The Psychological Impact of the Hamas Attack in Israel

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On October 7, Hamas launched a massive attack on southern Israel. The attack started in the early morning with the shooting of thousands of rockets into Israel and was followed by a triple attack by land, air, and sea, with terrorists attacking military installations and more than 20 Jewish settlements. They brutally murdered civilians, including babies, individuals with disabilities, and older adults; they raped women; they burned people alive; and they mutilated bodies.

The death toll among Israelis has exceeded 1300, including more than 120 soldiers. More than 200 Israeli hostages were also abducted into the Gaza Strip. Due to the large number of terrorists, it took hours before they were stopped by the Israeli military. Although Israel is well-acquainted with terror and wars, and research shows that its citizens are considered quite resilient, several aspects stand out compared to past events:

• The current situation is still ongoing and, therefore, bears a high level of uncertainty and instability. At this point, 2 weeks after the attacks, there has been no information regarding the civilians being held captive or their condition. It is still unclear how many were killed and who is still alive, as the terrorists burned people alive and there are no remains. This situation leads to the experience of ambiguous loss.¹ Ambiguous loss, defined as the physical absence of someone who may be alive, differs from death-related loss and bereavement because the individual perceives it as a reversible condition—that is, the individual keeps a realistic wish that the missing person will return. The ambiguity surrounding the loss leads to ongoing confusion and makes it impossible for closure and grief processes. Situations of ambiguous loss were found to relate to higher levels of psychological distress and post-traumatic symptoms.²
• The scope of the events and the horrific results of the massacre on the residents of southern Israel are beyond what has been seen previously. The Hamas terror attack was extremely brutal and inhuman, indiscriminately killing soldiers and civilians, including whole families, Holocaust survivors, babies, children, and older adults. The shooting of babies and children in front of their parents and the burning of people who were alive and crying for their lives exposed all Israelis to pure evil and cruelty, which is hard to conceive. The fact that Israel is a small and cohesive society means all Israeli citizens are exposed and will respond to the events. This, combined with the ongoing exposure to the danger of thousands of missiles all over the country and the fact that every Israeli family has a family member who serves in the military and is currently enlisted and may be in danger, leads to what has been termed in the literature as shared reality.^3,4 The notion of shared reality, which was originally coined to describe the unique burden of therapists and first responders who share the same dangerous reality as their clients, has been broadened in the past 2 weeks and refers to most Israelis. All are exposed, all know at least some of those injured or dead, and all share the ongoing threat from Gaza, while at the same time, most support the massacre survivor communities, primarily through volunteering.
• The nature of the brutal events led to a massive loss of resources for survivors. According to the conversation of resources theory,⁵ the more resources are lost or compromised, the more difficult it is to recover from traumatic events. Currently, there are about 300,000 residents (from the south and north of Israel) who were evacuated from their homes for security reasons or (as in the case of many of the southern settlements) because their houses and schools were destroyed and burned. Loss of housing and staying for long periods in a temporary shelter leads to financial loss and difficulties in returning to routine. Furthermore, because individuals lost several family members, as well as their neighbors and friends, they lost their natural support systems—which are critical resources in the recovery process.

All these aspects point to the understanding that Israel is experiencing national trauma—one that is believed to signal long-lasting implications for the future. Aside from typical acute phase responses, such as anxiety, fear, and intrusiveness, recent events challenge the basic assumptions and beliefs of many Israelis.

The terrible sights from the massacre triggered memories of the trauma of the Holocaust, which is still alive for Jews and Israelis. Watching people being dragged away as they raise their hands in surrender or being shot at and burned is a memory Israelis never dreamed of seeing again as free citizens in their own country.

For many Israelis who fought for peace with the Palestinians, it is a moment of rupture and questioning assumptions. Other basic assumptions that were sincerely held and now questioned relate to the disappointment and loss of trust in the formal institutions, including the military, the police, and governmental bodies, for not being prepared and unavailable when most needed.

In addition, contrary to conflicting sentiments in previous terror attacks, there is widespread sentiment that the just response to the Hamas massacre would be a significant military operation that would ensure the safety of Israeli citizens. Evidence shows that ideology and values may serve as protective factors against posttraumatic stress disorder (PTSD), which seems to be the case for most Israelis now. The majority views the planned operation as a necessary step.

The result of the above is that at this stage—2 weeks after the massacre, yet before Israel has initiated the full military response to it—Israelis feel a mixture of anxiety, grief responses, and pain, together with strength and determination. Israelis are exhibiting a high level of solidarity and support at this time.

Thousands are donating blood and money for the wounded individuals and communities, and volunteering to help with all the evacuees’ physical, bureaucratic, and psychological needs. Thousands of others returned from abroad to serve in the military reserves.

Rivka Tuval-Mashiach, PhD

Although it is hard to predict what the coming weeks will bring, it seems that Israelis now show a mixture of pain, bereavement, and resilience at the same time.

Dr Tuval-Mashiach is a professor at Bar-Ilan University. She is also affiliated with Natal, the Israeli Center for National Trauma and Resilience.

References

1. Boss, PE, Ishii C. Trauma and ambiguous loss: the lingering presence of the physically absent. In: Cherry KE, Ed. Traumatic Stress and Long-Term Recovery: Coping With Disasters and Other Negative Life Events. 2015;271-289.

2. Renner A, Jäckle D, Nagl M, et al. Traumatized Syrian refugees with ambiguous loss: predictors of mental distress. Int J Environ Res Public Health. 2021;18(8):3865.

3. Baum N. Shared traumatic reality in communal disasters: toward a conceptualization. Psychotherapy (Chic). 2010;47(2):249-259.

4. Freedman SA, Tuval Mashiach R. Correction: shared trauma reality in war: mental health therapists' experience. PLoS One. 2018;13(3):e0194359.

5. Hobfoll SE. Conservation of resources. a new attempt at conceptualizing stress. Am Psychol. 1989;44(3):513-524.