A mental health conference in Tel Aviv in early April 2006, organized by Lesley University, was designed to create a dialogue between Palestinian and Israeli psychotherapists and researchers, together with international contributors. Because I had organized an earlier conference on malignant prejudice, I was invited to speak on the family origins of prejudice. But once there, I realized I could learn more than I could teach. So I was disappointed when Mohammed Mukhaimar, the lone Palestinian in our discussion group was fairly silent the first day and did not show up on the second. When he arrived the third day, he explained that the Palestinians might have to leave early to time their return with checkpoint closings that change, often without warning.
Our group discussion suddenly seemed trivial compared to what Mukhaimar and his fellow Palestinians had to deal with. The organizers had made it possible for the Palestinians to attend by carrying out the complex logistics required to get them through the checkpoints, pay for their food and lodging, and make them comfortable by organizing pre-conference meetings that gave everyone a chance to test out expectations. This paved the way for us to hear their stories.
Like their Israeli counterparts, the Palestinian therapists and researchers work tirelessly and dispassionately to seek improvement for the many victims of conflict. Because the Palestinian population is itself so traumatized, it needs their help desperately—both to heal the daily trauma, and to keep such traumatized experience from leading to violence as the only salve to helplessness. While some of us understood the violence as personal and group reaction formation to feelings of helplessness, loss, and castration, therapists were tasked with intervening at individual and group levels.
I had worked with Israeli clinicians several years ago when my wife and I taught family and couples therapy in Tel Aviv. They are sophisticated, and although diverse politically, mostly sympathetic to the plight of the Palestinians and the colleagues who serve them. But this conference offered a rare opportunity for the Israeli and Palestinian groups to hear about each other's work in depth. The work of both groups—in treating trauma, infant mental health, and family therapy—was informed by similar practices around the world. But it was evident as we listened that the Israelis had a huge advantage in access to training, government money, and exchange with the wider professional world. The workers I met from the Alquds University in East Jerusalem and from Gaza Mental Health Program were wary at first about the grounds of their participation, but they grew increasingly able to tell their stories. They work with few resources and enormous daily trauma, against the odds, often in government run clinics that are always short of training, supervision, and resources.
The English psychoanalyst, Earl Hopper, and I sat with Mukhaimar and his colleague Marwan Diap, as they spoke about how they dealt with the traumatized children in Gaza. To illustrate, Mukhaimar told the story of a group of four 11-year-old girls, who decided to do something: They would walk to a settlement hiding a knife, call out a guard, imagining he would come to talk to them. They would stab him, grab his gun, and shoot as many settlers as possible. Fortunately other girls told the headmaster. Only as the girls walked towards the settlement, were they caught. Parents were called. As one girl's father shouted at her, she said (in paraphrase), “How can you be upset with me? When you watch television, you cheer at suicide bombers. The more Israelis killed, the better. I was trying to be your hero.”
The mental health workers know how destructive this attitude is for children. Although not psychoanalytically sophisticated, they understand identification with the aggressor, the turning passive helplessness into active violence, the girls' identification with their parents, and the group effects of identification with the demands of the most vocally aggressive parts of Palestinian culture. So they worked to introduce more possibilities into the girls' narrowed, self-destructive responses. They knew how Palestinian children's traumatically impaired capacities to mentalize led to a one-track idea of suicidal retaliation. Eventually, through psychodramatic group intervention, these girls came up with a scheme to raise money for victims—at first only to help families of suicide bombers with whom they identified, but later they moved to raising money for all children who had lost parents. This elaborated, no longer retaliatory point of view showed the first evidence of identifications that had enlarged to include the suffering of the whole group, beyond the rhetoric of militancy.
Mukhaimar and Diap then talked about working in isolation. The families they treat have suffered multiple losses. The mental health teams see evidence of constraint and trauma everyday. The professionals also suffer the continuing burden of treating social and personal tragedy, struggling against the burnout from trauma, too. They get out of Gaza with difficulty, and no one comes in to supervise or teach.
Later, I talked to a young woman doctor wearing a headscarf, pregnant with her first child. Born in the United States, her Palestinian family returned to Israel while she was a child. She spent her young years in the West Bank; but her family decided there was no opportunity for their children, so they moved back to
David E. Scharff, M.D., is co-director of the International Psychotherapy Institute, Chevy Chase, Md. He is also teaching analyst at the Washington Psychoanalytic Institute and clinical professor of psychiatry at Georgetown Medical School and Uniformed Services University of the Health Sciences, Bethesda, Md.
the U.S. where she completed secondary school, college, and medical school. She said she needs to give back to the Palestinians, speaking with altruism many Americans share, yet she feels estranged in both cultures. She has chosen a Palestinian identity. She is young, idealistic, with a nomadic quality to her identity, hungry for people to understand. I wonder how, with her own children, she will face the dilemma that caused her parents to move to back to the U.S.
Clearly, important Palestinian voices cannot be heard amid the political din. The Palestinian message I heard was matched by an equally strong wish on the part of Israeli professionals to reach out. I'm sure the situation is only worsening as resources dry up for these workers because funds are cut off to the new Hamas government. It's tragic that these articulate voices for peace and reconciliation are drowned by the politics of the region and of the world. These professionals know about the many Palestinians who preach violence, and they also know how the culture of violence stifles the development of mentalization, mutuality, and abstract thinking, and substitutes an impulse to action for the growth of self. Mukhaimar, Diap, and the young doctor are natural partners for Israeli and international professionals who would like to help. I came away believing that there are many on both sides who try every day to find ways of working together.