By Dr. Batya L. Ludman

Now is without a doubt a time that emotionally has many of us in a state of deep despair and profound sadness. The tension in our small country is very palpable and what we once thought and hoped would be short-lived has become a very unpleasant way of life. Over the past 17 months, even our language has changed. What we once termed "the situation" was then labeled an "escalation" and now the word "war" is part of everyday conversation. Those anxious before are feeling an even greater level of anxiety and those who once appeared to take events in their stride are feeling very unsettled. What is going on and how do we cope?

If most of us could step outside our current situation for a moment, we might appreciate that we are truly responding normally to what is a very abnormal situation. When the conflict was confined to "simply" the daily acts of violence in certain hotspots, we almost knew what to expect. As awful as it was, it was predictable and we could almost plan our day with it in mind. Today, this is no longer the case. Nothing seems at all predictable and for those who once felt they had control in their lives, this too feels shattered.
Just look at the impact the events of September 11th have had on the world. Sudden, random, horrendous acts of violence shake us all to the core. We cannot predict them, we have no control over them, and when they happen it is not only extremely traumatic, but it devastates our entire belief system. The pictures on television make the most violent movie look tame and we cannot walk away. If we cannot acknowledge that we are at war as a country, we certainly know we are at war in our minds. No longer can we casually go about our day-to-day activities without extreme hypervigilence. The simple act of getting into the car and driving our children to school can almost feel paralyzing. Our ability to anticipate and plan is taken away and our capacity to make even the most basic decision is challenged. Our family, our home, our soldiers, and our fellow Israelis are all in a position of great vulnerability. We may feel an overwhelming sense of helplessness and pain as we seek to understand and make sense out of what is going on around us.

How can we realistically expect to feel? It is the unusual person who can go about his daily activities as if nothing is happening, and for that person, I might feel great concern that at some point he too will have to face the current events. For the rest of us, it is quite common to feel a profound sense of grief and anxiety. This will impact on us socially, emotionally and physically, and may be far more consuming than one would have ever imagined. Although this is entirely normal, it may feel awful. Add to this our horrendous economic state and we are left feeling angry, frustrated, sad and depressed. While the Zionist dream may have brought us here, many people are starting to reevaluate their priorities with new seriousness. In the short term, those once functioning well are having difficulty with concentration, remembering details, focusing on something for any length of time, or making simple decisions. Some may become preoccupied with obtaining details, channel surfing and continuously discussing the current events. If your understanding of Hebrew is poor, this may increase your anxiety as you struggle to cope in a situation which because of the language barrier is made all the more uncertain. Sleep problems, eating difficulties and somatic complaints such as stomachaches and headaches are all very common.

What can you do and how do you attempt to cope in an adaptive way?
One of the best things you can do in a situation like this is to talk. Find a friend with whom you can share your worries and just simply talk. If your partner is caught up in his own struggles, choose a neighbor or family member. It does not even matter if that person is in a different country and you are communicating by e-mail as long as you have a place to voice your concerns and be heard.
Keeping a journal is often very therapeutic for some people. If you feel that there is no one with whom you can talk, seek professional help.

Look after your physical and emotional health. Now more than ever it is essential to eat properly, try and get enough sleep and get out there and exercise. If you are not at your best physically, it is harder to cope with the emotional roller coaster of events. Exercise is good for both the body and mind and is one of the best coping strategies that we have. Walk alone, take your child or find a partner. If meditation and prayer have been helpful for you in the past, now is the time to get back to it. It can only help you to feel better. Keeping our faith while difficult is essential for enabling us to move forward and see a future for our precious country. We must think positive.

As much as you can, plan your routine for the day. This not only gives you a focus but also keeps you moving in the right direction. Regardless of what is going on around you, there are still plenty of things to accomplish. If you have lots of excess energy, now may be the time to take on that cleaning project. The best way to cope is to put as much control back into your life as you can. Access the news that is most helpful to you. If you find that there is too much news, take a break from it. Do what works for you.

If you feel that you would like to do something, volunteer. Throughout the city and country there are many ways to get involved at this time and help out. Pick what you would enjoy, go on your own or take a friend and make a move towards lowering your stress level. Send a card or package to a chayal or someone in the hospital, donate blood or help facilitate support groups for children.

Take a break. Everyone needs to put a few sane moments into his or her day. If that break involves a relaxing shower-do it. If it is to go shopping or meet a friend for coffee, it can only help. Treat yourself to a good book and find some quiet moments to actually read. You must do small things for yourself now more than ever. Look at those around you and include them as well. Find something enjoyable that you can do as a family such as renting a movie. You cannot close yourself off and hide.

Above everything else, it is important to realize that you are not alone in your current difficulties. If you feel that you or your loved ones are not coping well, by all means seek professional advice and support. As a country many of us are dealing with symptoms of Post Traumatic Stress Syndrome-adults and children alike. What may require simple reassurance now may require more major intervention if left untreated.

I wish for all of us much peace as we struggle through the day-to-day difficulties at this time.

Dr. Batya L. Ludman is a licensed clinical psychologist in private practice in Ra'anana. She works with children of all ages and their families, as well as with adults and couples, in short term solution focused psychotherapy. She specializes in bereavement and loss, stress, anxiety, depression, parenting issues, behavioral problems, marital/communication problems and sexual dysfunction. She has conducted workshops on bereavement, stress management and critical incident stress and has published extensively in both the professional and lay literature. Send correspondence to batyaludman@yahoo.com

Maccabi Health Care Services Launches Support Group Hotline for Terror Victims

The Maccabi Health and Medical Insurance Services has launched a free support group telephone hotline for people who witnessed and / or are suffering emotional harm and anxiety from acts of terrorism in Israel.

A single Hebrew-language ad produced 70 responses. The project was initiated by Dr. Gilat Reish, the health fund's Jerusalem district medical director.

People suffering from emotional trauma may call 1-700-50-53-53 any time of the day or night.