Israeli trauma experts help counselors in Parkland, Florida

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Story highlights

  • Members of the Israel Trauma Coalition went to parkland to counsel the local counselors
  • One of the pillars of their advice is to try to return to normalcy as quickly as possible

(CNN)In the northern Israel town of Alon HaGalil one recent afternoon, a clinical psychologist and former Israeli special forces member named Yotam Dagan was worrying about how the students at Marjory Stoneman Douglas High School in Parkland, Florida, are going to react the next time the school holds a fire drill.

"If it's just done without any early preparation or warning, the sound of the bell is going to reactivate the traumatic response," Dagan told me, remembering that the shooter who slaughtered 17 innocent people on February 14 at the school is said to have pulled the fire alarm to empty the classrooms. "There are going to be meltdowns. There are going to be panic attacks."
Helping avoid those triggers is why Dagan and another psychologist recently flew from Tel Aviv to London to Miami to meet with teachers, counselors, first responders, clergy and others to offer practical lessons learned from Israel's vast experience with terrorism and war.
    Psychologists Yotam Dagan and Alan Cohen explain youth
interventions for trauma in Ft. Lauderdale after the high school shooting
in nearby Parkland, Florida.
    "It's not as if Israel knows anything America doesn't," Dagan's colleague on this trip, psychologist Alan Cohen, told me. "But we have a lot more practical experience in putting them into a coherent program."
    Both men are members of the Israel Trauma Coalition, a group of NGOs and government organizations that works to harness the knowledge learned in its country and share it with others in their field throughout the world.
    In March 2011, the group sent a delegation to Japan to help trauma experts counsel survivors of the earthquake and tsunami. After Typhoon Yolanda hit the Philippines in November 2013, it sent a team there. Israeli trauma experts have been dispatched to war-torn Ukraine and to Nepal after the 2015 earthquake. And on February 25, Dagan and Cohen landed in Miami to help the survivors of the Parkland high school shooting.
    Cohen lives in Kiryat Shmona, a town in northern Israel that was attacked in April 1974 by terrorists with the Popular Front for the Liberation of Palestine, during which 18 civilians were killed, nine of them children. Cohen didn't move there until a decade later, but he insists the incident left a psychological mark on the town that remains.
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    "People didn't feel safe in their homes for generations," he told me.
    Northern Israel has faced general upheaval and conflict for decades: rockets from Lebanon in the 1970s and 1980s, nearby military operations and of course the war with Lebanon in 2006.
    Other events in the area have left scars, according to Cohen. On February 4, 1997, two Israeli CH-53 Sikorsky transport helicopters collided on their way to the Israeli "security zone" in Southern Lebanon, killing all 73 Israeli military servicemembers on board. Just over a month later, on March 14, 80 seventh- and eighth-graders were on a field trip to the Jordan Valley and Golan Heights when they stopped at a popular tourist destination called the Island of Peace. A Jordanian soldier opened fire with his M-16 automatic rifle, killing seven of the school girls.
    "We also had a school massacre," Cohen recalled sadly.

    On the ground in Parkland

    Cohen and Dagan first met with Jewish Family Services in Broward County, which put them in touch with other community organizations, charities and health professionals; their first meeting was at a local school with approximately 60 counselors, psychologists and teachers. In addition to sharing their expertise on how to mobilize coping resources and to build on what already existed in the county, the Israelis talked about how to identify those in the local population who might need help.
    Most obvious, Cohen explained, are those who are geographically connected to the traumatic event -- those who attend or work at the school and their families and those who live in the surrounding area. Less obvious are those with social connections to the trauma: children and families in the community at large, who might not be obviously crying out for help. Then there are those with psychological connections to the incident, including people who previously attended the school, those with children who are the same age as the victims, people who have undergone similar bereavement difficulties.
    "They may also be suffering," Cohen noted. "Silently."
    Jessica J. Ruiz, the chief psychologist and director of clinical training for Jewish Family Services in Broward County, extolled the two men for sharing the knowledge learned from "generations and ripple effects" in Israel. "They've faced trauma themselves, and they know how to see people live through these events and come out with resilience and strength and live meaningful lives."
    It was important for everyone to hear that it is perfectly normal that psychologically the human body reacts to trauma. "We are wired to get out of the way of any threat," she told me. "Even if the lion is not in front of you or the shooter is not in the building, when you walk away your body is still alert." The body calms down after some time, but in the world in which we live -- social media, television -- our bodies may be triggered to think the trauma is happening again. Constantly being on alert for a threat disrupts our connections to other people, and the impact can be worse for children, who might withdraw.
    Cohen and Dagan were able to bring their expertise seeing impacts on large segments of the Israeli population over the course of decades, impacts that were sometimes unpredictable. Not only did post-traumatic stress disorder show up in places where it may not have been expected, so did added stress levels, which led to substance abuse or relationship issues, affecting the next generation.
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    Another part of their instruction is for community leaders: how important it is for them to be visible, talking about not just what happened but what it means and how resolved the community is to get through it. Citing former New York City Mayor Rudy Giuliani's post-9/11 visibility and candor, Dagan and Cohen make it clear how important it is for leaders to go out there and talk.
    "Most people just want to stay home," Dagan said. "Someone has to go out."
    Dagan told me that most of what the world knows today about trauma and PTSD was developed in the US.
    "But in Israel," he said, "since we're a small country -- and over the last seven decades, between war, terrorists, suicide bombers, lone wolves and knife attackers -- we did not have a choice but to take what we learned from (the) US and apply it to enable our communities to bounce back and resume day-to-day normal life as soon as possible."
    The children of Marjory Stoneman Douglas High School returned to school two weeks after the incident. Israeli society encourages attempts at normalcy quicker than that, Dagan said.
    "In Israel, something like this happens -- a suicide bomber attacks a restaurant or a bus -- and in a matter of hours, life gets back to normal. Restaurants are refinished and restored as soon as possible. In order to win this long-lasting battle, we have to bounce back to normalcy." At Tel Aviv's Sarona market, where two Palestinian gunmen killed four Israelis in June 2016, two restaurants opened to customers one day after the killings.
    Dagan said they tried to bring a "different paradigm" to Parkland. "Instead of looking to PTSD, we look at coping mechanisms and seek to strengthen them and inspire hope."
    One such procedure they call The Day After. The concept is based on a program developed in the US called the Critical Incident Stress Debriefing, an intervention process for a small group but modified for children and teens in a classroom setting. The debriefing can take several hours, Dagan explained, which doesn't work for a child's attention span.
    The goal in The Day After is to explain what happened, to "achieve a common ground of fact. And we talk about meeting and coping resources and how we're going to go through this together, and we explain how we will go back to normal life. It's a very structured protocol. We use it here in our schools."
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    As for the pending school fire drill, Dagan said, he has instructed the teachers to give students plenty of warnings and to maybe even play a more quiet version of the alarm before the real one.
    "Talk with the children," he urged them. "They need to think and make an informed decision about the next fire drill before they do it. We go through this in Israel" because of Hamas-fired rockets and drill sirens there. "When you do a drill sound siren, there's always collateral damage in terms of our own people. I realize fire drills need to be done. But if they don't plan, there's going to be damage."