Israeli soldiers on top of tanks are engulfed in a cloud of dust at a staging area along the Israeli side of the border with Gaza in August. Photo / Heidi Levine, for The Washington Post
Hours after Hamas assailants streamed from Gaza into Israel two years ago, Amir Lorch jumped in his car and sped to the site of the massacre, helping to gather the shattered bodies of his fellow Israelis.
He then deployed in late October 2023 as a reservist with the Israeli Army to the central Gaza Strip and witnessed, he said, “what people are capable of in times of revenge, when no one sees you and the thing that comes out is something dark”.
It was when Lorch was discharged in December of that year and reclaimed his job as the head of artificial intelligence at a Tel Aviv start-up that the lows began, he recalled.
Images of charred, mangled bodies stalked him in the marketplace and even in his apartment, where he could no longer sleep with his wife in the same bed.
The honking of cars and rude strangers would set off bouts of rage that stretched over weeks. He barely ate or slept. Soon, Lorch said, he was awaiting his next call-up, hoping to get killed in Gaza.
Two years into Israel’s conflict with Hamas in Gaza, returning soldiers are confronting post-traumatic stress disorder, or PTSD, in numbers unprecedented for Israel, mental health professionals say.
Since the start of the war, the longest in the country’s history, more than 11,000 soldiers have been admitted to the Defence Ministry’s psychological rehabilitation programme for those who are war-wounded, according to a ministry statement.
Tens of thousands more are believed to have PTSD without recognition or treatment.
The military is investigating at least 37 cases of suicides since the start of the war, it said – more than triple the total recorded during Israel’s last large war in Gaza in 2014, which lasted 50 days.
The issue made headlines most recently in July, when a combat veteran with PTSD symptoms burned himself to death by setting his car on fire. He had sought psychiatric care but was turned away twice by hospital staff, Israeli media reported.
The topic of PTSD, once taboo in Israel, is no longer so.
“We have been called to this issue in the past, but it has come up now even more so because of the soldiers who’ve returned from fighting in Gaza,” said Israeli lawmaker Elazar Stern.
At an August hearing, he heard from families who said that their sons had tried to get help but amid a high volume of cases were told to wait or were called back up for duty before they ended their lives.
Stern said the recent rate of suicides among released Israeli soldiers was “out of the ordinary”.
So much about Israel’s war in Gaza is exceptionally devastating.
The conflict was triggered by the attack on southern Israel, when Hamas-led forces killed about 1200 people and took another 251 back to Gaza as hostages.
Israel’s invasion of Gaza has killed more than 67,000 Palestinians, according to the Gaza Health Ministry, which does not distinguish between combatants and civilians but says most of the victims are women and children.
Casualties on both sides would certainly increase further if negotiations in coming days over United States President Donald Trump’s ceasefire plan fail to stop the fighting and the Israeli military resumes its invasion of Gaza City.
The Israeli military is scrambling to respond to the resulting spike in PTSD.
It is deploying, for the first time, therapists to Gaza; expanding training for combat soldiers in psychological first aid under fire; and operating suicide hotlines.
The military system is overburdened, so a wave of civilian initiatives has also emerged to pick up the slack.
With such a high proportion of Israelis serving in the military, many in this small country know someone suffering from PTSD.
Researchers warn that many clinicians who lack expertise in PTSD are missing the signs, leaving tens of thousands of soldiers to suffer untreated.
For Sergeant Major Lorch, now 32, the trauma began on October 7, 2023.
Driving into southern Israel in response to the Hamas attack, Lorch recounted, he found his way to Kibbutz Kfar Aza, guided by birds circling above, indicating the presence of dead bodies – the Israeli Army had disabled GPS to thwart incoming missiles from Gaza – and to Kibbutz Beeri, where 60 corpses of Israelis slain by Hamas were piled up.
As he collected fractured bones and body parts, he was consumed in those early days by “this huge adrenaline, this feeling that you’re really part of this big thing”.
At first, he said, the adrenaline rush continued into his Gaza deployment as Israel approved the call-up of its entire reserve force of 360,000 soldiers. His Yaara reservist unit quickly occupied a 10km-wide belt of land just south of Gaza City, later dubbed the Netzarim Corridor, that bisected the Gaza Strip and enabled Israeli troops to manoeuvre across the northern and central areas.
Soon, Lorch said, the tempo slowed and the continuing bloodshed seemed aimless.
“At some point,” he said, “you see there’s no mission.”
When he was discharged two months later, he was changed.
“At first, I thought I had to fight him, this guy who came back with me, who wasn’t me,” he said. “But also, the problem was, I’m a combat soldier, I don’t have emotions. So what … do I even do with all this?”
Only after a friend volunteered him for a programme at the Shamir Medical Centre, near Tel Aviv, did Lorch begin to admit that something was really wrong.
For eight hours a day, over 10 months, Lorch said he was guided through Eye Movement Desensitisation and Reprocessing therapy, or EMDR, learning how to process traumatic memories in an effort to remove their sting.
He said he continued to flail until another friend – one of the former soldiers under his command – drove him to a horse ranch in Sitria, in central Israel, where another kind of programme sought to help him find a way forward. The horses that he trains and tends at Danny’s Farm also keep him grounded. He knows that if he is feeling anger, they will sense it.
In August, when he suddenly felt enraged, he punched through the glass door of his oven. But unlike the bouts of rage that would consume him a year ago, he said, now he can call his farm-provided therapist and return to himself within six hours.
He has finally concluded that, even though his injuries are invisible, he is war-wounded.
“I get now that it’s like losing a leg; you won’t see it grow back,” Lorch said. “You need to put a prosthetic in its place.”
Researchers at Tel Aviv University’s PTSD clinic say returning combat reservists are particularly at risk because they are often called back up for additional tours even as they are in the midst of receiving treatment and are thrust back into the same panoramas of destruction and death that may have first traumatised them.
In launching its offensive on Gaza City, for instance, the Israeli military is calling up 60,000 reservists, many of whom were deployed previously.
Eliran Mizrahi, a 40-year-old combat reservist who commanded a bulldozer unit, shot himself in the head while on leave last year, two days before he was scheduled to redeploy to Rafah in southern Gaza, his sister Shir recounted.
She said that after sustaining a knee injury in a rocket-propelled grenade attack during an earlier deployment in Gaza, Eliran had showed severe symptoms of PTSD.
Before his death, he told Israel’s Channel 13 that he and his fellow soldiers “didn’t think we’d return, but we survived. So now we don’t know how to grapple with this”.
Eliran’s family battled with the Government to bury him in a military graveyard, which it originally resisted because he was off duty at the time of his death, Shir said.
The open-ended nature of the war, with no answers about the fate of Israel’s hostages and no clear end in sight, short of Prime Minister Benjamin Netanyahu’s stated aim of eradicating Hamas, is also exacerbating the sense of trauma for many.
Unlike in the past, however, there is now wide recognition that PTSD must be addressed.
As reservists have tallied hundreds of days of service and the Government’s war strategy has increasingly come under criticism from within the Israeli security establishment itself, concerns over the toll the conflict is taking on troops have come to the fore.
Soldiers suffering from PTSD have appeared before parliamentary committees and in street protests, demanding legislative reforms to improve access to healthcare and reduce the red tape that has delayed military burials for soldiers who died by suicide.
Now, the issue is routinely featured on morning news shows and in mainstream cultural events.
“There is no household in Israel without this thing … this thing that grows in darkness, in shame, in silence,” said a famous Israeli comedian, Udi Kagan, in a stand-up monologue that went viral in August on X.
Israel’s military and civilian health systems more broadly are still struggling to move beyond “the beginning, emergency response, and on to the problem we are facing now, which is that the consequences from this round of fighting will be here to stay for two, three decades,” said Yair Bar-Haim, who heads the Tel Aviv University PTSD clinic.
Over the past two years, hundreds of initiatives have begun to address the avalanche of new cases.
These efforts include about 15 healing farms as well as programmes that integrate structured talk therapy with methods like horse-assisted therapy, surfing, agricultural work, and ice baths.
They allow the soldiers “to buy time,” in which they can acquire skills to manage their symptoms, according to Eyal Fruchter, the former head of the Israeli military’s mental health department, who recently started an endeavour, known as the Icar collective, to map and integrate the disparate programmes.
David Yosefi, 31, a tank gunner in the armoured corps reserves, spent more than 300 days on duty, mostly in Gaza.
After long periods immersed in the sounds of tank fire and exploding 90kg bombs, and surrounded by vast swathes of territory levelled at the cost of thousands of Palestinian lives, he said, he was transformed into something “not 100% human”.
Back home, he said he remained crushed by guilt that his unit, like so many others, had not defended Israeli civilians on October 7, and filled with anguish after watching fellow soldiers die in his hands in Gaza.
Yosefi said that, looking to disconnect from civilian life, he would sleep much of the day and stare at his phone when in the company of his wife and young children.
He never went through the official Defence Ministry diagnosis process. Instead, he connected with another Israeli soldier suffering similar symptoms and started a reservist lobbying group, War for the Soul, that meets with parliament members, and works with a mental health organisation, Integrative Medicine for All, to offer five-day holistic retreats.
He said the wave of civilian initiatives like these is an extension of the emergency grassroots effort that developed after the October 7 attacks.
“No one called us, no one told us to come, but we saw the confusion and chaos, and we all got out of our homes that morning to save the country, and we’re doing it again,” he said.
Yosefi predicted that even after the Gaza war is finished, the struggle will continue.
“When the war finally ends, we need to be ready for it,” Yosefi said. “We’re expecting many more people who’ll need help.”
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