Drawing on lessons from the Holocaust, Israel prepares for extensive psychological care for released hostages

Israel celebrated the release of the first three Israeli hostages on Sunday, after more than 15 months in Hamas-held captivity. The country has been preparing to welcome the hostages with extensive plans, not only for medical care but also for psychological support, drawing on lessons learned from Holocaust survivors.

Dr. Einat Yehene, a psychologist specialized in rehabilitation, is leading the psychological rehabilitation team at the Hostage Families Headquarters. 

“These hostages come from a reality of extreme violence, constant fear, and dire conditions – exposure to violent scenes, nutritional deprivation, sleep deprivation, and threats,” Yehene assessed. She predicts that the recovery path for the hostages will be complex and time-consuming due to their traumatic and lengthy experiences during the captivity in Gaza. 

“These circumstances leave significant imprints on both the mind and brain. The experiences, combined with the loss of control and identity, lead to severe symptoms such as psychomotor paralysis, disorientation in time and space, and serious physiological effects. The hostages are likely to face neurological and cognitive challenges, including memory disruptions and an inability to connect their experiences in captivity to their new reality."

The rehabilitation process will be long and complex, extending far beyond the initial days after release. It will require comprehensive, systemic treatment – including motor and cognitive rehabilitation as well as prolonged emotional support," Yehene stated. 

While the recovery process is expected to be lengthy, Yehene stresses that the first period is critical. 

“The first days are critical,” she explained. “The focus is on creating a safe, neutral environment that prevents exposure to triggers that might retraumatize them. Gentle, sensitive guidance is crucial – without overwhelming them with questions or demands,” Yehene added.

The psychologist also warns of an expected mental roller-coaster experience that is accompanied by both euphoria, fear and anxiety. 

“During the initial moments of release, there’s immense euphoria, but it’s accompanied by fear and anxiety,” she said. “Families don’t know how to cope with their loved ones’ complex needs – nightmares, moments of alienation, or unexpected behaviors.

A January 2024 medical report titled "100 days in the tunnels: A new medical report by the Hostages and Missing Families Forum," warned that all remaining hostages are facing life-threatening conditions after three months in captivity in Gaza.

While it is currently unclear how many of the remaining 98 hostages are still alive, they have endured over 15 months of life-threatening conditions. 

The Israeli government assessed in November that approximately half of the remaining hostages are alive. 

While the national focus is on the hostages, Yehene also addressed the importance of dealing with the trauma of their respective families. 

"Moreover, the families themselves have endured prolonged trauma during the captivity period and require psychological support as much as the hostages. They must be guided on how to support their loved ones without adding pressure and helped to navigate the emotional and physical challenges ahead,” she explained. 

Looking ahead, the senior psychologist emphasized the need to restore the hostages’ sense of control by placing them in a safe and stress-free environment. 

"Our role is to restore the hostages’ sense of control. Even everyday actions, like offering food, must be done with respect and their choice in mind. Communication should be simple and stress-free, focusing on their most basic needs: safety, nourishment, and warm human connection. It’s a process of emotional balancing, almost like a ‘rebirth’ after a traumatic experience,” Yehene concluded.