Israeli program brings elite units together to begin psychological healing
By DIANNA CAHN | STARS AND STRIPES Published: May 30, 2017
JERUSALEM — A coconut fell on the roof of the hut where, in one of the most idyllic places he’d ever been and long after his fighting was over, Aviram Ben Chitrit met his war head on.
The faraway island in the Bay of Bengal felt like heaven. But even there, Ben Chitrit was a paratrooper — trained, fit, ready. When the disturbance came in the middle of the night, he reacted instinctively. He pulled his future wife from the bed and shielded her with his body.
“Someone is shooting at us,” he said.
“Aviram,” she said, “you need help.”
The coconut rolled off the roof. He blinked and breathed, unclenched his fists and slowly awakened to the calm around him.
But his war remained.
It had followed him across the world after his military service in 2009, and he could feel it, like a rucksack heavy with ammunition and shrapnel and the smell of burning flesh — some of it his own. He knew then that running away was futile. When he returned home to Jerusalem, he told himself, he would finally go into therapy.
Long before the attacks of Sept. 11, 2001, brought terrorism to the heart of the United States and introduced a generation of American soldiers to the deep psychological wounds of war, Israel was grappling with decades of such injuries.
Its young men and women have served in conflicts in every generation since 1948, adjusting to civilian life in silence and pressing on. After heavy combat, many travel abroad when they get home. That’s their normal. For some, it’s their first opportunity to travel on their own; for others, it’s an escape from trauma. They reunite for their annual reserve duty — part of their postconscription duties — sometimes returning to battle.
Much like U.S. special operations teams, they remain close — particularly a team that spent three years together, training as hard as humans can and learning to work in unison. They keep in touch and get together; they are there for the weddings, the funerals, the barbecues.
But they don’t talk about their war.
Reckoning with toll of war
Today, the country is starting to reckon with the tolls of its wars, with experts working in loose collaboration with the Israel Defense Forces to give its soldiers better tools to transition back to their civilian lives. At a time when U.S. special operators are being stretched to their limits, fighting ongoing wars for longer than at any time in American history, Israel’s experience could serve as a blueprint for helping them break through survival mode to transition home.
Ben Chitrit did undergo therapy for post-traumatic stress disorder when he got home. The more his psychologist heard his story, the more it was clear that he was not alone in what he went through. He was a special operator, one of a team of about 15. They shared his war.
The therapist told him about a program called Peace of Mind, which he said was seeing dramatic results. It offers intense treatment to special operations teams as a unit.
The program lasts nine months, with the seminal portion being an intensive weeklong trip abroad, where the team participates in group therapy every day and stays in the homes of a host community. It only works when the entire team commits to participating — something that originally seemed less than realistic and has emerged as highly successful. They listen to each other’s stories, hear about their own wars from each other and discover their injuries together.
Five years ago, Ben Chitrit sent the program an email. “I know people on my team that have to have treatment,” he wrote. “They have to talk. We carry it on our shoulders every day, but nobody talks about it.”
Then he sought out his teammates to get them on board. “It felt like we didn’t finish something,” he said.
After the 2006 war in Lebanon, psychologists at the nonprofit Metiv: Herzog Israel Center for the Treatment of Psychotrauma in Jerusalem noticed that the silence of its transitioning soldiers was weighing heavily on society and on their own children.
Naomi Baum had three sons and a son-in-law who fought in Lebanon in 2005. One lost a close friend. All were struggling with their transition to peacetime and having trouble processing what they’d seen.
Danny Brom, the founder and general director of the Metiv center, watched his son come home from that war. Meanwhile, a soldier approached another psychologist at the center, Ruth Pat-Horenczyk, to explore how his unit was coping. The psychologists saw an opportunity to bring whole special operations teams together for treatment. The same unit that had been to war together would process together.
It was an idea especially suited to Israel, where no one lives more than a short drive away, everyone serves in the military and teams stay together even after their mandatory service, for their annual reserve duty. Members might not willingly go into therapy to treat their own wounds, the psychologists said, but they might be persuaded to do so for the sake of their teammates. The trick was to get them together in a room, away from the diversions of their lives.
“We took these boys after they left the military, away from their cellphones, away from their families … into this sort of cocoon,” said Baum, a psychology professor at Hebrew University of Jerusalem and a trauma consultant and former longtime director of the Resilience Unit at Metiv.
‘A stone has been lifted’
The pilot group held a daylong workshop at a beachside location on the Mediterranean Sea in 2007. They then spent a week on a boat in the Netherlands. Far from their homes and their culture, they spent their days talking and their free time relaxing. Later, the program would introduce the weeklong stays abroad, where Jewish communities that support Israel raise tens of thousands of dollars and volunteer to open their homes to give the soldiers a welcoming refuge during their week abroad.
The results: “One of the guys in my son’s unit called to say, ‘A stone has been lifted from my heart,’ ” Baum said.
Today, Peace of Mind has worked with more than 50 groups, with more than 600 participants, said Alon Weltman, the program’s director and a medical psychologist. To Weltman, a former special operator, the methodology makes sense — from the initiation by a few teammates to the commitment of the entire team — because the units are so deeply connected.
“They are so bonded,” Weltman said. “The strongest force is the military unit, and in this process also is the power of the team. … The process is theirs. Whatever they bring and how they play it is what it will be.”
When Ben Chitrit told his teammates about the program, he had an incentive up his sleeve. “We get a free trip to New York,” he told them.
The first session — in 2016 — was a two-day meeting in Herzliya, north of Tel Aviv, at a surfing beach. The beauty outside belied the intense, stressful emotions that engulfed the room inside, hitting many by surprise.
They were suddenly back in Gaza, where Israel had launched an incursion following a series of rocket attacks by Palestinian Hamas fighters into Israeli towns. It was 2009, there was dust and blood, and their team leader was dead. After training together for nearly 2½ years when tensions with Hamas heated up, the men were itching to fight.
On a cold Friday night in January that year, they headed into the festering Palestinian territory.
They walked for hours in darkness, stomping through onion patches and strawberry fields to avoid mines. They stopped at dawn, sheltering in an abandoned building, and waited for darkness to resume their advance.
On the third night, they took shelter in an empty school. There were pictures of dead Palestinian suicide bombers on the walls, celebrated as heroes. This was not friendly territory.
Expecting an attack, their commander sent a team to pull security in a nearby house. Yoni Netanel led the team. Ben Chitrit, a medic, joined them. The group had just scattered to take up their guard positions when there was a massive explosion.
In a bloody daze, Ben Chitrit took stock. He had shrapnel in his eye, broken teeth, puncture wounds across his body. He couldn’t see to treat people. The other medic had a burst eardrum. He couldn’t hear anything and lost his balance.
Ben Chitrit looked over at Netanel — the only member of the team with a wife and child. He tried to help his friend; he would spend years questioning how he might have made a difference. But Netanel had taken a direct hit.
He was dead — killed by what would turn out to be friendly fire.
Seven years later, in a beachside room in Herzliya, a teammate wondered why he had to carry Netanel’s body from the building by himself. Why didn’t anyone help?
They all had unanswered, unspoken questions. The men emerged raw.
“It was like opening a room that hadn’t been opened for a long time,” Ben Chitrit said. “This room was messy and (full of) hurt. Most of us … had never spoken about it.”
By the end of those two days, Ben Chitrit said, some of the guys told him to forget it — they weren’t going to New York. It was too intense. He told the guys that they weren’t doing this for themselves. They had teammates who were not moving on with their lives. Do it for them.
“The commitment to each other makes us strong enough to get on that plane,” he said.
Every day in New York in 2016 was another journey into war. Teammates each had an hour to talk to the group. Weltman and Brom helped them find the right words.
Ben Chitrit said his hour felt like two minutes. Another teammate said he was fine and was just there for his brothers. OK, he admitted, he had nightmares, couldn’t sleep and was always on edge. He finally realized that he never forgave himself for not helping to carry Netanel out of that Gaza building.
On their off hours, the men spent time with their hosts — forming bonds that translated into friendships. They explored New York and partied into the night. There was so much energy to release.
“During the sessions, you want to die,” Ben Chitrit said. “You don’t want to be there. You want to [climb under] the floor. And after it, it is the thing I missed most from New York. To sit in that room and talk, to hear my friends talking; it was the most amazing thing we did in New York City.”
The group dynamic gives the soldiers an opportunity to recalibrate their most traumatic experiences, Weltman said. For the first time, they see the experience through the eyes of their buddies, and often see their moral injuries in a more forgiving light.
Soldiers talk about entering a home where the father of the family has a beard just like one of the soldier’s fathers. There’s a little girl’s backpack, just like one belonging to a soldier’s little sister. Or they don’t agree with the politics that put them there in the first place, Brom said. One soldier was celebrated as a hero for killing a sniper — but he never reconciled with the discovery that the shooter was a 50-year-old man. It made him question his entire belief system, Weltman said.
Militaries don’t give their soldiers tools to transition back to civilian life, he said. They come out morally or psychologically wounded or hypervigilant, without recognizing their condition. People can spend their lives never fully engaged after that kind of trauma. They can get married and have families, have successful careers, but part of them will always be buried on that battlefield.
Brom believes that isn’t the task of the military, whose role is to turn civilians into soldiers. Helping them transition back to civilians falls to society, he said. That part is as applicable in the United States as in Israel.
Tom Chaby, a former U.S. Navy SEAL commander who led the first holistic health program for special operations forces, known as Preservation of the Force and Family, said that while it would be more difficult in the states to get units together because they can be more geographically dispersed, the idea resonates.
“The fact that you are going with your unit to essentially go through the programmatics that, in our country at least, are stigmatized — you are normalizing something that has a stigma,” said Chaby, who co-founded a nonprofit for special operations forces called Warrior2Warrior. “And normalization allows you to have buy-in to what you are experiencing. I think that’s hugely important.”
In the decade since the program was launched, Peace of Mind has been able to map major operations and wars through the groups that have come through. Weltman said participants often emerge with new visions for their lives. In surveys conducted six months after the program ends, the majority of participants show a decrease in symptoms of depression and PTSD, Brom said.
The surveys have taught the clinicians several things: About 20 percent of the groups they treat have PTSD, while 75 percent have some symptoms — what he called “the gray area.”
The notion that “after three years of combat service, you either have PTSD or nothing — that is, of course, a ridiculous statement,” Brom said. “We can show that now.”
They have also found that symptoms intensify during the nine-month program but diminish afterward, and there are many more indicators of post-traumatic growth, which Brom and Weltman view as having greater flexibility in coping with the symptoms.
Many say they have better family lives. It’s common for at least one group member to marry shortly after their week overseas, Weltman said. “We heard people rethinking their careers or all kinds of choices they made, feeling like they have more freedom to choose,” Weltman said. “We hear from spouses or parents that something is more freed up, more open to the life experience.”
PTSD doesn’t go away, Ben Chitrit said. But he now knows how to live with it. He can prepare for fireworks or the smell of a barbecue — or handle the panic attack that can sneak up when the baby cries in the middle of the night.
He still can’t tolerate the smell of strawberries.
“Ridiculous,” he said. “A beautiful food.”
But he now lives free: “It’s the difference between being in prison and getting out of prison.”