The Psychoanalytic Reporter

Working under occupation: Psychoanalytic reflections on psychosocial service in Palestine

The author describes the workshops she ran under the aegis of Palestinian Red Crescent Society, working with Palestinian psychotherapists who share a culture of shame and despair with their clients

By Nina K. Thomas, PhD

Palestine was in the midst of a heat wave in the summer of 2009. I was in Ramallah to provide training to the psychosocial staff of the Palestinian Red Crescent Society (PRCS). Formal training in conducting psychotherapy is severely limited for Palestinian workers like those in the workshops I conducted. The nominal concern of the four and a half days of training in which I combined lectures with demonstration groups was “Caring for the Caretaker.” Our daily sessions focused on helping the nine participants recognize and disentangle their own traumatic reactions to living under occupation from those of their clients. All of those who participated in the 9 am to 5 pm sessions were field staff from psychosocial centers around Palestine including Hebron, Qalquilya and Ramallah. My translator was the supervisor of psychosocial programs for PRCS, a quiet, warm and thoughtful man who is deeply concerned both about the quality of work his staff is prepared to perform as well as the toll on them of doing so when they share the political, social and economic traumas of their clients. 

Sometimes we have to live like heroes
because we have these choices that are our inherited history…
confront or die.
- workshop participant, Ramallah, August, 2009

The ten days I spent in Palestine were challenging. The threat of violence, danger, and suspiciousness on all sides underlie most interactions with “outsiders.” The oppressive heat, minimally dispelled by an overburdened air conditioning system in the Society’s headquarters, made dressing “modestly,” while still withstanding the relentless temperatures, a particular difficulty. But the interminable heat was something all of us, the trainee staff, supervisors and I, shared. At times, like all new acquaintances in strange situations, we took refuge in talking about the weather.

Although I have spent significant periods of time in post-war, post-conflict countries, never previously have I been in a place where violence and the threat of violence hang so heavily in the air; where one must become accustomed to the indignities of being stopped and searched at random, or, as one of my Palestinian colleagues put it, “depending on the mood of the soldier.” I have also never been in a place where my identity as an American Jew, with family in Tel Aviv, whose roots extend deep into Zionist soil, complicated my experience so profoundly as it did in Palestine. I experienced both intense guilt about how Palestinians are forced to live and a sense of the terror with which my friends and relatives in Israel live. Because there is so much suspiciousness on all sides, I was guarded about disclosing my Jewishness in a variety of contexts, including to my Palestinian colleagues

I think of the work I undertook as in keeping with the “moral witnessing” of “Machsom Watch,” a group of Israeli women who monitor the treatment of people negotiating the checkpoints between Israel and the Occupied Territories (Ullman, 2006), with all the complexities that experience entails. I offer reflections on my experience in the West Bank and some of the complicating factors in working in an environment so thick with historical and contemporary traumas.

In thinking about the work I did, four elements emerge, each complicated by multiple layers of meaning intersecting with the others: (1) gender, (2) power, authority and agency, 3) shame, humiliation and powerlessness, and 4) despair.


Domestic violence and sexual abuse are problems the PRCS staff confronts regularly, yet they are deeply hidden in this small and sequestered society. This mixture of gender and violence seem to echo the domination and subjugation that keep reverberating throughout the lives of the Palestinians in general. The PRCS workers make that link, viewing domestic violence and sexual abuse as emerging out of the disempowerment of Palestinian men and the daily humiliations they experience as they are subject to the random behavior of soldiers and encounters at checkpoints. But does this analysis complicate and mask underlying issues that resist address. Is the cause of violence against women more complicated than simply the Occupation? As I ask the question I know, too, that I am in no position to disentangle the multiple strands involved.

Issues of gender definition, power differences between the sexes, between subject and object are all in the room, generating some of the greatest heat in our workshop, with men grumbling that women blame everything on men, and women bantering with the men about how they act as if they have all the power. One woman participant describes women solely according to their roles with no subjectivity of their own. “There are three dimensions of mothers,” she says, “in terms of fathers, husbands and brothers.”

And then there is the issue of clothing. Four of the six women in my workshop are clad in more or less strict, traditional Muslim dress, while at least one of the two who are not is both modest and provocative at the same time. In an effort to make a point about working in groups, addressing the importance of neither overlooking differences in the similar, nor the similarities in difference, I use the example of these similarities and differences among the women in the room, all of whom are Muslim and Palestinian. One of the men notes: “The women dressed traditionally are like nuns. The ones who are not are loose.”

Power, Authority and Agency

Three of the participants in my workshop come each day to Ramallah from Qalqilya. At 9 a.m. they have not arrived. Should I begin without them? I wait. When they arrive at almost 9:30, one tells me she must leave early. Only later do I learn what Qalqilya represents. It is a Palestinian village of about 45,000 people, with no shelter from the relentless sun and completely surrounded by the Wall. One gate opens for two hours in the morning, two hours in the afternoon, and two hours in the evening. To enter or leave Qalqilya, you must negotiate the checkpoint in the allotted time or risk waiting for it to reopen. It is hard to manage the frame working in such an environment.

The boundary wall surrounding Qalqilya separates families from one another, from their lands, and from their access to work or to school. And sometimes children are not able to get to school or the sick to health care. The populations the PRCS staff serves are, in the words of one staff person: “fearful all the time about their children and their husbands.” Fear and anxiety are a constant presence as too is the demand to submit to a subjugating authority.

Shame, Humiliation, and Powerlessness

One participant I am calling Rashid describes the experience of a member of one of his groups. Israeli soldiers came to the man’s home to arrest him. Rashid describes what happened. “He was late to open the door. His children were frightened and held onto his legs. When he opened the door the soldiers beat him and shot him in the leg in front of the children. They didn’t arrest him. They just left him there. The children have nightmares now.” I sensed Rashid’s urgency in having me understand the man’s experience.

Rashid is a talented staff person who would make a fine clinician with the right training. Indeed, the staff at PRCS is eager to learn and to develop the skills to deal with the pervasive and ongoing traumas that are so much a part of their own and their clients’—or beneficiaries, as they call them-- daily lives. They have told me of the challenges they face. Among them is the need to maintain a balance in their own lives and positive feelings about themselves. “When people are exposed to this level of violence, how do they re-establish their identity?” Another frames the dilemma this way: “Sometimes we have to live like heroes because we have these choices that are our inherited history … confront or die.” The Palestinians with whom I am working have few if any opportunities for establishing agency in their lives.

A participant I am calling Salee describes wanting to experience death. She made a pact with a colleague that each would do something to the other to bring her to the point of death, but they would have a signal when whatever the other was doing should stop. Salee never gave the signal to her colleague who was choking her to the point of suffocation. She collapsed in a coma requiring hospitalization for a week. I was alarmed by her story and discussed it with the head of psychosocial programming for the PRCS who explained that Palestinians feel they can have control only over their own deaths. It did not alarm or even surprise him to hear Salee’s story.

As I mentioned, each of the elements I describe is inseparable from the others, creating an environment that can easily produce a sense of despair. I do not presume to analyze the political and historical contexts of the region in this brief essay. My reflections are intended to illuminate some of the psychological consequences of decades of Occupation for the psychological lives of Palestinians past, present and future.

An earlier version of this paper was presented at the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis weekend, Salisbury, CT, Nov. 7, 2009.

Contact the author: Nina K. Thomas, PhD


Ullman, C. (2006). Bearing Witness: Across the Barriers in Society and in the Clinic. Psychoanal. Dial., 16:181-198.