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National Trauma: What Are the Consequences of War in the Middle East?

National Trauma: What Are the Consequences of War in the Middle East?

A suicide bombing breaches the peace of a Jerusalem night in August and is then followed by weeks of retaliatory strikes aimed at Palestinian targets. It is yet another episode in the back-and-forth violence that typifies this region's intractable conflict and the intergenerational hatreds it produces. Whether the current effort to follow a roadmap to peace will yield an end to the fighting is uncertain. But one thing is clear: the trauma this war inflicts on individuals continues, and its emotional and psychological consequences will affect both Israelis and Palestinians for years to come regardless of what happens politically or diplomatically.

As a result, despite the decades of hostility, there are still things to learn from the Israeli-Palestinian conflict. The consequences of violence, experts say, will affect how these people are able to get along if at all even if a truce evolves and the national interests of all parties are met.

"National trauma is something that has to be defined," Avraham Bleich, M.D., told Psychiatric Times. Bleich is chair of psychiatry at the Tel Aviv University Sackler School of Medicine and chair of the professional steering committee of NATAL-the Israel Trauma Center for Victims of Terror and War. "One of my primary goals is to define this issue."

Over the next several months, he said, researchers will work on polling the country's population to determine "what the public is thinking about national trauma." In addition, a multidisciplinary meeting is planned for early next year that will bring together experts who will consider national trauma from psychological, sociological, philosophical and medical perspectives.

That there is an impact capable of scientific measurement, however, is already apparent. Bleich and two of his collegues published an article in JAMA that measured mental health symptoms and coping mechanisms following exposure to terrorism based on a national telephone sampling (2003;290[5]:612-620). According to Bleich, this is the first study to consider the effects on a nation of prolonged exposure to trauma resulting from terrorism.

Although approximately half the respondents reported direct exposure to terrorism either personally or via a friend or relative, some two-thirds of the participants felt their lives or the lives of loved ones were at risk. The study reported that people experienced an array of stress-related symptoms from trauma, with approximately one-third of them reporting at least one symptom persisting over a month. Although not clinically evaluated for posttraumatic stress disorder, 9.4% of the respondents reported symptoms sufficient to warrant the diagnosis.

Behind those findings, however, Bleich said there is hope. "In spite of individual, social and national damage being done to each side there is a very, very great will to look to the future and to try to empathize with the other side's trauma and to use the trauma as a bridge rather than as a bleeding wall," Bleich said. "The hope for a peaceful, mutual future is a stronger healing force than the scars of the situation. Of course, there will be scars and there will be people preferring to adhere to the wounds and the scars, but hope for a better future is much stronger in my point of view."

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