Palestine Under Fire: Dr. Samah Jabr on Traumatic Stress — and Growth — Under Occupation.

A Palestinian psychiatrist on systematic brutality and mental health.

Dr. Samah Jabr is a psychiatrist and psychotherapist, human right activist and a writer. Based in Jerusalem, Dr. Jabr is chair of the mental health unit at the Palestinian Ministry of Health. She's written a number of pieces about the psychological consequences of the occupation of Palestine and is author of the book "Derrière les fronts-Chroniques d'une psychiatre psychothérapeute palestinienne sous occupation." (“Behind the Front: Chronicles of a Palestinian psychiatrist-psychotherapist under occupation.”)

I asked her some questions about mental health, in its broadest sense, under fire and under occupation. Below are some excerpts from her replies (although I encourage you to listen to the whole thing, above).

Each excerpt appears with the approximate time in the video that it appeared:

“There is no ‘P’ in Palestinians’ ‘PTSD’”
(3 minutes, 45 seconds)

… There is no “P” in the traumatic experience of Palestinians. They are never in post-traumatic stress disorder because the trauma is continuous, repetitive, enduring. If you think of a 15 year old boy in Gaza, this person must have been enduring developmental trauma that affects his growth, his personality and the way he conceives the world and the way he relates to others.

That's the level of atrocity and social suffering. So there is a lot of trauma, a lot of grief.

And grief is very difficult. It's complicated. People usually don't get the bodies of their beloved ones,don't do the usual rituals that help them digesting what's taking place.They cannot recognize graves for their children or beloved ones. They don't receive the people who come to pay condolences … it's a very aggressive experience that prevents a spontaneous recovery of people from trauma.

“Psychological damage … is the main aim of the violence”
(6 minutes, 43 seconds)

I think acts of violence, including war, are orchestrated to leave a huge psychological impact on people, to distort, to crush the belief system of people. It attacks the core beliefs and the conditional assumptions that people have about this world.

The damage in Gaza looks like as if there was an earthquake, but there was not an earthquake. This is man-made, and it is made deliberately to deter people and to change their mindset.

So the psychological damage is not accidental. It is the main aim of all this violence that is expressed against Palestinians. So there is no doubt that it leaves people damaged, traumatized.

Post-Traumatic Growth
(7 minutes, 42 seconds)

But I have to say also that's not the only image that we get from Gaza and from Palestine … I know colleagues who are deprived of basic safety, deprived of basic needs, but they continue to work. …

We have seen, for example, the Al-Jazeera correspondent (who) lost his family members, but he said, "I need to meet my responsibilities. I need to go back to work."

So there is also post-traumatic growth among Palestinians, and we need to pay attention to this.

Palestinian Culture, Palestinian Spirituality, and Sumud (صمود)
(8 minutes, 57 seconds)

I think that Palestinian culture and Palestinian spirituality gives them resources to stand up for all these atrocities. Also, there are virtues (that) people try to express in prosocial behavior.

In Palestine, we talk often about the notion of sumud. That's our Palestinian word to talk about resilience, collective resilience, and steadfastness and endurance. And I think (just as) trauma is transgenerational, post-traumatic growth is also transgenerational.

So we have these resources, and we are applying these resources in facing this atrocity and standing up (against) all this violence.

Neurology and Solidarity
(11 minutes, 17 seconds)

Of course, we know of the neurological damage that can result from traumatic experiences. Traumatic experiences are aimed to frighten people, make them freeze, and impose helplessness on them. And one of the definitions of trauma is that it is the disaster of helplessness.

So the thing is that it does not only attack the nervous system of so many individuals. It also attacks the social fabric and the relationships between people and between Palestinians and other groups.

But I think that international solidarity can contribute to the recovery of the social fabric of the Palestinian people. I think that pro-social behavior from Palestinians towards each other is also important for this recovery.

“This is not only work for mental health professionals”
(12 minutes, 23 seconds)

There will be a lot of work for us mental health professionals, but this is not only work for mental health professionals.

I think that people have the capacity to recover spontaneously if we stop the barriers that prevent them from this spontaneous recovery. Political violence and the continuation of violence creates a big barrier. Now, for example, there is no safe space to intervene in Gaza. Basic needs are missing for the vast majority of people. During COVID time, we were providing support effectively through telecommunication. This is not possible now in Gaza.

So I think that those who have the intentions of genocide against Palestinians have planned everything to leave a huge impact on Palestinians.

Everything is orchestrated and thought of in designing this attack on the Gaza population to create the highest physical and psychological damage. We need to stand up against this, and we need to recruit international solidarity in order to impose a ceasefire and to start the process of helping the recovery of the Palestinian people.

“Violence is a public health problem”
(16 minutes, 24 seconds)

… Violence is a public health problem. Any doctor, any person in the field of mental health and health in general should be very concerned about violence.

… In mental health we talk often about the biopsychosocial model. And in the social model, the violation of human rights, political violence, brutal power dynamics can crush people.

Every day in my practice I encounter people who don't have the biological element of the disease or the psychological conflicts, but the social part that includes a lot of violation of their human rights makes them sick.

Not Hopeless, Not Helpless
(36 minutes, 34 seconds)

What I know for sure is that Palestinians are not hopeless and are not helpless. They are trying to do whatever they can to stand up for all these atrocities.

But also, I want to say that Palestinians need solidarity. They need international solidarity.

And I have to say that in the midst of all this darkness, the initiative of the South African government and the South African legal team has given us light and hope. We hope that this will inspire a global anti-occupation movement similar to the global anti-apartheid movement.

And I hope that the occupation will end soon.