Four years later, Fatima has been through therapy. She has taken what her father calls “strong” medications to manage the flashbacks. The new apartment is darker and more cramped than the old one, but the Qurtans needed to get away from the scene of the trauma, the doctors said.

Fatima’s listlessness and spontaneous aggression had started to improve, Qurtan said — until war struck again in November.

This time, the explosions felt just as personal as they did the last, the possibility of death just as likely. When Israeli airstrikes rattled the buildings for a week during the Jewish state’s latest confrontation with Hamas, the eight surviving Qurtan children hid in the stairwell, as Gaza schools have taught children here to do.

Gazans often talk about the inescapability of war, and the symptoms of their suffering. They cast Gaza as a prison — one physical and psychological, where Israeli bombardment comes every so often,and there is little to do but bear it.

Indeed, there are few places in the Arab world where psychology and trauma are as openly discussed as they are in Gaza. But health professionals here argue that there are few places in the region that contain a population so traumatized, a youth so obsessed with conflict.

Every day on his return home from school, Ahmed Qurtan’s cousin and best friend Zohair sees a banner bearing a portrait of himself, bloodied and bandaged. Hanging next to it, on a wall in the entryway to the family’s building, is a similar portrait of Ahmed in his funeral shroud. Zohair used to be much smarter and more active before suffering a head injury in the same air strike, his father, Alaa Mohamed Qurtan, said.

“He’s not normal now,” the man said, as the boy cast his long eyelashes shamefully at the floor.

Psychologists say that few in Gaza would qualify as “normal.” The cramped territory has operated under an Israeli-enforced blockade that has strictly limited the flow of goods and people since the militant group Hamas won an election here in 2006. The enclave’s 1.7 million people, half of whom are under the age of 18, have endured two wars in the span of four years. Nearly everyone in Gaza knows someone who has died a violent death.

It’s the long-term implications that worry some experts the most. “Gaza right now has all of the reasons there for people to go toward the extreme,” said Issam Younis, director of the Al-Mezan Center for Human Rights in Gaza City, who has documented the impact of war and blockade on Gaza’s population. “In putting a whole nation under siege, you obstruct their future. And then what do you expect?” he said. “More hatred, more enmity, and more resistance against the Israelis.”