As parents of kids in Israel, it is nerve-wracking enough having your child so far away, much more so when the internet, news, and even the students have continuous reports of terror and violence in Jerusalem and the rest of Israel.

Here is some advice on how to help your child cope with the  stress.  

1. Safety First. There is no health without safety. If you see something that makes you uncomfortable – LEAVE.  Trust your instincts: The best defense is not to be there.

During Succot, I met a seminary student in Jerusalem who had just seen  a violent protest. Lots of police, lots of screaming.  She was breathing fast, sweating, and understandably shaken.  She also was unable to think clearly and make good decisions because that’s what happens when you are under stress.  She was frozen - didn't know what to do (think deer in headlights). If you always have a plan, always think “If I need to leave quickly, I can walk up THAT block”.  Having a plan, no matter where you are, gives you more control when something IS going on.

2. Avoid places where attacks have occurred. Attacks seem to be repetitive.  Also, avoid very crowded places at peak hours.  Choose wisely where you want to go and plan alternative routes and destinations in case you are uncomfortable.  Follow instructions of authorities, whether school, police, security.  If you don’t understand the language, ask someone nearby or follow your instincts and walk in the opposite from the trouble spot. Quickly.

3. Watch for signs of stress or anxiety. In our experience (through 2 intifadas, 2 wars, and several mini-wars since living in Israel) these are the most commonly seen symptoms of anxiety and stress during difficult times:       

-Stress responses. Our bodies are wired to cope with small doses of stress using “flight or fight” modes. Chronic stress, or living in a (perceived or real) continuously stressful situation can lead to abnormal reactions in some people.                         

-The “fight” reaction was seen in recent video footage of terror attacks when civilians gathered to watch rescuers, and even picked up umbrellas, sticks, and other items to hit the terrorist with. This is never a good idea.  You aren’t a superhero. Many attackers have more than one weapon, and sticking around or fighting may be dangerous.  

-The “flight” reaction is appropriate, but fleeing from every moving car and flinching with every ambulance siren is a sign that you are too stressed.       

-Abnormal physical and emotional symptoms of anxiety may include: Moodiness, feeling overwhelmed, difficulty relaxing, inability to quiet the thoughts in your head, feeling depressed or low-energy, difficulty focusing, headaches, nausea or diarrhea, difficulty sleeping, fast heart rate, clenching your jaw and grinding your teeth, fidgeting, and appetite changes.  The Mayo Clinic has a great chart on the common effects of stress categorized by body, mood, and behaviors.                  

-Hypervigilance is defined by a popular online medical dictionary as: “abnormally increased arousal, responsiveness to stimuli, and screening of the environment for threat; it is often associated with delusional or paranoid states."

In Israel right now, SOME hypervigilance is healthy: You SHOULD be more alert, you SHOULD be screening your environment for threats.  But we want to avoid paranoid or neurotic behaviors.

When you are safe in your school, your heart should not pound when you hear ambulances or helicopters.  You should not be hypervigilant to the point of thinking someone will attack you at any moment. You should NOT be unable to sleep, learn, eat, and function normally. You should not be continuously scanning your smartphone for news (sound familiar?).

6. Most importantly - If you witness any traumatic event:

- Do not observe: WALK/ RUN AWAY while SHOUTING for help. This is not the time to be shy.  Repeat attacks are possible at the same site within a short period of time.  Newsflash: You are not a paramedic, police officer or soldier.  You are a student. You cannot help and you may get hurt.

-Call your parents – let them know that you are safe. DO not make them more worried than they are.       Speak to your program head or counselor about the event you saw.     

- Ask for professional help if you are not able to recuperate within a day or two. There is no stigma about needing a little help.  Israel has many appropriate, English-speaking professionals who specialize in coping with trauma.  They can help you quickly, sometimes as quickly as one visit.

Parents, if you see these symptoms or feel that your child needs help, you are not alone. EMA Care can assist in providing assessments on the ground and (if needed) referrals to excellent, English speaking professionals who specialize in stress.  We can help liaison with yeshivas and seminaries to accommodate your child’s needs.

In this time of crisis, Dr. Aaron has volunteered to speak to students at yeshivas or seminaries to discuss healthy coping and to conduct a professional support group.  If you are interested in such an event at your child's school, please contact us or forward our contact information to the school.

Dr. Eliana M. Aaron is the director of EMA Care.  Dr. Aaron received a Doctor of Nursing Practice from Yale University and has 20 years of experience in nursing, health advocacy, health education and as a nurse educator.