Lili Bernstein (Goralnick), LCSW-R
Gelly??!!". I shouted into the phone.
It was about 11 p.m. and the sirens had finally died down.
I had figured it was a menorah fire, but I glanced into YWN when the sirens weren’t stopping. TERROR IN MONSEY screamed back at me. I called my dear friend and colleague Gelly Asovsky straightaway.
"It's our turn, Lil! What's the plan?"
"Straight into the storm, Gelly. I know the Rebbe and I'm calling the Gabbai tomorrow morning."
"Do it. We've got this! I'll start working on the team.”
We knew what we wanted. We wanted people to have Eye Movement Desensitization and Reprocessing therapy (EMDR) as quickly as possible to prevent Posttraumatic Stress Disorder and lasting psychiatric symptoms. We knew what the research said. When stress hormones are elevated, memory processing is impaired and can result in fragments, images stuck in the front of the mind, irrational narratives, nightmares, body sensations. The story needs to be retold with the eyes moving back and forth rapidly, sweep-searching across the brain to gather every piece and package it for long-term storage.
We had tried to get involved with Jersey City two weeks before, but couldn't find an in. So we sat back helplessly and wondered, "What treatment are they providing?" "Are they doing debriefing?" Years of research suggests that intervention is the quickest way to create lasting psychological suffering. "Those people need EMDR ASAP!!". We had felt so helpless.
Hanging up, I checked in on a couple close friends and my neighbor across the street. My husband stepped in with a stern look on his face at 12:30. "I think it's time for you to close the phone and go to sleep. I don’t want you to have nightmares." "There's no details yet. I was just talking with my friends." “No more phone.”
I shut the phone, lay back on my pillow and began talking to Hashem. As I prayed for these poor people, it dawned on me, I know easily three who were FOR SURE there. Oy vey. Acid began rising in my throat. I couldn't call them at midnight. They probably had their hands full, at the very least. This is, IF they were ok.
And the Rebbe! “Hello, Lili? You know the Rebbe!”
“Ok but the Rebbe can’t be hurt, it isn’t possible.” Came the irrational reply in my head.
That kind Rebbe. Every interaction we’ve had somehow had humor to it. The last time I saw him was in Nyack, just before my chuppah. I was hamming it up in front of the camera, twirling round and round with my arms spread wide. When I stopped, there was the Rebbe right in front of my nose grinning, with a very serious looking gabbai at each elbow. I froze. “Rabbi Rottenberg would like to see you” said the serious gabbai to his left. “YOU CAME??!! NO WAY!” I clapped my hands together gleefully. “Well I wasn’t going to miss it! I have five today, but this one was a definite!” Then he blessed me.
There would be a lot of big-name institutes rolling in in the next few days. But the Rebbe would let me help. This is what I held on to when I went to sleep.
Morning couldn't come soon enough, but when it did, I phoned the gabbai without even sitting up in bed. Voicemail. “Far Yiddish, drik tsvey…”
drik meyn kop…
“This is Lili Goralnick, I’m a trauma therapist here in Monsey. Just… please tell the Rebbe…he knows me… tell him ‘Lily Green’ (the name he knows me by) has a trauma team ready. Free of charge. We’re two ladies and two men, two for adults, two for children. EMDR should be done on people as quickly as possible. Call me.”
Then I left a message for the former client who I knew had to have been there. I sat up and rubbed my eyes. “Why isn’t she picking up? Oh, G-D…” I left a message. “I just need to know you’re ok.”
Then the EMT I know.
“Please tell me you arrived too late to see anything.”
“Just the opposite. I arrived before the police and when I ran in I was by myself and not even sure the guy was gone. I never saw so much blood in my life and I didn’t know what to do first even.”
“Oh G-D. Listen, you need to be seen today. Not tomorrow. Today. I don’t want you getting PTSD.”
“Ok but by the time I finished loading the ambulance the police had blocked the door and they wouldn’t give me my equipment. I stood in the cold for an hour in a bloody shirt waiting for my jacket and car keys, till a lady police finally agreed to let me tell her which is my jacket. I need to go back there”
“You’re going back in there??!! Bad idea!”
“I don’t have my equipment! I have to!”
“OK listen, if you see a gabbai, tell him I have a trauma response team ready and waiting.”
“Oh! Awesome. I’m going to give the message. Can I tell my friends?”
“Yes! Yes! Call me back with what time you’re coming for EMDR.”
I sipped my coffee and thought about my day. I figured till the detectives leave, till the place is cleaned up… nobody is calling. “Honey,” I said to my husband, “I had a shiva call to make a block from the Rebbe’s house, I’m not going to get my car in there. I need the fresh air for my nerves. I’m putting on my sneakers and I’m going to power walk to Forshay.”
“I’ll come with you.”
“What do you mean? You have Yeshiva today.”
“Well…I’ll go with you.”
So we walked, and I felt energized and focused. And protected.
I spoke with Gelly again about the team, and then to our EMDR supervisor, Victoria Britt, who was willing to come from Montclair to help. We went over the Recent Traumatic Event Protocol (RTEP) again, as well as which additional exercises to use and in what order. We were all awaiting the gabbai.
The former client called to say they hadn’t been in the house at the time, and were feeling ok. I breathed.
The EMT called back in the afternoon for an appointment, and when he walked into my office he was chuckling. “You really do know the Rebbe. Because when I mentioned to him your name, he got all excited and waved to his gabbai to write it down. “Yes yes! Lily Green, she knows a gitteh Yiddish! We need her!” He told me it was chaos over there still and I probably won’t have any cases till late tomorrow because they needed to finish with the detectives and cleanup.
We began with two relaxation exercises to begin restoring non-essential functions that shut down when the body goes into survival mode; saliva, digestion, verbal, problem solving. He felt calmer already and was ready for me to set him up with my EMDR equipment; two egg-shaped plastic vibrators that light up, connected by wire to a little box which I can use to speed up or slow down the back and forth vibration and light stimuli. He practiced watching the lights go back and forth and we decided on an intensity for the vibration. As per the RTEP protocol, I instructed him to begin an hour prior and end at a point when he was “safe enough” following the episode.
He began his story of arriving alone, not knowing if the place was safe, throwing off his jacket and cutting open peoples clothing to find their wounds. Blood everywhere, bones showing, and some very difficult speedy decisions with not enough bandages at first. He took his story to the end when he arrived home and got into bed. We took a few deep breaths together, and began to desensitize any remaining images that were repeating on him, using rapid side-to-side eye movements. Then more relaxation exercises. “I feel totally calm! Wow!” He walked out relieved and begged me to track down a particular EMT from another company who had been very upset. I said I’d try.
That night I tried the gabbai again. He picked up. Too chaotic still. A list of people will be made tomorrow.
Monday was a quiet day at the office, so I decided to cook for the week, until I get the list. By 3pm I started to pace. Members of the team were calling. They were ready to take cases. I started to get tense. We had a widely-researched, empirically-proven method to prevent the onset of PTSD. Four of us in Monsey were trained and waiting. I composed a mass text for all the therapists I know, just to get the word out that people could get EMDR immediately, free of charge.
I paced till 5. Then I put on the news on the tv I abhor but dust off for emergency occasions; hurricanes, blizzards; lunatics attacking my community with a machete. I flipped from 2 to 4 to 7 to 9 to 11 and back again, looking for answers. I wanted to hear that this man worked in Monsey and was angry at someone. Anything… so I could tell my clients that no, there’s no vile people staking out Monsey to see where to commit an anti-Semitic attack. I made sure to shut it before the “nightmare police” stepped in for his dinner. But not before I spotted the lady officer carrying the EMT’s jacket out of the house. I found a link to the footage and texted it to him. He had a good laugh, “I’m famous!”
That night I went to the office see my night clients. The last one exited the building with me together.
Tuesday morning a longstanding client called. “Listen here. I know you’re going to want to give people EMDR. But remember, people maybe never had therapy before, or they’re still getting their heads straight… don’t start pacing and getting frustrated. That’s what I want to say to you. In a few days you’ll be helping people. Don’t get frustrated, Lili. OK?” That was perfect chizuk, and I thanked her for knowing me so well. (I didn’t tell her she should’ve called me yesterday!)
Tuesday midday a different gabbai called. “I’m in charge of the mental health needs.” He told me that night the ladies who were at the attack or had family that was there were getting together. He thought it would be good if Gelly and I spoke with them. Gelly had been very busy trying to arrange immediate RTEP training for a handful of more EMDR therapists. We quickly came up with a program over the phone. After some back and forth, we nailed it down.
Honestly, I expected a roomful of crazed-looking ladies with crooked tichels. But that’s not what I found at all. They had baked, and sat before a lavish spread. They all looked beautiful and dignified. They chatted and even joked. But they were scared and in pain and suffering, and they expressed that. We got to hear one thing each lady enjoys to do, and what came out was impressive. Intelligent, capable, talented chassidishe ladies who were trying to hold themselves and their families together. We educated them about what happens in the brain and body during a moment of danger. We talked about fight, flight and freeze responses, and the role of the vagus nerve which runs from the throat through the digestive track down to the pelvic area. We then did several EMDR exercises to relieve chest pain, stomach paralysis, bladder over activity. We also did an exercise to weaken intrusive images.
We had each lady establish a “calm enough place” to bring up in their mind several times a day and strengthen with some basic EMDR. Mine would be my upcoming “Shabbos of TLC” at my dear friend and surrogate bubby, Judy. I envisioned her warm smile and open arms, her Hungarian accent; “Leelee! I’m So happy you caaame!” little squares of cheesecake in pretty cupcake paper, lavender floral linens, three little glass bowls of goodies next to my bed…
After the program, a few ladies pulled me aside. All presented some version of “I never got help for my childhood trauma and now it’s activated.” I assured them each they could get immediate help through the gabbai. It was after 10pm when I slipped out.
The gabbai had our assignments ready the next morning. To start, family home visits for Gelly, where she could do a group version of EMDR called GTEP with parents and kids. Men for our colleague Yisroel Teitelbaum, and ladies for me. The system we created was finally running.
None of the ladies who came to me initially had been at the massacre. But their husbands were. And their kids in some cases. I ran them through the EMDR RTEP protocol, calmed their system, and in a few cases had a little talk about something from childhood that had been triggered and required further care.
I saw that in all cases, the prefrontal cortex part of the brain that produces rational thought and shuts down in emergencies was still offline. We did some thinking exercises:
“I’m afraid to walk on Forshay Road.”
“How many security vehicles are on Forshay Road now?”
“One pointing each direction?”
“And how many men do you see when you look out your window onto Forshay Road?”
“Ok. So lets say, someone anyway grabbed you. How quickly would men be there to rescue you?”
Another went like this:
“I’m afraid someone might come through my double-bolted door.”
“Ok. Well…have the attacks been on public gatherings or small quiet houses on side streets?”
“Only in public places.”
“Only in public places. But let’s say that despite that, someone decides your house is very important, and they want to attack it.”
“How long, would you say, it’s going to take to bust the two bolts? Even with a gun…”
“I don’t think those bolts could break!”
“So you’d be out the back door by then?”
“Down the block!!”
People left my office with clearer minds, better able to eat and sleep and know that at least behind the bolted door of their home, they were safe.
And so the week went. A lot of calls, a lot of EMDR in addition to my regular clients (many of whom were out with flu, interestingly). Wednesday night I did yoga. A head cold developing. But I kept returning my mind to the upcoming “Shabbos of TLC.”
By Thursday Gelly and our supervisor had grown the team and planned additional training. I was focused on my cases, until Gelly called with the news that the gabbai had to hand the list over to Bikur Cholim. We risked being cut out. I began to sweat. “Wait. Come on. I worked there for 7 years. I’m going to call them and we’ll work it out. It’s going to be ok.”
Thursday night I went to the shul (was I really going in there??!! Yikes!”) to meet with the reps from NY State Crime Victims Services and learn how clients could get reimbursed for follow-up sessions. Then I went to vent it all out by a therapist myself. It was getting late. I picked up some Chinese food, and my week was thankfully over. Friday would be exercise, meditation and laundry. And a lot of nose blowing, because now I officially had a cold.
By midday Friday things were worked out with my dear mentor Dr. Schechter at Bikur Cholim so we could still provide RTEP as an initial treatment for those directly affected. “Lili, keep up the good work!” The calls were still coming, my next week was almost full.
When I stepped into Judy’s gloriously tidy home Friday evening, I melted into her yummy bubby arms with a sigh. “Leelee, you had a haaard week, I’m SURE!” On the wall behind her couch was a huge, wide photo. Seven couples and 60 smiling grandchildren. I stood before it.
Am Yisroel Chai.
teens, adults, couples and group psychotherapy