Abstract
Background: Handling and identifying human remains following mass-casualty terror events constitutes an extreme yet understudied form of occupational trauma. Although research on first responders has expanded in recent years, body handlers remain largely absent from both organizational and social psychiatric literature, particularly with respect to post-mission adjustment.
Methods: Twenty-four Israeli reserve soldiers (17 men and 7 women; aged 32–59) who participated in body recovery and identification following the October 7, 2023 Hamas terror attack were interviewed using semi-structured, in-depth interviews. Data were analysed using reflexive thematic analysis.
Results: Three temporal phases were identified: difficulties during service, difficulties after service, and challenges in transitioning back to civilian life (during or after service). Five interrelated thematic domains emerged across these phases: (1) extreme sensory exposure and emotional overload during service; (2) organizational disruption and insufficient preparation; (3) moral conflict between preserving the dignity of the deceased and the imperative for rapid identification; (4) persistent psychological symptoms and social alienation despite preserved functional capacity after mission completion; and (5) loss of role, feelings of emptiness, and longing to return to the mission. Participants commonly reported intrusive sensory memories, emotional numbing, and social withdrawal while continuing to function occupationally and within family life, which contributed to delayed recognition of psychological distress.
Conclusions: Body handling following mass terror constitutes a socially embedded form of occupational trauma characterized by moral distress, organizational strain, and challenges to post-mission reintegration. The coexistence of apparent functional recovery alongside ongoing psychological suffering underscores the limitations of symptom-based assessments alone. These findings highlight the need for organizational preparedness, moral and cultural atonement, and structured reintegration processes as integral components of public mental health responses to extreme occupational trauma.