Draft:SafeHeart

SafeHeart - Support for the survivors of the terrorist attacks on the festivals in the Gaza Envelope (Hebrew: לב בטוח, formerly Nova Help) is an Israeli nonprofit organization specializing in assistance and support for the survivors of the terrorist attacks at the festivals on October 7th 2023, including mental support and research.

The association was founded in 2023 by researchers and therapists active in the harm reduction and Safe Space community in Israel. SafeHeart has operated nationwide since its establishment, providing tailored psychological support to around 3,000 survivors by recruiting about 400 licensed therapists.

SafeHeart currently offers long-term treatment and support to approximately 850 survivors, which includes 36 therapy sessions for each patient in the initial stage. The therapists, including clinical psychologists, psychotherapists, psychiatrists and clinical social workers, offer a nonjudgmental and accepting environment.

The association operates in cooperation with the Israeli Trauma Coalition and is recognized as a national resilience center, working with the Ministry of Health, National Insurance Institute, and Ministry of Welfare.

History
SafeHeart began its activities following a surprise terror attack in Israel on October 7, 2023, as reports emerged from the south about the massacres at the Nova, Psyduck, and Midburn festivals, where over 4,400 people came together to celebrate - of which approximately 364 were murdered and another 44 kidnapped.

The event took place in an environment where most of the people were in altered states of consciousness, either due to late-night partying at a trance festival and/or due to alcohol and mind-altering substance consumption. In typical fashion of nature parties and festivals, the young party-goers timed their highs for the peak time of the festival, when the best DJs play against the backdrop of the magical moments of sunrise, but instead of the event’s highlight, at 06:29, the murderous terrorist attack began.

This unprecedented event requires special treatment and expertise in trauma therapy alongside therapists trained in psychedelic-informed therapy and damage mitigation - something that was unavailable in Israel’s public mental health sector.

To help the thousands of survivors, therapists from the trance community, who are experienced in establishing and managing safe spaces at parties and festivals, quickly joined together to establish a system that provides tailored psychological support to survivors, including professional clinical treatment by psychedelic-informed therapists with a non-judgmental approach.

During October, SafeHeart recruited ~500 professional and licensed therapists, who are well acquainted with the trance party community and have deep experience and knowledge in acute responses to traumatic events and psychological damage mitigation. In the first two weeks, therapists voluntarily provided acute intervention therapy to about 2,500 survivors to minimize damage and try to prevent the long-term effects of PTSD.

According to testimonies from SafeHeart, there are at least ten eyewitness testimonies of rape, gang rape, and sexual assault in different locations in the party area. These eyewitnesses remain anonymous due to their current mental state. SafeHeart’s team collaborated with the UN Special Envoy for Sexual Violence in Conflict, Pramila Patten and her team, who examined the testimonies of sexual violence that occurred on October 7th as part of an investigative report published on March 4, 2024.

Professional model
SafeHeart is a member of the Israeli Trauma Coalition and is recognized as a national resilience center, working with Amcha, the Ministry of Health, and the National Insurance Institute as a provider of mental health services to survivors of the massacres at the festivals.

Individual therapy
SafeHeart offers in-depth, one-on-one psychological treatments, comprising at least 36 individual therapy sessions for each survivor of the festivals of October 7th, with qualified and licensed therapists, who are experts in trauma therapy and psychedelic harm reduction, and are located nationwide.

SafeHeart also provides tailored psychological assistance to soldiers who survived the parties.

Safeheart’s network of therapists includes clinical psychologists, psychotherapists, psychiatrists, expressive arts therapists, and clinical social workers - all of whom have extensive professional experience with severe traumatic experiences and in the field of Psychedelic Harm Reduction and Integration.

This therapeutic framework is complemented by a specialized team dealing with extreme cases and emergencies, providing immediate support in acute crises, as well as a dedicated psychiatrist who is a member of the "trance tribe."

Retreats and group therapy
Alongside the comprehensive 1:1 therapy, SafeHeart built a series of retreats and group sessions, which constitute a significant part of the overall treatment system provided to the survivors. These group processes are based on clinical research emphasizing the importance of processing trauma collectively and the immense impact of community in healing and coping with trauma.

The retreats and group sessions take place in a comfortable location, with a limited number of participants, to facilitate processing and group cohesion with other survivors, alongside a team of qualified therapists that offer support. This is an opportunity for the survivors to share their experiences intimately, feel part of a community, and learn new coping skills in a safe and supportive environment.

The retreats are held in several locations and in collaboration with Kfar Maccabiah, the Slowness complex in Kibbutz Moran, and in the desert.

Support for survivors' families
Recognizing the significant challenges that the families of survivors face on their own and acknowledging the profound impact on families, as well as the importance of a supportive environment as part of the healing journey of the survivors, SafeHeart established a support system for the survivors’ immediate family members.

This framework includes three circles of support and guidance for families: dedicated community spaces for family members, knowledge and tools for caring for their loved ones, and the prevention of secondary traumatization.

Quantitative Research in Collaboration with the University of Haifa
In order to study the implications of such an event, SafeHeart is conducting a groundbreaking and in-depth study led by Professor Roy Salomon, one of SafeHeart’s founders and director of a laboratory at the University of Haifa. This is the world's first research examining how extreme trauma is experienced and processed when it happens under the influence of mind-altering substances. The research includes both quantitative and qualitative research (led by Guy Simon and Bar-Ilan University), with the aim to study the unique cognitive, physiological, and neural mechanisms related to this unprecedented phenomenon.

The ongoing research combines various methods, including surveys, interviews, heart rate monitors, sleep studies, saliva samples, and MRI brain scans, all repeated every few months over a period of three years.

In March 2024, the first pre-print of the research was published, presenting initial and significant findings. 657 survivors participated in the initial phase of the research, with all participants reporting imminent danger of death. 83% reported witnessing fatalities or injuries, 79% reported the murder of loved ones, and 68% reported injuries to loved ones. This means that all research participants were exposed to extremely severe trauma that could lead to significant psychological effects.

The research indicates that 68% of survivors reported taking mind-altering substances, with 26.7% specifically consuming MDMA. Researchers were able to show that the experience of trauma under different substances led to different psychological effects and expressions of symptoms during the initial trauma processing phase.

The initial findings suggest that MDMA use prior to the trauma had a positive impact on sleep quality, social interactions, and clinical outcomes compared to those who experienced trauma under other substances or even compared to those who did not use any substances during the event.

The research is first and foremost aimed at improving the quality of psychological treatment SafeHeart provides to survivors. There is continuous feedback between research and treatment, and as new clinical findings emerge, therapists adjust the treatment accordingly to provide the best possible response to survivors who experienced this disaster. In addition, the research allows the opportunity to learn from this tragedy and seek ways to assist in the healing of survivors, improve their long-term well-being, and increase professional knowledge in trauma treatment.

Qualitative Research in Collaboration with Bar-Ilan University
The qualitative portion of the study is being researched in collaboration with Bar-Ilan University and led by Guy Simon from the Department of Sociology and Anthropology. The research focuses on the experience of trauma under the influence of psychedelic substances among survivors of the terror attacks at the parties: the sense of agency, their perception of reality, and the implications of different coping mechanisms with the event.

The research examines the coping methods of party survivors that experienced difficult psychedelic trips, uncontrolled exposure to traumatic content, and the development of post-traumatic symptoms given the use of psychoactive substances. The aim of the research is to understand the unique characteristics of the collective traumatic experience of terrorism against a backdrop of identity-affiliation, under the influence of psychedelic substances. The research question is: What are the unique components of the subjective psychedelic experience when exposed to a terror event? In addition, such an unusual event cannot be understood solely through quantitative tools and requires documentation and phenomenological analysis to provide a tailored response to the survivor population.