On October 7, trauma did not unfold in hospitals or clinics—it erupted in the middle of music, movement, and altered states of consciousness. For thousands of young Israelis at the Nova Music Festival, a single morning shattered their sense of safety, memory, and self.

Within days of the attack, Ophir Netzer, a doctoral researcher in University of Haifa’s Salomon Lab, made a decisive shift. She left her original research path to enter uncharted scientific territory: studying trauma as it is experienced under altered states of consciousness. What began as an urgent response has grown into one of Israel’s most ambitious longitudinal trauma studies—and among the first in the world to examine mass trauma through the lens of psychoactive substances.

Working directly with survivors over the past two years, Netzer has helped uncover how different substances shaped the immediate and long-term psychological impact of October 7, why recovery has been so elusive for many, and how innovative approaches—including psychedelic-assisted processes—may open new pathways toward healing. Her work was recently recognized at the residence of President Isaac Herzog, where she was honored as one of Israel’s most promising young researchers.

AFUH spoke with Ophir about what she is seeing among Nova survivors today, what science is revealing about trauma and consciousness, and where she finds hope amid ongoing pain.

You’ve been working closely with survivors of the Nova Music Festival since October 7. Two years later, how is trauma still shaping their daily lives?

To understand where survivors are today, we first need to look at what happened immediately after October 7. In the beginning, there was an extraordinary communal response. People across Israel—civilians and volunteers—came together to create shared, safe spaces where survivors could talk, be together, and begin to process what they had been through. At the same time, organizations like SafeHeart were founded on that very day, providing emergency psychological support and continuing to treat survivors long-term.

But almost immediately, a war broke out. For the past two years, survivors have lived under constant stress—missile attacks, uncertainty, and the fact that people from the Nova party were still being held hostage in Gaza. This made it extremely difficult for them to process their trauma in a stable and safe environment.

In our research, we saw very high levels of post-traumatic symptoms in the first months after the attack. Unfortunately, we’ve seen these symptoms persist. At the one-year mark, more than 70 percent of the survivors participating in our study were above the clinical cutoff for PTSD symptoms. This is not a formal diagnosis, but it clearly reflects ongoing suffering and significant functional impairment. We are seeing similar patterns two years later.

Was there anything that particularly surprised you as you followed survivors over time?

What surprised me most was how little improvement we’ve seen over time. We hoped to see more recovery as the months passed, but many survivors are still struggling deeply.

At the same time, I am constantly struck by who these people are. The survivors who come to the lab are amazing—young people who carry immense pain, but also remarkable strength. They give their time generously, returning again and again for assessments, interviews, and lab visits. Almost every time, they tell us the same thing: “We just want to help our community. Maybe if you learn something from us, it will help others heal.”

That motivation is incredibly moving, and it’s something I carry with me every day.

Much of your research focuses on trauma experienced under altered states of consciousness. Why is this such an important lens?

This event is completely unprecedented. Trauma has been studied extensively, but never before in a situation where such a large number of people experienced an extreme traumatic event while under the influence of mind-altering substances.

In our study, more than 70 percent of survivors were under the influence of at least one substance—often more than one. Each substance affects perception, memory, emotional processing, and the way an event is encoded in the brain. To truly understand trauma in this context, we had to understand the specific state of consciousness in which it was experienced.

That’s why we analyzed how different substances were associated with post-traumatic symptoms in the months following the attack. This led to findings we recently published in World Psychiatry, the highest-ranking journal in psychiatry, based on data from nearly 800 survivors.

What did you learn from comparing survivors who used different substances?

We found clear and meaningful differences between groups. Survivors who had taken MDMA during the attack showed significantly lower levels of mental distress alongside higher sociality and improved sleep quality in the months that followed, compared with survivors who had taken no substances at all. These effects may be mediated by MDMA’s known capacity to reduce negative affect and enhance prosociality.

In contrast, survivors who had used alcohol or cannabis exhibited worse clinical outcomes, not only compared to those who took MDMA, but even compared with survivors who had taken no substances at all. These findings suggest that different substances shape how trauma is experienced and processed in profoundly different ways.

MDMA has already shown promise in clinical research as part of MDMA-assisted psychotherapy for PTSD, and our findings add important real-world evidence to that growing field.

How does working directly with survivors influence the way you approach your research?

Meeting survivors in person changes everything. When they come to the lab, you see not just their symptoms, but their courage, their humor, and their determination to keep going. Despite everything they’ve been through, many are deeply engaged in the research and eager to contribute.

They often tell us they participate because they hope their experience will help others. We regard this as an ethical obligation to uphold scientific rigor, transparency, and respect for participants and the communities they represent.

What has your time at University of Haifa meant to you as a researcher, especially while doing such sensitive and demanding work?

University of Haifa has given me something incredibly rare: the freedom to respond to reality as it unfolds. When October 7 happened, there was no roadmap for studying trauma under altered states of consciousness at this scale. Instead of being told to stay within the boundaries of an original research plan, I was supported in asking urgent new questions and building an entirely new research framework from the ground up.

The Salomon Lab and the broader academic environment at Haifa are deeply interdisciplinary, which has been essential for this work. We draw from clinical psychology, neuroscience, psychiatry, and consciousness research, while staying grounded in real-world clinical realities. We are also fortunate to collaborate with Prof. Roee Admon’s lab, which specializes in stress and psychopathologies and contributes essential expertise in trauma research. Just as importantly, there is a strong ethical culture here—one that emphasizes responsibility to participants, humility in interpretation, and sensitivity to the social context in which research takes place. That combination has shaped not only this project, but the kind of scientist I am becoming.

Looking ahead, how do you hope to build on this research, and what are your next steps?

First and foremost, we are continuing to follow the survivors longitudinally. Trauma does not resolve on a fixed timeline, and it’s critical to understand how symptoms, coping mechanisms, and resilience evolve over many years—not just months. This ongoing data will allow us to identify long-term risk and protective factors and refine our understanding of recovery trajectories.

Beyond that, I hope this work will help bridge the gap between observational research and treatment development. Our findings point to the importance of context, consciousness, and social connection in trauma processing, and I believe they can inform more personalized and effective interventions in the future. Ultimately, my goal is to remain at the intersection of rigorous science and real human impact—to ensure that what we learn in the lab translates into meaningful change for people living with the consequences of extreme trauma.

After two years of such difficult work, do you feel hopeful about the future?

I do feel hopeful. Our most recent data collection took place just before the ceasefire began, and now—with hostages returning and a pause in active fighting—there may finally be space for survivors to begin a deeper healing process.

The people we work with carry immense pain, but they also carry extraordinary resilience. If our research can help create new, evidence-based pathways to healing—not only for Nova survivors, but for others who experience trauma under extreme conditions—then their willingness to share their stories will have lasting meaning.