BE'ER SHEVA, ISRAEL -- When militants launched a barrage of rockets against citizens of southern Israel during a prolonged conflict in 2008, Dr. Gabriel Schreiber was called to treat a woman who was in an unresponsive state from war trauma, unable to get out of bed.
The woman was visiting relatives in Ramle, in central Israel, when the conflict broke out. One of the rockets hit in a garden that her children had been in a short while earlier. The idea of her children potentially dying because of her decision to visit relatives in the danger zone was too much to bear.
But Schreiber, director of the Psychiatry Department at Barzilai Medical Center in Ashkelon and dean of the Faculty of Health Sciences at Ben Gurion University of the Negev, had plenty of experience to draw from. He has been treating victims of trauma and post-traumatic stress disorder for many years, in this country that has been in a perpetual state of conflict since its war-torn founding in 1948.
All Too Familiar
As rockets again put more than a million Israelis in harm's way this week, Schrieber met with a team of visiting journalists. He spoke about lessons he and other researchers have learned -- lessons that can be useful around the world for treating soldiers and veterans, as well as civilians affected by the traumas of war.
Dr. Schrieber explained that clinicians have learned to follow three guidelines based on experiences of the Israeli army treating combat soldiers:
1) Treat the victim in proximity to where the trauma occurred;
2) Deal with it immediately; and,
3) Assure the victim(s) that feelings of stress are understandable and to be expected, though they are expected to recover from the experience.
"Sometimes you have to be not only empathetic but clever," said Schrieber in our interview in Be'er Sheva this week. Indeed, as he spoke, the city was on high alert following the latest round of clashes that began last Friday, when Israeli forces struck Palestinians they said were about to carry out a terror raid.
In the case of the young mother, Schrieber treated her by first having her sit in a chair instead of bed. When he began discussing her children, there was some sign of reaction, but still no speech.
When he suggested to her husband that he take the children home and leave the mother to recover where she was, the mother finally began to cry and talk about her feelings.
"This opened her up," said Schrieber. "If not, she would have had post-traumatic stress disorder."
Schrieber, who is researching a method to predict how patients will respond to anti-depressants based on the molecular structure of brain cells, has also completed a soon-to-be published study of the impact of continuous rocket barrages on Israeli society.
He says he found that constant preparedness at the workplace and at home, helps Israelis feel more secure. New construction regulations require all buildings to include emergency safe rooms and older buildings to be retrofitted with them.
"This structure creates safety," he said, referring not just to the physical reality of safety, but to the psychological sense of safety, as well.
As a result, he sees children who have grown up with bombardment as part of their life for the last decade coping relatively well. "Their resilience is better than that of adults," he said.
A Widening Arc
Schrieber's work has become more important as war-related trauma that comes from living under bombardment has spread in Israel, with the range of rockets from enemies in Gaza and Lebanon increasing. While once only outlying border areas were affected, large cities like Ashkelon and Beer Sheva are increasingly hit by the attacks.
Schrieber has found that people in smaller communities cope better with the attacks. That's because in Israel, small communities, such as religious settlements and kibbutzes tend to be more "ideologically cohesive" than urban areas.
Although the country is living under a much larger threat in the form of a potential nuclear standoff with Iran down the road, it has come to accept that the current rocket bombardments, though potentially deadly, are not an existential threat.
"Out of 100 missile attacks, only one person has been seriously injured," said Schrieber. "We can live with it. We are proud of our resilience. Maybe we are a bit crazy."
Schrieber isn't the only Israeli expert on trauma. Edna Foa, a professor at the University of Pennsylvania, developed a treatment technique for PTSD after the start of Israel's so-called Second Intifada in 2000 and has been applying it for treatment of American veterans, as well.
Adam Dickter, writing for Sci-Tech Today, is taking part in a journalists mission to Israel to view scientific projects. The mission is sponsored by American Associates of Ben-Gurion University.