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Growing numbers of Yom Kippur War veterans are seeking PTSD treatment

The Israeli television series “Valley of Tears,” now available on HBO, tells the story of the Yom Kippur War from the perspective of Israelis who fought it, and it’s prompting a national conversation about one of the most devastating chapters in the country’s history – both among those too young to remember it and the generation who paid the price of its battles and traumatic aftermath. The series is also credited with highlighting how deeply post-traumatic stress disorder permeates so many lives here, particularly among those who have served in combat.

In Israel, the broadcast of each episode was followed by a studio discussion with veterans. A dam burst open: former soldiers shared war stories, often opening up for the first time in their lives about them; their children and grandchildren asked to hear more, anxious to understand episodes that in some cases shaped their own childhoods.

Valley of Tears, Season 1 - Episode 4

Valley of Tears, Season 1 - Episode 4 Image by VERED ADIR – HBO MAX

A Facebook group about the series, opened by the Israeli Public Broadcasting Corporation, which aired the series this fall, quickly gained thousands of followers, among them veterans who used it to search for long-lost comrades. It also attracted people who lost their fathers in the war, some born after they died and who sought to crowdsource information about them and the battles they fought.

At the same time, Israel’s largest mental health support organizations reported a spike in calls to their hotlines in the months the show aired from former soldiers of all ages, including a significant number of veterans of the Yom Kippur War. ERAN, which offers online and telephone counseling, reported a 150-percent increase in callers to its services compared to the same period as last year. Many of those callers spoke of trauma, post-trauma and psychological distress as the result of military service.

“Some of those who call us talk about the show straight away,” says Dr. Shiri Daniels, National Director of Professional Services of ERAN.

“They tell us that the show has provoked a psychological response in them, which can include anxiety, stress, flashbacks, a low frustration threshold, acute pain and uncontrollably depressive thoughts. These are symptoms that exactly fit what we know about PTSD.”

According to Daniels, the show both increased awareness of the Yom Kippur war and combat-related PTSD while creating a “sense of social solidarity that has managed to help people feel that sharing their personal stories in an accepting, safe and empathetic space is possible.”

The response to the series is part of the larger phenomenon of Yom Kippur War veterans seeking psychological treatment for their trauma, often for the first time in their lives, 47 years after the fighting ended. It’s a war that Israel won, but at the cost of 2,673 dead and over 11,000 physically wounded. Now adding to the statistics is a new category of injured, those seeking treatment for PTSD.

NATAL, the Israel Trauma and Resiliency Center, reported a 60 percent increase in calls to its hotline during the two months that the show was broadcast, 40 percent were from people with mental health issues stemming from their army service. About ten percent of the calls were from veterans of the Yom Kippur War.

“We get a lot of calls from veteran fighters,” says Dalia Yosef, director of the NATAL hotline. “Transitions in life often trigger a call. People built full lives for themselves, with their partners, their families, their jobs; they didn’t feel like they needed therapy. Then they retire, maybe aren’t as healthy as they once were and the triggers that go off in their later years require the investment of significantly more resources. In other words, something extreme that occurs in their lives serves as a trigger for a much higher level of awareness of the events that took place, and then there’s a real breakdown. It bursts forth and we see it.”

“Some don’t want therapy and are happy simply with an ongoing talk on the hotline with the same volunteer. Others require clinical intervention and we work with them to lead them in that direction,” Yosef says.

Zahava Solomon, a world-renowned scholar in the field of traumatic stress is a social work professor at Tel Aviv University says of the rise in requests for help: “Studies we’ve conducted show that for the most part, these are people who haven’t sought help in the past, or who, according to the records, had some kind of disorder and only sought help at a later stage Post-trauma is not necessarily all or nothing; symptoms can build up in someone and the condition can worsen over the years. Before that, it supposedly ‘doesn’t meet’ the criteria to be considered post-trauma.”

According to data provided by the Defense Ministry in response to a Shomrim investigation request, 5,192 of the Israeli army’s veterans have been recognized as suffering from PTSD.

The Defense Ministry, however, didn’t respond to Shomrim’s request for information on individuals whose applications for recognition as sufferers of PTSD were denied, saying such information is classified. The ministry also refused to release data on the number of Yom Kippur veterans who’ve been recognized as suffering from post-trauma.

Aging and its impact on PTSD

Solomon says that studies of victims of shell shock and former POWs show that the aging process exacerbates and intensifies post-traumatic processes. As people get older, they are less preoccupied with planning ahead and more prone to looking back into the past, she says.

“A natural self-examination of sorts – what have I done, what did I want to be, how far have I come, what will I never be? The aging process also comes with many losses – you stop working, you become less significant, you can lose your social position too sometimes, some of the people in your age group die, and sometimes you get a little lonelier, your body ages and you lose abilities you once had and physical strength. For people who have undergone severe trauma in their youth, these losses, together with the introspection, can lead to the resurfacing of some of the things that were repressed or denied. It can sometimes even lead to a process of reconstruction,” says Solomon.

Aside from the aging process, Solomon adds, the ongoing state of conflict in Israel can itself serve as a triggering event.

“For victims of shell shock, just hearing others talk about their experiences in more recent wars is enough to cause a resurgence of the trauma,” she says.

“It’s a situation in which there’s a lot of external pressure and the wound cannot heal. A combination of stress from within and from the outside is deadly in terms of increasing the chances of an outbreak of post-trauma.”

Is post-trauma that erupts many years down the line also more acute?

According to Solomon the later onset of PTSD tends to be less severe.

She explains why: “First, they probably have internal resources or better coping mechanisms to begin with. Second, for many years they have accumulated and built up resources, not just lost them. They manage to get married, start families, establish a career, build a more complete and cohesive life and collect resources that also reflect and empower what they have.”

Flashbacks from the battlefield

Shaul Abir during his service in the IDF

Shaul Abir during his service in the IDF

“I’m sitting on a hill in Baluza in the Sinai with my comrades who’ve survived the first day and night of fighting, and we’re looking out over the terrain below us.”

This is the image that has been haunting Shaul Abir – a flashback from the Yom Kippur War, in which he served on the front lines and as a tank commander trainee.

“So I asked myself: Why that particular image? It doesn’t depict any harsh or traumatic incidents – and, after all, I did experience traumatic incidents during the war. When we got to the [Suez] Canal in the evening, the gates of hell opened: casualties, missiles, utter chaos, the worst kind of chaos imaginable, a sense of catastrophe. So why that particular image?”

Abir, 66, from the Galilee town of Timrat, embarked on a personal quest to decipher the flashback, a journey reminiscent of that same image that accompanies Ari Folman in his stirring film Waltz with Bashir, when he and his comrades emerge from the water, spent and naked, onto the shores of Beirut during the First Lebanon War.

Shaul Abir

Shaul Abir Image by Shlomo Yosef

Abir says he came up with nothing, “up until four or five years ago when a conversation about the war started during a picnic with friends in the Carmel Forest. I met dozens of veterans there, some of them from tank battalions. They started talking, 40 years and more since the war, and some crazy things came up. The barriers came down. Suddenly I heard someone mention Hanoch, a guy who served with me in the same company and who I hadn’t heard from him since the war. I immediately called him and told him about the image I see in my flashback. I asked him if he knew anything about the hill and he said: ‘Yes, come see me and I’ll explain.’ The moment I heard him say that I got into my car and drove to see him.” How was the meeting?

“It was very moving. When I walked into his home, I saw a picture on the wall of his son, who was killed in the battle in Shuja’iyya during Operation Protective Edge (the 2014 Israel-Gaza conflict). It was awful to find out. Then he explained the image from the hill. Dozens of wounded and dead were brought there. We were sitting on the hill and the dead were below us, about 50 meters from us; bodies covered with blankets, with only the boots sticking out.

“I guess what happened was that my brain inverted the image; instead of showing me the bodies that I could see from where I was sitting, it showed me the image of me and my comrades who had survived. As soon as the words came out of his mouth, it felt like a physical blow.”

Shaul Abir

Shaul Abir Image by Shlomi Yosef

Abir, who served in the past as an organizational psychologist in the Israel Navy, and held a similar role in the private sector, says he’s never been diagnosed as suffering from PTSD and hadn’t spoken at all of his part in the war until a few years ago. “As soon as the war ended, I enrolled in an officers’ training course and we didn’t talk about it there either, even though everyone on the course had fought in the war. I didn’t share anything with my wife and children either.”

But, he says, something from that parallel world on the dunes of the Sinai Desert was always there with him. Over the past year, he continues, “I started having a new kind of flashback, of calls coming in over a two-way radio. I hear commanders, orders being given, and sometimes just the noise of the radio. I push it aside pretty quickly. Sometimes, you just can’t hold back the tears, and I know that it’s part and parcel of the whole thing. When you’re older, you’re more susceptible to tears – and crying doesn’t scare you as much.”

How often does it happen?

“It can happen as much as once a day, or once every two or three days, and then I really freeze up. I switch myself off for two or three seconds and it passes.”

Over the past few years, Abir says, he and his friends who fought together have been talking increasingly about the war. “It’s taken 45 years for me to hear their stories, their perspectives, even though we fought in the same place. We have a WhatsApp group called The ’73 Screw-Ups. We message one another there and meet up sometimes.”

Your generation hasn’t spoken out or shared until now. What’s changed to make you willing to do so now?

“We never spoke about the war and didn’t think about it much, but it’s come back in a big way. Some of us are retired and have more time to think. The thoughts take you back there, and it’s hard to find answers. The fighters from then are caught up in a mad pursuit of the past, focusing on how to process and recount the events to anyone willing to listen, and perhaps be able to leave the past behind.”

This story was produced by Shomrim, The Center for Media and Democracy in Israel, a Tel Aviv based independent, non-profit investigative news organization. Shomrim, which works in partnership with other news outlets, sees investigative reporting as an essential tool for promoting democratic discourse and accountability in Israel.

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