The Traumas of Trauma Relief
As the introduction to this chapter has noted, war and occupation, as forms of systematic political violence, seek not only to inflict physical destruction on a subject people but also their means of cultural and social reproduction, including systems of meaning, truth and value, and social bonds such as community solidarity and family cohesion.
As this chapter has also sought to highlight, by taking the individual as the ultimate subject of therapeutic intervention, the discursive practices of Western psychiatry may actually serve to reinforce the negative effects of trauma, by depriving survivors of the cultural and political tools necessary to make sense of and resist the violence they endure. As examples below will show, trauma relief projects targeting Palestinian children and youth often obscure the context of occupation and resistance in their programming in an attempt to maintain political neutrality, and in so doing undermine the relevance of such programs to the lives of young people. By ignoring the collective nature of violence under occupation, and by assuming antisocial forms of resistance to occupation, trauma relief projects transform the violence of occupation into individual suffering that must be overcome through personal self-empowerment, transforming the political struggle against occupation into a personal project of self (see Marshall 2014; Sousa and Marshall forthcoming).The length that some humanitarian projects in Palestine go to in order to obscure the context of the violence they purport to assuage is evident in an external evaluation of a project run by Save the Children USA, and funded by the US Agency for International Development (USAID) in 2003. The project, part of Save the Children’s Community Psychosocial Support Program, sought to implement the classroom-based intervention method of trauma relief as developed by the Boston Center for Trauma Psychology.
The project targeted children and adolescents, and in some cases their adult caregivers, who had been exposed to the violence of the Second Intifada. The main aim of the project was to treat traumatic stress disorders such as excessive fear, depression, and aggression, as well as to “increase children’s ability to solve problems, maintain pro-social attitudes, and sustain self-esteem as well as hope for the future” (Khamis et al. 2004, p. 4), all factors which have been shown to positively counteract the effects of traumatic stress. Significantly, the project strikes a balance between promoting individual healing through self-esteem, self-reliance, and self-control, and “pro-social” outcomes such as strengthening communication with friends and family. The use of schools, community organizations, and summer camps to treat young people also emphasizes the social nature of this psychosocial support project. Likewise, the project evaluation underscores the importance of children’s hope, and their “trust in a positive future,” as a factor in their ability to cope with trauma (as measured by the “Children’s Hope Scale”). In addition, the authors assure the readers that, although all the impact assessment tools used in the evaluation use metrics developed in Western contexts, they address “universal issues” and, where necessary, have been modified to suit the local context. Yet, despite this purportedly context sensitive, collective, and community-based approach to trauma relief, Palestinians’ collective experience of occupation and resistance is not acknowledged anywhere. In the 104-page project evaluation, the word occupation is never once used and is only alluded to a few times through ambiguous phrases such as “conflict situation,” “background of violence and trauma,” “violence,” and once as the “Israel-Palestinian conflict.”Beyond the ethical questions raised by promoting “trust in a positive future” without acknowledging the context of asymmetrical warfare and decades long occupation, the unwillingness to address the causes and context of the violence alluded to by the project potentially undermines its aims.
This shortcoming was recognized by the evaluation itself. As the authors note, although younger children showed improved behavior and mood after completing the program, adolescent girls also showed increased worry about “conflict situations and potential threat events” as well as “increased hyperactivity when faced with difficult circumstances” (Khamis et al. 2004, p. 75). Perhaps the adolescent girls who participated in the project found it difficult to reconcile the focus on self-improvement and optimism during a time of widespread collective suffering, leading to a sort of cognitive dissonance. This is the conclusion that the authors draw about the adolescent males who participated in the project. The evaluation notes that young men reported that the themes addressed in the project were “immature, boring, repetitive, and had nothing to do with their ‘real’ lives” (Khamis et al. 2004, p. 76). Further, with regard to their future outlook, the young men “strongly voiced that they want to learn about leadership, and going to university, and how to travel, and how to find employment.” In other words, they want tools for overcoming the negative effects that occupation has on their lives - including feelings of humiliation and emasculation, blocked access to education, travel restrictions, and economic de-development - rather than self-esteem improvement exercises with no apparent relation to their present circumstances. The evaluation speculated that their views in part reflect the greater autonomy and independence that young Palestinian men have relative to young women and children: “they do not have the same level of protection against witnessing or being involved in the ongoing violence as their younger counterparts” and “they are in a position to observe the debilitating impact of the current socio-economic conditions within the West Bank and Gaza on their fathers, male mentors, and leadership” (ibid). Given the critical consciousness that these young men developed through their interaction with older men, the vision of a “potentially hopeful future,” the authors note, “must have appeared incongruent” (ibid). By not addressing the actual conditions of life under occupation and tools to critique and confront it, the effectiveness of the project remained limited.The example provided above illustrates that even projects that ascribe to a psychosocial model of community-based intervention potentially reinforce the negative circumstances of occupation when they fail to acknowledge them directly. Although the project discussed above was carried out and funded by large international organizations, the basic model is often replicated by smaller Palestinian NGOs seeking funding for locally based trauma relief projects. A study conducted from 2010 to 2012 in the northern West Bank examining trauma relief efforts in Nablus and surrounding refugee camps found similar avoidance of the language of occupation and resistance (see Marshall 2013, 2014; Sousa and Marshall 2015). For example, in donor appeals and project funding applications, euphemisms such as “past and on-going violence” or “violence and trauma” are often used instead of direct reference to the context of occupation (Marshall 2013). In addition, such projects often seek to promote “productive” forms of “self-expression” that enhance “self-confidence,” showing an emphasis on individual healing and personal development rather than collective recovery, resilience, and resistance. Such discourse de-politicizes the occupation, transforming it into a set of personal developmental hurdles to be overcome through individual introspection, rather than as a systematic violence directed at Palestinian society requiring political solutions to address it (Marshall 2014). Rather than harnessing the potential strength of communities and families to endure and resist violence, children are instead encouraged to find their own individual voice and shape their own individual futures.
Although trauma relief projects are typically vague about the source of violence threatening Palestinian children, such projects are often quite explicit about the threat that Palestinian children themselves pose should their psychological traumas go untreated.
For example, an internationally funded NGO in Palestine working with “war affected children and youth” in refugee camps seeks to provide “alternatives to violence” through providing activities that allow children to “release frustration” thus improving their “physical and mental health” (Marshall 2014). Here, it is assumed that Palestinian children are the ones that need to learn alternatives to violence, although they are themselves directly targeted by the violence of occupation and have few alternatives to avoid it. Another organization also working with children in refugee camps similarly sought to use arts and creativity to “encourage tolerance and peaceful expression” as well as to “improve the psycho-social health of marginalized Palestinian children from areas that have suffered violence,” once again conflating trauma relief and security, while confusing the directionality of violence in Palestine.The practices of colonial psychiatry as critiqued by Fanon echo in these examples. Palestinian children are assumed to be always already traumatized by an unnamed violence that if left untreated will produce a generation of potentially unruly, Palestinian youths, capable of launching another violent uprising. The solution is to equip them with the means to govern themselves through selfexpression and personal development. In this way, such programs could be said to operate within the logic of governmentality, seeking the regulation of society through the terrain of the self. For example, Cruikshank (1999) argues that civil society organizations potentially play a role in reproducing neoliberal forms of governmentality through programs which promote self-empowerment. Through such programs, she argues, “the self is made into a terrain of political action,” specifically “a terrain that carries with it new political possibilities for self-government” (Cruikshank 1999, p. 5). As Cruikshank (1999, p. 91) contends, “Building self-esteem is a technology of citizenship and self-government for evaluating and acting upon ourselves so that the police, the guards and doctors do not have to.” In the case of Palestine, NGOs could be viewed as transforming the work of policing unruly Palestinian youths, already outsourced from the Israeli military to the Palestinian Authority, into a project of self-governance.
Viewed in this way, international NGOs and civil society organizations in Palestine relieve the occupier of its burden of managing the population, allowing the occupier to focus on the acquisition and control of physical territory. However, the strategy of population management through self-care is by no means straightforward and often produces unpredictable and contradictory results. Bondi (2005) explores this duality of neoliberal governmentality in her research on psychotherapeutic volunteer-sector counseling. She argues that “As a form of governmentality, neoliberalism works by installing a concept of the human subject as an autonomous, individualised, self-directing, decision-making agent at the heart of policymaking” (p. 499). Nevertheless, such “aspects of neoliberal subjectivity hold attractions for political activists because activism depends, at least to some extent, on belief in the existence of forms of subjectivity that enable people to make choices about their lives” (ibid). Moreover, the discursive practices of psychotherapeutic counseling “elude their textual representation in important ways” (Bondi 2005 p. 502) making room for more liberating understanding of these practices than textual deconstruction allows. Similarly, although project proposals, reports, and evaluations of trauma relief programs may present a depoliticized understanding of trauma that focuses exclusively on individual healing, many Palestinian organizations may nevertheless see this work politically, as part of improving the capacity of communities to resist occupation. Likewise, the young participants in such programs may not see any contradiction between self-improvement and being part of a collective struggle against occupation (cross reference other Springer volume here). The following section will explore these views based on interviews and participant observation research with Palestinian youth workers and young people carried out in Balata Refugee Camp in the West Bank between 2010 and 2012 (see Marshall 2013, 2014).
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