Rights-based approaches mental health care is needed in the Occupied Palestinian Territory (OPT) to address the deleterious mental health effects of human rights abuses and neo-colonialism.
Palestine-based mental health professionals Maria Heilbach (psychotherapist) and Samah Jabr (psychiatrist) argue that purely biomedical understandings of Post-traumatic stress disorder and well-meaning trauma theory cannot capture the extent of the suffering occurring in and around the West Bank and Gaza Strip.
They then argue that to alleviate both the suffering of Palestinians and their victimization, mental health professionals must promote liberator Understanding of mental illness and trauma.
The authors explain:
Solidarity begins with acknowledging human rights violations and blaming the abuser, not the victims who react to these experiences. Who better than mental health professionals to understand how constant fear, pain and terror influence individuals? As psychotherapists or mental health workers, we are faced with the question of how we view our ethical role and how we intend to act accordingly:
Do we see ourselves as an active part of society or do we see the therapeutic space as a “non-part” of society? Working with trauma victims confronts us with unavoidable questions of social involvement, even if we are not always aware of them.
However, trauma theory has reached a worldwide impasse: it has developed into a symptom-focused medical approach that produces therapy methods that stubbornly ignore socio-political discourses and that disguise social and political problems as disorders. pathological. In general, little effort is made to address the effects of trauma at the international policy level. Yet, to respond to trauma in the OPT, a political solution is needed not only to reduce physical and psychological threats, but also to establish historical, political and moral justice.
According to the authors, PTSD is a hegemonic, quantifiable, and measurable diagnosis that puts the human rights violations that Palestinians suffer daily into a box that psychologists and psychiatrists understand. However, a diagnosis of PTSD, with no specific intention to contextualize apartheid and rights violations, necessarily decontextualizes and depoliticizes Palestinians from their reality.
The emergence and growing popularity of the diagnosis of PTSD in the United States and Western Europe in the late 1990s and early 2000s initially paved the way for Palestinian victimization.
Heilbach and Jabr note two main ways in which depoliticization occurs:
- PTSD is always “post” and cannot identify ongoing trauma and rights violations.
- By pathologizing and individualizing the response to ongoing human rights violations via a diagnosis of PTSD, well-meaning mental health professionals stigmatize suffering.
“The uncritical adoption of the context of the trauma takes the narrative away from the social and political context and the underlying reasons for the trauma and reduces it to individual psychological suffering, thereby stigmatizing people.”
Individualization is also an evil in itself.
“The socio-cultural conditioning of pain and trauma requires an approach dedicated to the collective sense of suffering, and which reinforces the sense of social cohesion and solidarity. Otherwise, social suffering will be misdiagnosed as a clinical pathology. Therefore, an individualistic approach is not enough when the trauma is caused by colonial practices at the collective level.
This prejudice of individualization comes not just from biomedical diagnoses of PTSD, but also from non-liberation-oriented psychotherapy modalities that fail to address the systems of oppression and forms of neocolonialism at play in the Palestinian collective psyche. Trauma-informed approaches are not enough, as the concept of trauma has also been colonized. The authors note that generally:
“The proposed interventions do not focus on personal empowerment or political advocacy to change the system of political violence, but individualize and depoliticize human rights violations. Many proposals adopt and strategically replicate a Western neoliberal framework of trauma in order to be eligible for funding… Thanks to international funding, counseling programs are offered, but political fears and concerns lead to their political decontextualization. As a result, the majority of programs take place in a political vacuum.
To address these harms, whether intentional or not, mental health practitioners and rights advocates must begin to examine the overall mental health of Palestine through a rights-based liberation psychology lens.
Liberation psychology, based on the fundamental principles of liberating thinkers Franz Fanon and Paulo Freire, allows the stereotypical individualistic process of psychotherapy to become an intentional act of resistance. Rather than asking “what’s wrong with you?” This move towards liberation psychology will encourage mental health professionals to start asking themselves, “what happened to you?
Both authors call on psychologists, psychiatrists and mental health practitioners around the world to stand in solidarity with Palestine and start the movement towards rights-based approaches to mental health.
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Heilbach, M., Jabr, S. (2022). A call for social justice and a human rights-based approach to mental health in the occupied Palestinian territories. Journal of Health and Human Rights. (Link)
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