It is difficult to concentrate our efforts as psychologists,
psychiatrists and social workers while facing an epidemic. We can't
pretend we can face the problem of violence and talk about peace in
either Israeli or Palestinian societies if we don't address the
sources of this epidemic. We should pay attention especially to the
ways our trauma-producing environment rules our lives. People here
are at increased risk of experiencing traumatic events. Our role as
professionals is not only to treat victims, but also to oppose
dehumanizing conditions and to encourage cooperation and network
building between professions and professionals, especially in
Jerusalem which should be a model of tolerance, peace and human
integration. We are looking for an integral psychosocial model for
health professionals to deal with the problem on different levels,
and to be more creative and more involved in forming public
Checkpoints and Humiliation
Since the beginning of the Aqsa Intifada, Israel has placed a
series of sweeping restrictions on the movement of the Palestinian
population in the West Bank and Gaza Strip. These restrictions
severely impair the right to work and earn a living, the right to
education and the right to maintain family life. Israeli
restrictions on the freedom of movement disrupt all aspects of
daily life for some three million people. Checkpoints affect people
from all walks of life, at least indirectly. The restrictions they
impose directly harm those hundreds of thousands of Palestinians
whose livelihoods are affected: farmers unable to reach their land,
students unable to reach their places of study, businessmen unable
to trade with other parts of the West Bank and Gaza Strip and so
Physically, of course, there is the direct threat to peoples'
health when they are denied health services or are delayed in
ambulances at checkpoints. Palestinian emergency services have been
debilitated by the closures, and there is no effective police force
operating. Cumulatively, these, and the less visible effects of
simple delays, long hours in queues and the daily humiliation of
being treated always with suspicion, will have long-term and
pernicious psychological effects.
One must also take into account the psychological affect here of
the victimizers, the soldiers who are the physical instruments of
policy. Much has been written about the effect on those who engage
in ritual aggressive behavior, those who by choice or by job
description have to treat the other as a justified target for
aggression. There are long-term effects on those who find
themselves forced into a conditioned mode of thinking in which it
is justified to treat other human beings in such a way because they
are somehow seen as less than human. The dehumanization inherent in
collective punishment cannot help but have such a negative
"Trauma Organized" Societies
I use checkpoints as an example to illustrate how pervasive the
harm caused by our current situation is, and how everybody is
affected. However we describe the checkpoints - as collective
punishment or security precautions - what they invariably serve to
do is to increase the space, physically and conceptually, between
neighbors. In effect, both the Palestinian and Israeli societies
behave as "trauma organized" societies, where violence is tolerated
as a normal way of life. By saying that we are living in "trauma
organized" societies, I mean to show that the effects of
multigenerational trauma are like an iceberg in our social
awareness. Legal and mental health professionals and systems work
from inside a paradigm of individual pathology and/or culpability
based on deviance, and separating justice and repair. The
victim-perpetrator dichotomy is part of this paradigm. It is
becoming increasingly obvious that all of us participate routinely
in this cycle of victim-perpetrator behavior to such an extent that
it has become acceptable normative human behavior. As such, it
serves only to reinforce trauma-producing contexts that contribute
to the intergenerational transmission of sexism, racism,
exploitation and poverty and a tolerance of different levels of
violence as a way of life among individuals and between nations. In
our situation, this is evident as we watch the wealthy among us
vote to decrease social programs for the poor, the powerful abuse
the privilege of their positions repeatedly to hurt the people who
depend on them, and the poor and disenfranchised self-destruct
rather than organize for constructive social change.
In our situation, under great risk of being exposed to traumatic
experiences, we must understand how trauma-producing environments
rule our lives. The male conditioning - to use violence as a means
of control - added to our acutely violent and militaristic
political climate, embedded within religious and philosophical
belief systems that permit and even encourage the use of violence,
has left us in a crisis that we will still be paying for a long
time from now, regardless of what happens. It is thus vital for us
to develop a framework of understanding for our collective
psychological situation and to inform professionals, policy makers,
public opinion leaders and sponsors, without whom we will not be
able to address correctly the needs for healing that both societies
Entrapped in the national and political violence, we have failed to
see that all violence is interconnected and that there are
identifiable cycles of violence that can be avoided, prevented or
circumvented. Israeli and Palestinian societies are a strong case
of societies that have become organized around unresolved,
multigenerational traumatic experience. Much like an individual
victim of repetitive abuse, violence has become a way of life - the
rule not the exception.
Savaged by Trauma and a Proposed Way Out
Palestinian and Israeli societies exemplify the nine "A"s of
1. Attachment (disrupted): We are immigrant and refugee societies.
When disrupted, attachment becomes an instrument to shape
individual histories and environments. This is also characteristic
of accelerated mega urbanization, another phenomenon we are
2. Affect (unmodulated): This refers to emotional numbing due to
continuous political/military/terrorist violence. Abuse becomes
fundamental to the functioning of society, almost an entire
3. Anger (unmanageable): Instead of facing the need for
reconciliation and making amends to those who have been hurt,
people focus on retribution, blaming only the "other" for their
situation and retreating into anger and passivity, while developing
"martyrology" and "victimology."
4. Authority (abusive): Power becomes divorced from responsibility.
The brutal exercise of law enforcement, the consequent devaluation
of human rights, a longing for a strong leadership leads to an
abdication of initiative and autonomy and conformism and obedience
to social and political pressures.
5. Awareness (diminished): As a consequence of dissociation there
is tolerance of incongruity, leading to a culture of denial for
obvious consequences of actions by individuals and institutions
(government and other), with a lack of attention and care for one's
life and the lives of others.
6. Addictions (multiple): The addiction to violence (media, games,
culture, faith in punishment, correction and incarceration,
segregation), a desire for escapism and substance abuse increase
and passive acceptance becomes a way to deal with "the
7. Automatic (repetition): Self-destructive behaviors, cycles of
violence and their repetition and pressure for more punishment as
prevention of repetition, feed themselves into an almost
8. Avoidance (of feeling and accountability): The high level of
violence leads to indifference to non-national-conflict-related
suffering and their possible resolution, to less attention paid to
rehabilitation processes. Everything becomes identified as
"situation" related, and both victims and perpetrators are
9. Alienation (from self and others): Our situation also increases
the tendency for individualism and greater importance is attached
to "me, myself and I." The consequences are less social cohesion
and solidarity, a greater deepening of income gaps with more
intrusive economic deregulation.
Treating these symptoms as premises, we need to develop approaches
and services that will serve both populations based on the
* Effective theories and practices for ending violence could be
considered adequate only to the extent that they are capable of
integrating all three levels of abstraction: the biological, the
psychological and the social/historical. Trauma-producing
environments increase the mind/body split paradigm. Most of the
funded policies, research and practices are language-centered and
ignore the emotional, bodily and biological dimensions and effects
of violence for both victim and perpetrator.
* Multidisciplinarity, both of method and concept, must be the
order. For therapy, we need intensive integrative settings to help
patients and communities integrate fragmented and traumatized
parts. Non-verbal/body-oriented approaches can bring back emotional
life, and the emotional life should be one of our main
* We must try to create a trauma-informed and coordinated community
response based on a public health perspective with a primary,
secondary and tertiary prevention and intervention policy as an
alternative to our current trauma-organized society.
* Finally, we need to develop an organizational model for an
integrative approach, substituting "wholeness" for "fragmentation,"
acknowledging the self as overwhelmed, working to replace a feeling
of powerlessness with a sense of control, and a model that seeks to
downplay divisive factors, such as class, gender and race, with an
overall sense of humanity.
The Needs and Strategy for Cooperation
Based on what was explained above, I believe a need for cooperation
is urgent since the return to a less violent environment alone will
not address the consequences of the traumatization endured by both
populations. To be able to effectively address peoples'
traumatization and engender a true healing process, we must go
beyond the dichotomy of victim and perpetrator. Ignoring the
national and political environment and the demand for retribution
and restitution will impair healing and public health services.
There is a therapeutic need for cooperation that will help
professionals and advocates on both sides handle the inclination of
their clients to identify the perpetration with the "other side,"
thus freeing themselves from having to adopt a victim-only point of
view. The ability to address perpetration, victimization and
healing within a paradigm of reconciliation necessitates this
cooperation. Furthermore, ignoring the difficulties and the
resentments that are parts of the communities of professionals and
advocates from both sides toward the "other side" is
therapeutically erroneous and dangerous.
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