Mental health policy in Palestine is largely based on short-term, emergency humanitarian aid and a biomedical approach to distress. It also takes sumud for granted, meaning it assumes Palestinians will always find a way to “get through.” In Palestine, there is not a system of sustainable public mental health services (Giacaman et al 2011). It is essential to understand how local populations (and not international aid agencies) conceive of their own suffering and well-being (Barber 2014). This paper is based on seven years of oral history interviews with a cohort of young adult Palestinians who grew up during the second intifada. Palestinian youth express that they live with Ongoing Traumatic Stress Syndrome (OTSS). The conditions that constitute ongoing traumatic stress are the inheritance of multi-generational trauma, compounded with continued violence. Political rights and freedoms are the key domains of good functioning for Palestinians (Barber 2014). For some Palestinians, the difficulty of local, daily living conditions can even at times trump larger abstract concepts such as collective national identity (Allan 2014). Palestinians make clear that lack of good functioning is not the fault of the individual but is the result of exposure to perpetual danger. Palestinians do not want their frailties to be pathologized, bio-medicalized and/or attributed to PTSD from the second intifada. Palestinians say their trauma is rooted in the near century-long Zionist project that led to the formation of the state of Israel and continues today in the form of the Israeli military occupation of the Palestinian territories. Young adult Palestinians convey that the occupation functions on a multi-pronged system of state-led surveillance, racism, and settler colonialism, which they talk about in three concrete ways: military detention/imprisonment, armed conflict-related fatalities, and immobility. This paper employs the art and science of portraiture (Lawrence-Lightfoot & Davis, 1994), to provide an in-depth and nuanced understanding of localized community expressions of well-being and normalcy outside the mental health clinics.

Palestinian youth engage with many criminalizing and/or pathologizing narratives and images of their experiences of political occupation. These narratives and images are produced by biomedical professionals, NGOs, and state agents(Nguyen-Gillham et al 2008, Marshall 2014). At the same time, western, psychological narratives of Palestinian youth rely on their representation as emotionally resilient heroes in the face of extreme hardship (Barber 2013). So, what might it mean to construct or conduct primarily transnationally-driven pediatric mental healthcare in the occupied West Bank, where emotional suspicion operates as a salient reflection of both Israeli state power and indeterminate Palestinian statehood, at the same time that western medical professionals attempt to shape a counseling culture using –and creating -- emotional hyperbole? Based on recent qualitative research in Palestine, this paper explores two child and youth mental health services programs in the cities of Ramallah and Nablus, Palestine. Always in relation to Israeli and western models of trauma and resilience, Palestinian mental health professionals negotiate a politics of occupation and sovereignty to reproduce/rethink/challenge the typing of Palestinian youth as emotionally deviant in diverse ways. By highlighting some of these strategies, the paper traces some of the local and global biopolitics in which Palestinian youth – either via public anger, mourning, or even joy -- first become “hailed” (see Butler 1990, 1997) as emotionally “other” in familial, activist, institutional, and public spaces. It then documents some ways in which pediatric healthcare workers engage and/or reframe youth behaviors, responses, and aspirations along such axes of possibility and impossibility of life course events; mobility and immobility; and participation in intra-statist and neoliberal economies.The data reveals the necessarily paradoxical use of western models of trauma and resilience for diagnosing, treating, and reifying Palestinian youth as emotionally deviant in response to both the local and global cultures and systems of which they are a part.

Background: Most studies on the mental health of Palestinians are on the prevalence of PTSD, anxiety and depressive disorders among survivors of Israeli violence. Diagnosis is usually based on a one-time interview using standardized tests built on Western models of mental illness and is often undertaken shortly after periods of heightened Israeli aggression. Whereas such studies are crucial to understanding the psychological consequences of colonial violence, they obscure nuances of symptoms and present an incomplete picture of mental health concerns in Palestine. This study utilizes the data of a major counseling center to understand who seeks counseling/therapy in three regions in the West Bank and for what reasons. The aim is to examine patterns of formal help seeking and concerns that depend on patients’ self-reports and in-depth assessment by practitioners over a long period of time; knowledge that is both lacking and crucial. Methods: The pre-existing data of approximately 900 adult service users who came to the Palestinian Counseling Centre between 2008 and 2018 will be extracted from the database for analysis. Non-inferential statistics and Chi-Square will be used to describe previous and current service users and search for statistically significant patterns across the selected variables. Results: Results will include demographic information (age, gender, education, occupation, type of residence and economic status), reasons for approaching therapy, diagnosis by counselor/therapist, duration of psychotherapy and how it was terminated. Discussion: Findings will be compared to studies on Palestinian mental health that mainly use standardized diagnostic criteria and tools. Patterns of mental health utilization will also be compared to those found elsewhere, both regionally and globally. The implications of the results will be discussed in relation to research, practice and theory in the Palestinian context.

Can the salient psychological approaches practiced in Palestine, particularly the ones centered on trauma and resilience, be used to understand and repair suffering under colonial conditions? How else should psychologists and mental health workers conduct their practice in Palestine? This paper examines the psychopolitcs of these two frameworks as they have been promoted and applied to the settler-colonial reality in Palestine. It is argued that practices of trauma and resilience in Palestine are complimentary technologies of colonial repair, and are integral to the productive powers of settler colonialism. Colonial repair seeks to re-appropriate and transmute the native’s wound to eliminate colonial resistance by helping the colonized better assimilate and adapt to the colonial system of oppression. The complimentary work of trauma and resilience in Palestine casts colonial subjects as devoid of the indigenous impetus to resist oppression, which in turn implies the subjective elimination of the natives, beyond their physical elimination/killing. Indigenous and psychoanalytic relational perspectives on repair are offered as alternative frameworks for decolonizing Palestinian mental health. I conclude with two interventions, charting an indigenous framework for conceptualizing Palestinian suffering and coping under colonial rule.