LIBERATION PSYCHOLOGY

Therapy, Awareness and the Development of Critical Consciousness

Samah Jabr

I CAME TO LIFE with an injury and pain. I weighed 5300 grams at birth, which took place through an ordinary vaginal delivery. However, because of my large size, the delivery was so difficult that, in order to save my life and that of my mother, the doctors had to break my clavicle. This caused permanent injury to the underlying left brachial plexus—the nerves connected to my supposedly dominant arm. For years afterwards, my parents used to carry me, as they went on foot from Shufat to the French Hill so that I could receive physiotherapy sessions at an Israeli medical center. I continued that treatment well into the time that I developed the capacity to remember what I experienced.

I remember Riva, the practitioner who was taking care of me—an Israeli woman, whom I now recognize as a religious Jew on the basis of her appearance. I remember the yellow ladders I had to climb to strengthen my atrophying arm. This was a difficult exercise, and I undertook it only to receive the chocolate I earned when I finished all of my training for the day. I also remember very well how exhausting this trip was for my parents, who did not have a car or speak Hebrew, and were apprehensive about the dominating Israeli presence in the center. These trips were especially hard on my mother, who would return home tired and sunburnt after the morning’s journey; I remember her making a yogurt-based emulsion to ease the sun’s effect on her face.

I had been the fourth girl in a row. My sisters were closer to one another in age; my mother had given birth to a stillborn baby boy just before me, and then had to cope with my difficult delivery and injury. I highly suspect that she suffered from post-partum depression after my birth. I also know that I was given the name “Samah,” meaning “forgiveness,” to make up for the disappointment of a fourth baby girl.

In primary school, I was overweight and myopic, with thick corrective eyeglasses. I was a “clumsy” child and therefore not a great physical play partner. When I joined play, I was often blamed for the team losing the game. The weakness in my arm and its limitation of movement caused me frequent injuries and led to the formation of multiple scars on my forehead and scalp. Perhaps, this early experience as a bit of a misfit made me sensitive and empathic to other people who have difficulty integrating—such as classmates with learning disabilities and students who come from a difficult social background.

On the other hand, my subtle physical weaknesses gave me a strong motivation to develop my brain muscles. I was very good at playing with words and stood out as a popular and reliable colleague and friend. I was labeled “the advocate” by schoolmates who sought my help when in trouble, and who asked me to write letters on their behalf to the teachers and administration. Likewise, I was labeled an “argumentative troublemaker” by the adults, albeit still esteemed as a wise child. As one might have anticipated, I was punished several times for standing up for my rights and the rights of others in the face of strong and powerful adults.

My adolescence, during the collective experience of the First Intifada, accentuated these early childhood traits. I was aware of being viewed as part of a broken, dysfunctional, defective community, and this interaction between the personal and the collective accelerated my development of a sophisticated understanding of politics and power dynamics. I developed hypertrophic qualities of openness, authenticity and autonomy, to the point that my friend, Betsy Mayfield, used to tell me, “You are embracing the world with one arm.” My mother used to warn me in a similar vein, “You can’t hold a big watermelon under one arm and not expect it to fall down.”

As a wise adolescent, aware of my parents’ anxieties, societal prohibitions and political oppression, I was keen to calculate risks so as to avoid putting them, or myself, in danger. The courage, caution and critical thinking I developed during my adolescence have helped me walk the narrow alleys and navigate a path to love and freedom through many subsequent dangers: the Israeli occupation, the oppression by Palestinian institutions, societal corruption, patriarchy and sexism and, as my world got bigger, to also deal with Western Islamophobia and complicity in the oppression of my people. My adolescence equipped me for a long journey in pursuit of well-being and liberty for myself, for my loved ones and for the injured Palestinian community.

I armed myself by studying and working hard in the field of medicine, followed by a specialization in psychiatry. Several theories of psychotherapy seemed appropriate for the mission of healing the traumatized individuals whom I encountered in clinical settings. Yet, I had to find “treatment” for the ill relationships caused among individuals, which weakened the cohesion of a community under military occupation. Our tendency to collaborate with Israelis, our pervasive distrust in ourselves and our collective sense of inferiority and helplessness are just a few of the symptoms typical of an oppressed community. I found it equally important to maintain close observation of the direct experience of people. I learned to draw my conclusions from the ground up and to seek remedies for historical and collective trauma by promoting agency, self-direction and wellness within individuals, within community development and through social and political action.

My work has been extremely varied. It has included policy-making and the development of national strategies, such as a national suicide prevention strategy and a national mental health response plan to COVID-19, etc., as well as extensive involvement in providing training and supervision for doctors and mental health workers, an area of involvement that contributes to building professional capacities and liberal and ethical attitudes in future mental health practice in Palestine. In addition, I have had a wide range of clinical experience with patients suffering from psychosis and other severe mental disorders, families with battered women in shelters, civil law prisoners, political prisoners, juvenile offenders and victims of trauma due to political violence and torture. In all of these groups, I see how political violence interacts with the individual’s bio-psychosocial vulnerabilities to provoke illness and impede recovery.

I also support the struggles of those whom I encounter outside the clinic—demoralized people oscillating between survival and surrender under oppression and enduring social ills, such as patriarchy, gender-based violence, corruption, nepotism, institutional hypocrisy and the subtle pernicious way of flattening and evacuating the values and belief systems of Palestinians and imposing false values on them by oppressive political powers.

When people protested against the death while in custody of the Palestinian opposition activist, Nizar Banat after his arrest by Palestinian security forces, official media diffused the situation, claiming that those demonstrators have an “external agenda,” that the women who participated in the demonstrations have no “honor” and that their slogans “scratch the purity” of the Palestinian society. The mobile phones of the women participants were confiscated, and their content was used as a subject to blackmail, silence and render them invisible. Like Israel’s agents who pose as Palestinians to assassinate activists in our markets and camps, Palestinian official security agents sneaked into opposition demonstrations wearing civilian clothes and started attacking the demonstrators with stones in order to break their bones, in images that remind us of the behavior of soldiers following the orders of Yitzhak Rabin to break Palestinians’ legs and arms. All of the above Israeli tactics are now copied by the Palestinian security system that not only identifies with but is also fascinated by the aggressor.

Activism through writing, public speaking, mobilization and networking with friends, colleagues and comrades, and advocacy for social and political justice have also served as medical-psychological interventions to heal the social ills burdening the occupied Palestinian psyche. I engage in this work as a conscientious citizen, pressured by the heavy weight of crushing oppression, affording me deeper analytical experience and understanding than an external expert looking on from afar.

Like many other Palestinians, my life is characterized by the theft of both space and time. In Jerusalem, where space is shrinking for its Palestinian residents, neighbors can kill each other for a parking spot for their cars or for an empty space on the roof of their shared buildings. I am aware of these strangulating constraints, as I live through the resulting aggression of this reality. My personal survival strategy includes hyper-functioning and politically analyzing this reality, as I live at the crossroads of the two worlds of Jerusalem and the West Bank. I feel that the chronic lateness and deliberate slowness of the bureaucracy and administration are yet additional tools to suffocate the people of Palestine. Liberation must mean taking possession of both our space and our time, and using them wisely, an issue that I struggle to explain to friends outside Palestine.

Generating local knowledge of Palestinian experience and sharing it with the world is another battlefield for me and other Palestinian scholars. Our special relationship with time, the lack of appropriate budget and appropriate personnel, are just a few of the obstacles on the pathway to generating knowledge in mental health. Scholarly writing takes endless effort in footnoting, proofreading and formatting, and often requires authors or readers to pay to have the journal or its articles forwarded to colleagues. Conferences are expensive to attend, even when one is presenting at them.

While I rely on confident colleagues to help me co-author academic papers to transmit Palestinian local knowledge and expertise, I also try to simplify and explain relevant international academic knowledge to Palestinians. The abstruse lingo of much academic writing can be above the heads of many of the people who are involved in social and political change. Instead, I would rather spend my time rendering the sophisticated language of academia intelligibly and popularly. I prefer to draw applicable points and bring take-home messages to ordinary people who can benefit from it.

With my growing reputation and authority as a leading Palestinian and regional mental health professional, comes pressure to write ambiguous medico-legal reports that are dictated by powerful authorities and serve their specific interests—another challenge which eats up into my physical and mental health. A hard-won reputation and financial independence have been my route to standing up to and resisting this kind of seduction and pressure.

I use my authority as a professional to advocate for an increase in staff and budget in mental health, to oppose stigma, ignorant myths, discrimination against patients, women, queer and fragile people in the community. I try to promote psychiatric treatment outside the psychiatric hospital and integrate mental health into primary health care and general hospitals.

I try to encourage the contextualization of Palestinian psychological thinking, questioning the Western concept of PTSD, exploring important notions like “jihad,” “shaheed,” “sacrifice,” “betrayal,” “honor,” “sumud,” “resistance,” “homeland,” “solidarity” and other influential concepts that are relevant to the Palestinian vision for liberation. I see the work of clarifying and validating the medical consideration of these concepts as a contribution to dismantling established and entrenched systems of injustice.

I have no illusions as to the extent of my influence or impact, but I will try to live long enough to leave behind a meaningful contribution in the liberation project of Palestine as enabled by and needed in my professional field. I find that the liberation of the mind, through therapy, awareness and critical consciousness ais fundamental to both my discipline and to the Palestinian project writ large, and that this is the area where I can contribute the most.

This day marks 45 years of holding a weak and painful arm to my body, as well as a partially weak and painful representation of Palestine in my mind. My physical experience has taught me something about asymmetry, power imbalances and tilting. Nevertheless, I know how to get around the weakness in my arm whenever I wash my face, cut my steak, drive my car and give a big strong hug to my loved ones. I use this experiential knowledge and understanding to undertake counter-maneuvers during moments of weakened morale, and I continue to wrestle with power relations and fight for the liberation of Occupied Palestine.