Jewish shrink helps Israelis and Gazans deal with trauma

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As diplomats, politicians and activists try to curb the injury and death tolls on both sides of the Gaza-Israel border, a Jewish psychiatrist is trying to heal the wounds that can’t necessarily be seen: those related to mental health.

It’s not often that a Jewish psychiatrist is spotted in the Gaza Strip. In the narrow territory home to more than 1.6 million people, psychiatrists and psychologists are rare and the public is wary of the mental-health professions − even if the practitioners are local.

But a professor of psychiatry from Georgetown University medical school has won acceptance there. On Dr. James Gordon’s 18th visit to Gaza from his native Washington, DC, as hostilities were starting to escalate in September, he was greeted warmly, he said, by high-school girls in hijabs, women in wheelchairs and groups of unemployed men.

They share a problem that is exceedingly common in Gaza: post-traumatic stress disorder. More than 50 percent of the local children and adults suffer from it, Gordon says.

For years, even before the violence turned again this month into a full-fledged war, Gazans have heard weekly and sometimes daily echoes of Israeli drones and air strikes against suspected Palestinian fighters.

Next door in Israel, communities near the border have also suffered years of unpredictable rocket fire from Gaza militant factions. Now hundreds of thousands of children on both sides have witnessed witnessing daily explosions and destruction − and in some cases casualties − with the scores of rockets that have hit Israel and scores of aerial strikes in Gaza.

Treating the silent casualties of war is urgent and transcends politics, Gordon, 71, told Haaretz. “Mental health is neglected, even in very good relief efforts.” An expert on psychological trauma and its treatments, Gordon has been working in conflict and disaster zones since 1995 with his Washington-based nonprofit Center for Mind-Body Medicine. Gordon and his CMBM staff teach health and mental health professionals drug-free ways of helping patients suffering from PTSD and depression through mindfulness, deep breathing, art, dance and writing therapy, guided imagery, biofeedback, meditation and exercise, dietary changes and communication. Participants learn these skills with the goal of helping themselves.

In 2002, at the height of the second intifada’s suicide bombings in Israel and the army’s strikes in Gaza, an Israeli psychologist and a Gazan psychologist who had heard about Gordon’s work in Kosovo invited him to visit. Gordon flew in and found PTSD and depression widespread among both populations. PTSD symptoms include flashbacks, poor memory and concentration, trouble maintaining relationships, disturbed sleep, crying spells, and self-destructive or aggressive behavior.

Over the years, Gordon raised $2.5 million for an Israel trauma care program, primarily from American donors and foundations and a small Israeli government grant. For the Gaza program, he raised $6 million, most of it from the Atlantic Philanthropies foundation. He flies back twice yearly to lead training and spend time with the locals and his staff.

“My family fled pogroms in Russia and Poland in the early 20th century and I grew up during World War II,” said Gordon. “Later I was so overwhelmed and impressed by stories of how people in the Holocaust managed to survive physically and psychologically it inspired my interest in helping people at the end of their rope find their own inner strength.”

After receiving his MD in psychiatry from Harvard in 1967, Gordon found evidence for the efficacy of his practices in clinical research studies. He fine-tuned the methods in hospitals and homeless and runaway shelters, and in war-torn Bosnia and Kosovo, post-9/11 New York, Louisiana in the wake of Hurricane Katrina, and Haiti after the 2010 earthquake there. In 2008, the Journal of Clinical Psychiatry published the first randomized controlled study on children in war zones, looking at adolescents in his Kosovo groups, learning the self-care methods. The study reported a nearly 80- percent reduction in PTSD and depression after ten weeks in the groups. The US Army has since contracted Gordon to study his methods with combat veterans suffering from PTSD.

In Israeli communities along the Gaza border, PTSD and depression rates are high and are much worse after rocket attacks from the Strip, Gordon said. “In Gaza they are always high.”

Gordon explained that there are tens of thousands who worked in Israel who are out of jobs, there is very little electricity, scarce and expensive water, ongoing noise from drones, sonic booms and air strikes in civilian neighborhoods, plus the fact that many people have lost homes, loved ones or limbs – creates a “sense of powerlessness that translates into behavior.

“I saw the same thing in Kosovo, Bosnia, Haiti, [and] I was asked to come to Israel and Palestine for the same reasons: violence among children ... [who] were frustrated and the aggression was boiling over.”

In Gaza, the trauma is complicated by having only a handful of psychiatrists with medical degrees, few practicing psychologists with more than a bachelor’s degree, and a public that rarely seeks mental health support.

“Many see depression, anxiety, hopelessness and aggression as ‘evil spirits’ and go to clergy as spiritual healers – they don’t [know about] psychology,” said social worker Jamil Atti, who oversees Gordon’s Gaza programs. To avoid the stigma associated with psychological treatment, CMBM advertises the groups as offering “mind-body skills.” “Most people come [to our groups] very skeptical but ... it is like magic, they start to open up, Atti said. “One 10-year-old boy who had suffered burns on his face [from an Israeli air strike against a Palestinian fighter] was suicidal and kept drawing himself in the beginning as a black face. By the end [of a 10-week program] he was able to find hope and draw himself as a doctor, helping others with plastic surgery.” Since 2005, the Gaza program has trained 420 health and mental health professionals, including staff members of hospitals and nonprofit organizations as well as 150 school counselors, through Gaza’s Ministry of Education. About 75,000 adults and children have attended groups run by these clinicians.

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