Mental Health and Violence/Trauma in Palestine: Implications for Helping Professional Practice* Academic Article uri icon

abstract

  • INTRODUCTIONA growing literature examines the effects of trauma related to the Intifada, including posttraumatic stress disorder (PTSD) among children (Qouta et al, 2001,1997; Punamaki et al., 2001; Thabet and Vostanis, 1999b), and how to work with Palestinian children who are depressed (Mandour and Hourani, 1989) in reaction to trauma. Topics examined in working with adults and families include attachment patterns and working alliance in trauma therapy (Kanninen et al., 2000; Soloman, 1996); the implications to communities experiencing trauma (Awwad, 1999), the experiences of anxiety, depression, and paranoiac symptoms associated with house demolition (Qouta et al., 1997); and the torture, ill-treatment and posttraumatic stress disorder symptoms among Palestinian political prisoners (El-Sarraj et al. 1996).The present study contributes further to this literature by considering politically contextualized violence in Palestine since the Al-Aqsa Intifada (September 2000) and its significance to individual, familial, and community functioning. The study is based on case study insight of four clients at the Treatment and Rehabilitation Center for Victims of Torture, Ramallah, Palestine. The impact of their experience of violence was all encompassing. Family functioning was significantly compromised, and individuals experienced such problems as psychological trauma, depression, social exclusion, and economic deprivation. Since the society is high context, the family and community helped to define and resolve individual problems. The paper concludes that while mental health therapy was pursued in each case, the political arena is the ultimate source for the resolution of these issues.TRAUMAINTHEMIDDLEEASTCONTEXTPolitical trauma and torture are associated with head trauma (Jacobs and Iacopino, 2001), bereavement, abnormal sleeping patterns (Astrom et al., 1989), withdrawal, numbness, hyperarousal (El-Sarraj et al., 1996), emotional disorders, and impaired school performance (Punamaki et al., 2001). Acute trauma disturbances include flashbacks, nightmares and sleep disturbances, concentration problems, heightened alertness or hypervigilance, and avoidance of people and situations that evoke memories of the traumatic events (Qouta et al., 1995). Coupled with these symptoms, acute trauma often falls under the clinical diagnostic category of Post-Traumatic Stress Disorder (PTSD) ' (cf. Friedman and Marsel Ia, 1996). Chronic stresses may be associated with such conflict and can lead, in turn, to problems of aggression (Baker, 1990), depression (Macksoud and Aber, 1996), anxiety (Zivcic, 1993), and regressive behaviors (Jensen and Shaw, 1993). Among children and young adults a variety of effects may occur, including but not limited to truncated moral development (Ferguson and Cairns, 1996), change in school performance (Sack et al., 1993), changed attitudes and beliefs, personality changes (Terr, 1983), and diminished hope for the future (Cairns, 1996).As a vast literature points out, the past 55 years have been exceptionally contentious for Palestinian and Israeli peoples (Hazony, 2000; Khamaisi, 2002; Segev, 2002). Although problems of violence between the Israelis and Palestinians have been ongoing, Ariel Sharon's September 2000 visit to Al-Aqsa Mosque in Jerusalem signaled a growing intensity of hostility (Ron, 2001). The Intifada in Palestine has precipitated retaliation from Israel and growing oppression of Palestinian people at the hands of the Israeli state and military (Hammami and Hilal, 2001) and it is important to link expectations of Palestinian governance with the current situation. As the Central Intelligence Agency (CIA) Fact Book points out, the "Israel-PLO of Principles on Interim Self-Government Arrangements (the DOP), signed in Washington on 13 September 1993, provided for a transitional period not exceeding five years of Palestinian interim self-government in the Gaza Strip and the West Bank. …

publication date

  • January 1, 2004