Even mental health professionals are impacted by Oct. 7 trauma

The attack of October 7, and the intentional dissemination of graphic content by Hamas, brought into sharp relief the extended reach of such trauma.

 A SEASONED psychiatrist from Connecticut, Dr. Ilan Fogel, found his visit to Israel unexpectedly extended as he felt compelled to help those traumatized by the war. (photo credit: Aviva Maller Photography)
A SEASONED psychiatrist from Connecticut, Dr. Ilan Fogel, found his visit to Israel unexpectedly extended as he felt compelled to help those traumatized by the war.
(photo credit: Aviva Maller Photography)

In the quiet of Kibbutz Yavne, Dr. Ilan Fogel’s holiday was interrupted by the October 7 massacre. A seasoned psychiatrist from Connecticut, Fogel found his visit to Israel unexpectedly extended as he felt compelled to help those traumatized by the war. His decision marked the beginning of an intense, three-week period providing psychiatric care to victims, an experience that would leave him with a haunting reminder of the insidious nature of trauma.

Fogel’s own ordeal began upon his return to the United States, where he says, “Everything fell apart.” Unable to eat or sleep, the cumulative weight of the harrowing stories he had absorbed overcame him. Intensive treatment followed – a sober reminder that even veteran mental health professionals are not immune to the effects of trauma.

His experience is a case study in vicarious traumatization, the psychological affliction that arises when individuals – be they mental health professionals or laypersons – empathize with those who have endured trauma and are exposed to their distressing narratives and images.

A documented horror

The attack of October 7, and the intentional dissemination of graphic content by Hamas, brought into sharp relief the extended reach of such trauma. It underscored how modern technology can be weaponized for psychological harm, extending the battlefield into the minds of the global population. 

The human brain processes images at 60,000 times the speed that it processes text. Its ability to absorb and retain images swiftly means these traumatic visuals become seared into memory, often resurfacing unbidden, despite the therapeutic interventions aimed at mitigating their emotional impact. Symptoms of vicarious traumatization can mimic those of Post-Traumatic Stress Disorder (PTSD), and include extreme sadness, difficulty sleeping, trouble concentrating, or emotional detachment. They may even precipitate a crisis of faith. Irrespective of age, experience, gender, or profession, it is impossible to accurately predict who will fall victim to its grip on the psyche.

 People gather and light candles to remember the victims who were murdered by Hamas militants at Dizengoff Square in Tel Aviv, October 17, 2023.  (credit: TOMER NEUBERG/FLASH90)
People gather and light candles to remember the victims who were murdered by Hamas militants at Dizengoff Square in Tel Aviv, October 17, 2023. (credit: TOMER NEUBERG/FLASH90)

This issue came to the forefront of public discourse when Prime Minister Benjamin Netanyahu reportedly considered fully releasing a documentary of these events to garner support for the war. In a controlled showing last month in the Israeli parliament, this same documentary resulted in several members of Knesset leaving the plenum in tears, requiring psychological intervention at the scene. One member fainted at its conclusion.

At present, the Israeli government is tightly controlling who views the film and how. After a private screening, psychologist and television personality Dr. Phil McGraw, better known as Dr. Phil, stated “I was sickened by video images I can never unsee.” Nevertheless, curiosity has many still eager to expose themselves to its graphic content despite the potential long-term effect on their mental health.

Many of the arguments circulating relate to being informed and aware of current events. The reasoning goes that we need to bear witness, as the documentary’s title implies, and this is not an incorrect assertion. However, in the same way that we acknowledge the rigors of becoming a surgeon will be tolerable for very few, so too is exposure to violent and graphic material. Even those who could legitimately claim to require such visuals for professional purposes are carefully navigating these waters. The Media Department at United Hatzalah, for instance, deliberately instructed its staff to filter videos and content of a disturbing nature.

A vicious cycle

Research has indicated that traumatic events perpetrated by man create significantly more psychological distress than do natural disasters. The psychological impact of human-induced violence, such as that witnessed on October 7, is profound, challenging our fundamental beliefs in the world’s safety and humanity’s inherent goodness. In the aftermath, many citizens of the South grappled with shattered trust in their government and military, and some, like a mother from Sderot who witnessed the violence firsthand, expressed a deep-seated loss of trust in her ability to protect her children.

FOGEL RETURNED to Israel several weeks ago under strict instructions not to provide treatment of any kind. Instead, he picked produce, volunteered on army bases, and delivered needed supplies to soldiers. The manual labor was part of his healing process, and his return was “the best possible thing I could have done.” Nevertheless, he says, upon arriving at El Al security in the airport, he burst into tears. The scars of his experience are still raw, a stark reminder of the pain that vicarious trauma can inflict, even on those trained to confront it.

The memories of October 7 linger, not just in the scarred landscape but in the collective psyche. Recognizing and addressing the insidious spread of vicarious traumatization is crucial. As we strive to rebuild and move forward, let us remember to protect our minds with as much care as we protect our homes and communities. 

Safeguarding our mental well-being in this digital era is a crucial challenge. Recognizing the power of choice in engaging with traumatic content and arming ourselves with the knowledge and tools to prevent psychological harm is paramount. Deliberate, mindful decisions, and a personalized, honest assessment of what we can and cannot tolerate is the best possible way to avoid incidental harm, and the invisible wounds of traumatic events.

The writer is a clinical psychologist practicing in Israel. She is a certified trauma specialist and a senior member of the United Hatzalah Psychotrauma Unit. Dr. Ilan Fogel is a board-certified psychiatrist residing in Connecticut. He is AVP of clinical development at Eli Lilly, and the proud father of two IDF lone soldiers.