Episode 133: An Israeli Trauma Therapist on Healing After October 7 [Transcript]

Narration is in bold. 

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Nahanni Rous: Hi, it’s Nahanni Rous. Welcome back to Can We Talk?, the podcast of the Jewish Women’s Archive, where gender, history and Jewish culture meet. 

This month, the last twenty living hostages returned to Israel after two years in Hamas captivity, and a ceasefire began. But the effects of the violence on survivors, their families, and Israeli and Palestinian society will take decades and maybe generations to recover from.

Merav Roth is a trauma therapist and psychoanalyst in Israel who has been working with survivors of the Hamas massacres, with released hostages, and with their families. This time on Can We Talk?, Merav tells us how some of the hostages coped in captivity, what it’s been like to work with them, and what long-term recovery from trauma can look like. Just a note that this episode contains descriptions of violence.

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Immediately after the Hamas attack two years ago, Merav and two colleagues organized hundreds of therapists to provide emergency aid to survivors. On October 9, Merav met members of Kibbutz Be’eri at the hotel they had been evacuated to. Some had seen family members murdered; others were raped or fled homes that were set on fire.

She stayed and worked with them for weeks. For the past two years she has continued to work with survivors of the massacre and with hostages released in every round of agreements—including the most recent one. Based on her experience, she has also written professional guidelines for working with released hostages.

Merav Roth: The first thing they need from the psychologist is to hear that they have a story, a life story that is not beginning and ending with the captivity. 

Nahanni: Hmm. 

Merav: It began before. It continues after. And therapy is the place where they need to, you know, interweave the threads of the self.

You know, the first thing I told them was, don't let anyone keep you locked in the terminology that you are a hostage or even a released hostage. And I asked them, Tell me a bit about yourself before captivity. And they opened their eyes widely because until then, everyone talks to them about captivity or here and now. So either they're trying to see if they're okay, in many ways, or they're trying to see what they went through, which is very crucial, of course, but working with trauma leads someone to a potential threat of collapsing into traumatic time. 

So when we are asking them, Tell me about yourself before, they immediately—the unconscious hears you and says, Wow, yeah, that's right. I'm a person, I'm a person in the world. They need to regain their sense of humanity, of being a human being in the world that had a past, that had hobbies and friendships and values.

And then the second thing I wrote in the protocol to ask them is, How did the things that you were help you during captivity? And when I asked them, they started smiling and one said, "I love music so much. And I kept hearing music." And I was naive enough to ask him, "Wow, they let you hear music? "And he said, "No, I was chained by my feet, but I played music in my mind and it helped me." And I said, "This is so unbelievable and amazing that you found this way from within, that you brought with you to the situation in order to help you to survive."

Nahanni: If you could pick one or two stories—and you’re starting to do this, but—stories of people that came out of captivity that have been really inspiring to you. I think that would be very helpful. 

Merav: There are many actually, but one is Keith Siegel. He came out in the second agreement, after a year and a half. He told a story that is very small, but very big, I think. He said, "When I was in captivity, I couldn't move. I was paralyzed almost. I didn't have any strength in my body. And I was lying down for six months. And one day, someone opened the window just a tiny bit. I was in darkness for a long, long time. And then he opened the window just a tiny bit and I saw the sky and I said to myself, 'Wow, this is something I should bless that I see the sky. And then there was a bird crossing and I said to myself, 'Oh, thank you God for letting me see a bird.'"

And it was a small story that tells so much about the ways people in captivity keep themselves in one piece. They are connected to nature, they are connected to good, they are connected to their values, and they collect them as gold. Every small piece of a good world, the right world, a valuable moment, they collect and they hold and they nurture. And this is, I think, extraordinary.

Nahanni:  Hmm.

Merav: When I was working with released hostages, they [told] me how they spoke with their family members every day in their imagination, of course, and they told them, "I am okay, and you keep being okay. I wait for you and you wait for me." And there was this contract. It was more important for them to survive for the sake of their family members, beloved ones that await them. One of them told me, "I felt I'm more lucky than them, because I know what's going on with me, but it killed me to know that they are probably worried to death."

And the other story that came to my mind is Tal Shoham, who said that every night after a day of suffocation, no food, no air, beating, torture, they sit, the four guys in the tunnel, in the small tunnel, they sit together and they ask each other if there is anything that hurt them today, anything that someone wants to share. 

So what I think is very moving, is that morality, human ethics, is a medication. Love is a medication. The strongest medications that there are, and it was holding these people together, both in their—in internal relations in captivity and in their imagined relations with their family members and also religious or spiritual thoughts, feelings, tendencies were very influential and also grew in some of the hostages in a very meaningful way. 

Nahanni: I can't imagine that there aren't lasting effects or damage, you know, done to a person. How much healing is possible?

Merav: You know, it's interesting. We are—in Israel, we are a state that is built on traumas. I'm second-generation to a Holocaust survivor, and I keep remembering our intergenerational traumas and wars and all that we've been through. I keep remembering it also as a reminder of the ability to recover.

There was a moment, it was at the beginning. It was the second week after October 7. One of those moments that I will always remember. There were two kids that—we came into their room with the state’s social worker to tell them that both their parents were murdered. 

And I came into the room and I was behind the social worker that told them. And then it was our turn, and I was there with my husband—my husband is also a psychologist, so we were both there. And then it dawned on me, and I said, "You know, kids, my father and Danny's father, my husband, lost their parents in the Shoah, in the Holocaust, and they became our loving, happy fathers, and we are their children, and we have children and we are here with you."

Nahanni: Hmm. 

Merav: I was hoping and praying that their unconscious hears something. I was certain that they cannot really see and hear and understand anything clearly. But I keep saying it also to the therapeutic community here: Israel was built three years after the release of Auschwitz. So we know that you can build a future after huge atrocities. But at the same time, we know that these people will have traumatic symptoms for the rest of their lives and also intergenerationally.

And we need to hold both. I don't aspire for them not to have traumatic syndrome and traumatic symptoms and traumatic effects throughout their lives. But what I want for them is not to have only this. And I think if you work with these people, and I know—I work many, many years with traumatic loss, and I do know and believe that they can have a life alongside their traumatic loss. And this is what we want for them. 

Nahanni: Mm-hmm. 

Merav: I will add one little thing that  I was talking about with the released hostages—it's a group that I'm conducting in my office. And they told each other that people call them heroes. And it's so silly. Why do they call them heroes?

I said to them, "You know, when you were in captivity, in order not to collapse you and in order to survive psychologically you needed to use and to maximize your psychological capabilities and your spiritual path and capabilities more than any other person ever. This is truly an amazing development. You have been through a truly unbelievable psychological and spiritual development that kept you in one piece. Otherwise you would not talk to each other and to me right now."

Nahanni: Mm-hmm. 

Merav: And you don't even know yourselves what strengths you gained during this terrible, horrible experience. But you will find out. And when I told them that, they began talking about the things that they find out about themselves right now that surprises them. 

Nahanni: Mm-hmm. So they're thinking, Why are people calling us heroes? We didn't choose to do this. But you're saying that the choice and the power is in their response. 

Merav: Yes. It is a true one. 

Nahanni: Mm-hmm. I was thinking as you were speaking about sharing your grandparents' story and your parents' story, that this seems like  an unprecedented situation that has called on you to enter it maybe more fully as a person than you might otherwise be used to doing professionally. 

Merav: Absolutely. Usually people who went through radical traumas, they divide the world to those who understand and those who don't.So of course, it's not possible that all the therapists will have the same experiences as our patients in order to help them. But I find it useful in certain moments, it's counteracting the cruelty and the murderousness that they faced through a very warm and direct human connection, first of all. And it includes flexibility, both in the setting— we went to the houses where the evacuees went. Wherever they were, we were. 

Nahanni: Mm-hmm.

Merav: So I met one of my patients from the first agreement. I went to the house she was evacuated to for months. And her daughter would cling to her, and friends were there and her mother was there. We sat in a corner and we talked. And sometimes it was two hours and sometimes it was 15 minutes. How much she could take, I was there. Because the psychological state required flexibility.

Nahanni: Yep. Have you had experiences in the past two years that have changed the way you thought about trauma and healing? 

Merav: I think one of the most impressive things that I realized is that morality and the spiritual state is sometimes the thing that holds the whole system.

When someone feels, uh, completely disoriented, confused, humiliated in agony, in pain, extremely afraid—they feared from moment to moment to moment to moment for two years or for a year and a half that someone can shoot them in the head because that someone was there in the room with a gun or near and could come any moment.

Some of them were asked to dig their own grave, and then they would say, "Ah, okay, we don't shoot you." And they go back to the room. Some of them were forced to see someone tortured and do nothing, and they suffer terrible, blame, self-blame. And of course, a lot of violence and sexual violence. So a lot of very, very extreme agony.

So when you are in complete agony, you have this internal human understanding about what should be and how I was supposed to be treated. These notions, which are so abstract in a way, they are also very basic and crucial for the psychological survival. 

So this is something new for me. I didn't think about it in this clear way until I've heard the released hostages telling me again and again and again how they held their notion about what should be and how a human being is supposed to be treated as a way to hold their whole psychological system in one piece, in the most dreadful situation one can imagine.

Love and ethics. Love and ethics—and imagination. Love, ethics and imagination are like three cures that interweave and that combine forces and they keep you going in very, very radical and intimidating situations.

Nahanni: Can you talk about any ways that men and women might experience trauma and healing differently?

Merav: I think in captivity, the women, on the one hand, they are more threatened because they're threatened to be sexually abused. It's not that it didn't happen also with several hostages [who are] men, but women are very afraid for their body to be used. And, you know, in interviews and research, we know that sexuality is a weapon.

So this is one thing that differentiates, that women were extremely afraid of this aspect. And some of them had to go through it. Some of them had to see someone who is taken, uh, in and out, in and out from the room, knowing that she's going through it. It was really one of the harshest parts of the captivity for women.

On the other hand, women knew, most of them knew and believed that they will go out first, and that they are a good card in the hands of the Hamas, so that they will keep them in one piece and bring them together back in order to get the terrorists out of jails in Israel.

So this, on the one hand, it helped them feel, Okay, we will survive. Most of them tried to believe that and hoped, although they were afraid to die every moment.

Again, transgenerational trauma helped. One of the families that I work with, the grandmother who was held with her daughter and the, and the grandchildren, her ancestors' traumas from the Holocaust helped he. Again, seeing a future for these—for her daughter, for her grandchildren, telling them stories, imagining things, playing together. She remembered—the mother remembered her grandmother saying how she played with a doll during the Holocaust, so she played with the kids in captivity. So I think there is a certain flexibility and ability to contain vulnerability that is more, um, more used by women.

Nahanni: Hmm. It's very interesting that you would say that intergenerational trauma could be helpful in these situations.

Merav: Yes, yes, yes, yes. I have quite a few stories showing this both on me and on patients. Yes.

Nahanni: So I want to ask you now about the bigger picture in this situation, because these are, I mean, many, right? Hundreds of people affected on a very personal level, but then there's an entire country, an entire society, and in fact, two entire societies that have experienced an unbelievable saga over the past two years on both sides.

Merav: There is a huge report that came out just three days ago or something like that, by the state government Minister of Health, speaking about the psychological and health state of the general society in Israel.

And it is alarming. Sixty-eight percent of the society suffers from high levels of depression or anxiety. Forty-five percent of the general society have potential PTSD. Sleeping disorders, violence in the families. It's really alarming.

And, I think first of all, it shows something that is very sad, but also moving, that people identify with the sorrow of others, because it's not that all the society was directly affected by what happened on October 7. 

Nahanni: But on the other hand, everybody has been in this emergency, in this war, in this, you know. Missiles from Iran and—

Merav: Exactly. Everybody are threatened for two years. We're in [a] terrible war. Our kids die in this war. Our sons and daughters who become 18 and this country, surrounded by countries that we are not in peace with. Everyone has to go and enlist to the army—my daughters and everyone. So it's very, very harsh on the psychological system to be in the war for two years.

And also the devastating humanitarian crisis in Gaza that we are also confronted with. And, you know, as a second generation, I was taught two things: A: always defend yourself and Israel is very important because Jews have to have a state, so we need to defend ourselves. But there was also a second lesson: Never, ever turn your back on vulnerable people who are tortured or killed for no reason.

So a war is such a terrible situation, but for me and for the Israelis, we had double moral injuries: one towards those, our brothers and sisters, the Israelis, who we felt we want to save and we cannot. And the other is towards children and women and men in Gaza, who are also terribly victimized by this terrible war, and hurt both  by their regime and by our soldiers in the war. So this is devastating. It makes the whole society ill.

I hope that our state will understand that it needs to contribute a lot, a lot, a lot of money just to the mental health systems. Because we will have hundreds of thousands of people—we already have them referring to get help.

Nahanni: Mm. And I can't imagine that on the Palestinian side, there's anywhere near the mental health infrastructure that there is on the Israeli side. 

Merav: You are right. We have relations with psychologists in Gaza. There is a beautiful touching correspondence between several psychoanalysts and psychotherapists with friends in Gaza. So there are ties that were built during the years. 

Nahanni: And what are you hearing from Palestinian colleagues in Gaza? 

Merav: The situation is terrible. They lost their homes. They come back to the places they lived and there is just sand. It's horrible. From what we hear, from what we hear, it's really devastating. It's unbearably terrible. And I think this is a part of our trauma too. To know that our neighbors are in such suffering.

Nahanni: As an Israeli, as a daughter of survivors, as a trauma therapist, and as a human being, how have the past two years changed your outlook on life?

Merav: I think I'm a sadder person. I'm sad. I'm sad that the world can be so cruel. I'm sad because I'm meeting every day a very deep sorrow of many, many people.

And at the same time, I think these two years have proven to me that what I believed in was very true. Even in the darkest corners, the life instinct is always there, and you can always pull a thread of light.

And what I told you about the ethical standards that are holding people together, this is the beautiful aspect of humanity—that on the other hand of cruelty and murderousness, there is the other part as well of beautiful, ethical standards that, keep us going, belief in the good and beauty that we need to cherish and to cultivate. And I see that every day as well. So I think that my perspectives are not so very much changed, but they are in much more, clear colors and strong colors, and some of them are sad colors, but some of them are also very beautiful colors that give me hope for the future also, right now.

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Nahanni: Merav Roth works with released hostages and their families and with survivors of Hamas’s October 7 attacks as they recover and re-establish their lives.

In a follow-up message, I asked Merav what she does to take care of herself, since she has been absorbing so much sorrow. She responded, “Maybe now that all the living hostages are released I will be able to begin to think about it.”

Thank you for joining us for Can We Talk? Our team includes Jen Richler and Judith Rosenbaum. Our theme music is by Girls in Trouble. You can find us online at jwa.org/canwetalk, or anywhere you get your podcasts.

I’m Nahanni Rous. Until next time.

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