Therapeutic Intervention in a Continuous Shared Traumatic Reality: An Example from the Israeli–Palestinian Conflict

Abstract

Growing political instability around the world has exposed an increasing number of communities to military conflict. Social workers and other mental health professionals who work as trauma workers, and who both live and practise within these communities, are doubly exposed: directly and indirectly, personally and professionally. The present study examined the consequences on trauma workers and on the therapeutic process itself of working in a continuous Shared Traumatic Reality. The study was based on content analysis of three focus groups conducted among thirty trauma workers, between the ages of thirty and sixty, who were trained in a variety of therapeutic professions, mainly social work. Findings suggest that a high level of exposure to life threats and emotional distress can coexist with high levels of professional functioning and resilience. Results further point to complex implications associated with therapeutic relationships and settings that include: diminution of the transitional space, strengthened sense of identification between workers and clients, and acceleration of the therapeutic process. The discussion reviews the variables that facilitate and impede the professionals' functioning and highlights the unique effects of continuous exposure.

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“… Professional training. Over the years, it has become clear that the impact of disasters and war circumstances has increasingly complicated the tasks of professionals involved in therapeutic interventions in an ongoing traumatic reality ( Dekel and Baum, 2010 ; Lavi et al, 2017 ). The knowledge accumulated to date indicates a need to address this complexity already during professional training, emphasizing specialized training in dealing effectively with emergencies.…”

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“…Several studies on the effects of working in a shared war reality have reported a decrease in perceived professional competence among MHPs [5] and a sense of being deskilled [3]. However, other studies reveal a strong perception of professional competence [19] and high levels of professional confidence [9] among these MHPs.…”

“…Post-traumatic growth also has been reported among nurses working in a shared war-related reality in Israel [10] and in Gaza [15]. Positive consequences also can include heightened intimacy in the therapeutic relationship [4,20], a strong therapeutic alliance [19], a high level of work satisfaction, and a sense of agency and helpfulness [7].…”

“…Work under shared reality conditions exposes MHPs to the blurring of boundaries between professional and personal lives [4,16,17], including boundaries between work and family loyalties [5,18]. Research also points to the blurring of boundaries between MHPs and their clients [5], manifested in their difficulty separating their personal experience from that of their clients [19].…”

“…Work in a shared traumatic reality also has been associated with positive consequences. These consequences may include a sense of growth, both personal and professional [4,10,16,19], and a sense of resilience [19]. Post-traumatic growth also has been reported among nurses working in a shared war-related reality in Israel [10] and in Gaza [15].…”