Chapter 6 

"WOUNDS OF THE MIND" 

"Someone looks you in the eyes — then blows you up; it shatters basic human assumptions." 

Some basic human assumptions may be shattered when "someone looks you in the eye – then blows you up", or when there are media images of people dancing in the street in jubilation, holding up the limbs of our dead in their hands. People can't believe someone they don't know would blow up the bus they are sitting in (or the train as in Madrid). Such acts challenge and shatter ordinary assumptions making it hard to re-build assumptions about people. 

The international media often practices role reversal as if the victims and wounded are themselves to 
blame, especially if they are living in the 'territories'. Video clips of women bombers asserting their 
desire to be shahids (martyrs) make Israeli civilians wonder what was going on in their minds. What 
went wrong to cause them to do this? Assertions that deprivations are a root cause of suicide bombing 
are disputed. Many of the bombers have come from professional, educated, employed and even 
privileged backgrounds. 

In Israel public recognition often follows a terror attack. There is a lot of public goodwill towards 
terror victims. People experience a sense of shared fate and identity, as if relatives have been killed or 
injured, as if all citizens are part of a single family. The direct victims may experience a wide range of 
responses from others, such as support and heart-warming gestures from strangers, as well as 
intrusion on their privacy, or avoidance. Many feel abandoned when they are replaced in the headlines by the victims of more recent terror attacks. 

There is some expectation on the part of survivors and families of victims that they will be helped and 
in some way compensated, yet they may also feel a tinge of guilt when they receive financial help 
because their loss has led to things being 'a bit better than it was before'. They feel a lot of anger that 
is sometimes even directed at the Social Services and Social Security systems trying to help them, as 
well as at terror attacks and terrorists.

Civilians also have to cope with regrets: "Unfortunately I got on a bus later than usual (which blew 
up)." People also reflect on what could have been omens of disaster: "I felt that something was going 
to happen that day." "I made an extra cell-phone call to my daughter."

There may also be cultural differences in how different sections of the Israeli population react. For 
example, some people may feel less inclined to seek help, even when they need it. Physical injury can 
lead to neglect of psychological damage, especially if someone is hospitalized for a long time and 
there are numerous surgical and medical interventions that may themselves be traumatizing. The 
needs of siblings can also be overlooked, if a brother or sister is killed in a suicide bombing. 
Professional care-givers and social workers may experience the need to do a balancing act between 
their regular case load of work and special crises. In order to do their work properly when a crisis 
occurs, people must act automatically and be task-oriented and self-regulated. All their energies are 
taken up, perhaps to a certain degree at the expense of ordinary care and prevention. Ordinary 
matters almost become trivialized. Problems such as bed-wetting assume different proportions when 
compared to a wounded and traumatized individual who has lost several family members in a bus 
bombing. Professionals and associated workers often work at high energy levels. They need time to 
stabilize their own physical and psychological strengths. 

Most people feel some degree of trauma, even if they think they are not traumatized. For example, 
when an Israeli goes abroad he/she may feel strange entering a foreign shopping mall, where there is 
no security check.

Basically, terror has to do with facing questions of identity, of belonging. It challenges us all to be in 
contact with feeling who we are, and where and to whom we belong." 

Sources; Interview 13 June 2004 with E. P. Lecturer in Postgraduate Family Therapy 
and School Counseling, Ranaana 

"I saw body parts crashing through the broken car window" 

 
Recalling that attack eight months later, F felt that the spirit of her dead mother had helped to 
save her. Her son had telephoned his wife who came to take Frida to a nearby hospital. Frida was 
wounded on the right side of her face, but was discharged the same day because she did not want to 
stay in hospital. She remembers after the bombing attack that she felt fear, and had some panic 
attacks. No volunteer organizations helped her, but a social worker visited her at home in the 
apartment where she lived. She consulted with her own local doctor, which particularly helped her. 
Eight months later the thoughts which helped her were hope for peace and quiet for Israel. She still 
feels some fear boarding public buses to travel to a nearby coastal town because she remembers the 
bombing. When she recalls the bomber who killed 17 people and wounded 53 in that Haifa bombing 
she says that they are 'ugly' and 'should not exist'. When she sees another bombing on TV, she 
remembers again that day of the bombing in Haifa and gets headaches and some heart symptoms. She 
says "Fear doesn't leave me, it is always with me." 

Source: Interview November, 2003 (see also F's testimony in section 3.2) 

Images of severed arms, bodies sliced in half, spurting arteries etched in his mind 

"The smell was still there," he said, "It choked me, it nauseated me. A prisoner in solitary confinement 
has more freedom than I do. I am in this house almost 24 hours a day." He often cries himself into a 
couple of hours' sleep at night, his sweaty palm clasped tightly into that of his wife. Since the 
bombing, he has lost 10 kilos in weight. He eats one meal a day, better than the starvation that lasted 
for the entire week after the attack. During that week, he ate and drank almost nothing. He would 
vomit up even the brittle edge of cracker. He was so weak that his wife had to take him to the 
emergency room to receive an infusion. 

Sources: Gutman, "The Unseen Victims", Jerusalem Post Magazine, June 2002

Bleeding bodies lay everywhere as screaming women protected shrieking babies 

An hour later, Danit still remains at the spot, immobile. 

Her husband had come to fetch her son and left. Her mother, also lightly wounded in the attack, was 
in hospital with the rest of the family. Yet, Danit's legs refuse to bend, lift, or push forward, and take 
her away from the site, now crawling with the media and curious by-standers. Her voice barely 
audible, her face ashen and her lips almost blue, Danit manages to say, "I know I am probably in 
shock, I will become myself again, but the problem is, how will I forget the babies crying, and the 
women screaming 'Save me, save me!'" Danit, though battered by shock, is one of the lucky ones. She 
knows she will recover, and staying at the scene is actually therapeutic. She begins to talk with 
photojournalists about her experience, recounting the sights she saw earlier and how she feels. They 
exchange stories, even manage a furtive smile. 

Source: Gutman, "The Unseen Victims", Jerusalem Post Magazine, June 7, 2002 

In 2004, it was estimated that 40% of the population in Jerusalem have some degree of Post Traumatic Stress Disorder 

On the front-line in the war against trauma 

 
Today, Natal, the Israel Trauma Centre for Victims of Terror and War, operates out of an office in a 
converted house in south Tel Aviv donated by the Recanati family. It functions as a multidisclipinary 
treatment center for victims of terror and war-related trauma, aiming to improve their quality of life. 
It trains professionals and at-risk populations in preventing and coping with trauma. It furthers 
knowledge and awareness about terror and war related trauma in Israeli society. In the first two and 
a half years of Natal's work it received around 700 calls for help. Since the year 2000 ten thousand 
people have sought the organization's help. 

Natal operates a free 24-hour telephone hotline, a front line in the war against trauma. The hotline is operated by non-professionals who have received a six-month training. They provide immediate emotional support to clients, and are supported by professional counselors. Details are recorded only with the permission of the client. Some clients want to enhance their link by visiting Natal personally. Some never appear, preferring to maintain a regular telephone counseling link, even over a three year period, with the same volunteer. Calls are reported to the Head of the Hotline, who decides if a personal meeting is desirable, or if the client needs personal 'classic' or dynamic group psychotherapy. Some clients find it hard to establish that first link. They may feel apprehensive, even fearing a degree of stigma because they need help. Some even feel guilty that they need help, especially in a society where strength and resilience is highly valued. Sometimes telephone counseling and 'staying with the line' can produce the motivation to come in personally for therapy. 

Natal also operates a therapeutic Social Rehabilitation Group, which is a meeting place for trauma 
victims, and their families, who seek to meet others with whom they share a common experience. 
Professional staff include experts in trauma and loss, who combine traditional verbal methods with 
innovative non-verbal strategies such as movement and art therapy It is a supportive environment that 
encourages social interaction for those who wish to improve their quality of life. Group members are 
invited to 'coffee chats', lectures, trips, social interaction and confidence building sessions. The group 
promotes non-verbal therapy through activities such as drawing and painting, body movements and 
yoga. This therapeutic approach helps clients process their traumatic experiences and recreate their 
sense of security and purpose. Each client is individually evaluated by senior staff that recommends a 
personalized treatment program. 

Many clients, who may range in age from 48 to 60, and who suffer some degree of post traumatic 
stress disorder (PTSD), are not working. Many experience problems of finance, and problems within 
their own social support systems. By bringing them in for group therapy they meet others with similar 
experiences, re-learn some social skills, and discover new skills. One type of social group-work 
involves learning cooking skills. Many clients neglect to feed themselves properly, perhaps living 
alone, and not cooking often. Another activity involves painting on glass. Even those who deny having 
artistic skills surprise themselves by producing colourful and expressive artwork. There is no analysis 
of what is produced. The production process is the therapy.

 
Many factors influence the development and characteristics of conflict-related trauma in an 
individual or community: for example, whether a person was actually inside a bus blown up by a 
suicide bomber, or whether they saw it as a bystander; whether they sustained injury and how severe 
it was; what they personally did at the time, such as whether they 'froze' in horror or rushed to help 
wounded victims; what people around them did; what their family and friends did later; and, how 
much help they received from professional sources. 

Change can begin when a traumatized individual recognizes what is happening to them and what happened to cause the trauma they are experiencing. Natal staff and volunteers themselves can also experience 'secondary traumatization'- they feel symptoms of trauma arising directly from the work they do with those who experienced trauma from war and terror. Staff and volunteers meet regularly to share trauma-related experiences and coping strategies. Individual counselling is available if they want it.

 
Natal's community staff has developed an ecological community-based program which has been 
empirically shown to be effective. This program is currently offered through a variety of seminars, 
workshops, lectures and conferences aimed at enhancing the ability to cope with emergency situations 
and stress. These community activities target mental health professionals, rescue and emergency 
service workers and high-risk populations. A Natal visitor (from Irish television) reported that around 
3000 policemen in Ireland suffered some degree of PTSD due to the chronic nature of the conflict in 
that society. Natal works with other Terror Victim Organizations, social services and social workers. 
There is a 'Trauma Coalition Group', and links with municipally run trauma activities in various 
parts of the country. 

The traumas of war and terror are widespread, affecting individuals, families and societies. Their 
effects are often instant, and also long-lasting. As one civilian survivor said, "Being a victim of 
suicide bombing changes your whole life. Things are not as they used to be – in a negative way". For 
the often-traumatized survivors of suicide bombings and other terror attacks, Natal is helping them 
cope with their pain and suffering so that it can be more bearable, if it cannot be cured completely. 

Source: Interview with the Clinical Director of Natal, Dr S. U, Tel Aviv, 27 October 2003 

"Sometimes we cannot sleep because the smell of badly burned flesh will not leave us" 

What is different about ER than other types of work, like working in a general ward, maternity ward, 
outpatients clinic, is that we experience after a terror attack a massive influx of serious injuries. What 
we see within a very short space of time is not the usual types of ER admissions. When suicide 
bombings take place, we see people who are badly and extensively hurt, from blazing passenger 
buses, destroyed cafes and discos. We see a mother with no hand. We see a man with his brain 
exposed. We do our work as expected. But, at night we may dream of those sights. Sometimes we 
cannot sleep because the smell of badly burned flesh will not leave us. 

People outside the hospital, and people elsewhere in the world, do not understand what we see. We feel that as professionals our job is to save people; if we cannot, we feel bad. After the last patients have gone, even that same night, or maybe two days later, our staff, as many as 50 people at a time, sit down in our seminar room with our social worker and psychologist. Staff are given an opportunity to express feelings and to say what they feel. A safe place – where you can even cry. They have permission to feel bad, but they will still be able to function. Our meeting gives legitimacy to their feelings and thoughts. Nobody judges others. Staff may begin with the statement 'I feel bad'. Or, 'I felt my heart beating more quickly than usual', or 'I have children - what will happen to them if this happens to me?' Or, 'I felt such deep sympathy for the children who were carried in.' 

The first time new staff are in ER when the torrent of patients arrive can be difficult. After that, you 
think that you know; time makes some difference. If there is not a suicide bombing every day – as 
there has been sometimes – we have time to forget and to heal ourselves a little. But the next bombing 
makes the bad feelings re-emerge. We are sensitive; we care about our patients. Our seminar lasts as 
long as people need it to, even 5-6 hours. At the end I look around into the eyes of all the staff. If 
someone, maybe a male nurse, won't look at me, I say to him, 'Come and see me later in my office.' I 
say 'How do you feel?' If they do not answer, I look in their eyes – and I can see they are still lost. 
Then I say, 'Come and see me when you want'. They still need to be 'harnessed'. 

You can't let the staff go home; maybe they will be alone, with no one to speak to them. You learn how to look into the eyes of people. The suicide bombings will not break our spirit. Those who make the bombs and those who send the bombers will not win. We will still be here. Peace for the people of Israel is not like peace say between Holland and Belgium. Our peace will always be different." 

Interview with Senior Nurse A, Emergency Room, Ichilov Hospital, Tel Aviv February 2004 

I simmered until I boiled over – earlier diagnosis of PTSD would have saved a lot of heartache 

 
Forty-four-year-old S recalls," We were going from the mall to meet my husband for a Purim outing. 
We started to go downstairs towards the car parking area. Suddenly there was a huge explosion 
which knocked me against a column. Dust started to fall from the ceiling. If the blast had been 
seconds earlier we would all have been dead. We had just left an area encased in glass panels. My 
father said 'Let's get out – the ceiling could collapse!' My mother stood immobile like stone. My 
daughter Yael, aged five, stood in a daze. My daughter Dana, aged eleven, started to scream. People 
emerged from the shattered mall covered with blood. The whole area was littered with broken glass. 
The area looked like a war zone. My husband had been trying to contact us but our cell phones 
weren't working. 

I had gone into 'automatic'. I said to myself, 'We are going to get out of here'. I picked up my kids and 
we all got into the car. I was worried about everyone else – except myself. For the next two days, I 
worked like a robot. I had no feelings except for superhuman strength. I got my mother to see a 
doctor, and my best friend came to help with our kids. I had bruises on my arm and my watch had 
been shattered. I hadn't felt it break. My ears had been affected. I could not hear well for a long time. 
When the media reported the extent and carnage of the bombing, I could hardly believe it. I 
discovered that a colleague and her mother had been killed in the blast. I felt shocked. My mother had 
a hard time after the bombing and needed tranquillizers. She had sleep disturbances and fits of 
crying. My daughter Yael had total amnesia. Dana required therapy for two years. At first she 
wouldn't sleep by herself. She used to hide, sometimes in a closet. She was anxious every time an 
ambulance went by. She didn't like to go out much. 

When I look back now I feel that the care I received at that time was wrong. I had often felt poorly 
physically, occasionally with some jaundice. I had often felt nauseated with no appetite. When a bus 
pulled up in the street, I would sweat. Everywhere I went I would first look for the exit. I felt my body 
was going berserk. I was anxious, depressed, full of worries. I even lost a pregnancy. It took me a 
long time to learn to let go before I felt better. I felt a lot of anger about what had happened to me. I 
also felt guilty that I still had two legs and two arms, while other survivors had lost limbs. 
But I still found it hard to cry and let myself go. 

It took maybe three more years before I felt relaxed. I still used to have panic attacks, with fast heartbeat, sweating, and feelings of faintness. I couldn't get a hold of myself. I seemed to 'simmer until I boiled over'. Then I saw a couple of psychologists. My husband is the son of a Holocaust survivor. He is strong. He used to say 'Everything is fine'. But I wished someone had stepped in earlier to help me get therapy. No-one told me about any organization that might have been able to help me. Not even my doctors. An earlier diagnosis of PTSD would have saved me a lot of heartache. Nobody really knew how I felt – I hid it. Only a couple of close friends knew. 

Then came the Second Intifada. The thoughts which help me today are that I cannot control 
everything. What has happened to me has reinforced my atheism. Unfortunately, I hate Purim. It 
provokes too many memories – everybody in costumes. I associate Purim with blood. A tragedy can 
tear your life apart like a piece of paper. 

I feel now that I want to live. I have re-learned how to cry. A team of three health professionals 
helped me to be able to cry. They helped me to regress almost to nursery school time. I was eventually 
able to throw away my damaged watch from the time of the bombing. I found it is OK to be emotional. 
What do I feel now about bombers and their families? I feel how dare they destroy my life and that of 
other families. When I see on TV yet another suicide bombing, if I see children or young people 
involved I turn to another channel. I feel anger and disgust, not anxiety. What helps me now is that I 
do more volunteer work. I feel I can let go now and move on. You have to get past the anger to move 
on. It took me 3-4 years before I felt happy, and could truly feel joy. Now I have almost come round 
the circle to what I could feel before the Dizengoff bombing. I am determined to live a full life.

 
Sources: Interview with S, 18 June 2003 

Dispelling some myths about death and dying 

Myth

Reality

After a suicide bombing it is important to identify the body – or what is left – of your loved one. 

Studies show the worst grieving is often that following the death of a child. You lose a lot of things, but to lose a child is to lose the future. Sometimes parents feel, "I will never get over this." 

Parents may also feel a sense of failure at having lost a child, in the sense that they could not protect 
the child. Grieving sometimes involves a feeling of guilt on the part of those left, like the daughter 
who had discreetly left a family celebration to have a secret smoke. While she was out a suicide 
bomber detonated his explosives. When the daughter returned, it was to a scene of parents and family 
massacred by a suicide bomber. It usually takes three months to realize that a loved one has really 
died. If that person lived away from home, it may take longer. This means that the immediate support 
system needs to remain in place for at least three months. Some studies have shown that bereaved 
parents are often more efficient after their loss when they are at work, as a way of exercising some 
kind of control. They 'hide' in their work. Sometimes people 'freeze' their grief.

 
There are three main issues when dealing with death; that death is a 'taboo 'subject (this can also 
affect health staff); that it is unlucky to talk about death, even calling cancer 'the disease' rather than 
calling it by name; that there are particular fears of death, such as in 'counter-transference' where, 
for example, people meet a dying child and think the child may be 'the same age as my own child'.

 
Grief is slow; it may take one or two years to overcome grief. This time frame jars on the accustomed 
speed involved in western lifestyles, where media images flicker across screens for 30 seconds, and 
even meals can be prepared in three and a half minutes. With grief it is not acceptable to take 'shortcuts'. It is not like the 'instant Internet'. Grief takes time. It has a beginning, middle and end. 

Bereavement counseling is 80% verbal and 20% body language. Grief may even get worse over a 
five-year period. If people know it can be overcome, they have a better chance of doing so. Trauma 
over death can also affect medical students when first dissecting bodies. Those who are actually doing 
the dissection may not be as affected as those observing it. Western society marginalizes death. It 
trivializes it, often using contrived and ghoulish media images.

 
After a suicide bombing it is important to identify the body, or what is left of your loved one. Parents 
of one dead sixteen-year-old only had the arm left of their daughter. How do you help them to go and 
look at it? You go with a colleague to see it yourself. Then you come back and carefully tell the 
parents what you saw. Then you lead them gently into the room where they themselves can see with 
their own eyes the arm of their daughter. Leave them alone for a few minutes. Alternatively, the dead 
loved one may look curiously the same. For example, a young girl who sat next to a suicide bomber 
on a bus died of explosive impact injuries (to her internal organs). When her parents saw her, her 
face was almost untouched. Within several months the realization set in that their daughter was really 
dead. 

Sources: Interview 5 November 2003, plus paper presented by Lynne Dale Halamish, "Post 
Traumatic Grief Counseling for Children Involved n Terror Attacks" at the Conference: 'Planning 
for Peace While Coping With Terror', Kibbutz Emeq Hefer 13-14 November 2003 

"At first we thought the explosions were only fireworks" 

The suicide attack had taken place on 17 January 2002. Nearly two years later A recalls, "We were sitting at our table enjoying the Bat Mitzvah. My husband took our son home because he didn't feel well. He returned. People were dancing, drinking, and joking. Suddenly, we heard shooting. At first we thought it was fireworks. "A couple of minutes earlier Rosa's sister A had left her husband's side. When she came back after the shooting she saw her husband lying on the floor in a pool of blood. 

Anna recalls, "People were crying, there was chaos. I felt shock. Immediately after the first killings guests tried to overpower the terrorist. His eyes were staring, maybe from drugs. Guests threw bottles, and ice, at him, kicked him, used anything they could. They killed the terrorist to prevent him from killing more people. He still had half his bullets left and one of his three grenades. The guests were really heroic." 

Rosa recalled that other guests had helped her a lot at the time. However, the police seemed to take a 
long time to arrive. Rosa's husband was taken to nearby hospital, but he died on the way. Anna 
remembers, "My husband danced with me only once that evening. Mostly he sat at the table, with his 
back to the entrance of the hall. That day he had behaved a little strangely. Usually he used his credit 
card at the market, but that day he had paid everybody." 

Immediately after the attack, people visited Rosa and Anna, including a Government Minister, and the 
local mayor. The factory where Rosa worked stopped work for a day after the tragedy. Eventually 
Anna started to draw comfort from Kabbala (Jewish mysticism). After the suicide attack several terror 
victim organizations tried to help the two sisters and their grieving families. But, overall, the sisters 
did not feel that it helped very much. They also consulted a psychologist but felt that did not help 
either. Afterwards, they recalled, they had felt very nervous. 

Rosa says, "Today I draw comfort from my grandsons. My husband dreamed about our daughter 
getting her own apartment. On the anniversary of his birthday my daughter and I went to visit his 
grave to wish him 'Happy Birthday'. On the way home we saw an announcement about the sale of an 
apartment. My daughter bought that apartment on my husband's birthday. The local mayor has 
erected a monument to our dead husbands in the centre of Or Akiva where we live." 

Sadly, tragedy continued when a year after the suicide attack killed his father, Anna's twenty-year-old 
son committed suicide. He had been very close to his father. The loss of the two husbands on a single 
night was a terrible blow. Rosa misses her husband, who liked to joke and dance, and constructed 
wooden kitchen cabinets as a hobby. When she sees another suicide bombing she feels very bad. "I 
turn off the TV," she says, "I would like to see more peace and quiet and less evil. People outside 
Israel should know what is really going on here." 

Anna and Rosa both want to move on to conquer their grief and to continue their lives. They sit, the 
pain and grief still etched on their faces, surrounded by photo albums and pictures of their husbands 
and of the Bat Mitzvah celebrations on that fateful night two years ago. 

Source: Interview with Rosa and Anna , Or Akiva 10 November 2004 

"In one second three generations of our family were murdered. For our family it was a Holocaust in Israel" 

When I arrived at the Rambam hospital in Haifa they told me that, except for my sister-in-law and her 
two children, other family members were not there. I said, "I know that my wife IS here ". The woman 
who had called me earlier said she had seen my wife and that she had given her my cellphone 
number. I searched for Galit for more than two hours. By this time my parents were at the hospital 
with me. Then we heard that Galit was in surgery, badly wounded. It was about 6.15 pm, just four and 
a half hours since I had landed at the airport. 

I realized that it would be some hours before I could see Galit. In order to find the rest of our family I 
also knew I would have to go to the Forensic Institute at Abu Kabir near Tel Aviv. Leaving my parents 
at the hospital, I set out in a taxi for the almost two-hour drive southwards. When I arrived, Professor 
Hiss met me. He told me he could not immediately show me my family members who had been killed. 
They were not yet ready for me to see. He was wonderful to me. He took blood to use in DNA testing 
to see if a young boy brought in after the bombing at Maxims was my ten-and-a-half-year-old son 
Asaf. 


I returned to Haifa and went to our eldest son fourteen-year-old Omri. We walked in the street 
together, and after we talked we both cried. He said, "I want to stay with a friend." I returned to the 
Rambam hospital at 3 am, after not sleeping for 24 hours. I didn't feel tired. I didn't feel anything. 
When I first saw my wife at 3 am in the middle of that night, her head was covered with dressings. The 
shrapnel had made a hole in her cheek. I could see her tongue through the hole. She had instruments 
in her mouth. It was terrible to see her. She couldn't talk, couldn't see, couldn't move, couldn't feel 
when we touched her. After three days, she began to understand what had happened. The doctors in 
Intensive Care stayed with us all the time, from Saturday to Tuesday. I talked a lot with them, 
especially about how to be able to tell the story of what had happened to our family. Then the doctors 
told me that Galit was paralyzed – and I fainted. Galit had upper spinal cord injury, wounding of the 
right hand which had affected the nerves, a broken left arm, shrapnel and metal ball injuries all over 
her face and upper body. (The shrapnel injuries to her eyes destroyed her vision for a month). At five 
thirty Professor H phoned me to say it was our son Asaf in the morgue." 

Galit recalls, "The day of the bombing my husband was flying back from a business trip to Brazil. lt 
was a sunny day, so I took my younger son Asaf at midday to the beach to meet my parents and my 
brother Moshe his wife Orly, their children and my mother's cousin. We were a big family group. 
Someone suggested we go to the Maxim beach-side restaurant for lunch. We sat down to eat. I was 
talking to my sister in-low. Suddenly, I could not hear anything. It was as silent as death. I couldn't 
see anything. I didn't understand what was going on. I thought 'Why do I have such a headache?' I 
drifted in and out of consciousness. I was screaming 'Help me'!' People came to help me and put a 
tube down my throat. I told those people that my husband was landing at the airport at that time, and 
gave them his cell-phone number. They said they were going to take me to hospital. I remember being 
taken into the ambulance. As I was unconscious on arrival nobody in the hospital knew my name, so I 
was listed as 'anonymous. 

I remembered seeing the suicide bomber standing between my father and my brother in the 
restaurant. She had looked like a young Israeli women, and she was very pregnant. I remember 
thinking 'What is she doing standing between my father and my brother?' When the restaurant 
exploded I didn't think anything, but I knew members of my family were dead. Later, I remember Ofer 
asked me 'Do you know what happened?" I said "They are all dead except my niece (five-year-old) 
Adi and my husband." Then Ofer told me that Adi had survived, and her mother Orly, and her son ten-
year-old Oran (who was totally blinded by the bombing). But, I knew my parents were dead: my 
charismatic father, seventy-one-year-old Z. A, retired naval officer and submarine captain; 
my 'super-mother', seventy-year-old Ruth; my brother, forty-three-year-old Moshe, who worked in 
marketing medical equipment, and his nine-year-old son, the cute and ever-energetic Tomer. Above 
all, I knew that we had lost our youngest son, ten-and-a-half-year-old Asaf, a warm and beloved child 
who had loved everyone, and who was very good at sports. 

After two and a half weeks in hospital I was transferred to the Rehabilitation Unit in Tel Hashomer 
hospital in Tel Aviv, where I stayed for eleven months. My most frequent thoughts after the bombing 
were that I needed to concentrate on my remaining family, and on personal survival, and on living. 
But this was like talking from the head, not the heart. I couldn't mourn and I couldn't cry. I felt 
immense pain and sadness. For us the attack had been like a 'Holocaust'. In one second three 
generations of our family were murdered. I didn't know who to think about first. I thought of our 
surviving son Omri and his losses. We tell our children in Israel that the Shoah will not happen again, 
but for our family, it did happen. This was not Germany or Poland, but Israel. We cannot teach our 
children Israel is a safe place for Jews. 

My husband has stayed most of the time with me. He took a year off work. At the beginning I couldn 't 
move at all. I had to be fed and bathed. I was not used to being helpless and I needed a lot of 
patience. The hardest thing was not being able to be with our son Omri. Our close-knit family was 
split. Ofer stayed near the hospital where I was in Tel Aviv. But, our son Omri was in Haifa. It was 
eight months before I got back to my own home for weekends. But then we had to move from there 
because I could not manage the stairs. Now we live in a rented apartment with no stairs. 

We were helped a lot after the bombing by our close family, and by friends and work colleagues. 
Friends took it in turn to sleep near me in hospital at one period. At first we did not consult 
Psychologists. Now I am doing some art and making ceramics, and talking weekly with a 
psychologist. We were helped by the Terror Victims organization One Family who have visited us 
every week. We are not in contact with other terror victim families and do not belong to a support 
group. I prefer to sit with people who have not been through what we have experienced. If there was a 
God and He had mercy such things would not happen. Even at the funeral of our son we didn't want 
mention of the mercy of God. The Jewish Reform movement has helped us a lot, over our son's 
funeral, with supportive contact, and with thousands of e-mails from many countries. Basically we 
have been able to receive the state and health benefits which we have needed." 

Galit has been at home now for three months. She says "What helps me most today is doing what I 
can for our son Omri. He has recently done very well at his exams and sports. Only now, fifteen 
months after the bombing, we are getting back to being a family. But it is frustrating for me to need so 
much help and to have to recognize my disabilities. The hardest thing is weekends or holiday times, 
when I realize my whole family is not here any more. I feel sad and miss them so much." 
Neither Galit nor Ofer think about the female bomber who slaughtered their family. They say, "She 
was a monster. All bombers are monsters wanting to kill us. I cannot describe them as human as they 
are destroyers of people, of babies. When there is another suicide bombing on TV we watch a bit to 
know what is going on, then we turn off the TV". Galit says, "I cannot look at those kinds of pictures 
again. Before the Maxim bombing I could watch a bombing for an hour and feel pity for people. I 
don't need that. I know exactly what happens in a suicide bombing" 

Source: Interviews with Galit and Ofer S., Haifa 19 December 2004, 13 March 2005 

The seminar began with much animosity, if not expressed hatred.

When mental health professionals themselves become victims of trauma, especially secondary to a 
war situation, it becomes the ultimate test for fellow professionals. Now they are put in the position of 
supporting and helping those who provide assistance to others. It brings to the surface one's own 
uncertainties, fears and vulnerabilities. Whatever the specific character of any particular war, it 
always involves destruction, pain, loss and death. But while the physical loss can be reconstructed or 
replaced and the pain and sorrow may gradually diminish, it is the psychological scars, the trauma, 
the horrifying images and memories that do not heal for many years. 

In Israel, one meets such people in the form of Holocaust survivors of more than 50 years ago, who till this day, relive their trauma and frequently transmit it to the second and third generations. (Some elderly women who were Holocaust survivors cannot even today bear to see piles of hair on the floor of a hairdresser.) 

Israel's unenviable experience of multi-generational trauma was put to good use in the summer of 
1992 when a plea for help was received from a Muslim leader in the former Yugoslavia. At that time 
Israel was in the middle of its struggles with the first Palestinian Intifada. Riots and casualties were 
daily occurrences. The mental health professionals were desperately searching for ways to cease the 
violence and prompt peaceful negotiations between the Palestinians and Israelis. 

Therefore it was somewhat ironic to receive this plea for help from a Muslim leader in a country which no longer existed – Yugoslavia. "After visiting the areas, it was quickly learned that the psychological damage far exceeded the extensive physical damage. There were hundreds of children completely traumatized and adults whom the war had drastically dehumanized. Worst of all was to see the 'helpers' – physicians, psychologists, teachers and social workers – who were completely exhausted, frustrated, 
disoriented, and unsupported. Some were on the verge of breaking down and burnout. It was difficult 
to witness caregivers who themselves had no one to take care of them, and sadly they were unable to 
do it themselves. 

In addition it was not easy to escape the religious and ethnic hatred between groups. 
This was a deep and dark hatred fueled not only by atrocities in this war, but based on far-reaching 
historical memories that had long been suppressed, only to surface and be manipulated by those in 
authority and in power. Hence these two sources, immediate and remote, together created a toxic 
memory that was poisonous and destructive for human interrelationships.

 
It became clear also that in order to save and help high-risk populations, i.e. children, refugees, girls 
and women who had been raped, it was more important and imperative to first help the professional 
helpers who were providing assistance. As it would have been hard to teach recovery methods under 
constant bombardment, shelling and sniper attacks, with UNICEF assistance, two-week programs 
were developed in Israel, with seminars, intensive training in various trauma relief issues, de-briefing 
sessions, and dealing with individual stress and burn-out. It allowed participants to recharge their 
batteries, and to develop realistic goals of what they could accomplish when they went back to work 
with a population that was at risk and more directly affected by the war." 

The first workshops were designed for mental health professionals who had been compelled to take on 
the almost impossible mission of providing non-stop treatment for war-affected and traumatized 
children and adolescents. Chronic post traumatic stress disorder and other forms of mental disorders 
such as depression and anxiety, may be observed among one-fourth to one-third of individuals 
exposed to unusually stressful situations such as disasters, acts of violence and various war-induced 
stresses. Each workshop contained participants from each of the adversarial groups. 

A year and a half later, representatives of these same groups were involved in a joint workshop. Participants included psychiatrists, psychologists, teachers, university professors, sociologists, and librarians. Graduates then conducted workshops when they went back to Yugoslavia. To date, this model has become the standard training method of mental health professionals in the former Yugoslavia. The 
theoretical basis for the workshops was predominantly derived from the Community-Oriented 
Prevention Education (COPE) model as designed and described by Dr Ofra Ayalon in 1987. This 
model is primarily geared to help children and adolescents to promote coping skills in order to deal 
with stressful events of everyday life, and also with emergencies caused by the disruption of social 
equilibrium and security. The basic premises in this approach are that distress caused by death, 
separation, threat to health, pain and loneliness can be mitigated. The goal of the workshops was not 
only acquisition of skills, but also promotion of professional self-assurance. From a state of extreme 
exhaustion and a sense of helplessness, the hope was to re-charge the 'batteries' of the trainees and to revive their sense of self-efficacy, competence and professional pride. 

The main components of the program included theoretical and conceptual inputs related to stress and 
trauma, children of families who have been traumatized, expressive methods including 'bibliotherapy', 
story-telling, puppetry, video therapy, an and music therapy. Small-group work was used to enable 
trainees to plan a project that would eventually be applied in their own workplace and/or community. 
Over the two-week period a very poignant group dynamic evolved. From a group of professionals 
who had come from different, separate, perhaps even hostile, regions of the former Yugoslavia, with 
each individual containing his/her own diverse expectations and mixed emotions, developed a 
'learning organization' (as one participant chose to call it) with a blossoming motivation to absorb as 
much as possible for application back home. In conjunction with the enhancement of their individual 
awareness, the group members learned to overcome inner conflicts, strengthening their self-
confidence, and drawing upon the enrichment of their previous knowledge and skills, hence instilling 
in them a sense of expertise in their exhausting mission. The evaluation conducted at the end of each 
workshop yielded very high appraisals. 

Follow-up later revealed that graduates had also been involved in conducting local seminars and training workshops with professionals from various disciplines, such as school psychologists, teachers, mental health specialists. 

In 1995 a combined training seminar for members of all parties in the former Yugoslavia resulted in 
an 'Integrative 'seminar in neutral territory in Visegrad, Hungary. The seminar revealed the critical 
significance of the identity crisis generated in a situation such as the one in the former Yugoslavia. 
The identity confusion stemmed not only from the disintegration of one's former nation, but also from 
the disillusionment of assumed moral integrity. While the 'Integrative 'seminar began with much 
animosity – if not expressed hatred – between the different adversarial groups (i.e. Bosnians, Croats 
and Serbs) it gradually evolved through initial dialogues into an interactive and subsequently 
mutually supported professional network. 

What became rather apparent , but puzzling, during this seminar were those frequent vacillations which occurred among the trainees. At one moment they would behave in a strictly professional and non-partisan manner, and moments later, they would expose their ethnic or national identity, breaking down into adversarial factions. This led to the realization of how policies influence people differently, and that historical animosities between groups do not necessarily diminish automatically with evolving affection among individuals belonging to these groups. However, even an enforced dialogue may start a process of de-mythologizing the enemy and projecting one's own hatred and rage, a process that eventually may lead to reconciliation between former adversaries. Individuals who are victims of disastrous situations respond first and foremost as human beings, regardless of their religious, ethnic or cultural background and differences. 

Sources: Gal Reuven, "Colleagues in Distress: Helping the Helpers" International Review of 
Psychiatry, Vol 10, Issue 3, Pages 234-238, 1998; Ayalon, "The Road to Peace Begins Inside," 
Paper presented at the Johns Hopkins Children's Center Colloquium on Children and Violence, 
October 28-9, 1996, Baltimore, USA