Son 20 alive and 48 deadall men, except the corpse of a woman, Herbar27-year-old volunteer at the music concert and murdered by her captors after October 7, 2023.
For the living, Israel’s Health Ministry has asked the Red Cross to prevent Hamas from overfeed at once to hide extreme hunger to which they have been subjected during two years of captivity. If they are given too much food at once, they can suffer serious consequences, such as cardiac, neurological and respiratory problems. The clinical term is refeeding syndrome (refeeding syndrome).
With the last ones released, in February 2024, says the head of nursing at the Beilinson hospital, Michal Steinmanthey had to act as detectives: “We went system by system“, ears, eyes, mouth, hair, skin, kidneys, urine, whatever, muscles, to think about what is happening to a person who is in those conditions of captivity,” he points out. Steinman.
But the worst is hidden: the psychological traumas and the consequences left by 734 days of kidnapping and torture. In the hospitals that will receive them, Sheva, Ichilov, Sourasky and Beilinson itself, the ministry has announced that a psychiatric evaluation will be carried out. The Soroka and Barzilai centers will be left for emergencies due to their proximity to Gaza.
It is a captivity that is too long, so long, say the medical teams, that they had no protocol nor were there guides in the medical literature. Authorities have ordered separate areas for hostages, with private rooms with a family member or trusted persona double examination (the first immediately and the second after reunification), and the psychiatric evaluation in less than 24 hours. And from there, stable teams will be assigned with a doctor, nursing, social work, psychiatry, psychology, dietician and forensics.
The traumas they will bring
The range of symptoms that clinicians anticipate is typical of complex post-traumatic stress disorder (PTSD): insomnia, hypervigilance, nightmares, dissociation, depression and loss of basic trust. They have returned, but they are no longer the same. Prolonged exposure to constant danger and threat of death will not allow them to live normally.
Ghostlydirector of the clinical unit at NATAL (Israel Trauma & Resilience Center), emphasizes that prolonged captivity and interpersonal violence, the “encounter with cruelty” of another human being, raise the traumatic load above natural disasters or accidents: “The trauma of captivity is the worst there is. We know the names, the faces, the stories and their previous lives. But during the return process, they will need privacy to return to life and little by little regain control over their lives,” explains Aloni.
From the National Center for Post-Trauma and Resilience (TAU) they add two key ideas: there is life after, but the cost does not disappear: rehabilitation is systemic and will last for yearswith social support and psychotherapy as pillars, and will need drugs to alleviate symptoms such as insomnia and intense anxiety.
Survivors of long captivity confirm the depth of the damage. In Hostage, Eli Sharabi narra 491 days kidnapped -440 of them in tunnels- with extreme hunger (“one dry pita bread a day”), while he was losing his nails and his eyesight. With lucidity and observation skills, he describes his captors as euphoric after the attack on October 7, convinced that they had conquered their kibutz Be’eri with ease and moved by a mixture of fanatical hatred, religious indoctrination and triumphalist delirium.
He hears them speak Arabic with resentment towards “the millionaire Jews”, a reflection of a conspiratorial and revenge myth. Those from Hamas alternated between brutality and minimal gestures of compassion – “a slice of clementine, a popcorn” -, always under the logic of a hierarchy that depersonalizes everyone.
Sharabi sees them as guardians trapped in obedience and paranoia. He summarizes his experience as a “descent to the bottom of the human condition,” where solidarity between prisoners was their only form of resistance to a structural evil that annuls the other as a person. It is a raw portrait of physical degradation and moral resistance that anticipates prolonged processes of grief and trauma.
How can this trauma be treated?
The international evidence that the Israeli teams take as a reference coincides in a first line of trauma-focused psychotherapies: Prolonged Exposure (PE), Cognitive Processing Therapy (CPT) and Eye Movement Desensitization and Reprocessing (EMDR).
In PE, the patient relives traumatic memories in a controlled and repeated manner until the fear and anguish decrease. In CPT, the patient works through the distorted thoughts and beliefs left by the trauma, such as feelings of guilt or believing that they will never be safe, and they are replaced with more realistic interpretations. EMDR combines trauma evocation with bilateral stimuli (eye movements, sounds or alternating touches) to process the memory and reduce its emotional load. They are treatments with measurable results and are usually combined with interventions on sleep and chronic pain. In the acute phase, stabilization, psychoeducation and recovery techniques are prioritized. grounding.
At the organizational level, the multidisciplinary team and joint clinical meetings allow a personalized plan covering frequent comorbidities of captivity: malnutrition, injuries, infections, consequences of sexual violence, more common in women, but may have also occurred in men (two Israeli teenagers were forced to perform sexual acts on each other and subjected to abuse by their captors, according to The Times of Israely UN special envoy reported clear and convincing information of sexual violence against some hostages).
Netanyahu affirms that Israel is prepared to “immediately receive” all hostages kidnapped by Hamas
Coordination with forensics will cover identification and chain of custody in possible crimes, without interfering with therapeutic care. Privacy is not a whim, it is part of the treatment.
They will need protected and quiet spaces, time and control over their own narrative. NATAL and the center of TAU recommend limiting public exposureavoid converting the biography of the returnee into media content and stagger the return to social roles (family, work, community). They will need years of monitoring, with peaks on significant dates and at times of new crises. A support network will reduce relapses
Families must react with ethics of care: protect the privacy of the returneedo not force stories, avoid informal “interviews” or exposure on networks. Clinicians at the national PTSD center insist that families will learn to identify triggers (noises, confinements, smells), accompany them without infantilizing them, and respect the “if they want to talk, they will talk.” The process will be uneven: there will be improvements and setbacks. The function of the family is not to “get information,” but to maintain the control that captivity took away from them.
What does it feel like to return to family and society? No two cases are the same, but the literature and testimonies point to a mix of relief, deferred grief, survivor’s guiltanger and distrust. Some will feel strange in open spaces, others, anxiety in crowds or tunnels. Reintegration is viable, “you can live, start a family, work,” the clinicians remember, but they live with permanent scars.
The trauma is also in Gaza. In parallel, the Palestinian civilian population is suffering from massive trauma – displacement, mourning, lives suspended – and, despite misgivings about the terms, several voices in Gaza have asked Hamas to accept the plan to end the war. Independent barometers help frame those voices: PCPSR surveys in 2025 showed decline in support for Hamas and the use of forceand changes in political preferences, while rejection of the de facto denuclearization of Gaza and distrust that the release of hostages would end the war alone persisted. They have urgent material demands and low expectations of leaders.
Broken bridges, and how to rebuild them
Eli Sharabi describes his captors as euphoric and fanatical men, blinded by an ideology of hate and plunder, convinced that the Israelis are existential enemies. In parallel, he warns that His captors also feared the civilian environment: They hide him in houses and tunnels so that the Gazans themselves would not lynch him if they saw him, a phrase that summarizes both the total isolation of the hostage and the moral decomposition of the context. His conclusion is that Hamas’s ideology—a mix of religious supremacism, martyrdom propaganda, and political greed—dehumanizes both the captive and the captor. The “cruelty” he mentions is not a specific excess, but a method: kidnapping, hunger and humiliation as tools of power and story.
After two years of horror, public trust between the two peoples has been broken. Let us remember that many of the concert attendees and kibbutzin residents were pro-Palestinians and supporters of peace. Attitudes of compromise are fragile on both sides, skepticism dominates the climate and there is talk of a peace born of fatigue. Contact between the two peoples, from person to person, cannot work if there is no symmetry or recognition, as the academic Ifat Maoz explains about Jewish-Arab encounters.
The socio-psychological narratives of Daniel Bar-Tal y Era’s Halperin They identify persistent barriers, such as exclusive victimhood, zero sum, delegitimization, which feed back into violence. Reversing them requires visible benefits and shared regulatory frameworks.
In practice, clinical and social diagnosis are related: the privacy and control that professionals ask for hostages are analogous to what communities ask for peace: basic security, stability and their own voice. The return to life of the liberated requires protocols, therapies and silence. The return to life of societies will require verifiable steps, mobility and tangible benefits that replace fear with reasonable expectations.