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Victims of terror or missile attacks
Recommendations for people who wish to offer
Psychological support
The political situation is such today (in Israel and probably
soon in other countries with populations that harbor anti-human
ideologies) that there is a high probability that some of us
will be witness to a terror attack or be victims ourselves of
an attack. What is being perpetrated today against Jews and
against Israel, the symbol of the Jews, will also be perpetrated
against all mankind.
It is therefore more and more probable that we will encounter
people who have undergone a traumatic attack.
For the third time in a few weeks, I found myself in a situation
on the ground where I was able to give moral and professional
help to panic-stricken individuals and families who were trying
to find loved ones following a terror attack and who were unable
to obtain information about them from any source, and were losing
control as a result of their pain and anxiety. The same reactions
are often seen in victims when they find themselves alone several
hours following a terrorist attack; after receiving emergency
medical aid, victims often find themselves among strangers who
do not understand what they have been through. Survivors also
experience great anxiety in the days following an attack: this
is a time when auditory injuries accentuate the feeling of being
imprisoned in an inner world full of turbulent images.
My profession is to help people and I do this through psychotherapy
or counseling. As an expert, I also help people in authority
understand and analyze situations of conflict, and I train criminology
students in psychological and sociological issues and on ways
of handling explosive social conflicts.
The fact that I myself have experienced situations of war, of
great stress, of psychological anxiety and of bereavement, enables
me to understand many of the parameters at play in such situations.
My training as a psychotherapist and psychoanalyst obliges me
to first analyze and understand my own personal reactions before
helping others.
In times of emergency, it is important not just to rely on
the knowledge of experts. All citizens should know the main
guidelines on how to react in such circumstances in order to
be able to help others, in order to avoid doing harm and in
order to help themselves.
RECOMMENDATIONS
1. Determine the priorities
Do not hinder the work of those whose task it is to treat victims
as quickly as possible and ensure the safety of others; these
officials are usually overworked and can become authoritative,
brusque and harsh. Be understanding of the priority given by
officials to medical and police issues, for the lives of victims
or potential victims are at stake and can only be ensured by
the rapid deployment of medical, police and military services.
Psychological care should therefore be given in such a manner
so as not to impede the work of such services.
2. Provide victims with a comforting presence
People who have undergone a trauma or mortal threat need to
feel a human presence at their side. This can be done by providing
physical proximity and gentle accompaniment adapted to each
individual, to their way of being and at their rhythm. Take
care not to use rough movements and avoid the use of gestures
that may violate a victim’s sense of modesty and cause
further harm to his or her integrity. The right distance, which
is closer than the norm, needs to be found, while returning
to a normal distance as quickly as possible.
3. Acknowledge each individual’s way
of expressing suffering
It is important to accept and acknowledge the way a victim
expresses suffering following a trauma. Each person has a different
way of expressing suffering, depending on their personality
and background; one person may freeze and seem calm, while another
will shout and react hysterically. These two responses are,
in fact, identical expressions of suffering and should be understood
as such.
4. Acknowledge expressions of suffering
People who wish to help should quickly identify the forms or
codes of expression articulated by victims and should repeat
and re-frame them. This imparts to victims that they have been
understood and establishes a relationship with them, which is
of cardinal importance since a primary fear among trauma victims
is the loss of close relationships. It is important to understand
that these codes of expression are vital to victims.
The codes are also a means by which victims are asking to be
reassured on the issue that is most frightening to them. Intervention
at this stage and at this level can bring great comfort to victims.
As the same time as one is acknowledging a victim’s expressions
of suffering, one should also prevent others from making negative
statements or expressing scorn towards victims. Such attitudes
are common and can cause psychological harm to victims at a
moment when they are most vulnerable.
One should also try to prevent expressions of suffering from
disturbing other victims who may be nearby, and who are also
in distress and require calm.
5. Protect victims
Prevent journalists from rushing towards the victims and violating
(this is the exact term) them by photographing or filming them;
victims have the right to their dignity but are unable to safeguard
it at such moments. Those who violate the dignity of victims
at such times are like abusive adults who rape young children.
Make sure that onlookers, in particular voyeurs seeking a prey
to watch, are kept at a distance.
At the same time, the process of answering journalists’
questions can help victims regain a sense of normality, of being
in touch with others, of communicating, socializing and feeling
equal.
6. Reconstruct
At this point, one can begin to help victims re-integrate with
life by encouraging them to perceive the simple, positive aspects
of their situation (they are alive, they have found their loved
ones, they are receiving comfort, they have received the gift
of life again, say thanks, smile, laugh). But this stage can
only be reached after victims have been allowed to express their
pain according their individual personality and background,
as noted above, and by protecting victims from the negative
reactions of people who do not understand such forms of expression.
It is therefore important to identify as soon as possible each
victim’s individual way of expressing pain, laughter, sadness,
and communication. Once a victim feels understood, it is then
possible to construct a relationship of trust on which to work.
Victims need to be helped to express their own thoughts and
choices. It is also important to preserve their personal effects
and avoid transforming them into anonymous numbers or into “patients”
who have lost their identity papers, clothes and bags.
One must therefore reconstruct as quickly as possible the victim’s
integrity which was shattered in the attack.
7. Re-establish communication
Victims who have been deafened by noise and who only feel connected
to their own turbulent inner world can be helped by the methods
noted above to re-experience communication with others and the
outside world.
8. Make the images meaningful
Victims will continue to be flooded by images of the attack
and by turbulent emotions for several days or weeks.
It is important to help victims view this as a normal phase
which will vanish of its own accord like a storm that passes.
This phase also has a positive function, for it allows inner
work during which the victim tries to connect the images and
to construct a meaning that is easier to live with. But this
inner work will be hampered if it is not expressed verbally,
particularly in communication with another person. The expression
of feelings allows the images to be integrated into the victim’s
personality (i.e. into the totality of sensations, images, words
and meanings that form the victim’s personality).
Victims will feel, for some time, a need to talk about many
analogous situations or experiences. This is another way of
creating meaningful connections that enable the integration
of the new experience. In this way, victims emerge from a traumatic
experience with a renewed sense of their own strength and their
ability to overcome dangerous situations. The important thing
is that they were able to overcome the trauma though a connection
with another person. This enables victims to avoid feeling they
have undergone an experience that no one else understands, and
a situation where they feel not only broken but totally alone
and helpless.
9. Synthesize
Do not ignore the cultural, familial and spiritual background
of the victims and communicate in their language, using their
vocabulary.
Psychological counselors are rarely able to work in a victim’s
private, spiritual language. This spiritual dimension, which
is often repressed and prohibited in the modern world, is vital
in order to maintain a person’s inner integrity and ability
to relate to others. The Modia site provides counselors with
background on Jewish anthropology, which is indispensable if
one wishes to give psychological support to Jews and enable
their personal development.
The experience of receiving such aid during a trauma imparts
to victims a deep sense of stability and security towards themselves,
towards others, towards humanity and towards life.
10. Acknowledge the victim’s desire for
independence
Counselors and helpers should take leave of victims as soon
as the latter are ready. Victims want to move and should be
enabled to do so.
11. Psychological support must be combined
with spiritual/religious support
Support through prayer is very important. Read Psalm 6 (link)
and others.
Read about the significance accorded in Judaism to the need
to confront death.
People who give professional psychological support should be
aware that victims will also seek support in their cultural
and religious environment. In order to understand this phenomenon
better and in order to recognize and integrate it in treatment,
read: --- htm
These 11 RECOMMENDATIONS are intended to help victims themselves
understand the psychological impact of a trauma and to help
professionals and all kind-hearted people who wish to offer
psychological support to trauma victims
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