After more than two years in captivity — exactly 738 days — Hamas released the twenty adult Israeli hostages still alive who had been held in the Gaza Strip. The first seven were released a few minutes after 07:00 AM.; the remaining thirteen were released shortly before 10:00 AM. Italian time. From the television images, they all appeared to be in reasonably good health. But what invisible wounds would they carry with them? How does one survive an experience that distorts one’s perception of time, of the body and of trust? Meanwhile, on 7 October, Roei Shalev, a survivor of the Nova Festival massacre, took his own life after witnessing his girlfriend’s death two years earlier. A few months earlier, 22-year-old Shirel Golan also took her own life. How does one live with survivor’s guilt? To discuss these issues, we spoke to Noemi Grappone (pictured), a psychotherapist who specializes in trauma resulting from war and violence, and an EMDR supervisor.
Dr Grappone, what are the psychological consequences of such prolonged kidnapping and imprisonment?
Kidnapping is an extremely traumatic experience that can lead to post-traumatic stress disorder (PTSD), dissociation, memory impairment, and an altered sense of self. Surviving does not mean returning to your former life. It means living with intrusive thoughts, flashbacks, sleep disorders, relationship difficulties, an inability to experience pleasure, depression and dissociation. It can also lead to feelings of guilt upon release towards those who are still detained or who died during the kidnapping. PTSD can cause an individual to freeze or become hypervigilant.
It is a profound trauma that requires time and highly specialized treatment.
How does one’s perception of oneself and the world change during captivity?
There is a loss of trust in others, in the world and in one’s own values. Those who have experienced captivity no longer have any points of reference, be it family, relationships or politics. An identity crisis develops:
“Who am I now? How can I reintegrate into society? How can I return to a normal life?”
What mental survival mechanisms are activated in conditions of isolation and deprivation, when you don’t know if or when you will be freed?
In order to survive, the mind triggers forms of dissociation.
However, when the brain becomes accustomed to this dissociative state, reintegrating it becomes more difficult. This requires highly specialized intervention with specific tools to rebuild internal connections and ‘reintegrate’ the dissociated part of the brain.
Is EMDR an effective treatment for these cases?
Yes. EMDR was originally developed for veterans and war survivors. While it is a powerful tool for dealing with complex trauma, it does need to be adapted and personalized.
How long does the healing process take?
Years. Liberation does not mark the end of trauma. It only ends when the past is truly left behind and the person embraces the present and a new perspective. There is no need to rush back to normality.
For those who have experienced horror, normality feels like a rebirth.
What should be done in the first few days after release?
Psychological support must form an integral part of the humanitarian response.
We cannot save a body and forget about the soul.
Telling their story requires listening, time and space, but this can only happen once they have come to terms with your own history. Remember, there is no need to rush, as physical liberation does not coincide with psychological liberation, just as physical healing does not coincide with spiritual healing.
When considering the two suicides of 7 October survivors, what thoughts might go through the minds of those who escaped a massacre?
Surviving this kind of massacre is hugely traumatic, made worse by the presence of the perpetrators. It is not a natural event, but the result of human barbarity. Survivors live in a state of ongoing trauma that is very difficult to overcome. Unfortunately, news reports and anniversaries can reactivate all the cruelty of the event, exacerbating the pain. There is such a thing as anniversary syndrome. Without treatment and in conditions of loneliness, these traumas can become lethal.
So, what message can we offer to those who are now emerging from years of nightmares?
The trauma must be recognized and addressed. They need timely, highly specialized, personalized care. There are no universal answers. Everyone has the right to treatment, dignity and rebirth.
