“Many of the families are trying to get back to normal, but there is no normal.”
How do former hostages move on when the lives they once knew have been completely destroyed?
In the six months since the horrific Oct. 7 attack in Israel, some of the victims who were kidnapped by Hamas have been fortunate enough to be returned home. But even those who managed to survive this harrowing ordeal will never be the same: They face an increased risk of mental health issues, ranging from depression and anxiety to post-traumatic stress disorder, and in many cases, they no longer have families to return to.
Luckily, they’re being helped by a team of 450 psychoanalysts, including Dr. Ofrit Shapira-Berman, as part of the organization First Line Med. After we first spoke with Dr. Shapira-Berman in the weeks following Oct. 7, we caught up with her again to learn how the returning hostages and their families are doing, how women hostages in particular have been affected by the violence, and what’s ahead for those who made it out alive.
You spoke to Katie Couric Media last November after some hostages were freed from Hamas. How are they and their families doing now?
Most of them are not doing very well. They may be doing better than what we feared, but basically the trauma is being delayed. Almost all of them either have family members who are still in Gaza, or they’ve come back and found out their family members have been murdered. I’m treating a young woman who came back badly wounded. She’s been in the hospital for three months, and she will need to stay there another four months at least. She’s already had three surgeries, besides the two she had in Gaza, so she’s under a lot of pain. Whoever is not badly wounded just travels all over, from one rally to another, to speak on behalf of the hostages. So they’re really in a fighting mode. They’re not in the healing mode.
It’s very difficult for the families — many of them do not really understand the impact of being held in captivity. So I think many of the families are trying to get back to normal, but there is no normal.
We’ve seen horrific reports of virtually all of the female hostages being sexually abused. What are you learning about how this experience is affecting the mental health of women who were kidnapped differently than men?
I’m not sure that all of the ones who were released already were sexually abused. I think all of them were sexually harassed, that’s for sure. Abused — I think some of them were. Because they are all in a mode of fighting for the friends who are still there, I don’t think that they can really start their healing process. We are all extremely, extremely worried about the ones who [are still being held by Hamas]. We do know for a fact that some of them are very badly abused. We know that some of the hostages that came back were there to see it, so we have some of the details.
I do want to say, though, that they were all terrified of being raped. They were all being guarded by men and all were touched without consent. So they were very, very, very scared. But not all of them, of course, were sexually abused.
How does wartime trauma affect people who are actually involved with it?
They will be affected differently. The soldiers who are active will be less affected than the civilian survivors who were just caught in bed. And not only were they slaughtered and witnessed atrocities, but they also have no home to go back to. Their kibbutz was burned down. It’s still a war zone in many ways. They are also refugees, so that makes it a lot more difficult for them than it is for the soldiers.
What about their family and loved ones who didn’t necessarily experience being kidnapped or attacked themselves?
Most of them are in therapy. The organization that I’m heading is providing free long-term analytic therapy for all the people who were directly affected by the Oct. 7 [attack]. I am guessing that most of them just want to go back to normal life. And, of course, they’re very happy that their children or parents are back.
But I think it’s very different for the hostages who are back, because their situation is very delicate. For example, people are coming to the hospital day and night. They’re hovering over [the hostages who have returned] with gifts and money. They’ve all become very famous while they were not here. People can recognize them in the street, and they go over and ask questions. They have good intentions, but it’s not wise.
Is it possible to heal from a war that’s still raging on?
I don’t think so.
Why’s that?
Because there is a contradiction between being alert and healing. It doesn’t go together. There are therapists who believe you sort of have to encourage someone to go back to normal life and function. But I don’t think that that’s the best way to heal. Those people need a lot of time and something that is peaceful and safe and quiet to be able to process what is going on. And they can’t — everyone is talking now about the possibility of another war with Lebanon, with Hezbollah, with Iran. So, I mean, how can you heal?
I think everything will have to be over before they will be able to process what they’ve been through. And it’s not just about processing because, unlike other traumas, there are no holes in their memory. They remember everything. It’s more like being able to separate or distinguish between what happened before the war and what happened during captivity — and how to manage their new life.
What are some methods you recommend for those affected who are trying to recover from the trauma?
What’s most important for me is that they will have as much time as needed and a place where they don’t have to function or to be perfectly well. Many of them keep saying that people ask them, “How are you doing?” And they say, “Well, I’m doing okay.” I’m treating a young woman who’s not even 20 yet, and she has lost her entire family. She was in another shelter at the kibbutz and her brother called, so she picked up the phone and she heard everything — the banging, the shooting, the screaming, and then the silence. Whenever people ask her how she is doing, she says, “Well, I’m doing fine.” Now, of course, she’s not doing fine.
I want her to have a couple of hours a week when she can touch her pain. I want her to be able to tell me that she doesn’t want to live anymore in order for me to be able to understand why she doesn’t want to live. She told me, “I don’t want to digest what happened.” I understand what she’s saying, but if she can digest it, that means it’s possible to go on with her life.
And so I think everyone around them wants them to digest, to process, and to go on. And people tell them, “Well, it has been six months already.” And I’m saying, “Well, it’s only six months, it’s nothing.” So the one thing that I would recommend to anyone is first of all, to see a therapist and to see someone who has time and who has the patience to just be there for as many years as it takes. And there is no rush for them to function.
Is there anything that gives you hope for these families and these survivors?
I’m actually quite hopeful for the ones who are back already. I think most of them are going to be okay. Eventually, they’re going to be okay. Many of those who were released, they’re not the ones who were most horrifically abused. The ones have stayed behind — I’m less hopeful for them.
This conversation was edited for length and clarity.
