The Jerusalem Post - The Jerusalem Post Magazine
Addressing ‘invisible’ wounds
All who read of Golani veteran Itzik Saidyan’s self-immolation last month must be asking how someone begging for help could be ignored. According to Saidyan, the Defense Ministry, while recognizing a physical disability, does not give the same consideration to those suffering from battle trauma. Those battles were fought, we should remind ourselves, for each of us.
Saidyan witnessed his friends and Golani colleagues being burnt alive in a tank during Operation Protective Edge. Just writing this sentence sends shudders down my spine.
Apparently as a result of Saidyan’s self-immolation, the Defense Ministry announced a new plan to reform the current system, but is the Defense Ministry the right address for those suffering from post-traumatic stress disorder (PTSD) caused by battle trauma?
Hitherto the Defense Ministry evaluated whether the veteran is entitled to a specific percentage of disability allowance while, simultaneously, deciding if the request is genuine. The applicant is cross-examined to explore whether a childhood or other experience (rather than the battle experience) is the true cause of his PTSD. How must it be for a traumatized veteran, who has found the courage to seek help, to face questioning as to the legitimacy of his claim? Where is the sensitivity to the fragmented and traumatized soul appearing before those who will pass judgment?
In September 2019 I wrote about the Herzog Hospital’s nine-month Metiv “Peace of Mind” (POM) program for veterans who recognize they have suffered trauma, as well as for those who believe, often initially, that they were unscarred by their battle experience. While the focus is the group’s trip abroad, it commences with a seminar six weeks prior to leaving Israel. A second seminar takes place six weeks after the group’s return home, with the final session six months following the return to Israel.
RECENTLY THE Magazine spoke with veteran Jonatan Zimerman. Today aged 35 – married with three young children and living in Jerusalem – Zimerman joined the Givati Reconnaissance Battalion in 2005. As deputy commander of his team, he served in the West Bank and Gaza. In 2007 his unit witnessed the death of colleagues, which left a painful mark on his team. Zimmerman described how soldiers cope in the midst of battle, but it is later, often when returning to civilian life, that the feelings of trauma manifest themselves.
An example he gave was of a friend seated in his tank during the Second Lebanon War waiting for the battle to begin, but it never did. Anticipation – feeling alone and helpless – can contribute toward post-traumatic stress more than the reality of the event itself.
The Magazine also spoke with Ari Zecher 28, born in the United States, who was an IDF officer in command of one of the units in 2014 during Operation Protective Edge. He witnessed three colleagues killed and dozens injured at a booby-trapped UNRWA Clinic. Following his IDF service, while not initially recognizing any problems within himself, he was pleased to participate in the unit’s POM project. Looking back he recognized his post-army behavior was not what it should have been; his POM participation, listening to how Operation Protective Edge affected his colleagues, contributed toward a better understanding of himself, plus appreciation of how he too was affected by the experience.
A prime factor in the success of the POM program is that all members of the unit are part of the program; there is no stigma attached to joining such a trip. Accompanied by two psychologists, participants meet daily for group therapy. These sessions enable participants to share their innermost feelings together, out of Israel, in a relaxed and informal atmosphere. Trust develops, creating a safe environment to reveal anxieties. Participants who hitherto felt they had no problems often began to recognize they shared the unease expressed by others. PoM helps individuals realize, “I am not alone!”
TO FIND OUT how Metiv, the Israel Psycho-trauma Center affiliated with the Herzog Medical Center, is evolving today and its connection to the Defense Ministry, the Magazine spoke with Prof. Danny Brom, who founded the program in 1989. Of Dutch origin, Brom founded the Dutch Institute for Psycho-trauma in the Netherlands where, in 1986, he obtained his PhD in the effectiveness of different treatment methods for PTSD. He explains that the Defense Ministry’s Rehabilitation Unit deals with veterans suffering from physical or psychological damage; they are not proactive in screening released soldiers but passively await applicants. The 1% of combat soldiers who turn to them is in contrast to the 10% to 20% of those suffering from PTSD who do not seek help. In other words, the Defense Ministry’s process of recognition of those suffering from PTSD is far from satisfactory – it is the tip of the iceberg.
Metiv recognizes that its service must expand to offer meaningful comprehensive care for veterans. Brom speaks of three phases:
• Expand the POM project, which is funded by Jewish communities worldwide who host groups. To date this concept has benefited 120 groups, embracing 2,000 veterans. Aside from the current group therapy experienced through the POM visits abroad, Brom believes that more individual therapy must be available. Far too many veterans simply slip through the cracks.
• Provide first-line individual therapy for those who have a high level of post-traumatic symptoms. This treatment has about a 35% success rate, which is considered far from satisfactory.
• Make available second-line individual therapy for those who did not respond to previous therapies.
Brom spoke of a new treatment: methylenedioxymethamphetamine (MDMA)-assisted therapy, which is showing excellent potential. It is psychotherapeutic, with two or three sessions supported by the MDMA psychedelic experience resulting in the veteran feeling acceptance and compassion both for self and for others. The concept is about to receive positive coverage in the prestigious US publication Nature Medicine. The Health Ministry has approved this new treatment for PTSD as part of a comprehensive program. The success rate is about 68%, significantly better than the results reached by other veteran-orientated therapies.
WHAT OF the Defense Ministry’s future role? Acknowledging the challenge of combat soldiers successfully returning to civilian life the ministry recognizes Metiv as a service provider. Just prior to COVID-19, it decided to sponsor the POM project – with a difference: taking a unit of veterans to a location in Israel (rather than abroad), where the same program is followed. The inaugural trip will take place in June.
It should not have taken Saidyan’s extreme action for the Defense Ministry to reexamine how veterans are treated. Rather than set up an entirely new structure, perhaps the ministry should be funding organizations such as Metiv (and others) whose sole raison d’etra is to give expert support and treatment to traumatized veterans.
Today is May 14, the Gregorian date back in 1948 when David Ben-Gurion declared the State of Israel. 73 years on, we in Israel remain ever indebted to our brave young soldiers – those who have given their lives and others, like Saidyan, whose lives have been shattered in ensuring the one Jewish state survives. We wish them all a complete recovery and peace of mind. They deserve the very best of support and our deep appreciation at all times.
Where is the sensitivity to the inner fragmented and traumatized soul?