Treating post-war traumas

'We are now seeing the results of the war in terms of stress experienced by children and adults.'

By WENDY BLUMFIELD
bomb shelter 298 AJ (photo credit: Ariel Jerozolimski [file])
bomb shelter 298 AJ
(photo credit: Ariel Jerozolimski [file])
The war in the North lasted only a month, but the trauma can live on for years. Children are particularly at risk for post-traumatic stress disprder (PTSD), and their experiences and fears can affect them for a lifetime. Chi.LD (The Haifa Center for Children with Learning Disabilities) is no stranger to trauma therapy. The trauma center was established in Haifa in the aftermath of a series of terrorist attacks in 2002, in conjunction with the municipality. There was a need to help victims and their families, as well as the indirect victims - adults and children affected by an environment of fear and anxiety. The center functions throughout the year, offering after-school activities for children who would otherwise return home hungry to empty homes; an early childhood rehabilitative daycare center; and specialized therapies for children within the regular school system. Situated in a charming old stone building in the heart of the Hadar neighborhood, the center was at great risk during rocket attacks. During the summer vacation, the kindergarten and afternoon club are generally closed, but the war spurred the staff to work in the office and from their homes to plan the coming school year, particularly taking into account the urgent need to expand their trauma treatments. Sharona Stanhill, who came to Israel at the age of nine with her family from London, together with former American Leah Zryl, is responsible for resource development, coordinating fundraising and organizing sponsored walks and activities of support organizations in Israel and overseas. An occupational therapist herself, Stanhill is aware of the need to suit the therapy to the individual. "We are now seeing the results of the war in terms of stress experienced by children and adults - not only those who stayed in the area during the bombing but also those who took refuge away from their homes." Specific population groups are facilitated to work through their anxieties. "One group of elderly women in a pensioners' club actually saw rockets fall, and they are now working through their feelings of vulnerability," says Stanhill, focusing on one of the problems in this particular war when there was not enough time between sirens and explosions to take shelter. People with children in their arms, the elderly and infirm were highly aware of this time factor. Comparisons are made with the much longer blitz on Britain during World War II; but except for the rockets or buzz-bombs as they were called, the delivery of bombs was usually by regular fighter planes which - lethal as they were - allowed some warning time to get into shelters. The farther north one lived, the shorter the timespan between sirens and rockets landing. A seven-year-old child who lived on the top floor of an apartment block in Haifa begged to sleep in a neighbor's apartment on the ground floor because it was nearer to the building's shelter. "For adults too, habits and routines changed," says Stanhill, "and often past anxieties are reawakened." She describes her own fear of being caught out on the streets during a rocket attack when driving to or from the center. "People shopped or did necessary errands in a hurry, anxious to get home," she recalls. For parents, anxieties were exacerbated by the fact that many had to work, and the usual organized summer activities for their children had been canceled. In many cases, children were left alone without adults in the home. "Most schools have counselors and psychological services, so when the school year started some of these post-traumatic stress disorders could be picked up. Disadvantaged children often slip through the cracks due to lack of communication and language difficulties, and our first job was to find those most at risk." The center is accessible to the entire Haifa and northern region, but the daycare and afternoon clubs focus on neighborhood children. The founder, family doctor Dr. Jeremiah Lubasch, is himself the father of a large family. Therefore, the needs of the large haredi community on the Hadar are integral to the facilities offered at the center. The other disadvantaged population groups are Arabs and new immigrants, and it is in these families that parents work long hours while children finish school and return to empty homes. Taking refuge with family or friends in the center of the country did not protect victims entirely from trauma. Watching TV one evening, this writer was impressed by a group of mothers sitting in swimsuits on Nitzanim beach, where they had taken refuge in the tent city provided by millionaire philanthropist Arkady Gaydamak. The children were playing, some families were snacking, and the scene looked like a holiday camp - until one looked at the mothers being interviewed: Most of them were weeping. One little boy whose family relocated with relatives to the south of Tel Aviv was fearful and sleepless every night until his father returned from his commute to work in Haifa. Each evening he asked his father to draw a map showing how far it was between Haifa and where he was staying. "Moving large families out of the area during the war was not an easy option," agrees Stanhill. Despite the extraordinary generosity of citizens who opened their homes, sometimes to complete strangers, alternative accommodation was nevertheless often uncomfortable and crowded. Even in loving extended families, relationships were often strained as in-laws coped together with active and lively children deprived of their routines, friends and summer activities. The first step in planning the trauma therapy was to coordinate with school principals, teachers and social workers in populations that were specifically high risk. Adults and children who experience catastrophic events have varying degrees of trauma reactions. Some have worries and bad memories which, with the support of family, caregivers and communities, gradually disappear over time. Others may experience more long-term stress reactions and post-traumatic stress disorder. Symptoms can include constant fight-or-flight reactions, palpitations and panic, oversensitivity, sleeping difficulties, nightmares and flashbacks. There can be anger, denial and avoidance of emotional and social relationships, lack of self-esteem and feelings of personal failure. Many of these symptoms are similar to those of depression, but conventional treatments of depression are not effective. PTSD can occur immediately or months later and cause long-term concentration and functioning difficulties in school or at the workplace. Thus the trauma program originally created for intifada victims was redeveloped and made available to adults and children who suffered in the Lebanon war and need to move on. Creative therapies offer a way for people to express their feelings, thoughts and memories when words are not enough. Professional art, drama, dance and movement therapies are employed, while psychotherapy is offered to help victims discuss their trauma and build inner mechanisms to help them cope with their feelings and fears. Individual therapy and support groups are offered according to the victims' needs. One innovative therapy is called eye movement, desensitization and reprocessing (EMDR). It combines principles of neuroscience with elements of therapy and uses visual and audio stimulation to help victims express terrifying memories. A unique feature of the center is the Snoezelen Room, a non-threatening environment that includes sensory aids which provide auditory, olfactory, visual and tactile stimulation while, at the same time, being calming and safe. The room incorporates a variety of light projectors, shimmering optic fibers, serene music, vibrating bubble tubes and safe padded textures, a water mattress and soft bean bags. Gail Suskin, originally from South Africa, is a professional dance and movement expressive therapist. She studied the therapy of the Snoezelen Room at Beit Issie Shapiro in Ra'anana and now teaches at that center. "This is a safe place where children or adults traumatized by effects of war can begin to communicate, regain confidence and rebuild trusting relationships" says Suskin. "It's like going back to the womb." Mothers and babies, too, benefit from this environment. A baby is born from the safe, dark, warm body of his mother where his systems work without effort, into a harsh, bright, noisy world where he has to learn to feed and activate his body - described by American psychologist and philosopher William James as a "buzzing booming confusion." After giving birth, mothers are raw physically and emotionally and, apart from adjusting to their own changing needs, are learning to tune in with their babies. "We see such a calming, soothing effect on the mother and the new baby in this room," says Suskin. Pregnant women and new parents were under specific stress during the month of war, with maternity wards moving into crowded hospital basements and babies brought home to an unpredictable routine and environment. New mothers are particularly vulnerable to fear and anxieties about their babies' dependence and, in the most normal of situations, depression based on hormonal and life change are well documented. In regard to the value of art therapy on children, Suskin says, "We saw what we expected in their pictures: houses on wheels, guns, fire." The original funding for the Snoezelen Room came from a Dutch foundation and other private sources. The most recent fundraising focus was for therapies to deal with the present crises. One project covered by this funding will be the renovation of the pet corner. During the war, volunteer Elsa Morvin came in daily, dodging rockets to feed and care for the animals. However, the pet corner was vandalized during the summer and is now due to be repaired with more secure fences and stronger cages. Morvin, a dance teacher who immigrated from Russia 40 years ago, raised seven children together with several animals. She firmly believes in the value of bringing nature and animals into the lives of children. In Israel and overseas, funds are being raised by organizations and individuals who understand the urgency of caring for the more vulnerable in society. Stuart Palmer, a volunteer fundraising coordinator for the Haifa center, compiled a book of his wartime blogs. One of the many hats he wears is that of hasbara, lecturing and writing for the media and Jewish and Christian groups overseas. He has combined two of his interests by donating the proceeds of this book to ChiLD. As the cycles of violence ebb and flow in Haifa and the North, ChiLD meets the challenge of healing those who are traumatized and helping them move on beyond the nightmares and fears. The Center for Chi.LD is located at 16 Rehov Arlozorov, Haifa. Tel: (04) 867-8758