ST. PAUL, Minn. — The Center for Victims of Torture (CVT) today issued this statement on the mental health impacts of the Israel-Palestine conflict and the need for an enduring ceasefire.

For the past seven months, the world has watched the carnage taking place in Gaza, often in real-time through social media posts from reporters and individuals who are living through it. Some Palestinians who were able to flee the Israel-Palestine conflict have begun to seek CVT’s rehabilitation services. They have described the horror of living in a war zone, during ongoing bombing and recurring displacement, all while struggling with lack of food, clean water, medical supplies and other basic necessities.

The traumatic impacts of this conflict are, and continue to be, profound – for all of those that it touches. Hamas’s October 7, 2023 attack on Israel killed nearly 1,200 people. Hamas took more than 200 others hostage. In response – over the course of seven months – Israel has employed asymmetric military capabilities and related resources to extensively bomb Gaza and invade with ground troops, resulting in more than 34,000 civilian casualties and over 1.6 million people displaced. Israel is reportedly detaining as many as 10,000 Palestinians in the occupied West Bank and East Jerusalem, including several hundred children.

On May 4, the head of the United Nations World Food Programme announced that northern Gaza is now experiencing “full-blown famine,” which is “moving its way south” – more than one million people are facing starvation and disease – while Israel continues to obstruct the flow of humanitarian aid. On May 6, the Israeli military announced its intention to use “extreme force” in the Gazan city of Rafah – where more than one million Palestinian families are sheltering – and the following day invaded with tanks. Doctors Without Borders has warned that “the consequences of a military offensive [in Rafah] would be catastrophic.”

There have been credible reports of torture throughout the conflict.

Those suffering the pain and grief of this conflict will likely carry those wounds for a lifetime, and the effects will persist for generations.

In the immediate term, a ceasefire is critical. In the long term, any transition to post-conflict resolution must include recognizing the breadth and depth of the conflict’s traumatic impacts and provide opportunities for individual, family and collective healing to address the cycles of generational and collective trauma.

Ongoing and Continuous Traumatic Threat

Post-traumatic stress disorder (PTSD) is a common consequence of exposure to various forms of conflict-related violence, torture included. But what those in Gaza are experiencing right now cannot be described as “post-traumatic” in any sense of the term.

Instead, we can best describe the current situation as ongoing and continuous traumatic threat. Unlike a post-traumatic reaction, the symptoms associated with ongoing traumatic threat are actual survival skills needed to stay alert and protect oneself during an active threat. For some, being hyper-alert, not sleeping and preparing for the worst, may mean the difference between life and death. However, the longer the conflict persists without rest or resolution, the more detrimental the effects on the individuals living in a conflict zone. Essentially, one can forget what it feels like to experience relative safety. This can have chronic health and mental health consequences.

Current trauma is compounded by the historical backdrop of significant political, economic and military disparities; mass displacement; loss of land; and restrictions on movement and access to resources.

Similarly, hostages and detainees living under the uncertainty of indefinite detention – especially where such detention is prolonged – and with no control over basic aspects of their lives, may well suffer profound harm, in addition to any abuse they have already endured. The effects of indefinite detention often include severe and chronic anxiety and dread, depression and suicidality, and personality changes. Their loved ones, who do not know their condition or fate, may be experiencing ambiguous loss – a situation or problem that defies closure, that has no answer and thus no resolution. This ambiguity can be profound, and can traumatize and immobilize grief and coping processes, and prevent individuals and families from moving forward with their lives.

The Role of Identity in Trauma

The trauma and grief in the region right now are deeply imbedded in identity. This is distinct from other experiences of trauma. When persecution and suffering are rooted in one’s sense of self, it shifts one’s individual and collective identity. What is distinct about the Israel-Palestine conflict is that identity-based trauma and grief have deeply planted roots in generations before. This can alter the experience of those impacted now as well as the collective story that communities will tell about themselves for decades and generations to come. If managed well with opportunities for healing and peace, this can be transformative. If not, it can persist.

Intergenerational Wounds

The trauma and grief experienced right now by many is also evocative of deep generational wounds. Many analyzing the reaction of local and global communities have expressed surprise at the deep divisions in opinions being expressed and the forceful public dialogue about this conflict. It is important to remember that many witnessing and consuming content about conflict have pain, wounds and suffering of their own. Those wounds are intergenerational, ancestral and connected to land, family and identity. The emotions are real and lived, and the source is connected to historical, familial and geographical ties.

Impacts on Those Outside the Region

Those outside of the region directly affected may also experience adverse mental health and social consequences from the conflict. The rise of Islamophobia and antisemitism undermines a sense of basic safety for diaspora communities globally. Many are left wondering if this conflict will expand further, grow and harm community and family in other places.

In addition, modern social media engagement presents a new layer of complexity, and we do not yet fully understand the potential mental health consequences. We all are exposed to an onslaught of information and misinformation, sometimes without the tools to know how to digest and understand it. In a polarized environment, that can prevent many from feeling secure discussing the topic with communities, families and friends. This exposure, plus isolation, can have an impact on many who are interacting with content about the conflict. Self-care and collective care are essential if we are to overcome this.