability and humiliation, and increase susceptibility to PTSD, whereas the experience of being potent and active can serve as a psychological shield. So when a survivor describes how helpless he felt while hiding in a closet, we offer an alternative narrative and point out his heroism: “It takes a lot of self-control to be able to stay quiet for so long like you did. It’s amazing how in the midst of that terror you had the resourcefulness to find an excellent hiding place.”
Victims of terror, just like victims of sexual violence, have been objectified: They were treated not as human beings, but as objects of a lust for killing. Now they must reclaim their sense of self by means of a narrative that presents them as the protagonist, rather than as the perpetrator’s commodity. As therapists, we listen to their story and try to find moments when they were potent. A girl who describes how she lay in the safe room and pretended to be dead after her family was murdered would be praised for showing enormous initiative by then climbing out the window when she realized the terrorists had set the house on fire. An event that could easily have been depicted as the ultimate helplessness—pretending to be dead—is retold in a way that emphasizes the survivor’s strength. Because the question is not just What happened? but also: What do I think of myself about my behavior in light of what happened? And: How will I tell my story? This girl will need all her mental fortitude to cope with the loss she experienced. The reality imposed on her is intolerable, which is why it is so important to construct a narrative that will bolster her, that will help her survive it and, hopefully, move into a life that contains moments of joy beside the pain.
Of all the stories people tell themselves, the story of guilt is probably the most pernicious. Almost all of the testimonies I’ve heard from October 7 include a dimension of guilt: Survivors of the kibbutz massacres blame themselves for getting out alive while their relatives were murdered. Partiers who managed to escape the rave blame themselves for the deaths of their friends. Guilt is a poison arrow that must be extracted to enable recovery. But some of the survivors cling desperately to their guilt, refusing to give it up. Merav Roth, an Israeli psychoanalyst who works with victims of the massacre, described meeting parents who blame themselves for their children’s deaths. She underscores the importance of offering an alternative story. Only when she told parents that their children were demanding that they keep on living, for their sake and in their memory, were they able to slightly relinquish their guilt and choose life.
The roots of guilt are deeply embedded in Western culture. Religion teaches us that God punishes sinners. Our society seems built on the implicit idea that bad things don’t happen for no reason: They happen to people who did not work hard enough. People who have sinned. People who, in some way, deserve it. Victims of violence and terror, therefore, tell themselves that they deserved to be hurt—because they were not brave enough, or smart enough, or strong enough, to save their loved ones. And perhaps this story, disturbing as it is, is preferable to the thought that things did happen to people who did not deserve it, that the world is an utterly chaotic place, that bad things happen to good people all the time.
Read: A shocked and frazzled collective mind
I met with a woman who’d fled the war zone and was suffering from acute anxiety. When I asked her how she used to relax in the past, she told me how much she loved Taylor Swift. I asked if she’d be willing to try leaving her house for the first time, and suggested that she go to the park and listen to music. She looked at me in astonishment, as if to say: We have hundreds of hostages, and you’re telling me to go for a walk and listen to Taylor Swift?
From this woman’s perspective, resuming normal life would be sacrilege, an abandonment of the hostages and casualties. Even those who were saved from the inferno sentence themselves to mental imprisonment because of their profound identification with those whose worlds have fallen apart. To be happy, to laugh, to make love—these now seem impossible. Gently but consistently, we offer patients a different narrative, in an attempt to clarify for them—and perhaps for ourselves—that returning to life is not a betrayal. On the contrary: It sanctifies the lost lives.
Years ago, when I studied creative writing, I turned in a story that my instructor rejected as incomplete. “What you wrote here is not the end,” he said when he handed back the pages. “It’s only the beginning.” His words have stayed with me constantly since this war began. Loss and trauma have the capacity to erase our belief that there can be anything beyond them. Pain is an ocean with no sign of land. You look around in every direction and find nothing but more pain, as far as the eye can see. To cross this ocean, you must believe that there is something on the other side. And so, like my demanding creative-writing teacher, I have found myself asking my patients to keep imagining something beyond this point in time. To remember who they were before the trauma, and to allow themselves to dream of the people they could still be.
This article was translated from Hebrew by Jessica Cohen.
login
who are we?
contact us
qosheapp
Toi Staff
Gideon Levy
Belen Fernandez
Rami G Khouri
Donald Low
Mort Laitner
Ali Fathollah-Nejad
Nikkei Editorial
Michael Kwet
visit website
