Injured in the Field:

J

ust a few weeks after his long-awaited induction into the Israel Defense Force, Amit Sha'ar posted a tragic poem on Facebook. In it, he begged to be spared the trauma of donning an army uniform and given time to "reassemble all the broken parts of me."

Sha’ar was born and raised on Nirim, an Israeli kibbutz about a mile from the border with the Gaza Strip. The year he was born saw the very first Qassam rocket fired from Gaza into Israel. They have not stopped falling ever since.

Like so many of his peers, Sha’ar never experienced a more normal reality; for him, the color red will forever be linked to the early-warning siren for incoming missiles and the panicked rush to the bomb shelter, not the colors Liverpool, his favorite soccer team.  

In August 2019, Sha'ar, who had been highly motivated to serve in a combat unit, joined the Bardelas Battalion, which secures Israel’s southern borders, from the Dead Sea to Eilat. However, during his army service, he began to display symptoms of post-trauma, as a result of having lived his entire life in the shadow of missiles.  In April, he was granted a psychological discharge from the IDF, with a diagnosis of PTSD.

"As a child, I didn't suffer from anxiety," Sha'ar says. "After Operation Protective Edge in the summer of 2014, my bar-mitzva year, I went into depression as a result of an incident on the final day of the operation, when two people I knew personally from the kibbutz [Ze’evik Etzion, the kibbutz security officer, and Shahar Melamed, a member of the kibbutz emergency team] were hit by a rocket and killed. It took me time to get over the shock. I was 13 and suffered a post-traumatic reaction. It didn’t last long and I recovered, but when I began my military service, the trauma resurfaced and suddenly I was experiencing daily panic and anxiety attacks."

Did you attribute this to the security situation you had experienced?

"Yes, because I also had incident-specific flashbacks. Before I began serving in the army, I didn’t have flashbacks. We immediately recognized the connection. My father's a psychologist, so he caught on immediately," adds Amit with a smile.

Amit Sha'ar: "We all suffer post-trauma all of the time. The only question is when it will erupt. This is something that we all repress, no one will admit that they suffer from it, but there is always the feeling that something is being repressed"

What in the army triggered the outbreak?

"It was a general feeling. The atmosphere there is very oppressive. You do what you're ordered to do, and this puts people who come from an area like the Gaza border under a lot of pressure. The very fact that during wars you spend a lot of time in the mamad (safe room) and don’t leave it for any length of time … doesn’t sit well with a situation in which, every day, others decide for you what you have to do. Also, there are a lot of training exercises and shooting drills; I simply couldn’t shoot. My commanders were actually very sensitive to my difficulties and listened to what I had to say. The problem is the entire military system."

How did you feel about wearing uniform?

"I had a lot of problems. When I lived on kibbutz, there were always uniformed soldiers walking around. I have nothing against them, but wearing uniform was a throwback to the past, which was difficult for me."

How would you describe your childhood and adolescence in the Gaza border area?

"You live your life in survival mode and in constant fear. At any given moment, a Qassam rocket could land. When we were younger, [terrorists] would launch mortar shells and there was no warning system. That was even more dangerous. I had a good childhood as far as the people I grew up with, but there were a lot of rocket attacks."

Did you or your friends undergo any psychological preparation before you enlisted?

"No. I worked out. I really wanted to be combat soldier and was ecstatic when I was accepted to a frontline unit. I didn’t think anything untoward would happen to my mental state; it didn’t cross my mind. But already, on my first day in the army, I got a slap in the face."

After six weeks in the combat unit and many anxiety attacks, Sha’ar asked to be transferred. His new position was in the Southern Command Education Corps. "I felt slightly better," he says, "but was still left with oppressive feelings – both in the army and sometimes when home on leave. I was still part of a framework and I still had the uniform."

He was discharged from the army this past April. "For a long time, the army wanted to discharge me. I tried to stay and took on different positions. I fought hard enough, but in the end I agreed to the discharge. I am at peace with the decision."

Are you frustrated by what living so close to Gaza means for your life?

"I would certainly prefer to raise my own children somewhere else, at least until they reach a certain age, because of the price of living here. In my case, my parents couldn’t have known in advance what would happen. And once it did, they couldn’t have known that it would continue and reach this point."

Are you an exception among your peers?

"Not at all! We all suffer post-trauma all of the time. The only question is when it will erupt. This is something that we all repress, no one will admit that they suffer from it, but there is always the feeling that something is being repressed. I have two other friends from the area who were discharged from the army for psychological reasons. Let’s put it this way, I'm not the first and I won't be the last."

A ticking time bomb

PTSD is one of the most sensitive and under-discussed issues in Israel. Trauma centers are deeply concerned by the phenomenon, mental health therapists deal with it on a day-to-day basis, parents struggle with it, and young sufferers' experiences with the disease are complex and painful.

Despite all the difficulties – and the political debate it may spark – PTSD must be discussed openly and frankly. Young people from the Gaza border area, the 'Qassam Generation,' are incapable of functioning properly in the army because of the emotional trauma of having lived through the complex security situation in Israel's south. In some cases, military conscription causes PTSD to surface. Some of these young people drop out of combat units or are discharged from the IDF; some do not even enlist.

Pearly Haziza: "When my son enlisted, he applied for a combat position. He told me: ‘What I want most is to protect my home from rockets.’ But when he enlisted and began his basic training, something changed. It was very difficult for him emotionally"

Yizhar Sha’ar has been the director of the Eshkol Region Educational Psychological Service for the past 18 years. He lives on Kibbutz Nirim and has three children, including Amit.

"We're talking about an entire generation that has been exposed to the reality of war," he says. "They join the IDF and develop PTSD – especially those serving in combat units. Everything they've seen and endured comes to the surface. Overexposure to situations that simulate war during basic training, for example. Some of them cope and this may boost their sense of self-esteem. But for others, it can break them."

Dalya Yosef, director of a dedicated helpline, is unequivocal. "This is a ticking time bomb," she warns. "History books will tell the story of the children who lived in the shadow of the Qassams. To be born and grow up feeling that there is no safe place in the world is not normal and exacts a heavy price."

Yosef was born and raised in Sderot and set up NATAL, the Israel Trauma and Resiliency Center, in 2006. In this terror-stricken city, the current IDF dropout rate stands at 28 percent – almost double the national average.

"Look at it from the perspective of a child growing up there," she says. "Not only is that child's physical home in danger, they are grabbed by their parents and rushed to a bomb shelter. Not only that, but when they look in their mothers' eyes, they see that the world's really not a safe place. If this were a one-off thing, then you could cope with it. But these youngsters have been living like this for almost 20 years. It’s crazy. And then we are surprised that when they enlist and hold a rifle for the first time, they break down?"

Pearly Haziza lives in Sderot with her five children. "When my son enlisted, he applied for a combat position," she says. "He told me: ‘What I want most is to protect my home from rockets.’ But when he enlisted and began his basic training, something changed. It was very difficult for him emotionally. Every time he failed the obstacle course test he was kept on base for the weekend when all the other soldiers were allowed home."

One incident, Haziza recalls, was particularly difficult. "All the soldiers were allowed home for Independence Day, but he was not. We begged for him to be allowed out, and finally, we pulled some strings, and he was allowed to come home the day after the holiday. I eventually contacted one of his commanders and told her it didn't make sense that my son couldn't do the obstacle course. I asked her what she thought could be done. Then asked for my son to see a mental-health officer. After several meetings with the officer, my son passed the test. The officer told me my son has anxiety issues as a result of the security situation. And it’s true; as a child, he really was affected by the Qassam rockets."

Ultimately, her son's service in a combat unit was a success. From her perspective as a mother, however, his military service was extremely tough. "I’ve read about the dropout rates in Sderot and they're perfectly understandable. I know a soldier from Sderot who enlisted, went to the shooting range, and went into shock. He just couldn’t hear shooting and simply blocked his ears. The reality here is not normal. It’s killing our soul."

Haziza courageously shares that she herself has been suffering from PTSD since August 2019, when she took her daughters to a concert by pop singer Eden Hason.

Yizhar Sha’ar: "Many of these kids don’t want to open up and talk because of the great shame they feel. After all, it affects how others view them. But all the young people from our community who have enlisted suffer post-trauma to a greater or lesser extent and their army service is a nightmare."

"I was in line to enter the venue when the missile siren went off. I ran to the shelter and on the way my dress got torn, one shoe fell off, and I hurt my knee. People were pushing in all directions. Luckily, my older daughter grabbed my younger daughter and ran with her. I froze. I couldn’t help anyone. People were fainting, screaming. Afterwards, my younger daughter, who is 6, refused to leave the shelter. Forty minutes later, when we did leave, I saw a terrible scene: there were hats, shoes, diapers, and strollers strewn all over the place. I have flashbacks to this scene when I’m trying to fall asleep."

Fewer recruits, more dropouts

This is a story with countless conflicts. On the one hand, many of the new recruits from the Gaza border area are highly motivated and determined to excel and they complete their army service with no particular difficulties. Many of them serve in elite combat units and later become officers. This is why some of the people contacted declined to be interviewed – even though they are more than familiar with the issue. Some even opposed our investigation, arguing that it would damage morale and the image of the towns and communities in the Gaza border area.

Others did not want to be portrayed as victims. In the words of a teacher from one of the kibbutzim adjacent to the border fence, "I don’t want to contribute to portrayals of us as tragic figures and I don't want to tell you about a 15-year-old girl who still wets her bed at night." Others still said that there is no reason for "one rotten apple to spoil the whole barrel."

But we can no longer afford to ignore the youngsters who encounter emotional difficulties before and during their army service. Mental health professionals are the first to encourage discussion of this issue.

"Many of these kids don’t want to open up and talk because of the great shame they feel," according to Yizhar Sha’ar. "After all, it affects how others view them. But all the young people from our community who have enlisted suffer post-trauma to a greater or lesser extent and their army service is a nightmare. Some of them serve in combat roles and suffer; others have already been released from combat units but still suffer from PTSD. It doesn’t matter where you are serving: the very fact that there are soldiers and uniforms is tough for them."

Talia Levanon, director of the Israel Trauma Coalition, concurs. "There are young people from the Gaza border area who enlist and are highly motivated, but after some time, we see that they have problems adapting because of the strict framework, the heavy demands, and, of course, the exposure to guns and so on." The coalition she heads brings together 40 organizations that treat trauma and provide mental health services in the Gaza border area.

According to NATAL's Dalya Yosef, however, there is another conflict at play here. "Young people from the Gaza border area feel that they need to be in combat units for moral reasons. But we need to examine whether this is true from a more realistic perspective. There is a dissonance, and this is part of the problem. These are young people with a well-defined set of values, the ‘cream of the crop,’ who wish to contribute to the country because this how they were brought up. They are torn between what is really happening to them deep down and their duty to the country and the ethos to protect it. And then there is another conflicting ethos: the region they live in has been under constant attack for 20 years and the state has failed to protect them."

In Sderot, the IDF dropout rate is high – 28 percent. In 2017, 87 percent of the young men eligible for the draft enlisted; a year later, this plummeted to 81 percent. These figures are a major concern for Alon Davidi, the mayor of Sderot, who reached out to the head of personnel in the IDF in an effort to find a solution. In addition, the city and the IDF have, for the past few years, run various empowerment programs for young and at-risk youth, aimed at ensuring soldiers' welfare and reducing dropout.

In the past few months, more worrying figures have emerged. In January, Yedioth Ahronoth reported that almost one third of males of conscription age are not expected to enlist this year, up from 26.9 percent in 2015. The IDF fears that one of the reasons for this could be the increase in the number of exemptions given on the grounds of mental health. Figures show that in 2020, the percentage of males exempted for mental health reasons is expected to stand at 8.3 percent, up from 6.5 percent in 2019 and 5.4 percent in 2018. Moreover, approximately 15 percent of all new recruits drop out at some point during their military service.

Yosef Rahimov, a social worker who lives in Sderot with his wife and four children, runs the city's branch of Yated, the National Program for At-risk Young Adults. He, too, recognizes the conflicts.

"In Sderot, we have young people suffering from PTSD who cannot enlist in the IDF. Among those who are eligible, some feel deprived. They say that no one is looking after them, so why should they give anything back to the country? Then there are those who say that, in spite of everything, they will take on the duty of defending the country because there aren’t enough recruits.’ This is a dialog between two opposing points of view and unfortunately, the former is more prevalent right now. If a young man is not very motivated when he enlists, even if he is not on the post-trauma spectrum, this will impact the quality of his service. We see this in the relatively high dropout rates and the number of soldiers who are reassigned different roles. Someone can start off in a prestigious position and end up in an administrative role. This is not an insignificant phenomenon."

What happens to these young people after they are drafted?

"Even if they have managed to stay in control of themselves for a long time, joining the army and exposure to the whole military system, can lead to sudden outbreaks. The army is sometimes a catalyst that triggers an outbreak of PTSD," Rahimov explains. "Combat soldiers might find themselves in a situation which causes latent PTSD to surface. Another cause might be the pressure and demands of the army. At home, they were supported and understood, and there were plenty of supportive frameworks. Here in Sderot, people have shown a lot of resilience; they feel have someone they can lean on. This feeling is undermined in the army."

What can be done to help these young people?

"The IDF must be better prepared. It should give these young people a pre-army preparatory course, like it gives candidates for elite combat or technology units. After all, serving in the IDF is not only about military service, it is also about serving in the People’s Army, the melting pot of Israeli society."

It's not their fault

Last summer, the Eshkol Regional Council and the Kibbutz Movement brought the issue of the new recruits to the attention of researchers at the nearby Ben-Gurion University of the Negev.

Prof. Limor Aharonson-Daniel, vice-rector of the university and founding director of the PREPARED Center for Emergency Response Research, picked up the gauntlet, and her research team, in cooperation with local authorities and the IDF, is studying would-be recruits and their parents in the Gaza-border communities.

The goal of the one-year study, according to Aharonson-Daniel, is "to accompany the young people as they begin their army service, so that we can identify and then reinforce supportive elements." At the same time, she hopes to improve the army’s role by, for example, improving that part of the process that assigns recruits to their positions."

In his 2019 book – 'On the Emotional Frontline' – Yizhar Sha’ar expressed his growing concern for the mental health of adolescents in the Gaza-border area. He insists that "there is no reason to wait for the study."

"When they enlist, their repression and defense mechanisms come under threat. The tension, pressure, and exposure to war simulation may trigger anxieties which could have various symptoms. I asked the IDF to take action, including preparation in high school, and to help alleviate their guilt if they don’t succeed."

Dalya Yosef, director of a dedicated helpline, is unequivocal. "This is a ticking time bomb," she warns. "History books will tell the story of the children who lived in the shadow of the Qassams. To be born and grow up feeling that there is no safe place in the world is not normal and exacts a heavy price."

What do you mean by guilt?

"Just think what happens to all the hopes and ambitions of these young people who grew up on a kibbutz or moshav. It is in their DNA to contribute to the country and to be combat fighters like their parents and siblings. Suddenly they have a breakdown and are not able to function. Some are discharged, others go from combat units to less prestigious positions. There are those delay their army service and do a year of community service first; they are so frightened that they don’t even begin their army service. The system is still unable to cope with these issues. The worst thing is when army doesn’t understand what is happening with these young people, accuses them of faking it – and washes its hands of them. People need to feel that they are understood."

And this is not the case now?

"Only partially. You have to remember that the army wants soldiers who function well. On the one hand, these young people are really motivated to do well, but on the other hand there is something stopping them. If you can't function, the army gives up on you. Officers and staff need training and there must be a range meaningful solutions for these soldiers. The state shouldn’t punish a soldier who is discharged from the army because of PTSD. Remember, wherever they go, they will be asked whether they served in the army; people don’t show much compassion."

A. lives on a kibbutz in the Sha’ar Hanegev region, which borders Gaza's northeastern corner. She provides an example of how the needs of these soldiers are not being met from 2019, when the IDF launched Operation Black Belt, during which thousands of rockets were fired from the Gaza Strip into Israel, following the assassination of a senior Islamic Jihad commander.

"My oldest son was serving in the army," A. says. "He knew that his home was under fire, and he found this extremely difficult. He was upset and called home constantly. At night, he couldn’t sleep and was very worried about his younger brother, who has had PTSD since Operation Protective Edge and which has gotten worse in the past two years. None of the officers asked my son what was happening at home. There doesn’t not seem to be any awareness or sensitivity."

Did your son tell the officers how he was feeling?

"He told them how difficult everything was for him, that he was worried about his family, that couldn’t asleep, and that trauma from the security situation was surfacing. He was very open, but they weren't sympathetic. They told him to take a hot shower and go to sleep. Outrageous! They should have spent time talking to him, trying to understand, or referred him to the welfare officer. This just made us feel even more invisible. We need to keep much closer tabs on these soldiers."

Prof. Zahava Solomon, a researcher of psychiatric epidemiology in the School of Social Work at Tel Aviv University and an Israel Prize laureate for the study of social work, agrees. Her comprehensive study of residents of Israel's south at four different points between 2010 and 2015 definitively found that Gaza-border area residents display a greater rate of psychiatric disorder symptoms than the general public.

"A generation has grown up here that doesn't know anything different. This is a generation that has seen violence, more violence – and a lot of anxiety. We see wildly varying reactions; as a society, Israelis show, and have shown on various occasions, a remarkable ability to habituate. People still live in all the kibbutzim in the Gaza border area. But along with this adaptability, we also see very high levels of anxiety and a lot of anger."

"Fear of Stigmatization"

Last August, Yedioth Ahronoth broke the story about mental difficulties suffered by the 'Qassam generation' when they enlist. Since then, the story has all-but disappeared from the agenda. Yizhar Sha’ar is not surprised. "Most people just tune this story out and say that everything will be okay. But people are suffering."

Until recently, G. served in the Education Corps in Sderot, where she mentored young people before their call-up.

"In the army, soldiers from Sderot don’t always talk about their trauma," she says. "They sometimes put on an act. Even before they enlisted, whenever the security situation got worse, I would detect things I hadn’t seen before: stuttering, eye twitching, or repetitive physical actions such as rapid head movements. In some cases, the teenagers themselves did not even notice these symptoms. We informed the draft centers about some of them, explaining that it would be more difficult to deal with them."

G. raises another interesting point. "Very often, the parents of these young people can predict that they will drop out, and they are afraid of sending them to the army. However, if the army learns to be more accepting of them, there is no reason why they shouldn’t enlist. They need a framework that will give them confidence, independence, and an equal starting point."

Merav Vidal is a social worker and has been the director of the mental health facility in the Eshkol region since 2012. She points out another burning issue: parents of children who are about to enlist sometimes have emotional difficulty dealing with their child’s post-trauma and some, fearing it will hamper their child’s army service, may not allow them to go for therapy. "In many cases, the parents are the barrier to therapy," she says.

"As parents, our child’s conscription forces us to face our ever-present guilt, which peaks at various developmental stages of life. The enlistment stage is a challenge for all parents, even if they live in Tel Aviv."

How is this difficulty expressed?

"Mainly in the therapy sessions before enlistment. Or the trigger for therapy is their difficulty with conscription. We often see it in parents who are frightened to send their child for therapy because it may hinder their options in the army. People are afraid of being stigmatized."

What does the therapeutic team tell the parents about this?

"That the problem exists whether they admit it or not; that by naming it, we can be more specific in deciding the correct action. If a young person is very sensitive to noise but doesn’t want to treat this because they want to be accepted into a combat unit, what will happen the first time they participate in a shooting exercise? If a young person suffers from PTSD, then other positions in the army will be more suitable."

Vidal believes that, "the army has to be especially aware of new recruits with this kind of life experience. They grew up in this situation, and sometimes, when you don’t know anything else, it is difficult for you to understand that you have a problem. You suddenly meet the outside world; you have to cope with the various demands of meeting people who grew up very differently. Suddenly, you recognize that your way of reacting and leading your life is not the norm."

Dalya Yosef says that joining the army can be one of the most dramatic transitions in life, which requires resources, and that new recruits experience a role reversal.

"From being in a place of protecting myself, I now have to defend others – even though I’m not sure if I’m really strong enough for the role. An 18-year-old boy must be capable of being in a combat role, handling a gun, and he knows that tomorrow he might be called to fight in Gaza, when just yesterday, Gaza was attacking him."

"Recruits do not undergo proper psychological preparation to reinforce their resources and check whether they are up to task. There is no understanding or awareness of the depth of their trauma. We cannot recruit them like everyone else because they are different. These are not children who grew up in leafy suburbs. Let’s take responsibility and recruit them in a different way."