About seven months ago, Gil Vivante – a successful mechanical engineer who had worked at a number of large and small tech companies following his military service – realized that he had to take a break. The post-traumatic stress disorder that he had been grappling with off and on for some 15 years had returned, mostly triggered by stress from work. He hadn’t slept for weeks. He was constantly on alert and on edge. He wasn’t functioning at home with his family or at work. He and his wife knew that this situation couldn’t continue.

Vivante enlisted in the Israel Defense Forces in 1998, serving in the Paratroopers Brigade’s 890th Battalion. As an enlisted soldier, he was deployed in the “Security Zone” of southern Lebanon. In 2002, as a reservist, he fought in that year’s Operation Defensive Shield in the West Bank. In 2006, he went back to Lebanon to fight in the Second Lebanon War.  

“I went through a number of complicated events in the ‘Security Zone,’ in Defensive Shield and in the Second Lebanon War, which I won’t get into even though I don’t have a problem talking about them,” he told eJewishPhilanthropy.

In 2008, Vivante first sought help from Natal, the Israel Trauma and Resiliency Center, a nonprofit that provides mental health assistance to Israelis, particularly related to trauma. “Three months after I started receiving psychological help from Natal, I was diagnosed with chronic leukemia, which was treated with medication that I still have to take today,” he said.

Vivante received psychotherapy from Natal from 2008 to 2021, which he credits with giving him the ability to “get married and have two children,” as well as develop his career in high-tech. When his mental health situation deteriorated approximately seven months ago, “my wife supported me to leave my work and to get help,” he said.

He began undergoing traditional psychological and psychiatric treatments. He also started to do yoga.

“I was in a WhatsApp group for veterans of the 890th Battalion… and one of the guys posted something about ‘Brothers in Yoga’ – so that’s how I got to them,” Vivante said. “We did our retreat in the Jerusalem hills, and that’s how I started my internal journey.”

Neta Margalith developed the idea for Brothers in Yoga soon after she returned to Israel in 2020 after spending several years abroad in yoga ashrams – in the United States, the Bahamas and India. Like many young Israelis, she had left Israel shortly after completing her military service in 2014, having served in the Israel Defense Forces’ personal security unit, guarding then-Chief of Staff Benny Gantz.

When she returned to Israel, she said the stresses and traumas from her military service came back too. “Suddenly, the pains I had from the army came back,” Margalith said. “My body was the one speaking, and it said there were some mental health issues that had not been resolved.”

As she began studying trauma-sensitive yoga, a specific variety of the practice that is specifically geared toward treating complex trauma and PTSD, Margalith said inspiration struck.

“I realized that if I had come back here [to Israel], it was for a reason,” she said. “So one day, I just decided that this is what I want to do. I didn’t know how, I didn’t have proper training, but there was just this understanding that there are tens of thousands of people who aren’t being helped and who don’t have the tools that they need.”

It is generally estimated that 10% of combat veterans experience post-traumatic stress disorder, though a larger number will likely experience post-trauma-related symptoms that fall short of full-blown PTSD. There is a critical need to find effective PTSD treatments as the most common methods currently used are often ineffective. A much-cited 2015 study published in the Journal of the American Medical Association found that the most common treatments for military-related PTSD only resulted in between 28% and 40% of combat veterans losing their PTSD diagnosis. These treatment methods also see high dropout rates, further reducing the overall efficacy.

In 2021, PTSD care for veterans – or lack thereof – became a top issue in Israel after one such combat veteran, Itzik Saidyan, set himself on fire outside the offices of the Defense Ministry’s Rehabilitation Department in Petah Tikva to protest his poor treatment by the government bureaucracy. His self-immolation sparked protests and debate, as well as public acknowledgment by the ministry that its PTSD recognition and care system in general – and in Saidyan’s case – were deeply flawed and required a major reform. Saidyan was badly burned but survived and continues to speak about the need for PTSD care.

According to Alon Weltman, a psychologist studying the cognitive and physiological effects of combat exposure, yoga can be a particularly useful tool for people, particularly combat veterans with PTSD, as it can help address some of the particular characteristics of PTSD in former soldiers. Until recently, Weltman was the clinical director for the Peace of Mind program at Metiv: The Israel Center for the Treatment of Psychotrauma, which brings groups of IDF veterans who served together to communities outside Israel to process their combat experiences. (Full disclosure: This reporter’s wife is the director of research at Metiv.)

“In terms of trauma, a lot of it happens within the body, so the body is a ‘stage’ where things can be worked on. Yoga taps into that stage,” Weltman said.

“One of the ways in which people become combat soldiers is through physical exercise… In that training, we treat our bodies differently. We learn to suppress certain feelings, we learn to use the body as a tool, to ignore certain sensations [like pain or fatigue],” he said. “Yoga allows you to do the opposite with the body. You pay attention to your body and don’t just use it.”

Weltman said regaining this type of awareness of the body helps the person learn to regulate their emotions – an ability that is disrupted by PTSD.

He warned that yoga instructors need to know how to teach combat veterans with PTSD as in some cases, the types of breathing exercises performed in yoga can exacerbate PTSD. Weltman also stressed that yoga “as a standalone is not a treatment for PTSD. In my eyes, it is not sufficient in itself.”

However, he said, yoga and other types of alternative therapies can both serve as an effective complementary treatment to traditional methods and can also prompt a person with PTSD who is not currently in treatment to begin therapy. 

Margalith said Brothers in Yoga itself does not necessarily see yoga as being a treatment that can cure PTSD on its own.

“There are some people for whom it is a complementary tool, who need additional tools in order to regulate their mental functioning. There are also a lot of people who have been through some kind of effort to process [their trauma] and who now feel that something is stuck or they feel they’ve gotten everything they can out of that ‘conventional process’ and who see yoga as a solution,” she said.

Vivante said that for him, yoga is a complementary treatment, alongside the one-on-one, couples and group therapy that he is currently part of and the medication he was prescribed by a psychiatrist.

“I have a much bigger tool kit to help me in cases of regression,” he said, citing the breathing techniques specifically as a useful way of “grounding” himself.

“I can’t say that any one thing is the solution, but everything that helps is a step toward growth,” Vivante said.

Perhaps more significant than the yoga itself, he said, was the sense of camaraderie and togetherness, which came out of the program.

“It allowed me to meet people who went through things like what I went through,” he said. “It gives me a feeling of strength to know that I’m not alone.”

Margalith said she was inspired by the The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, a best-selling book on the role that the body plays in trauma, as well as by an American nonprofit, Warriors At Ease, which also provides yoga therapy to combat veterans.

To get the program off the ground, Margalith partnered with Oren Gavriely, a high-tech entrepreneur and yoga instructor, and Eliav Uval-Neeman, a musician and yoga instructor, who manages Brothers in Yoga’s center.

The group first launched its programs in December 2021, initially operating under the auspices of the Yahalom Foundation, which supports veterans of the Yahalom combat engineering unit. 

In January, the organization launched as an independent nonprofit, with funding coming from private donors in Israel and the U.S. 

Brothers in Yoga offers combat veterans a four-month program. The program begins and ends with a three-day in-person retreat at the organization’s ashram in the moshav of Mata, outside Jerusalem. The rest of the program is conducted through regular sessions over Zoom.

Margalith said Brothers in Yoga found this hybrid model to be successful. Participants first experience the “intimacy and human contact of the retreat,” allowing them to “disconnect from the noise and the telephones and the outside world,” she said. “It creates something magical. It’s amazing.”

Continuing the program through Zoom both allows the participants to integrate the teachings into their daily lives and also, logistically, makes it easier for people to take part from anywhere in the country.

Each session is run by an instructor who has been trained in trauma-sensitive yoga, with help from a social worker or psychologist, Margalith said.

“It’s not just about doing the movements on a yoga mat. It’s about singing together, about opening your heart and your emotions. It’s about proper nutrition and how food affects us. It’s also about learning about the yoga way of life – which by the way is similar to Judaism – what is the purpose and meaning of my life and how do I find new meaning,” she said.

The Brothers in Yoga program is open to anyone with a security background, whether or not they have been recognized by the Defense Ministry as having PTSD from their service, she said. 

The program runs on a pay-what-you-can model with a minimum payment of NIS 1,500 ($405), far less than the actual cost per participant of approximately NIS 5,000 ($1,350), Margalith said. Brothers in Yoga is becoming a recognized service provider for the Defense Ministry so that participants who are recognized as having PTSD can get reimbursed for their treatment.

So far 70 people have been through the program, with a new group of 10 participants – the first one to be made up of female veterans – starting this past weekend. Approximately one participant from each cohort stays on with Brothers in Yoga to study to become a certified yoga instructor, which they can both use to help run cohorts for the organization and to teach yoga privately.

Vivante was part of Brothers in Yoga’s fourth cohort. He remains in contact with both the other participants from his session and is still involved with the group, speaking to new cohorts and prospective participants, he said.

Margalith said she plans to expand the program in the coming years. Each cohort would only have at most 16 people in it but as their pool of instructors grows, Brothers in Yoga would have more cohorts running at any given time. Within five years, Margalith said she hopes to have had 1,000 people go through the program.