Tent of Nations 2019 [5]: Reframing Trauma and Resilience

[I’ll be introducing in this blog the definition of community psychology in the context of this project, beginning with Western biomedical perspectives and moving towards the nuance required to talk about psychology in the context of Palestine.  Please enjoy!]

10:00 pm, August 9th, 2019, Wesley House

On February 14th, 2019, I got to meet Dr. Sasikumar Balasundaram, a professor of anthropology formerly at William & Mary, and currently at Southern Illinois University. Sasi, as he was introduced to me by the campus minister, specializes in child refugees, and medical anthropology. I was excited to sit down with him to talk about my ideas for the project. 

I told Sasi about my ideas for the project, and he told me a story of warning. He told me stories about families and children in Sri Lanka after a devastating earthquake. Floods dominated towns and villages, and thousands were left homeless. An influx in aid from all over the world arrived to ease the communities after this tragedy. Meals, prepackaged, building crews, toys and playgrounds were all built by volunteers in a matter of months. Doctors and psychologists arrived to tend to the injured and traumatized. 

When the psychologists asked the children about their trauma after the earthquake, the children were confused. They gestured to their new toys and houses. This was more things than they had ever had, and honestly more than they knew what to do with. The earthquake, in their eyes, had manifested as a sort of strange carnival; they received gifts from strangers and houses and facilities that they didn’t recognize. They told the psychologists that they hoped for another earthquake soon so they could get more things, and the psychologist was mortified. 

He told me this story to show me that the concept of trauma isn’t concrete; it’s framed in whatever context it’s placed. Some things I might find traumatizing aren’t going to elicit the same response from an individual or from a community in another part of the world. In fact, the idea of trauma isn’t going to be a useful lens for me to examine my time in Tent of Nations with, and a more constructive way to appoach Daoud’s request for resources on trauma would be to ask him more specific questions about what that meant to him and what he needed, and what specifically would he like to see out of my lessons with the volunteers. 

My struggle for a long time while trying to plan for these lessons was how “psychological”, so to speak, my approach should be. I was very nervous when Daoud told me he wanted these resources on trauma. I am an undergraduate and I’ve done no clinical work before, and I have no experience as a real counselor (only a camp counselor!). I read the guidelines for psychological first aid, which I would highly recommend to anyone interested in mental health work or even in just being a better friend, but that ultimately played a very small role in my planning for the workshops I lead. 

This is what I knew beforehand from mandated reporting training that I figured was still applicable to a Palestinian setting: don’t force children to talk about a traumatic experience. Don’t prompt a child to talk to you about something traumatic. Don’t ask leading questions, or “expose” a child to their peers. Treat any information they give you with respect and honor the trust they have given to you. Don’t let your personal feelings cause you to become too emotional to listen to the child in an objective and receptive way.

I called Daoud over Whatsapp to talk to him about specifics about what he wanted the volunteers to hear. His answer was that he wanted the children to know that their dreams were possible, that they are loved, and that they are stronger than their negative situations. Daoud told me that his approach has always been to focus on the positives, and turning the negatives into positives. 

I was so happy that I had called. I was honestly getting way too stressed and tired trying to fit a psychological model or social work model into this camp environment when I knew that it wouldn’t work. I think that I felt a lot of pressure to make this as psychologically academic as possible since I got a research grant to do this work, and I wanted it to be so good that I got in over my head with what I could possibly accomplish on my own. 

So I began to redefine my search. I sent Daoud what I wanted to teach the volunteers, not about trauma, but about communication, cultural sensitivity, and listening skills. The volunteers will not be psychologists by the time I am done with them, but I’ve trained summer camp counselors on how to communicate with children and one another, and together Daoud and I could do the same thing for these volunteers. 

I will post the original document in another blog so you can see the planning I originally did; I modified the order when Daoud gave me the exact times for how long I had each day to teach. I can say that the staff, in their post-camp surveys, indicated that they found the workshops on communication very useful, and that they were happy to have heard them. 

 

Mental health is not a common conversational topic in Palestinian society, although that is changing slowly as more and more people become educated on the long-term effects of war and violence within their communities. Approaches to trauma are different in the West Bank, first due to culture, and also due to the different nature of a lot of the trauma that people face in Palestine when compared to European and North American nations. I believe that there is a strong effect of traumatic experience on the mind of Palestinian youth, and that it leads to anger, depression, and violent outbursts if the violence done to the children is ongoing and terrifying. However, the way that trauma is dealt with and compartmentalized in this culture and situation is, just like Sasi told me, different than one from the US might expect. Trauma is just a fact of life here, and everyone has their own. Children at camp were a perfect example of this. While one of our guests told a story one morning, a child told us very nonchalantly that their house was bombed once. The volunteers did a good job of not letting it visibly show how striking the camper’s words and tone were; we didn’t want them to know that what they had gone through had scared us, because that could very well upset them. 

This project, I’ve realized, is not a social psychology project or a cultural psychology project per se. I would consider it a community psychology project. Community psychology studies the complex interaction between how communities shape individuals’ lives and minds, and how individuals shape communities as well. There are many foundational outlooks to community psychology, and one that I thought a lot about while at Tent of Nations was pragmatism: essentially, whatever is effective is true. In the context of trauma within a Western biomedical perspective, trauma is treated in many different ways, and some of them work better than others. The mental health system is flawed, and just as the traumatizing agents and systems aren’t easily removed, the systems in place to stop them take community action to overcome. In Palestine, the same holds true. Until a just solution is reached, political violence ends, and the hatred stops (which would be considered a systematic, or second-order, change), a first-order change (treating the individual) must be created, and will be most effective on the communities’ own terms. Here’s what I know about useful language:

There’s not really such a construct as “post-traumatic stress disorder” here like there is in the US, although many Western individuals and organizations often diagnose this in Palestinians for many reasons (fundraising for activism, raising awareness, political use, etc.). Post-traumatic stress disorder is a useful construct in a context where the trauma isn’t ongoing, as it is in the West Bank or Gaza. Trauma is certainly present, and no one in the region will deny you this fact. However, a diagnosis out of the DSM-5 will not solve any problems in the West Bank. There aren’t enough mental health clinicians, or even enough healthcare resources at all, to treat the sort of community-level trauma that has been inflicted on Palestinians. That’s why a different construct is needed, and a shift from individualized Western medicine to large-group positive community-organized problem-solving and is going to be more effective. Tent of Nations is one of many locations where this sort of work takes place, and it works. 

I was incredibly excited to find, within the first few days of being back in Williamsburg, several articles about resilience in Palestinian children and youth. Studies have found that resistance (political resistance, that is) is a protective factor and can help build resilience. It can build self-efficacy and help children cope. This is represented in the sample from Veronese et al. 2012 [my bibliography can be found here]; those from the refugee camp showed the highest life satisfaction, despite their circumstances, likely because they feel that their lives and situations are in direct opposition to the military authority they live under; hence, their existence is resistance. I can affirm this based on what I saw (although anecdotal evidence isn’t as compelling as Veronese et al. 2012; Gilligan, 2009; Massad et al. 2009; and many others). In an area where nonviolent resistance to oppression is the most effective way to feel in control of your own life, those who have the most to fight against may also feel the most powerful. 

 

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