The fighting between Israel and Gaza is over, for now. But experts say trauma remains

At 25 years old, Emily Segal can tell the difference between the sound of a rocket crashing into Israel and an Iron Dome interception.

Prior to the recent escalation of violence in the Middle East, Segal, who lives with three other roommates in a mid-rise building in Tel-Aviv, considered Israel to be one of the safest places in the world for her. Now, she said she is frequently on edge, and loud noises are a cause for panic.

When she does leave her apartment, she said she speed walks. The revving of a passing motorcycle outside stops Segal in her tracks. And the sound of a single falling dish in the kitchen sends Segal and her roommates running to the nearest bomb shelter.

“It’s horrifying,” she said. “Your heart really stops every single time and your body tenses up. It’s something that I didn’t even know existed, this feeling.”

Nourdine Jamal, a 24-year-old teacher living in eastern Gaza, does not have the advantage of living in an area protected by Iron Dome technology. Since the bombings began on May 10, he said his little sister has started sleeping in his room.

“My sister, she keeps clinging to me each night because she is scared of the Israeli bombings,” he said. “When I’m looking at her eyes, I see a harrowing scene in her eyes.”

Living in Gaza, Jamal says even the prospect of going outside to buy groceries terrifies him.

“You are scared to go out. You are scared of the warplane to target you by chance,” he said.

“It’s unbearable.”

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On May 21, Egypt brokered a ceasefire between Israel and Hamas to end the fighting. While the bombings may be over for now, experts say the trauma could be long-lasting.

“The ceasefire is actually the start of a long struggle to deal with the traumatic experience that they have,” Dr. Abdelfettah Elkchirid, an assistant professor at Wilfrid Laurier University, told Global News.

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Post-traumatic stress disorder (PTSD), which is also known as shell shock or combat stress, occurs after a person experiences extreme trauma or a life-threatening event. Survivors with PTSD often relive traumatic events through vivid flashbacks or nightmares, feel severe distress when coming into contact with real or symbolic reminders of the trauma and experience dramatic behavioural changes.

The effects of PTSD can be immediate, such as exhaustion — but some can be residual.

“As far as the lasting effects, there is a lasting anger or sadness, lasting emotional outbursts and also lasting feeling of depression,” he said. “Because everywhere you go, you could see reminders of that violence. It doesn’t matter which country you live in, you will see constant reminders of that violence months, sometimes even years after there is no more violence.”

For survivors, these feelings could manifest into heightened emotions such as a sense of being constantly on high alert or a loss of trust, either in themselves or in others.

If left unchecked, Elkchirid said they could lead to difficulties building interpersonal relationships and maintaining healthy family relationships in the future. Trauma survivors can also start losing interest in things or activities they used to enjoy out of a fear that it could be taken away from them again, he added.

However, Elkchirid said “you only start feeling that way after the ceasefire, because before you’re planning in a survival mode and you do not have time or energy to process the trauma that you just experienced.”

“You’re worried about your life, your safety, the life and safety of the loved ones. Will we make it tomorrow or tonight?” He said, adding the prolonged bombings meant that Israelis and Palestinians were constantly re-experiencing the trauma without having a chance to cope with it.

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Trauma affects you too

According to Elkchirid, even just the threat of harm to a loved one can trigger a traumatic-like experience and manifest into what is known as secondary or vicarious trauma.

“Individuals who are here, for example, in Waterloo or Toronto or Kitchener might think that what took place thousands of miles away did not affect us,” he said. “It actually did.”

People who are suffering from secondary trauma may exhibit uncharacteristic anger and irritability, feeling overwhelmed, fatigued, emotionally numb or hopeless, engaging in self-destructive coping mechanisms, diminished concentration and experiencing trauma imagery, which is seeing events over and over again.

Without a peaceful solution to the issue causing trauma, Elkchirid, who specializes in social work practice with refugees, and survivors of trauma from war and torture, said survivors and their loved ones will keep re-experiencing trauma on a periodic basis.

How to support friends and loved ones

When a traumatic event occurs, Dr. Eliana Suarez, an associate professor at Wilfrid Laurier University, says that a person’s amygdala, which is the centre of the emotions in the brain, becomes activated and highly charged.

Suarez, who specializes in trauma and resilience in post-conflict, says the broca area — which is responsible for language — becomes flooded with emotional memories, leading to higher cortisol or stress levels. PTSD occurs when the nervous system gets “stuck.”

“You have these memories and they don’t leave you alone,” she says.

According to Suarez, “we are wired to survive” and adapt, regardless of what happens.

But how a person heals from trauma depends on how safe they feel in their new environment and the traumatic event has passed.

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“The basis of many interventions is actually reducing those life stressors for people who are survivors of trauma and just providing some sort of social support,” she says.

Suarez said raising awareness and advocating for peaceful resolutions, rather than overwhelming a PTSD survivor with more confrontation can help them feel both empowered and supported.

Encouraging PTSD survivors to channel their trauma outward into helping others, volunteering with members of the community and performing acts of service can also help foster a person’s resilience.

“That kind of focusing on others than yourself is one of the first expression of the person, this kind of resilience,” she says.

According to Suarez, a person who has undergone even a single traumatic event will likely enter a new state of normalcy — but it isn’t a return to what they had before.

“You go back to actually moving forward,” she says. “People are not only surviving, but they also can be thriving after that.”