BURNING FLOWERS, BURNING DREAMS

CONSEQUENCES OF SUICIDE BOMBINGS 

ON CIVILIANS IN ISRAEL 2000-2005


Chapter 5 

"COPING WITH THE CONSEQUENCES OF SUICIDE BOMBINGS"

5.1. COPING WITH EXPOSURE TO TERRORISM – A 2002 STUDY OF THE ISRAELI EXPERIENCE | 5.2 COMMUNITY SUPPORT – A PILLAR OF CRISIS INTERVENTION | 5.3 USING VOLUNTEERISM TO COMBAT TERRORISM – EXPERIENCES OF THE ISRAEL CRISIS MANAGEMENT CENTER | 5.4 IMPACT OF BOMBINGS ON THE ALREADY DISADVANTAGED | 5.5 ALMAGOR – THE TERROR VICTIM ORGANIZATION CAMPAIGNING AGAINST TERROR | 5.6 ONE FAMILY – JERUSALEM-BASED TERROR VICTIM ORGANIZATION | 5.7 IMPACT OF TERROR ON CHILDREN | 5.8 KIDS-FOR-KIDS – HELPING CHILDREN COPE WITH TERROR | 5.9 WHAT HAPPENS TO FOREIGN WORKERS? | 5.10 WHAT TERROR MEANS TO THE DISABLED | 5.11 WHAT CAN I DO TO HELP MYSELF? PERSONAL COPING STRATEGIES | 5.12 WHEN EVERY DAY COULD BE GOODBYE | 5.13 THERAPEUTIC APPROACHES USING MUSIC, ART AND HORTICULTURE | 5.14 COPING WITH TERROR – THE BOTTOM LINE 


After the dead are buried and the wounded leave hospital, survivors and families of victims attempt to 
rebuild their often shattered lives, and passers-by retreat into a state of silent and painful memories. The word 'cope' implies contending successfully with or dealing competently with a situation or problem. 

How do civilians cope after a suicide bombing or other terror attack? In this chapter we take a look at 
professionals and organizations who counsel and assist survivors, families of victims, passers-by and 
primary responders. They provide pieces of the practical and therapeutic 'mosaic' through which people are helped to cope in the immediate and longer term with the consequences of suicide bombings. 

Interviews with survivors and bereaved families provide other pieces of this mosaic. Some approaches are well known, some are more innovative. The inputs necessary to help people cope with psychological and emotional 'wounds' left by suicide attacks are dealt with in more depth in chapter six. 


5.1. COPING WITH EXPOSURE TO TERRORISM – A 2002 STUDY OF THE ISRAELI EXPERIENCE 


Before and after the War of Independence in 1948, the civilian population has had to cope with various 
attacks, such as the Arab riots during Mandate times in 1929 and the First Intifada 1987-1993. The latter 
included the signing of the Oslo Accord between the Government of Israel and the PLO. There were 
bombings in buses, shopping malls and markets. Then came the second Intifada, beginning in September 
2000. Since then Israeli society has experienced continual terrorist attacks, including suicide bombings, 
knife or gun attacks, drive-by shootings, and intrusions into homes. A 'terrorist attack' is defined as any 
armed attack by a self-proclaimed terrorist gang (Source: Israel Defence Forces). 

By April 2002, after 19 months and 13,000 terrorist attacks, 560 of which were carried out within Israel's 
1967 so-called 'green-line' borders, no study had examined the psychological impact of the on-going 
terrorism in Israel and ways in which civilians were coping. 

In 2002 a telephone-based survey of Israeli residents was conducted to determine the prevalence of Post Traumatic Stress Disorder (PTSD), and to identify coping modes used to deal with exposure to terrorism and its on-going threat. The target population selected consisted of all adult Israeli residents aged 18 years or older. Accordingly, 742 individuals (each representing a household) were randomly reached by telephone. Of these, 512 agreed to participate in the study. The sample consisted of 250 men (48.9%) and 262 women (51.1%), aged 18 to 66 years. There were 444 Jews (86.8%) and 68 Arabs (13.2%), and most of the sample lived in urban areas. Of the 444 Jews, 56.7 % were born in Israel and 43.3% were immigrants. With respect to income, 179 (49.3%) reported a net family income below the mean (about $2000 monthly), 145 (31.7%) reported a mean family income and 132 (28.9%) reported a family income higher than the mean. Interviews were carried out by trained interviewers by telephone for 12-15 minutes, in Hebrew, Russian and Arabic, using a structured questionnaire containing 51 questions. Trauma and stress-related mental health symptoms were measured and participants were asked to rate their agreement with each stress symptom on a 5-point Likert scale (Bleich et al., 2003). 

RESULTS OF SURVEY OF 510 ISRAELI ADULTS

 
84 (16.4%) Personally involved in terrorist attacks in past 18 months 

113 (22.1%) Family member or friend wounded or killed 

78 (15.3%) Knew someone who survived uninjured 


(Bleich et al., 2003) 


Of 510 respondents, 299 (58.6%) declared that they had felt depression, but the majority of participants 337 (82.2%) stated that they felt optimistic about their personal future. Just over sixty-six percent said that they felt optimistic about the future of Israel. At the same time, 307 (60.4%) felt that their lives were in danger and 345 (67.9%)) felt the lives of their family and acquaintances were in danger.

Seventy-four percent agreed they would function efficiently in the event they were caught in a terrorist attack. Only 5.3% felt that they had a need for professional treatment. The presence of PTSD was significantly associated with being female, 16% versus 2.4% men with symptoms of PTSD. Lower income was also associated with PTSD symptoms. Respondents mentioned tranquilizers and alcohol or cigarettes being used less frequently as a coping mechanism. Coping mechanisms mentioned as most useful included self-distraction through activity, active search for social support, faith in God and checking whereabouts of family and friends after attacks. 


The models showed that coping by avoiding television and radio was similar to coping models used during the German Blitz during World War Two when Londoners endured long and constant bombing. "In fact, the behaviour of the Israeli and British populations seems to have been similar: neither had a substantial number of psychiatric casualties, and both became habituated to the stress. Along with feelings of depression, low sense of safety and other TSR symptoms, both populations reported high levels of self-efficacy and optimism" (Bleich et al., 2003). 

Nearly 4 in 10 had survived attacks, lost family members or had family or friends wounded.

The telephone survey also revealed how those who had been wounded in a terrorist attack showed no more adverse emotional effects than those who had not been exposed to an attack, either themselves or through a family member or friend. This finding may be accounted for in one of two ways. One is that those who experience terrorism may understate their distress and continue with their lives without being affected by it (Z. Solomon, 1995). 

Conversely, this finding reflects the wide-ranging impact of the persuasive traumatic reality in Israel, which has either directly or indirectly (e.g. through the news media) affected virtually the entire population. Indeed, a study after 9/11 in America concluded that the psychological impact of a major 
national trauma is not limited to those who experience it directly (R.C. Silver, 2002).

 
There appeared to be no difference in the traumatic sequelae experienced by the urban and non-urban 
population, or by Jewish and Arab populations. The study showed that after 9 months of unremitting 
exposure to terrorism, Israeli society was coping. Despite the limited sense of safety and substantial distress, most Israelis reported adapting to the situation without substantial mental health symptoms and impairment, and most sought various ways of coping with terrorism and its ongoing threats (Bleich, A. et al. 2003). 



5.2 COMMUNITY SUPPORT – A PILLAR OF CRISIS INTERVENTION 


An Israeli international expert on stress and trauma, Professor Mooli Lahad, observes, "Israel has been quick to deploy mental health teams to treat terror victims on the spot, but overall the country's response to the crisis is largely improvised...The ability to improvise, something Israel excels at, is a great resource in a one-off disaster. Over a period of time, however, improvisation is inadequate...In most countries people affected by a disaster expect little from anyone. In Israel, it's very different; people expect the central government to react. People expect that society will help them. At times of crisis, the knowledge that you are not alone, that someone will help, is a great resource" (Eren Frucht 2002). 

Providing community support to people who have been affected by terror attacks is one of the pillars of crisis intervention. It is common for most community interventions to include debriefings in groups as an expression of the importance of the community for people's well being. After terror attacks mental health professionals act as consultants to the community, except where there is extreme individual distress requiring explicit professional intervention. The people in the community remain the primary agents of intervention, rather than the mental health specialists. Community members develop a greater sense of responsibility towards vulnerable others, thereby increasing their own coping abilities. 

Israel already has a long track record of civilian volunteerism. But, during the past four years, one of the 
major strategies employed in Israel for coping with the results of suicide bombings, and other terror attacks, has been a further massive outpouring of volunteerism. In many countries of the world large amounts of 'humanitarian assistance' are provided in time of crisis. In Israel, such assistance has to be provided in other ways, often by volunteers. Perhaps this is a type of 'home-grown humanitarian assistance'. Even those who have themselves experienced terror attacks, including suicide bombings, play a role in such voluntary activities. 



5.3 USING VOLUNTEERISM TO COMBAT TERRORISM – EXPERIENCES OF THE ISRAEL CRISIS MANAGEMENT CENTER 


In 1992 Ruth Bar-On, ex-director of the Israel Public Council for Soviet Jewry, heard that a Russian 
immigrant had been killed in a terror attack. "From the TV it looked like they were getting a lot of support. I didn't think I would have a place there; I just went along to reassure myself that everything was being taken care of. But I was stunned by the isolation and loneliness I witnessed." In other subsequent attacks, she saw people with no relatives, no friends, no Hebrew, no money to even get home from hospital. "I never thought there could be such a cruel vacuum" (Halle, 2003). She thought that Israeli society would respond with spontaneous support at a time of tragedy. "I didn't take into account that people are afraid of pain, that immigrants grieve in different ways, that codes of behaviour can be so different." 

From this realization eventually emerged the Israel Crisis Management Centre, commonly known as 
'SELAH', which means 'rock'. By September 2003, ten thousand crisis-stricken individuals and their families had used Selah's services. Children who had lost their parents and were part of a support group in 1996 were now running peer support programs for newly bereaved youth. In 2003, Selah ran more than a dozen weekend retreats – for wounded young adults following terror attacks, for bereaved Ethiopian parents, for grandparents raising their orphaned grandchildren, and others. Ruth Bar-On says, "It is very hard for people who have suffered a serious loss to construe meaning. With terror, sometimes it's easier. Loss in terror attacks is viewed as a national loss. It is difficult to be comforted, but sometimes there is comfort in being part of a chain of heroism and that has some meaning. When it comes to non-terror victims, there are very few sources of support (as for families bereaved after an air crash)" (Halle, 2003). 

Selah receives 95% of its funding from the philanthropic world, including British and North American 
Jewish communities, but has great difficulty in raising money for tragedies other than terror. Immigrants 
often need special help. In addition to dealing with their immediate troubles, many have also incurred 
previous losses. Such losses include living in their original country, language, friends and family. "There is more vulnerability and less ability to cope when resources are depleted, so it is really a double trauma for new immigrants. In this sense 'new' describes those who are still culturally isolated, like a tree without roots; what will you do when there is a storm?" 

Immigrants from English speaking countries tend to be more 'connected' to each other and their immigrant associations, which can fill part of the void. But often such organizations do not have expertise in trauma, and the immigrants' needs can be enormous, particularly in the long term. In the western world, you are expected to take just 2-3 weeks to recover from trauma. Very few people will listen to you beyond that. A person wounded in a terror attack two months ago can feel forgotten. It is extremely important to stay in contact with them for the long term, because that is when their needs really unfold. Very often they can only speak then, when there is no one there to listen, and feeling isolated and disconnected is a very big threat to the recovery process." 

Selah has nearly 600 volunteers who speak all the languages of Israeli immigrants, plus 10 paid workers, including social workers and psychologists. Selah also offers support to tourists and foreign workers in crisis. The Director says, "I hear about a lot of tragedies, but I see miracles of life that nobody else does. Sometimes it is hard to fathom how strong life is in the face of unbearable tragedies and how people discover strengths that they had no idea existed" (Halle, 2003). "Selah's members stay with the victims of attacks long after media attention has moved on to the next story" (Price, 2002). 

In the long term, needs really unfold

Selah has developed a comprehensive and culturally sensitive program of outreach, crisis management, and long-term support tailored to meet the special needs of immigrant victims of terror attacks and other tragedies. "During the immediate emergency response to an attack, teams provide vital practical and emotional assistance, and serve as bridges to other resources. Volunteers visiting the hospitals or homes of the families can assist in the complicated task of assessing immediate needs and resources of the victims and their families. Volunteers can also stand by bereaved families during the process of identifying bodies. They can provide essential information and solve problems of transportation, translation, and contact with other family members in the country or abroad. During the next stage of crisis support they may visit homes and help with developing needs such as day-care for children of the injured, or building a support system around a parent tending a hospitalized child. They may find shelter, household items, medical equipment, providing bridging support until government services take over" (E. Pardess, 2004). 

Trauma Survivors Provide Support to Other Terror Victims

"Volunteers play a wide range of roles in the aftermath of trauma. They may be part of rescue teams, 
staff hot-lines, be available at walk-in centres, hospitals, and outreach programs, and provide crisis 
intervention and on-going support. Volunteers are a valuable human resource that can help meet 
community needs which cannot be met by government agencies. They enable social agencies and 
human services to be able to expand their services to 'high risk' populations. Active outreach by 
volunteers has been described as one of the spontaneous community responses in the aftermath of 
disaster, where volunteers play a vital role in rescue, relief and recovery efforts (Danieli 2001), 
(Drabek 1986, Norris et al. 2002). However, these may be ineffective if not properly planned and 
organized, and uncoordinated outpouring of volunteers may even interfere (Craig & Fuchs 2002, 
Gillespie & Murty 1994).

 
Volunteer resources during a time of disaster or other community-wide trauma may foster both individual and community resilience and post-traumatic recovery (Rosse 1993). Terrorism is an attack on the community to which volunteerism is a communal response. Trauma isolates, often threatening to destroy the bonds between the individual and the community. The presence of volunteers conveys a message of caring and connectedness. The sense of belonging and being part of a community is more important in the process of reconstruction of meaning and resolution of trauma. 


Understanding the motivation of volunteers is important in mobilizing them and reducing attrition 
rates. Volunteering in the aftermath of terrorism (and other disasters) is for many a way of coping 
and an avenue to self-growth. Instead of remaining passive spectators witnessing horrors (in cafes, 
buses, shopping malls) or on television, people choose to engage actively in reaching out to others 
and to alleviate suffering. In the face of the ongoing threat of terror, the active nature of helping 
others can reduce the sense of helplessness and promote a feeling of connectedness. But, supporters 
need to be supported. By providing adequate support, on-going training, and guidance, agencies 
deploying volunteers can ensure an effective emergency and long-term support system while 
conserving and even enriching the volunteers' resources. 


Following a tragedy there is usually an initial outpouring of help, which tends to subside within the 
first few weeks. Grief, trauma and pain do not go away quickly. Unfortunately, it is just when the 
reality of the loss begins to sink in that the victims are often the most alone. It is crucial, therefore, to 
channel as much of the initial volunteer resources as possible to the long-term, when many vital needs 
begin to emerge that are not apparent in the first stage. Volunteers' support is the most important 
during difficult times that trigger the most painful memories, such as holidays or anniversaries, when 
loneliness is heightened, during security crises, or after major terror attacks. 

The importance of operating a 'telephone chain' of volunteers reaching out to offer support cannot be overstated. The long-term presence of volunteers provides a protective shield and conveys society's acknowledgement of the pain and the message, 'We Remember!' 


'Healing retreats' are held for the bereaved and injured at weekends, and vacation outings include 
groups for mutual support which help people reconnect through sharing grief, re-build bridges 
between past, present and future, and restore continuity in life. The presence of volunteers is central 
to this process. Orientation for new volunteers is carried out by groups led by veteran volunteers. 
Volunteers are selected by using criteria of self-confidence, initiative, problem-solving skills, 
sensitivity and compassion. Screening for such qualities helps guard against burnout and attrition. 
Through training, volunteers are empowered to respond in a sensitive and responsible way by 
activating their natural listening skills, common sense, life experience and inner strengths. Volunteers 
learn communication skills through role-playing in small groups and sharing perceptions and 
feelings. 

Empathy is a major issue; 'stepping into another's shoes' and stepping out of them, and the 
difference between empathy and over-identification. Grief and mourning processes are discussed and 
volunteers encouraged to become aware of their feelings about bereavement and death. Crisis 
intervention skills are covered, such as how to initiate contact with people in shock, how to cope with 
possible initial rejection or ambivalence and how to provide a quiet, responsive, responsible and 
reassuring presence in the midst of chaos.

 
Volunteers can also play an important role in helping survivors and families of victims tell and re-tell 
their 'stories'. Telling one's story to an understanding listener helps restore continuity, a sense of 
identity and connectedness. New volunteers are sent out with experienced volunteers who serve as 
role models and sources of inspiration, and help them move on gradually from an observer role to 
active involvement in crisis intervention. 

Support providers working with disaster and terror survivors are subject to risks ranging from emotional exhaustion and burnout, through heightened anxiety and nightmares, up to secondary traumatization marked by the full range of Post Traumatic Stress Disorder symptoms. Burnout may stem primarily from the enormous stress of the work, with its many demands and the resulting sense that one can never do enough. Volunteers who do not receive adequate support may soon find their emotional resources depleted. 

Helping volunteers find an optimal interpersonal space reduces the risk of debilitating over-involvement. They may be prone to over-identification impeding their ability to provide support. They may find emotional wounds are re-opened through the experience of helping others. Volunteers often ask 'Am I doing the right thing?' 


Meetings, workshops and seminars can provide essential feedback, affirmation and reassurance. The 
shocked, grieving and traumatized people they work with cannot be expected to do this. Family 
support is also important so that they can better understand and accept the volunteers' reactions when 
they return home after a difficult experience.

 
Among the volunteers are those who are survivors themselves and/or who have themselves lost family 
members. Having themselves coped with tragedy, they now reach out to help others. Such volunteers 
often have a special sensitivity, understanding and perspective. Their contribution to the volunteer 
endeavour is immense. For the newly bereaved and injured, they are often able to offer a unique 
source of support that conveys a special understanding – without their having to say a word. 

A woman called Tanya lost her son in a terror attack. At first she did not want to live. Luda, a volunteer 
whose son had been killed three years earlier provided her with a role model for living. Tanya said 
later, "It was the first time I met a woman with the same fate. I saw a woman who was alive, who 
wants to continue living, working, eating, a woman with two feet on the ground. At that moment I 
understood that I would actually live." Tanya herself later became a volunteer visiting bereaved 
families. 


Sources: Interview with Eleanor Pardess, psychologist, 22 June 2004;Pardess, "Training 
and Mobilizing Volunteers for Emergency and Long-Term Support" in Yael, Brom, Shalev, & 
Waiser (Ed.): "The Trauma of Terror: Learning from the Israeli and American Experiences" 

 

5.4 IMPACT OF BOMBINGS ON THE ALREADY DISADVANTAGED

 
Civilian survivors and families of victims of suicide bombings often come from poorer sections of Israeli 
society, already living in difficult socio-economic circumstances. They often do not have private transport.

 
For example, in 1999, it was reported that only around 55% of Israelis had private transport. Therefore, they are the civilians who are most often blown up in buses by suicide bombers. In August 2004, 10% of the eligible Israeli population was said to be unemployed (Central Bureau of Statistics). In 2003 it was estimated that one in five Israeli children could be classified as 'poor'. In addition to existing deprivations and disadvantages, many civilians who have been wounded in suicide bombing attacks have not be able to resume their normal occupation due to injuries sustained. 

In February 2005 it was reported that in Israel the "average family spends 10,076 shekels (2,343 US$) each month. On average, the country's households spend 21.6% of income on housing, including rent and other expenses; 21.2% on transport and communications; and 17.3% on food. Taken as a whole, these three basic essentials constitute 60.1% of the average household's spending. The wage of an average salaried worker in November (2004) was 6947 shekels (1,615 US$) monthly. The fifth of the population with the lowest incomes spent 20% of total consumption expenses on food" (D. Kennemer, 2005). In February 2005, a UNICEF report stated that more children in Israel live below the poverty line than in 26 other Western countries...30.8% in 2003, according to the National Insurance Institute figures" (Leila Kreiger, 2005). 


5.5 ALMAGOR – THE TERROR VICTIM ORGANIZATION CAMPAIGNING AGAINST TERROR 


The Terror Victims Association "Almagor" sometimes known as TVA was founded in 1986 in response to 
the release of Palestinian prisoners by the Israeli government of that time. Some of the released prisoners had been involved in terror attacks against civilians. Victims of those terror attacks petitioned the Supreme Court against the freeing of the convicted terrorists, and TVA evolved into a support group for those victims. 


At that time there was not the same government framework as exists today to deal with the families of 
victims of terror. Today TVA has an extensive network of volunteers who visit families of victims of terror 
attacks, including suicide bombings. Although TVA does not employ social workers, a number of 
experienced social workers voluntarily provide instruction to volunteers on how to go about their work of 
visiting families of victims. Another activity of TVA is the use of terror victims themselves who voluntarily 
provide emotional and practical support to families coping with tragedy. 

In this way a meaningful and therapeutic outlet is provided for terror survivors to assist other terror victims. TVA volunteers visit those injured in terrorist attacks, help care for victim's children and household needs, arrange for social workers to counsel victims' families, organize social gatherings for families of terror victims, conduct legal battles against terror perpetrators, organize memorial services and projects; run an emergency telephone hotline, and assist terror victims to obtain government benefits. 

Dynamic atmosphere of caring pervades busy Almagor headquarters. 

It is nearly the festival of "Purim" when children dress in costumes and families eat ear-shaped 
cookies filled with poppy seeds or nuts to commemorate deliverance from the tyrant Haman in ancient 
Persia over two thousand years ago. In the oldest terror victims organization, "Almagor", which 
means 'no fear', volunteers are packing festival treats into boxes. They will be distributed to families 
who have survived suicide and other terror attacks and families of terror victims. 

Almagor has 1,600 clients and concentrates on social aspects of helping people cope with terror. Some clients meet twice weekly, thirty to sixty people at a time. Then there are fortnightly meetings for people aged 18-30. These are lively events with 15-20 youngsters, and there may be an invited speaker, singers, plays and karaoke sessions. 

Some Almagor volunteers assist students with homework. Some regularly visit terror survivors, like a 23-year-old man who was wounded in his eyes, legs and hearing in a Jerusalem bus bombing a year ago and spent a year in hospital. Almagor volunteers visited him regularly. He is just now "coming back to normal life ". 

Volunteers visit another family where both parents died in a terror attack. The children attend meetings for youth, and their grandparents, who are caring for them, attend the adult support group meetings. People who survived particular bombings or lost relatives come to network and talk to other bereaved families. A dynamic atmosphere of caring pervades the busy headquarters. 


Teenagers recently went on a four-day trip to the Golan. They rode horses, went kayaking and had a 
chance to meet other youngsters who had experienced similar traumatic events and who said "we are 
all going through the same experiences. "After the trip they kept in touch with each other. 


Source: Interview at Almagor in Jerusalem, March 2005 

TVA has continued to exert constant pressure on successive governments to put the fight against terror on the political agenda. For example, dozens of demonstrations were organized against the Oslo Accords. TVA also organized a law suit against the late Yasser Arafat in Belgium. Over the past four years TVA resources have been over-stretched as the numbers of suicide bombings and other terror attacks increased significantly (www.terrorvictirns.com, 4 March 2005). 


5.6 ONE FAMILY – JERUSALEM-BASED TERROR VICTIM ORGANIZATION 


From the charred remnants of the Sbarro Pizzeria bombing in 2001 was born a terror victim organization. 
Today, in a northern Jerusalem industrial estate are the headquarters of the One Family Israel Emergency Solidarity Fund, better known as 'One Family'. Since September 2001 One Family has grown from a table and a computer in a private home to be the organization it is today. 

Originally funded through the generous donation of a twelve-year-old girl's Bat Mitzvah gift, the organization has grown in line with the mushrooming needs of Israeli terror victims. By the beginning of 2004, almost two thousand people had been helped by the twelve paid staff and 460 volunteers through a wide range of activities and financial assistance. The director's own father had been killed in a drive-by shooting, and two volunteers had lost children in terror attacks. 

Coping with the ravages of the terror industry 

One Family provides an eloquent response 

When a terror attack occurs, amid the carnage and confusion, One Family springs into action. Help 
to survivors begins through the organization's relationships with all of Israel's emergency rooms and 
trauma centres. The One Family's petty cash fund is utilized by hospital staff to tend survivors and 
families of victims using networks of social workers and friends. In cases of death, One Family does 
an initial visit to the bereaved family and a family profile is created for each family to determine any 
special needs. 


One Family provides direct financial, legal and emotional assistance to the survivors, checks with the 
National Insurance Institute and hospital workers about rights, and makes sure victims receive 
entitled care. There are group discussions, children's programs and rehabilitation programs. One 
Family provides personalized care and support, listening to problems and giving based on need. It 
maintains ongoing, unconditional one-to-one contact, creating a sense of family among victims, and 
helping to re-build shattered lives. There is a full-time legal counsel to help sort out urgent legal 
problems of families suddenly plunged into chaos by loss and grief, such as mortgage problems and 
inheritance where there is no will.

 
Immediate needs may include emergency care and household upkeep, and short-term needs such as 
services not covered by National Insurance or the social services. In the longer term, One Family may 
provide counselling, job retraining and placement, legal advice, financial advice, service coordination and outreach. By February 2004 there were over 2000 direct financial aid grants, including aid for rent, purchasing of furniture, debt relief, home alterations, home purchase, transportation, purchase of computers, clothing, and grants for tuition so that survivors and families of victims could pursue studies and courses. Gifts of festive baskets of sweets, cheesecakes, honey, and flowers are sent to families on festivals. Some families have needed electrical appliances, and others orthopedic beds, or treadmills for wounded survivors. Families have also been helped to fund weddings and Bar Mitzvahs. 


Psychological help is also provided. There are special activities like youth camps and retreats 
including travel abroad to the USA, England and Belgium. In this way victims can feel that they have 
a family of concerned people around the world, helping, caring and praying for them. Volunteers 
maintain regular contact with victims, visiting lonely families, providing tutoring, babysitters, 
household help, driving wounded family members to hospital or therapy sessions and hospitality on 
the Sabbath. There is an Adopt-a-Family Project which creates a lasting bond between overseas 
communities. By February 2004, 158 families had been adopted, with One Family overseeing the 
'twinning process'. There have been retreats for healing in Haifa and the Dead Sea, with counselling 
by psychologists, and a retreat for widowers and bereaved parents in Tiberius beside the Sea of 
Galilee. 


A 'Big Brother Program' operates to pair teens who have experienced terrorist attacks with older 
teens and young adults who have had similar experiences. This helps them adjust to their new 
circumstances while getting on with their lives. It coordinates and supplements sponsorships for such 
youth who are invited to spend time abroad. These trips provide healing time for victims badly in need 
of a change of atmosphere. By early 2004 One Family was working with at least 439 children who 
had been orphaned or who had lost a parent in terror attacks. Israeli Arab victims of terror also 
participate in these activities. 

The Youth Division established in 2003 organizes quarterly camps with indoor and outdoor activities, which provide a healthy retreat from the daily pain and tension of the victim's lives. Photo-therapy, music therapy, and art therapy are made available to participants. The summer camps have included 300 participants. The One Family Orphans Fund is devoted to providing long-term educational and housing assistance as well as mental and physical care. 


As of February 2004 there were three regional coordinators, one for Jerusalem and the south, one for 
the West Bank and one for the northern region. One Family's financial expenditures up until 
February 2004 amounted to around 9 million U.S. dollars. To raise funds in the USA for One Family, 
a fund-raising art auction was held, and a dance-a-thon in Beverly Hills, and elsewhere a company 
put together and sold a highway safety and first aid package for emergency use in a car. 


Sources: Interview with One Family, Jerusalem, 9 February 2004. 




5.7 IMPACT OF TERROR ON CHILDREN 


In the nineties, studies on the impact of terrorism on children in Israel found that "The loss of family, 
caretakers, and friends may shatter their world and put them at high risk. Children tended to "regress, suffer from sleeping and eating disorders, lose trust in others, have impaired concentration, drop in their 
schoolwork. Some become aggressive and violent. Small children keep re-enacting the trauma in their 
games and have recurrent nightmares" (Terr 1990). 

Israeli international trauma expert Dr Ofra Ayalon observes, "In all instances of child survivors of current terrorist attacks, one of the most prominent stressful elements of the traumatic experience was the perceived failure of their meaningful adults to shield their children or themselves from danger. The traumatic experiences need to be acknowledged, expressed, listened to, witnessed by caring others... tolerated, contained, treated and healed. Major obstacles block the need of victims and survivors to voice their emotional turmoil and be heard by others. A helpful strategy mentioned by a (child) survivor was the effort to record and bear witness: 'In the hospital, with bandaged hands, I kept writing my diary.' 

Apparently, survivor guilt torments a great number of children who survived suicide attacks on their school bus or were the only survivors of their families in some recent suicide bombings of homes and shops" (Ayalon) 2005). There are "two distinct circles of support for the children traumatized by terrorism. The first is composed of family members, friends, neighbours and colleagues. 

The second is comprised of children who share the same fate, and in which the giving and receiving of support takes place on an equal ground, with the tacit consent that 'only someone who has gone through a similar experience can understand my suffering'... Between the external world that harbours violence and atrocities and the internal vulnerable sense of self that is uniquely individual, lies the 'transitional space', the domain of imagination, play and creativity... (Children often attach themselves to transitional objects such as a blanket or doll)…The symbolic value of the primary transitional objects gradually spreads and becomes an ever-growing transitional space of the child's play and games, forming linkages between inner needs and outer realities. This transitional space can be the bridge between the situational terrorist events and the psychological traumatic experience" (Ayalon, 2005). 

CREATIVE TOOLS HELP CHILDREN VENT PAINFUL EXPERIENCES 

Debriefing is offered "as a structured way to elicit the personal story of the experience with an emphasis on sensory perceptions like sight, smell, sound, touch, taste, and thoughts, feelings, and behaviour experienced during and shortly after the event... "By using a variety of creative techniques and tools, children's group debriefing offers safe space for ventilation of painful experiences... COPE cards is a package of 88 illustrated cards devised for processing trauma and help in enhancing coping... (They) provide an opportunity to tell the personal recollections of the traumatization within a safe environment.

The purpose of hearing the details of the trauma story is to revisit the scene and, in so doing, remove the grip of terror and horror...By the use of images and imagination, they serve as a protecting screen against being overwhelmed by intense emotions. When the memories become too much to bear, one can return to the imagined story or look for cards that may serve as anchors for a sense of thriving, surviving and healing" (Ayalon 1993). 

In this approach a group of 5-6 children take a card to give them a 'voice' to tell their story. Then there is exchange of suggestions of how to cope with the figure's story, like how to push away fears and bad dreams" (Ayalon 2002). 

Drawing and finger painting have also been used to help children cope after terror attacks, as well as maps made of the attack scene, clay models, poems and simulation games. The COPE approach "informs helpers about children's traumatic sequelae, their needs for help and the responsibility of the community (especially the educational community) to respond to these needs. Secondly, it provides training for community personnel, both mental health and education professionals, as well as para-professionals and volunteers, who learn how to deal with traumatic events and their consequences. The third component involves targeting three intervention strategies: anticipatory, buffering and recuperation, roughly corresponding to the three stages of a crisis" (Ayalon 2002). The COPE approach has gained international acknowledgement and is published in several languages. 



5.8 KIDS-FOR-KIDS – HELPING CHILDREN COPE WITH TERROR 


Inside the Old City of Jerusalem, an organization was created to help children and adolescents cope with 
terror. As the violence and bloodshed of the Second Intifada gathered momentum in 2000, so did Israeli 
coping responses. For Israeli children, the toll of grief and loss grew daily. 

Yeshara Gold, a resident of the Old City of Jerusalem was inspired to help children mend their shattered lives. She and her co-workers created 'Kids-for-Kids', popularly known as K4K, a youth organization for the recovery of young victims of terrorism. Based on love, they have developed over the past four years many innovative approaches to enhance coping and to heal grieving children and adolescents. They listen to urgent requests of young terror victims and their families. They also use services of existing psychological clinics which incorporate conventional narrative and play therapy with art therapy. Such therapy can be on an individual basis, or in a group or family setting. Sometimes K4K covers costs of clinical therapy.

Programs include 'Eyton' for youngsters aged 9-13 who have lost siblings, parents or close friends from terror attacks. Another approach is 'Footsteps' which consists of special sessions, activities and workshops to aid emotional recovery from grief and trauma in teenagers. Workshop sessions and conferences are organized by professionals in the fields of trauma, grief, and crisis intervention. 

K4K professionals and volunteers have structured an array of programs designed to assist in the task of 
helping children heal on a spiritual, emotional and societal level. "Whether a child was wounded in an 
attack, witnessed an attack or lost a loved one through an attack, the shock of the event is deep set. In fact just being in the environment and hearing the news of daily casualties and living in fear of imminent danger can cause damage to a child's psyche and sense of self, according to psychologists. 

After a suicide bombing, one teenager said, "God hates me – otherwise He wouldn't let this happen to me". "It is rare that a teenager will come out so quickly with his feelings... As for younger children, they often don't even have the words for theirs" (Beloff 2001). It is hard to even begin to fathom the world of horrors many children inhabit as they struggle to contend with daily accounts of deaths and injuries, sounds of gunfire, and palpable tensions everywhere they turn. For example, "if a parent dies, a child may think it is his/her fault... up to the age of nine they will think he/she is responsible, no matter what the circumstances of the death are. To make matters worse, the child will dream about the parent at nights. After seeing his beloved parent in his dreams, he must wake up every morning to the wrenching reality that his mummy or daddy is not there" (Beloff 2001). 

There have been numerous Israeli children who have lost both parents in terror attacks. Self expression is vital in terms of recovery for kids who are not expressing themselves. It is important to get their feelings down on paper, or to enable them to draw what they feel with the aid of an art therapist. Many K4K programs are concerned with post-traumatic stress disorder and preventing its development. 

One strategy used by K4K is to give children a workbook to help stimulate his/her positive thoughts and 
conclusions. Every day the children write down declarations of appreciations, happy experiences of the day and any accomplishment of challenging activities. This develops coping skills and helps them discover their own inner strengths. "Dealing with children can be difficult because they often do not know how to express how they feel. The stresses and perils are ongoing, also for their parents Most parents and even teachers do not have the training to know how to approach children in crisis." (Beloff. R. 2001). 

"Digital story-telling helps adolescents break cycles of pain"

K4K also makes use of 'Digital Story-telling', using narrative in specially designed workshops. 
Youngsters create their personal computerized digital story on a compact disk. The movie format uses 
self-written stories and scripts, voice-over techniques, photographs, artwork, videos and music. The D 
Story process empowers the makers, breaking the cycle of feelings of helplessness. 

For example, one story has a scene of a bus devastated in Jerusalem by a suicide bomber, and Sara, a teenage girl, tells us what really happened when she was passing nearby: She rushed to help and saw a wounded baby lying on the ground, its arm almost severed. She picked up the baby and accompanied her to hospital. In the story she describes her actions and her feelings. The 3-5 minute self-made digital 'mini-movies' are powerful and eloquent. 


Source: Interview with Y. G, Kids For Kids, Jerusalem 2004. 


The organization's founder and international director never considered that their efforts would need to reach outside of Israel. But following the suicide attacks which killed thousands of civilians in New York and Washington on 9/11, American children also needed help with terror. 

Thousands of children in New York and hundreds in Washington lost a parent in just one day. An initiative called 'Hugs Across the Water' enabled American children to link up by e-mail with a pen pal in Israel who has experienced the pain and confusion wrought by senseless hatred and violence. Children reach out to other children who are suffering. 


K4K receives cartons of toys from children overseas. This action is like 'just being there, and loving, with a listening heart.' Pop stars have raised funds for K4K by making a CD 'The Stars Come Out for the Kids'. 
There have been gift-giving campaigns for teenage patients and international 'get well' e-mail campaigns.

 
5.9 WHAT HAPPENS TO FOREIGN WORKERS? 


A 2002 Human Rights Watch Report observed that by targeting public buses suicide bombings affected all sectors of Israeli society, not only Jews but also foreign workers. Among the victims of the suicide bombers have been foreign workers from Romania, China and the Philippines. Among many immediate and longer-term socio-economic consequences for foreign workers, disability may mean losing their occupation, and inability to send money home to their countries of origin. 

For foreign workers – a practical booklet on how to recognize suicide bombers 

On 3 July 2002, two suicide bombers headed for a crowded area near Tel Aviv's central bus station 
where many foreign workers congregate after hard-working days. Each bomber carried a bag packed 
with around five kilos of explosives surrounded by nails and metal objects to maximize casualties. 
Near a snack bar popular with foreign workers they mingled with the crowd and then blew themselves 
up. Three people were killed; an Israeli, a foreign worker from the Philippines, and a foreign worker 
from Romania. More than 40 people were wounded in the attack, four seriously. Arafat's Fatah 
Tanzim movement was blamed for the attack, despite Islamic Jihad's claim of responsibility.

 
Between 2000 and 2003 four Philippine foreign workers had been killed and 14 wounded in suicide 
bombing attacks in Israel. Another suicide bombing near the Tel Aviv bus station killed five people 
including three foreign workers, two from Romania and China. Fourteen people were wounded. 

On 5 January 2003 (the third bombing at the old bus station in under a year) 23 people died including a 
Chinese foreign worker. One hundred people were wounded. On 12 April a female suicide bomber in 
Jerusalem's Mahane Yehuda market detonated her explosives killing 6 civilians including two 
Chinese foreign workers, and wounding one hundred and four people. In the northern coastal city of 
Haifa in December 2001, Egged bus number 16 was blown up killing 15, including a foreign worker 
from the Philippines and wounding forty people. On 5 March 2003 on Haifa's Boulevard Moriah, a 
bomber blew up a bus killing 16 people and wounding 50, including a foreign worker from the 
Philippines. Further north on 4 August 2002 as Egged bus 361 wound its way towards the mountaintop city of Safed a bomber blew up the bus at the Meron Junction, killing 9 people, including another 
foreign worker from the Philippines. Sixty people were wounded. 

Also in August, a foreign worker from the Philippines who worked as a house cleaner and was a widow with elderly parents and a 16year-old son, was killed when Egged bus number 2 was blown up in Jerusalem. Her friends held nightly Catholic prayer meetings in her memory, before her body was flown back to the Philippines. 


In November 2003 there were 30,000 Philippine foreign workers in Israel. The Philippine Embassy 
expressed satisfaction with the treatment which had been received by their wounded nationals, 
including free hospital treatment, surgery, and longer-term treatment. Former Prime Minister 
Binyamin Netanyahu once visited hospitalized foreign workers from the Philippines. Hospital staff 
were reported by Filipinos to have been 'very compassionate' realizing that they often had no family 
or close relatives in Israel. For illegal workers with no official papers, some sought help from the 
non-government organization, Physicians for Human Rights. Others, despite official Israeli government assurance that they would not be apprehended in hospital after a bombing, preferred to treat themselves, even picking out shards of glass from their wounded bodies and applying first aid. Most wounded foreign workers from the Philippines stayed on to work in Israel, and there has been no drop in the numbers of new Filipino workers coming to Israel. 

The Philippine press reported the bombings which killed and wounded their nationals. Such bombings 
were viewed, to some extent, as 'part of everyday life in Israel'. The Embassy felt it was important that 
their nationals did not succumb to feeling victimized by terror. They have produced and circulated to 
their foreign workers a practical booklet outlining how to recognize suicide bombers, and how to 
avoid being killed or wounded. 


For example by taking a shared taxi instead of a public bus, and how to prepare a sealed room (bomb 
shelter) in case of major terror attack. The Embassy expressed the hope that this present report would 
provide a deeper understanding of how Israelis actually reconstruct their lives after the bombings, 
and what coping strategies can also be useful to foreign workers here. They felt that the deep spiritual 
faith of Filipinos is an important component of their resiliency. 


Sources : Interview at the Philippine Embassy, 18 November 2003; D. Rudge: 'Fatah Blamed for 
Tel Aviv Attack', Jerusalem Post, 9 July 2002; Haaretz, 25 August 2003 



In December 2003, one foreign worker from the Philippines wounded in a Tel Aviv suicide bombing was 
interviewed. 

"I thought maybe I have lost my legs; maybe I am going to die"

On 5 January 2003, 29-year-old registered nurse Marvin, who had been working in Israel for three 
years, went out to buy a brush for washing clothes. He thought it would not take long. He and his wife 
lived in a small apartment in South Tel Aviv near the old bus station. He passed video shops, cafes 
and small supermarkets in the crowded streets. Unemployed people stared out from the coffee shops. 
Women hurried past with children and plastic bags of shopping. Somewhere loud music played as the 
evening sky was darkening. Marvin recalls, “Suddenly there was an immense explosion. People were 
rushing in one direction. I thought if I run in the other direction I may escape. Then there was a 
second explosion. I was thrown up into the air, and I felt numbness in my arms and legs from the 
bomb blast. I couldn’t hear properly. I was lying bleeding on the street. 


A passer-by in army uniform dragged me away to a safer place. I felt blood coming from the back of 
my head and I could not stand. I knew I was wounded in my right thigh, my left heel, and that my right 
arm had an open fracture. I kept thinking of my wife and of my elderly parents in Tarlac in the 
northern Philippines , and my wife’s parents. I thought maybe I had lost my legs and I thought maybe I was going to die. After 8-15 minutes Magen David Adom staff arrived. They took me to Wolfson 
hospital, then later I was transferred to Tel Hashomer Hospital, partly through the help of a past 
employer. I was unconscious for almost a day. When I gained consciousness the doctors told me they 
didn’t know yet whether they would do surgery on my head. They told me a metal screw had 
penetrated my brain. 


The following day my wife and brothers came to see me. They hadn’t known if I was alive or dead. My 
wife stayed with me and slept in the hospital. The hospital social worker helped us. Staff from the 
Philippine Embassy came to see me, and religious people visited me. People from a Kibbutz where I 
had worked looking after elderly people came to see me later in rehabilitation, and they encouraged 
me to go forward. 


Three months later the metal screw was removed from my head. I realize I may have lost a little of my 
long-term memory. For example, I can’t remember the time when I was a student. Sometimes I feel 
dizzy. Recently doctors removed a metal ball from my right arm. For four to five months 1 attended a 
rehabilitation centre for physiotherapy and occupational therapy paid for by the Israeli Government. 
I have started work looking after an old man, but I cannot lift things. Fortunately he is still able to 
walk himself. I tried to start working earlier in a laundry store with washing machines. I worked there 
for 3 weeks, but I kept fearing another explosion, so I left that job. I have been helped when not 
working by Social Security. We get by on a small income because we are thrifty. For seven months 
Social Security paid 80% of the apartment rent. We used to send two hundred dollars a month to our 
elderly parents in the Philippines, but now can only send one hundred. I am the eldest of three 
children in my family. 

My left hand is better, but I still feel some numbness. I want the screw removed from my elbow but 
doctors tell me it may not be ready for removal for 2-3 years, so I have to live with it. They will do 
something to improve the hearing in my right ear. Today the thoughts that help me most are that my 
wife and month-old baby are with me. Twice I have dreamt of the bombing, have relived it in my 
dreams. I don’t think about the suicide bombers or their families. But every time I see an Arab-looking 
person it reminds me of the bombing. I don’t feel anything against the Palestinians. I continue to 
believe in miracles. I would like people outside Israel to know what happens because they really can’t know the reality here unless they have experienced it themselves. Sometimes I think that if I had not run in the other direction, 1 would have missed the second bomb.” 


The two male bombers had used very large bombs, intending to kill as many people as possible in an 
area crowded with civilians and overseas workers. Fatah and el-Aqsa Martyrs’ Brigades claimed 
responsibility for the bombing. 


Sources: Interview with M. S, 2 December 2003

 

5.10 WHAT TERROR MEANS TO THE DISABLED


For civilians who are already disabled terror and suicide bombings pose extra challenges. For those without sight or hearing terror attacks or even additional security measures can be traumatic experiences. Their unwitting actions can be mistaken for suspicious actions.

The vulnerability of the deaf and blind

It was 6 a.m. in Jerusalem and the streets were still shrouded in shadows. A 40-year-old man in a
khaki coat, his hat pulled down over his face, was walking to the 'mikvah' (ritual bath for religiously
observant Jews). A police patrol called out to him to stop, but he didn't hear and he continued
walking. Suddenly he found himself surrounded by police pointing guns. He panicked, related the
Director General of the Association for the Deaf in Israel. Until he managed to make them
understand that he's deaf it was extremely traumatic. You could still hear it in his voice months later.


Source: Wisemon, "An Extra Challenge" The Jerusalem 29 Report, July 2002



5.11 WHAT CAN I DO TO HELP MYSELF? PERSONAL COPING STRATEGIES


Coping with trauma is not new to Israelis. From the end of the eighteenth century Jews in Palestine, and
what later became the British Mandate in Palestine, have been coping with terror attacks, such as the Arab riots of 1929, the siege of Jerusalem in 1948, the First Intifada and now the Second Intifada. What are some of the contemporary strategies and personal coping approaches which are being found useful? Survivors and families of victims of suicide bombings interviewed admitted: "Yes, I do feel traumatized sometimes"; "I jump at loud noises"; "I hate the smell of burning hair (hair dryers at the hairdressers)"; "When I look into a cup of rose-hip tea, the first thing I see is not tea, but blood"; "I scrutinize the people waiting to get on my bus"; "When I go abroad I wonder why there is no security check at the entrance to their shopping malls".


How do civilians cope with terror as a way of life? What do civilians advise other civilians to do to cope
more effectively with terror and trauma? Here is some of their advice in their own words:

"Coping With Terror as a Way of Life"

"If you feel like crying – cry." Don't try to hide what you are feeling. What you feel is not unexpected.
Talk to family and friends about what you feel and listen to what they feel.


"Keep in contact with your loved ones." Try to know where they are – or are supposed to be – all the
time. Never mind your cell-phone bill.

"Maintain good social support networks" in your family and in your workplace. Remember colleagues
also share pain and suffering. Maybe arrange a group discussion led by a counsellor or psychologist.

 
"Enjoy festivals and help others to celebrate, like poorer families, the elderly, lone soldiers." Reach
out.


"Increase your voluntary work." The country is brimming with voluntary organizations, and one is
waiting for you.

 
"Have extra patience with other people, they also 'burn on a short fuse' and can get angry quickly."


"Be kind to your pets – they don't know what is happening."


"Don't beep your horn so much." It doesn't really help and bad driving is a feature of the landscape.


"Discover the healing force of nature. Plant flowers, seek the silence of the desert and walk by the
sea."

 
"Enjoy listening to music. Dance, watch good movies and videos. Avoid violent movies or videos – we
have enough violence for real."


"Keep your sense of humour, the terrorists cannot kill that. Your jokes may live afterwards."


"Don't feel ashamed if you feel the need for trauma counseling." Regard it as a positive step to seek a
psychologist, a bereavement counselor. If you need help, seek it, that's what professionals are for.

 
"Try to understand why the terror attacks are happening, even though you may hate the terrorists."
Don't lose sight of our common humanity with Arabs who do not support terror.


"Mainstream terror attacks into the pattern of your everyday life – what else can you do?"


"Keep going on buses and trains and planes, but, have a look at who is boarding the bus and who is
sitting near you." Maybe sitting nearer an exit door could help a bit.


"Make a will so that if you go suddenly your family know what is supposed to happen to your material
possessions." It can help them at a painful chaotic time.


"Avoid watching too much TV coverage of terror attacks except for 15- 20 minutes a day. Get actively
involved in a media watch network."


"Cook new recipes for your family. Eat a good, healthy, balanced diet of Mediterranean-style foods. It
makes you happy". Eat seasonal, locally grown food like fruit, olive oil, 'humous' (chickpeas). Avoid
drinking too much coffee, or alcohol – the 'buzz' they give only lasts a short time.


"Give of yourself and your possessions to others who may need them." "There is always someone
worse off than you. Try to reach out to them."


"Thank the Almighty every day for things which are still good in your life ". Even though you may feel
the pain of nails or metal balls still embedded in your body.


"Things may get worse but they may also get better. It may take time to get better. Be realistic, but
never lose your optimism – it is a gift".


Sources: Interviews with survivors and families of victims of suicide bombings and other terror
attacks during Civilian Project 2001-5


 
THE DUAL ROLE OF MOBILE PHONES DURING TERROR ATTACKS

The mobile phone continues to play a mixed role in terror attacks. After a terror attack the cell-phones start ringing. Anxious family members are trying to contact their sons, daughters, fathers, mothers, brothers and sisters. Sometimes they are lucky; their calls are answered by a survivor. Sometimes there is only silence on the line; there is no-one alive to answer. However, the mobile phone is also used by the bombers to trigger their explosives. So the device is being used both by terrorists to perpetrate the attacks and by relatives of their victims.


5.12 WHEN EVERY DAY COULD BE GOODBYE


Why do many Israeli women and their children so often end a telephone conversation with the words 'I love you'? Because activities which are considered normal elsewhere around the world, like getting on a bus, or having a cup of coffee with a friend, could in Israel be a fatal activity. Civilians never know where a suicide bomber may strike next. Could the bomber be the well dressed young man who declined to take change for his ticket from the bus driver? Yes, it was. Could it be the young veiled woman standing at the bus stop 'dressed' in a belt of explosives? Yes, it was. Could it be an 'Israeli soldier' in stolen uniform at a bus station? Yes, it was. Or, an unusually heavily clad man waiting in line for a shopping mall to open? Yes, it was. That's why it's better to say 'I love you' to your loved ones, while you can.

No Time To Say Goodbye; Why We Need to Say Goodbye Before We Die

In 2001, in a town in the Negev desert, an Israeli woman heard of the death in a terror attack of a
much loved sister-in-law, Hadas, living far away near Haifa. On Friday, 9 November 2001 at 11.45
am, kindergarten teacher Hadas drove six kilometres from her home in the rural community of Mevo
Dotan, not far from Jenin, to collect her eighteen-month-old daughter from the nursery. She wanted to
get home early to start cooking the Sabbath meal. Soldiers at a nearby check-post asked her to wait
until an army jeep was going her way, so that she could go with them for better security. But, as she
was in a hurry she decided to go alone. Suddenly shots rang out.

She ducked down as she continued driving. Then a hail of gunfire. One bullet pierced her heart. Later, she was discovered dead in her car, pierced like a sieve by the 24 bullets of a Hamas gunman. Meanwhile her bus driver husband Itzak was taking schoolchildren home. He heard the shots and he even saw in the distance the remains of the car amid a crowd at the scene of the attack. He also saw an ambulance. He shouted "It's Hadas for sure!"

To protect the schoolchildren he turned away along a different road and safely delivered them home. On a far-away desert road to the south, her brother-in-law heard of the terror attack on his car radio. He called his brother Itzak who said "something has happened!" Itzak went to the scene – and saw his dead wife.


In the desert town, Itzak's sister Levana was cooking for the Sabbath when she heard the news of her
sister-in-law 's death. "I felt a hard pain, like a stomach-ache. I could not breathe properly. I could
not cry. I thought, 'I must be in control of myself. I told my three children of the death of their aunt. I
got my neighbours to take care of my children. I kept thinking, 'What will happen to my brother's
children?' I threw clothes into a suitcase. My husband and I drove through the desert and on down the
coastal plain. It was two and a half hours before we reached my brother's house. It was a terrible
drive. We felt so confused."


"When we saw my brother it was like he had shrunk inside. He was so unnaturally quiet. He had been
organized in the first few hours. He had waited for the social worker to arrive before he told his
children their mother was dead. He cried a lot, which was not like him. He kept repeating, like a
mantra, 'Why did she have to go out then? Why did this happen to me?' Later he said to me, 'You
should take the meat out of the fridge – it was for Shabbat.' But when I looked in the fridge, there was
nothing there. Hadas had not even had time to put meat in the fridge."


"I used to talk to my sister-in-law on the phone every Sabbath eve, about our families, news of the
past week, ideas for new recipes. She lived for her children and family. She was very lively, and loved
playing cards with me at home. Sometimes we met in Tel Aviv for coffee. We were very good friends.
On that terrible night driving up from the desert northwards I felt a numbness. I tried hard to
remember my last conversation with my sister-in-law. Even now, two years later, when I sit down to
meditate, I see her in my mind. I try to get an 'image' of her, not a picture, but an image. I try to
visualize her. I sit every week for fifteen minutes to meditate like this. I believe this is what she would
want."

"Now, after what has happened, I think often about the way we remember people who have died. It is
the Jewish custom for close relatives of the deceased to 'sit Shiva' which means the seven-day initial
mourning period. When Hadas died, many people visited Itzak's house to comfort the family. One
evening I sat alone in the large tent erected in his garden for the mourners. It was cold and I lit a
cigarette. I started to think of Hadas. The image stuck in my head of when her body had been brought
home, and Itzak had insisted on seeing it. He had said, 'How small she looks now.' Sitting alone in the
cold, dark tent I could not conjure up her image alive. I felt I could not remember her well enough
alive. I needed to see her speaking, smiling, I felt responsibility for her children aged eighteen months
to sixteen.

When I am with them now, I act like she would have done. It is important 'to see things as she would have'. I still feel a big pain inside when I see photos of Hadas. That part of my life is frozen.


Until now I cannot find anything to comfort me. I am not religious. We had planned to go all together
to Turkey; she had never travelled. I thought afterwards, why had we had not done that sooner? We
had so many other joint plans. I wanted to ask Hadas what we were supposed to do if she died. What
she would like us to do for her family. When I see my brother's difficulties in bringing up his family
alone it disturbs me."


"I wanted desperately to have been able to say goodbye to Hadas; there was no time to say goodbye.
We need to say goodbye before we die. After three months I took a notebook and wrote down what I
myself would like my own children to think about and to know if I myself died tomorrow. So that it
would not be such a big pain for them. I wrote down what I wanted my husband to know, and my
children. The ways in which I love them and what is special to me about each of them. I would like
them to know that I feel I have had a good life. That now, even after the tragedy of Hadas's death I
feel the important thing about life is to smile and to be kind. It is a simple way to go forward, not so
painful. Her death will cause me pain all my life, but I feel I am learning to deal with it. I feel that I
have learned what the most important things in life are, so I don't waste any time. I live intensively. I
feel more secure now that if I die suddenly, they will know that I died peacefully."


Sources: Interview with L, 30 November 2003, Mitzpe Ramon


 
5.13 THERAPEUTIC APPROACHES USING MUSIC, ART AND HORTICULTURE 


Various therapeutic approaches have been employed to help survivors and families of victims of suicide
bombings and other terror attacks to cope and move forward from painful trauma towards eventual healing. The extensive appreciation of music, art and horticulture in Israel has enabled such therapeutic approaches to be applied more easily. The following three examples of therapeutic approaches relate to music, art and horticultural therapy. The first illustrates music therapy in action.

"Hope Shattered Into Death -All We Can Do Is to Ease the Pain"

One Friday night in 2001 youngsters gathered outside the Dolphinarium Disco on the beachfront in
Tel Aviv. A suicide bomber, disguised as one of them, waited to detonate. When he did, the blast killed
twenty-one youngsters and wounded one hundred and twenty. "In just one minute, youthful joy of
living turned into a bloody massacre. A Russian-born composer/performer Zlata Razdolina, who had
been one of St Petersburg's flourishing composers/performers, and who had moved to Israel when
members of an anti-Semitic organization threatened to kill her, presented not long after the bombing
a special concert in memory of the dead teenagers.

 
"I called every parent, every family and invited them personally." And, to her great surprise they
agreed to come. "The memorial concert seemed very important to them. Suddenly they realized that
they were not forgotten and that we all remembered. Memory, which holds them together, is the only
cure that can, maybe, heal those agonizing emotional wounds. There were some parents, originally
from Russia who were even thinking of leaving Israel who did not enjoy life here and were thinking of
seeking a new home. But now they say Israel is the only place they want to be. Their child's blood
connects them to the soil of our land."

Zlata plays the piano and keyboard and sings in Hebrew, Yiddish and Russian. For that memorial
concert she wrote new poems, after the painful experience at the Dolphinarium. At the concert she
reached deep into the hearts of families who were still mourning their young ones. They, like Zlata
had made Israel their home and then had to acknowledge the searing pain of loss in a land where
peace is a dream and poems teach that this dream is still out of reach. Zlata spoke of "hope shattered
into death, crying, and wounds that would, unfortunately, not be easily healed. All we can try to do is
to ease the pain."


The use of music to relieve pain has been recorded throughout history from the oldest known
documentation of medical practices, the Kahun papyrus c.1900 BCE, which refers to the use of
incantations for healing the sick. In the Middle Ages the Italian tarantella dance was used to relieve
the pain of stings or bites of tarantulas. Current music therapy is sometimes used in medical and
dental settings. Studies of use of music therapy have recorded reduced post-operative pain,
normalization of blood pressure after surgery, reduced pain in cancer patients, and reduced sensation
and distress during the pain of childbirth. Music therapy uses client-therapist interaction through
music, in order to preserve healthy qualities, promote development and change, and achieve better
quality of life. Dynamic music therapy workshops are used to promote self-development and
emotional maturity, and work in clinical setting enables integration of professional skills. The music
therapist is a professional who employs skills and knowledge derived from interdisciplinary training,
combined with a thorough knowledge of music and therapeutic theories and methods. Research is
currently being carried out in Israel to scientifically verify if music can decrease perception of pain,
and what types of music can produce that effect.


Sources: Ajzenstadt, "Composer Seeks to Heal Parents' Dolphinarium Wounds With Music"
Jerusalem Post 3 September 2001; Moont, 6 September 2004



The next example illustrates how art-making is used as a therapeutic approach to treat survivors of traumatic terror-related events.

Art Therapy is the marriage of art and psychotherapy

Dasha is in sixth grade at school in Haifa. She took part in an art therapy session and drew a picture
showing a yellow background with dramatic black pieces of wreckage. At the bottom, lying on the
ground is the figure of a woman with blood-stained head and clothes. Her eyes are closed. Through
this drawing Dasha expressed her own pain after a terror attack. Child psychologists noticed that the
process of art-making could be therapeutic, especially with children undergoing psychotherapy.
Art as therapy was originally used as a diagnostic tool by psychologists and not as a form of healing
by itself. It can help people grow and rehabilitate and heal in the process of making art. People are
encouraged to express what they cannot say with words through drawing, painting and other art
forms. It may involve constructing, arranging, mixing, touching, molding, gluing, drawing, shaping,
painting, forming and other similarly tangible experiences. Through art therapy people may find
relief from overwhelming emotions, crises or trauma.


In South America and Africa, people heal themselves using creative processes as tools. Generally, art
therapy has been practiced elsewhere with adults, children, adolescents, elderly people, people with
terminal illnesses, war veterans, people with disabilities, prisoners, and people with emotional
disorders. "Art therapy is essentially the marriage of two disciplines, art and psychotherapy. The
word 'theraperia/therapia' comes from the Greek word meaning to 'be attentive to'. In art therapy a
skilled professional attends to the individual who is making the art, and this guidance is key to the
therapeutic process. This supportive relationship guides the art-making experiences and helps the
individual find meaning through it along the way" (Malchiodi 1998)

 
Training in art therapy began in the 1970s in the USA and in Israel in the 1980s. In 1995 art
therapists in Oklahoma City in the USA worked with 120 survivors and families of the Oklahoma
bombing for two weeks following that tragedy as a way to help survivors express their grief. In Israel
aspiring art therapists need to have a first degree in psychology, social work or a related subject.
Currently art therapy is available through treatment centres with professionals such as psychologists,
who offer it alongside various other expressive therapies. The largest employer of art therapists is the
Ministry of Education, due to the traumatization of children since 2000. Art therapy may involve
therapist and client undertaking several 45-minute sessions after school hours, alone at a table with
art-making materials such as paint, clay, or pencils. The therapist acts primarily as partner in the
artistic exploration, gently guiding the client in a way which strengthens them, using free and
interactive drawing.


One terror victim support organization had a client who was so traumatized at losing a family
member that she could hardly speak or move as a result of the trauma. By the end of the art therapy
she could both speak and dance. Art therapy can be very useful with children because they often
cannot express themselves in words, and may not be aware of how they feel. Art-therapy links to the
vital and healthy part of a person, tapping in and strengthening them, making them feel better
understood and not alone.


Sources: Interview with art therapist T. H ; Malchiod, "The Art Therapy Sourcebook"
Lowell Home, Los Angeles 1998; "Target: Israeli Children" Ministry of Education, State of Israel,
2002



The last example is horticultural therapy, the use of plants and gardening as a therapeutic approach to
healing trauma.

"We are starting to come back to life like a bud flowering"

The therapist had bought new plants to the therapeutic community centre's greenhouse near Tel
Aviv's Tel Hashomer hospital. The centre provided multi-therapy, art therapy, computer therapy,
jewellery-making, sports and horticultural therapy. Help was needed to plant the flowers in pots.
Soon a group of patients was assembled and accompanied by volunteer singers they began to plant
the flowers into the plastic pots. The large table was soon covered by green foliage and young
flowers. The singers sang and the planters planted. 'The flowers are beautiful' they said 'can we take
some home?'. The planters were all patients suffering from trauma, for some the results of Israel's
recurrent wars. For others, the result of the Second Intifada with its ugly legacy of bombed buses and
cafes, and traumatized civilians. The previous week the same group had toured near the Sea of
Galilee, visiting historic trees on the biblical tree festival of Tu Bishvat. Stories were told of the
historic trees, and new trees were planted. The healing powers of nature were being applied to
wounded emotions and wounded minds. Twice a week patients have opportunities to actively
participate in horticultural therapy.


'Horticultural therapy' is basically an interactive process designed to produce psychological,
emotional and spiritual healing and increase resiliency following trauma. It can enhance feelings of
responsibility ad achievement, and increase self-growth and optimism. It can be a social or a solitary
activity. Activities such as planting, being close to nature are allied to professional treatment for
traumatized people. The main purpose is to improve the patient's quality of life physically and
psychologically. The horticultural therapist assesses the needs of a traumatized patient and uses this
knowledge to design an intervention to fulfill the client's needs. This may involve approaches and
activities like basic training in gardening, increase of client's curiosity about growing plants, flowers
and herbs, stimulation of the senses (e.g. the smell of roses), increase in the senses of hearing, touch,
and taste, and increase sensitivity to the surrounding community.

 
Horticulture as therapy originated from treatment in a psychiatric hospital in the United States where
people found comfort in nature. In ancient Egypt physicians reputedly recommended patients to take
calming walks in gardens to reduce stress. The often rural location of psychiatric hospitals has aided
in developing horticulture as therapy, using herbs and vegetable growing. By 1798, in Pennsylvania,
USA. such approaches were in use with patients also engaging in some farm work. In 1817 a new
psychiatric hospital was built around a large garden with wooded and shaded areas and a vegetable
garden. In 1900 war wounded benefited from horticultural therapy. By 1917 Bloomingdale hospital
had opened a facility to teach horticultural therapy. During the 1950-1960s the professionalism of the
therapy further developed and a master's degree in horticultural therapy became available. In Israel
horticultural therapy was used with the elderly. In 1999 the first course in horticultural therapy
became available in Tel Aviv University, with the first graduates by 2000. Horticulture as therapy is
also used in England.


Perhaps, after all the destruction of the suicide bombers, growing living things, plants, flowers, trees,
herbs, reminds people of wholeness, growth, capacity to achieve. The clients in the Tel Hashomer
Community Centre said, 'We can laugh and enjoy. We are starting to come back to life again, like a
bud flowering."


Sources: Interview in Tel Aviv with I. R. Horticultural therapist 31 January 2005;
Additional information from Zehava Even-Paz, Tel Hashomer Hospital, Tel Aviv, January 2005



USING NARRATIVE THERAPISTS

Every municipality in Israel employs psychologists who specialize in counseling, group interventions and
crisis intervention. They believe that people themselves are the main experts regarding their own lives.
Narrative therapists try to understand people's stories through their own eyes. Narrative therapy does not
assume there is a 'truth' to discover, and any personal experience, event or situation can have many differing meanings. The meaning a person attaches to events will determine his/her subsequent reactions to those events, and consequent activities. People usually attach meaning from their own cultural, religious and ideological points of view.


5.14 COPING WITH TERROR – THE BOTTOM LINE


After suicide bombings the personal struggle begins to cope, to carry on, although life has often changed
forever. Coping is about not letting terror destroy your ability to create a routine which will be good for you.

It is about trying not to be pre-preoccupied with things that you personally cannot control. It is about having confidence that the government or whoever is in power and your security forces are on your side. Israeli civilians often tend to be' future-oriented.' Terrorists try to instill fear and helplessness, increase
vulnerability, and cause grief. Coping is essentially about individuals and communities learning to manage new ways of feeling and behaving. For Israeli civilians, perhaps living always with the proximity of death, life itself assumes an added dimension. It becomes more precious. As a suicide bombing survivor says" terrorists and bombers try to freeze us with fear but they can't because we contain elements which can unfreeze our fear and pain. They don't understand that. They want to die, but we want to live."

 
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