As reported by CNSNews.com, May 28, 2004.

Israeli Children Show 'Amazing Resilience,' Experts Say

By Julie Stahl

Jerusalem (CNSNews.com) - Despite nearly four years of ongoing terrorism, Israeli children and adolescents have shown an "amazing resilience" for coping with trauma and pressing on with their lives, mental health professionals from Israel and the U.S. said.

Experts from Israel and the U.S. recently gathered outside Jerusalem this week, for a conference on treating traumatized children and adolescents. The conference is part of an ongoing bi-national effort to protect children from terrorism and violence and to develop treatment for traumatized children.

"The main focus of this conference was to create a dialogue between experts from the United States and Jerusalem around common issues, how to treat traumatized children," said conference organizer Ruth Pat-Horencyzk, who directs clinical services for children at the Israel Center for the Treatment of Psychotrauma.

Dr. Danny Brom, director of the Psychotrauma Center, said the conference was part of project undertaken at the beginning of the Palestinian intifadah in September 2000 when the United Jewish Appeal Federation of New York approached several Israeli agencies to see how they could work to protect the children.

After the U.S. was attacked in September 2001, bi-lateral involvement increased, he said. "So the whole thing is basically about how to create a resilient society when terrorism is an issue that comes into the communities. It's not a war at the borders. Suddenly it's in each family," Brom said.

When trauma stems from terrorism or violence there is an "initial shock" and sometimes a sense of loss but if that shock continues, the child or adolescent may go into a "survival mode" instead of carrying on with his/her life, said conference participant Dr. Julian Ford, director of the Center for Trauma Response, Recovery and Preparedness at the University of Connecticut Health Center.

"Trauma is a state of shock. It's the body's self-protective response to being threatened," Ford explained. "Post Traumatic Stress Disorder (PTSD) is when...what we call an alarm or survival alarm reaction...continues even when the threat isn't present."

Ford works with parents and children who living in communities plagued by poverty, gang violence or family violence. "Much of the treatment is to help parents recover from their own alarm reactions so that they're not constantly pushing the alarm buttons for their children," he said.

According Pat-Horenczyk, Ford has developed a group treatment for traumatized children that Israeli professionals have adapted to the culture here.

The impact of terrorism on Israelis and Americans is different from personal traumatic experiences, such as child abuse and sexual abuse, said Shelley Horwitz, from the UJA-Federation of New York.

"Israelis are living in a very traumatic society," Horwitz said. "There's not been an end to the violence. There hasn't been the time to stop and grieve and mourn and put it behind them...

"[In the U.S.], we had really one large horrific event [9/11] and it had a lasting impact," Horwitz said. "We also don't have in many ways the preparedness. We don't have the mentality that here in Israel is automatic even on basic levels - opening up your bags [to show security guards the contents and] not picking up bags on the streets [which could contain bombs.]"

According to Horwitz, the "sense of safety" for Americans has been shattered and many expect that there will be another terror attack.


According to Pat-Horenczyk, a majority of Israeli children and adolescents have been exposed to terrorism, but they have shown a remarkable ability to rebound.

"The data shows that the majority of children and adolescents were exposed either directly or indirectly to terrorism - namely either they were present, or they lost somebody meaningful to them or they know somebody that was injured or they planned to be at the sight of the attack or were just before or after [at the site]...

"However, it is amazing...but the majority of people cope in a very remarkable way. They don't develop symptoms. They show resourcefulness and resilience," she said, adding that many Israelis volunteer to work with victims of terrorism or the poor as a means of coping.

Only about five percent of adolescents develop "full blown" symptoms of PTSD while another 10 percent suffered isolated symptoms such as anxiety or depression, she said. "But if you think about 85 percent of the youth, they cope and they maintain their daily routine," she added.

According to Ford, those statistics are very similar to those in the U.S. where two to five percent of the children will develop PTSD at some time, not necessarily related to terrorism.

"So under incredibly different circumstances - here we have a nation of incredibly resilient 'copers' and not just coping but really going on with life," he said.

Brom said there was a big difference between what is happening in Israel and what happened in New York where six to nine months after 9/11 there was still an "acute" response among Americans long after the situation was no longer acute.

In Israel, he said, people have gotten used to the threat where in the U.S. they've not yet adapted to a "new normalcy." Nevertheless, Israelis may end up paying a price, he said.

"I'm sure we're paying a price for [it] but in a way for the time being it works," Brom said. "The question is what will be after. That's a very big question. How can you wind down from such a thing?"

Television 'most traumatic' for Palestinian children

Palestinian psychiatrist Prof. Abdel Aziz Mousa Thabet from the Gaza El-Naser School of Public Health at Al Quds University in the Gaza Strip said he warned a decade ago about the long-term affects that violence would have on Palestinian children as they grew up.

Although the conference last week was an Israeli-American effort, Pat-Horenczyk also invited Thabet to speak, but she stressed that the invitation was solely a "professional" one and not based on any political interests.

"Professor Thabet is one of the best," she said. "He did very good research."

Despite the fact that a permit was obtained for Thabet to enter Israel and speak at the conference, he could not enter due to the situation on the ground. However, Thabet discussed the situation involving Palestinian children in a telephone interview.

Thabet said he had warned professionals in Europe for years about the consequences the first intifadah (Palestinian uprising) would have. That uprising began in 1987 and was all but over by 1991-92. People who were children then are now in their early 20s and exhibit more aggression, he said.

"It's very dangerous," he said. If the children have no faith, no hope and also their parents have no hope, the results will be similar. "I think peace is good for all of us."

Thabet estimated that about 23 percent of Palestinians suffer from PTSD. But, he said, the trauma is hard to classify as "post-traumatic" since the adversity is chronic.

According to Thabet, the most commonly used strategies by children in the West Bank for coping with their stressful situation are obeying their parents, trying to improve themselves and working hard in school. In the Gaza Strip, it is the same, he said, but they also pray.

The least common coping methods in both areas are taking drugs, smoking and drinking, he said, attributing that to the fact that these behaviors are not acceptable in their culture.

When asked what effect Palestinian Authority rhetoric, including calling on children to commit suicide and become "martyrs" has on the children, Thabet said the most common traumatic event was watching television.

Thabet said he has tried to persuade PA-controlled television many times not to show pictures of violence and tells parents during therapy not to allow their children to watch television.

In addition to gruesome news scenes, PA television often airs dramatizations of alleged Israeli army brutality and martyrdom stories, watchdog groups have said.

According to Thabet, for 91 percent of the children in Gaza and 95 percent of children in the West Bank, watching television (where they see mutilated bodies) was the most traumatic event, while seeing houses bombarded and artillery attacks on homes of neighbors were the next two traumatic events in that order.