What's next for Edan Alexander? American freed, but trauma lingers for Hamas hostages
The world cheered as the last living American hostage under Hamas control was reunited with his family.
In an exuberant scene caught on video after his May 12 release, Edan Alexander threw his arms around his parents and shrieked with joy when he spied his siblings. Later, he posted on Instagram wearing shades and holding a bottle of Corona.
But after the initial euphoria, the journey is not always easy for freed hostages. Israeli doctors who have worked with the dozens of captives released in recent months told NorthJersey.com, part of the USA TODAY Network, that many face a complex rehabilitation.
It's still too early to know the full extent of the suffering that Alexander, 21, endured during his nearly 600 days in captivity in Gaza. In an interview published May 14, his father, Adi Alexander, told The New York Times that his son, an Israeli soldier, was held with a bag over his head at times and handcuffed, beaten and interrogated about his military service.
Yael Alexander, Edan's mother, said at a news conference that her son was plagued by hunger, thirst and unsanitary conditions during his time in Gaza, not to mention constant anxiety about the war raging around him.
With bombs and military strikes shaking the tunnels where he was kept, he feared that any moment could be his last, his mother said.
Alexander, who volunteered for the Israel Defense Forces after graduating from Tenafly High School in suburban New Jersey in 2022, was guarding an outpost near Israel's southern border during Hamas' 2023 terror attack, in which 1,200 people died and 251 hostages were taken. The attack triggered a war that has also claimed 58,000 lives in Gaza, according to the territory's Hamas-run health ministry.
Israel says about 20 hostages are still believed to be alive in Gaza, along with the remains of 37 others. Four of the dead are Americans. Roughly 147 have returned home in ceasefire deals or through rescue operations.
Doctors who have treated them say freed captives have expressed relief and joy to be home – but also a difficulty resuming their old lives.
Many suffer from emotional and physical scars, including anxiety, flashbacks and PTSD. Some feel survivor's guilt because there are still hostages remaining in Gaza, said Irwin Mansdorf, a clinical psychologist and senior fellow at the Jerusalem Center for Security and Foreign Affairs.
That emotional weight can complicate the rehabilitation process, because many returnees feel they can't avail themselves of their new lives while hostages are still suffering, said Mansdorf, who also served in the emergency division of the IDF Homefront Command.
Some are still held captive by the horrors they experienced in the underground tunnels where they were held for months.
"The hostages went through severe physical and emotional abuse, including maltreatment, lack of food or medical treatment, and physical interrogations, regardless of whether they were civilians or military," said professor Asher Ben-Arieh, dean of the School of Social Work and Social Welfare at Hebrew University in Jerusalem. "Many were subjected to sexual abuse as well."
Ben-Arieh, who has met with prisoners of war, Holocaust survivors and hostages, said he's optimistic about the chances for rehabilitation for the returnees. He recalls a former POW telling him he "had a good life but always had the scars. I believe this can be true for the hostages: They can have a good life but will have to live with the scars."
The time it could take to heal physically and emotionally from such an ordeal depends on a variety of factors, including a victim's resilience, their age and their experience during captivity, said Ben-Arieh, who also directed the Haruv Institute in Jerusalem, which developed protocols for reintegrating Oct. 7 hostages.
Dr. Noya Shilo, head of the Returned Hostages Clinic at Sheba Medical Center in Israel, which has treated 46 released captives, said that in many cases, recovery is a lifelong journey.
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That's especially true given the shock of Oct. 7, when Hamas gunmen overran villages and a music festival, shattering Israeli civilians' sense of security.
"Very early on, we understood that this was like nothing else ever done before,' Shilo said. Without any precedent or medical literature to rely on, her team had to think outside of the box to create a new clinical discipline.
'Civilians had been taken hostage from their own homes and saw their world destroyed," she said. "This wasn't just going to take a few days at the hospital."
Recoveries involved working with a team of experts in social work, psychology, yoga therapy, spirituality and alternative medicine, she said.
"This kind of trauma affects the body and mind as well as the spirit," Shilo said.
Medical experts learned that the trauma affected the mental health of everyone in the hostage's social and familial circle. "It was like their entire family was also taken hostage," she said. "We have to also treat the family members or loved ones of those captured or killed."
The therapeutic community took lessons from Holocaust survivors, who were often haunted their entire lives by the atrocities they experienced. Despite the PTSD, she said, many of them 'managed to transform that into growth and led productive lives. We want to make this possibility present for the hostages.'
But Holocaust survivors – many of whom declined to speak about their experience until old age – didn't have to grapple with the pressures of social media or the paparazzi. "The hostages were abducted as anonymous individuals, and now they are famous for the worst thing that happened to them and to Israel," Shilo said. "This is something that requires a lot of process."
Ayelet Noam-Rosenthal, a lecturer in the psychology department of Jerusalem Multidisciplinary College and one of the writers of the Haruv guidelines for the reintegration of child hostages, noted that the "emotional recovery for many of the returning hostages is deeply tied to the remaining hostages in Gaza."
"Many of those who returned found themselves at the center of the public campaign to bring the others home and, as a result, have not been able to focus on their own healing process," she said.
One of the most important aspects of supporting the returning hostages is to help them regain a sense of control, Noam-Rosenthal advised. "Restoring agency is key to healing, and the role of the surrounding environment is to provide quiet support, respect boundaries and follow the returnee's lead," she said.
The protocol also recommends asking the returnee's permission before giving a hug or turning on a light, and offering choices of what to eat.
After Edan Alexander's release, it appeared that the Alexanders were heeding the words of the experts.
They told a reporter at the Tel Aviv hospital where their son was being monitored that it was a blessing just to sit next to him and relax together. "We are chilling and trying to listen," Adi Alexander said.
Yael Alexander added, "He needs time. ... We will give him whatever he needs."
This article originally appeared on NorthJersey.com: Hamas hostage, American Edan Alexander, released; trauma lingers
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