Abstract
Purpose
The purpose of this paper is to explore the role of psychologists working with a community mental health center in the Gaza Strip, using Freirean pedagogical and Fanonian post-colonial theories as a framework. The study aims to highlight how political injustice contributes significantly to psychological distress in the region. It emphasizes the importance of collective well-being, liberatory practices and agency in therapeutic work. This research seeks to demonstrate that psychology and science cannot remain politically neutral, as they are inherently imbued with values that can either uphold oppressive systems or promote resistance and advocacy for change.
Design/methodology/approach
This study uses a theoretical and qualitative approach, drawing from Freirean pedagogical and Fanonian post-colonial frameworks. It involves reflective analysis of the authors’ experiences as psychologists from Italy and South Africa working with a community mental health center in Gaza. The research includes a critical examination of political and social contexts that affect mental health in the region. Through the roles of trainers, clinical supervisors and researchers, the authors integrate liberatory psychological practices and emphasize solidarity with the people of Gaza, providing insights into the interplay between political contexts and psychological well-being.
Findings
The findings indicate that political injustice is a primary cause of psychological distress in Gaza. The research underscores the dual role of mental health professionals: while they might inadvertently promote adjustment to oppressive systems, they also have the potential to enhance resistance, advocacy and activism. The study reveals that liberatory psychological practices can empower individuals and communities, fostering agency and collective well-being. Furthermore, the mental health needs of the population, alongside humanitarian aid and physical safety, are critical for the current crisis and future rebuilding efforts in Gaza.
Research limitations/implications
This paper is limited by its qualitative nature and the specific context of the Gaza Strip, which may not be generalizable to other settings. However, it provides valuable insights into the role of psychology in politically charged environments. The implications for further research include the need to explore liberatory practices in other conflict-affected areas and to examine the impact of psychologists’ roles as advocates for change. The study highlights the importance of integrating political awareness into psychological practice and research, encouraging professionals to engage actively in addressing systemic injustices.
Practical implications
The practical implications of this work emphasize the need for mental health professionals to incorporate political awareness and advocacy into their practice. By doing so, they can support communities in resisting oppressive systems and promote collective well-being. The research suggests training programs for psychologists that focus on liberatory practices and agency, equipping them to work effectively in conflict zones. Additionally, the study advocates for strengthening psychological services in Gaza, both during and after crises, to address the population’s mental health needs and support rebuilding efforts.
Social implications
The social implications of this paper highlight the critical role of psychology in addressing the political and social determinants of mental health. By aligning psychological practice with liberatory principles, mental health professionals can contribute to social justice and empower communities to resist oppression. The study advocates for a shift in the perception of psychology as a politically neutral discipline, urging professionals to engage actively in social change. It underscores the importance of solidarity with marginalized populations and the need for mental health support that is responsive to the broader socio-political context.
Originality/value
This essay offers original insights into the application of Freirean and Fanonian theories in the context of mental health work in Gaza. It provides a unique perspective on the role of psychologists as agents of change and solidarity in politically oppressive environments. The research contributes to the growing body of literature on the intersection of psychology and social justice, highlighting the potential of liberatory practices to empower communities. By challenging the notion of political neutrality in psychology, this study adds value to the discourse on the ethical responsibilities of mental health professionals.
Keywords
Citation
Veronese, G. and Kagee, A. (2024), "Does psychology fail in the face of genocide? Insights about Gaza before and after October 7, 2023", International Journal of Human Rights in Healthcare, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/IJHRH-07-2024-0053
Publisher
:Emerald Publishing Limited
Copyright © 2024, Guido Veronese and Ashraf Kagee.
License
Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode
The theoretical context of our pedagogical work
As international teachers, supervisors and scholars who have been teaching and conducting research in the Gaza Strip over the past several years, our point of departure is critical consciousness (Freire, 1996). Critical consciousness, as articulated by Paulo Freire, engages in constant evaluation and re-evaluation of how social and political structures protect and maintain social injustice (Mayo, 2020). It is thus a foundation for activism for social equality. As Freire has argued, all pedagogy is a call to action (Freire, 1996), especially in societies characterized by inequality and social oppression, as is the case in Gaza. To this extent, education is an instrument to create an egalitarian context, in which society is transformed by students gaining and experimenting with knowledge. Freire was highly critical of the “banking” system of education, in which students are the depositories and the teacher is the depositor. In the banking system students are seen as empty accounts to be filled with deposits and are thus required to receive, memorize and repeat information (Freire, 2018). Such an approach preserves the status quo as students’ creative energy is stifled, which serves the interests of an oppressive system. Instead, critical consciousness has dialogical teaching as its goal, which creates a process of learning and understanding that involves theorizing about the experiences shared in the dialogue process. The development of critical consciousness through dialogue in this sense provides an expression of social discontent as this constitutes the lived experience under an oppressive system (Shuster and Giesemann, 2021).
We imagine our work as teachers, researchers and clinical supervisors in Gaza as a liberating engagement and a way of displaying solidarity with the Palestinian people whose political oppression has been ongoing for the past 75 years. Education for liberation is focused on critical engagement rather than transferring information from teacher to student. For example, posing problems and jointly imagining and discussing approaches to their resolution through dialogue forms the basis of such an approach (Harris and Roter, 2024). As teachers, we are also taught in dialogue with our trainees who are simultaneously teachers and students. All are jointly responsible for the process in which intellectual growth is mutual and nonauthoritarian. The same applies in the research domain in which the development of the research question and the method of data collection require that investigators and research participants work together as coinvestigators (Heckert et al., 2020). Such an approach is not without its challenges given the level of technical expertise and skill required. Nonetheless, our approach in Gaza is to involve local partners, including clinicians, researchers and where possible research participants at each step of the scholarly process. Consequently, local Palestinian researchers have first authorship on scholarly publications while our names are listed further along in the authorship sequence.
In tandem with a Freirean approach, we also draw on the theoretical contributions of Franz Fanon in conceptualizing a postcolonial perspective to our work. The world as it exists rests on a history of colonization in which human bondage was globalized. The resultant crimes such as slavery, colonialism, apartheid and racism have constituted an “avalanche of murders” (Fanon, 1963, p. 193). The objectives of the colonizers in various parts of the world to own and control the lands they appropriated has a parallel in Israel’s aim to own and control Palestinian lands, i.e. the Gaza Strip, the West Bank and East Jerusalem. The foundational concepts for a liberatory psychology from a Fanonian perspective include collective well-being, human needs and empowerment (Bulhan, 2004).
Collective well-being
Well-being for Palestinians is embedded in the politics of dispossession (Sabbagh-Khoury, 2023) and cannot be attained without the resolution of the occupation of Palestinian land. In this sense, any approach to psychology has to be informed by a political position, and an awareness that the psychological pain of Palestinians occurs due to oppression. Collective rather than individual well-being is thus a cornerstone of a psychology of liberation that we seek to contribute to in our work in Gaza (Atallah and Masud, 2023). Historically, psychology has emphasized the individual as the unit of analysis and intervention (Chomsky, 2023), for example in terms of diagnosis, assessment and psychotherapy. Concepts such as adjustment, adaptation and competence inform a psychology of individualism (Israelashvili, 2023). Yet, as is the case in Gaza, as long as collective freedom is denied, individual well-being is not possible. Psychological theory has been largely silent on the needs of oppressed groups (Bulhan, 2004). To this extent sociality, human interdependence and intersubjectivity have much greater utility for the psychology of liberation than the assumption of individualism.
Human needs
In the Gazan context characterized by extreme physical danger, death, destruction, grief, trauma, famine and hunger, the needs of safety, shelter and satiety are paramount. A psychology of liberation needs to consider these needs, while simultaneously attending to emotional distress, social suffering and collective trauma. Bulhan has offered the following basic needs that drive the behavior of people:
biological needs such food and safety;
sociability and belonging;
integrity of the self;
longevity and symbolic immortality;
self-reproduction in praxis; and
self-determination (Bulhan, 2004).
Under conditions of the siege of Gaza, and certainly in the context of the 2023–2024 crisis in which thousands have been killed, these needs have been under severe threat (Hassoun et al., 2024). Thus, goal-directed and socially meaningful activities are of great importance, as people engage as active agents in the world which they seek to transform and are transformed by Neville et al. (2024). Here, the overlap between a psychology of liberation offered by a Fanonian lens and a Freirean perspective is evident, as both theoretical positions converge to conceptualize and advocate for the liberation of oppressed people. The absence of the right to self-determination is a fundamental barrier to Palestinian liberation, even as all paths to a just peace remain closed at present. Self-determination endows humans with a measure of agency, control and influence over their social conditions (Shalbak, 2023).
Liberatory practices and agency
Fanon’s theory of violence is highly pertinent to the context of Palestine. The violence of resistance as a reaction to the violence of settler colonialism is to be understood in the context of such a history (Caridi, 2023). When human needs are frustrated, people experience disempowerment and thus lack agency. At an individual level psychotherapy has been thought of as a way to empower people to manage and negotiate conditions of adversity (Hunt, 2023). Yet, an alternative approach is to transform social institutions and systems by organizing and mobilizing people to overcome the structural barriers to collective well-being (Prilleltensky, 2008). Social change in addition to individual change has the potential to lead to empowerment, agency and volition. It is entirely likely that psychotherapy may be appropriate and necessary for a particular person experiencing distress but is essentially conservative with respect to the status quo of oppression.
An intersectional and feminist lens is also important in triangulating postcolonial and antioppressive theories toward liberation and healing practices (Doetsch-Kidder and Harris, 2023). Indeed, a sole postcolonial gaze risks focusing the discourse exclusively on colonialism and white supremacy. Instead, intersectional feminism triangulates gender, race and class as the main dimensions of domination and liberation. Bell hooks has criticized Fanon’s psychoanalytic analysis of racial domination, suggesting that he was a victim of white colonial domination, but also of his own victimized black masculinity (bell hooks, 2015). Fanon was likely unaware of the oppressive forces within Black patriarchy and the ways in which he was a victim of his own subjugated black masculinity (Yokum, 2024). Moreover, an exclusive focus on class overlooks the dynamic forces of power against nonmasculine and racialized bodies. Thus, poor and subjugated people must be analyzed in their intersectional vulnerability as marginalized entities under conditions of oppression. We therefore take a feminist stance because, as trainers and supervisors, we cooperate to centralize the feminine figure of the Palestinian mental health provider in Gaza, acknowledging that the majority of our trainees and supervisees in Gaza are women. We embrace an intersectional and transnational feminist perspective in our work to oppose Israeli oppression and recognize the liberatory potential of radical feminist practices as a universal opportunity (bell hooks, 2000). While a feminist approach also has an agenda of liberation from homophobia and patriarchy, the primary source of oppression against women and nonbinaries in Gaza is, above all, the oppressive and violent colonial power imposed by Israel.
Working in solidarity with the people of Gaza
Guido Veronese
As a white, male, Western psychologist, family therapist and scholar, I have always questioned the meaning of psychology and mental health within a capitalistic realm. I came to the clear conviction that my discipline is deeply rooted in patriarchal and imperialist foundations, serving power by domesticating bodies and minds in the Foucauldian sense, surveilling and controlling those who oppose or are nonfunctional to the white, masculine capitalistic status quo. This realization naturally led me to approach Palestinian social suffering as an opportunity to engage in actions to decolonize mental health and foster a psychology of liberation.
I was raised in a communist Italian family severely affected by the two major wars in Europe (World War I and World War II). My maternal grandfather migrated to Belgium at the age of nine to work as a miner in Marsinelle. He lost his father under mysterious circumstances and returned to Italy in his 30s during the rise of Mussolini’s fascist regime. He found his family decimated by famine during the Great War. My grandfather left permanently and moved to Milan, where my mother was born. The Second World War brought financial ruin and my paternal grandfather, a decorated military officer, lost his job and was jailed for alleged war crimes.
I began my work in Israel in 2006, then moved to the West Bank and founded an international group, Psychologists for Human Rights, which aimed to combine activism and professional help in Palestine. In 2009, I entered Gaza, two years after the siege began. During that time, I met Dr Eyad El’ Serraj, founder of the Gaza Community Mental Health Program and a prominent intellectual and activist (Watts, 2014). We discussed psychology as a liberatory practice rather than an instrument for control and surveillance, and the need for a depathologizing systemic family therapy practice in Gaza. My work at GCHMP began in 2014 when I was invited to teach at their diploma in Community Mental Health and Human Rights, and to be part of the research, training and family therapy team as a supervisor. From 2009 to 2014, I worked in Gaza, collaborating with schools in the Jabalia refugee camp and at Mercy Corps US as a trainer and supervisor. Since the Israeli onslaught starting in October 2023, I have lost close friends, coresearchers and students.
Ashraf Kagee
Having grown up as part of the oppressed community in apartheid South Africa, my worldview was influenced by the struggle for liberation, suspicion of rampant capitalism and commitment to nonracial democracy. In the 1990s, I intended to work in Gaza, but the second intifada occurred and this plan proved impossible. Instead, I studied trauma among former South African political detainees. In 2016, I attended a conference on mental health and human rights in Gaza, organized by the Gaza Community Mental Health Programme (GCMHP). I presented my data on posttraumatic stress and met some of the GCMHP staff. We agreed that I would return later that year to run a series of workshops on research methods and cognitive psychotherapy, two areas in which I had some expertise. Since 2016, I returned to Gaza several times to conduct training and assist with research. Colleagues at the GCMHP have been appointed as research associates at my institution, Stellenbosch University, which provided them with access to the university online library, the ethics committee and various computer programs for data analysis. Over the years our team has produced several scientific articles on mental health in the Gaza Strip. Our projects have been informed by locally developed research questions, with data collected by local colleagues who are also listed as first authors on publications. Such an approach seeks to ensure that epistemological power resides in Gaza and that as an outsider my contribution is supportive and facilitative rather than owning and leading the process. In terms of clinical training, I provided several workshops on cognitive behavior therapy and in-person and online supervision sessions. Online clinical supervision was not without its challenges, however. Sometimes the internet or electricity would cut out or the translation process would slow down the exchange. However, despite these challenges our work continued.
I was invited to visit Gaza on each visit, rather than imposing myself on the local population or the GCMHP. These invitations were built on trust which in turn rested on a shared political, ideological, theoretical and practical commitment to human rights and social justice between my Palestinian colleagues and I. In this sense we are also part of the Gaza community, having been accepted into intellectual community of Palestine. After the Hamas attack October 7, 2023, the situation changed quite dramatically. My colleagues and friends in Gaza and I were no longer concerned with research, training or supervision, but with their physical survival in the context of the Israeli onslaught. Many lost their homes and were displaced. I learned with great sadness that some of the students whom I had taught had been killed in the Israeli attacks.
Political positioning
As psychologists and researchers, our concern is with political and social injustice as a driver of psychological distress and mental health conditions. To this extent our view is that the field of psychology cannot and should not be politically neutral. Notions of scientific objectivity and dispassionate scholarship are impossible as researchers, scholars and clinicians are themselves politically and socially located.
There is a specific role that visitors can play in the context of the blockade that Gaza has been placed under since 2007. The presence of a visitor has provided the opportunity to witness and give testimony to the experiences of the population. Yet, a visitor from abroad was able to leave Gaza while local people could not. Even though one of the authors (Kagee) lives in South Africa, a middle-income country that itself underwent the colonial experience, he is not Palestinian by nationality. However, we argue that this does not amount to colonial privilege as Palestine and South Africa are both part of the global South, both have experienced political oppression, both are characterized by social inequality, limited resources and social divisions. In this sense, we posit that our visits to Gaza have not been colonial undertakings but are part of an international solidarity that many feel toward the Palestinian cause for freedom.
There are also ontological matters at play, that of being a human being in the context of suffering by fellow human beings, and positionality, that is, having a presence in a context that has a complex set of problems, that is at this point without solutions, and where the political players are highly polarized from one another (Lustick, 2019). Such a context demands that clinicians and researchers critique their own epistemological and ontological premises, especially when it comes to notions of freedom (Ndlovu-Gatsheni, 2018). The liberal idea of freedom asserts the importance of constitutional order with its consequent individual freedoms. Yet, liberal freedoms are insufficient in the context of social oppression. A radical view of freedom suggests that, as long as there is social inequality and structural oppression, freedom is impossible (Oshana, 2014). Freedom is thus both a condition and a process and involves activism and agitation for social change. In this sense, freedom also ties in with epistemological access, that is, empowerment through education, capacity building and making resources available in the service of creating opportunities for people to achieve both personal and communal freedom (O’Brien et al., 2013).
Capacity building is mutual and dynamic, not unidirectional. As western-educated doctoral level psychologists with several years of experience as researchers, teachers and clinicians, who have worked in Gaza as trainers and scholars, there are also important learnings that accrue to ourselves as well. These include developing an understanding and appreciation of context, communal culture, the lived reality of the people, narratives of steadfastness and the ways in which people in communities support each other. As non-Arabic speakers, we are also at a linguistic disadvantage, similar to the experience of those who are not English-speaking in an English-speaking context.
Our work often feels controversial and entangled in unsolvable paradoxes and contradictions. The disparities in power and privilege risk portraying our presence in Gaza as colonial and extractivist. The outcomes of our work are part of the hegemonic neoliberal tertiary education system, enhancing our universities’ prestige and ranking through grants, international relations with the Global South, publications and other products of the neoliberal academy. Often, our presence in Gaza seems like a form of gentle and sustainable colonization, masked under the guise of the Sustainable Development Goals (Afifi and Ghabra, 2023; Helbich and Jabr, 2022). These goals allow imperialist and historically colonizing entities to flood the Global South with green, technologically advanced, gender-sensitive and social justice-informed projects that primarily (re)generate income, power and supremacy of the North over the South (Bhatia and Priya, 2021).
Even so, our approach remains too white and masculine to foster genuine support and solidarity with Gaza’s comrades and people. We are increasingly troubled by the scientific models and methods we export to Gaza, building capacity that will never compete with the North due to the initial economic, technological and psycho-emotional disparities. These models have been constructed and validated within the empirically supported, yet highly colonial, ivory towers of the North. The current aid system ultimately reproduces subjugated and subaltern bodies and minds, dependent on the external Western world and but still colonized (Joseph, 2021).
What we find most valuable about our work in Gaza is the companionship, brotherhood and sisterhood, we have developed over the years. The compassion and mutual understanding we share have profoundly impacted our context, life and approach to science. The essence of our presence in Gaza can be summarized into two concepts: radical love and alliance (Atallah, 2022; Glass, 2009; Ihmoud, 2023a). Radical love for the land, the spaces, and the places continue to provide meaning in our scholarship and professional existence. Even though we have some skepticism of the usefulness and even the ethics of psychological disciplines that work to readapt and resocialize domesticated bodies to iniquitous and unsustainable living conditions, our work in Gaza has reconciled us with an idea of a psychology of liberation based on relationships and meaning-making. Radical love extends to our displaced and dispossessed brothers and sisters in Gaza, whose strength and steadfastness or Sumud (Ihmoud, 2023b), empower them to operate from the margins for the good of their people and humanity as a whole. We suggest that this love for truth and justice is the path to healthy agency and salutogenesis. It stands in stark contrast to the complicit silence of the international community, including mental health and psychological societies, universities and Western democratic civil society bodies. Standing as allies and witnessing the struggle for dignity and liberation is the most motivating stance we can take right now. Such a presence at and through the margins can help both oppressed and oppressors. It aids the oppressed in decolonizing their lives and minds, and it offers the oppressors liberation from the illusory promises of privilege and domination.
Values and service
There have been several instances where psychologists have been complicit with oppression. One of the most notorious examples is the failure of the American Psychological Association (APA) to ban its members from being present at sites of physical torture in the years after the 9-11 2001 attacks. An independent investigation found that APA officials colluded with the US government to enable the torture of detainees (Aalbers, 2022), thus violating the ethics of the profession. Similarly, the Israeli military also employs psychologists who operate in the interests of the Zionist state, assisting soldiers in implementing the occupation of the West Bank and the current onslaught on Gaza (Ben-Shalom and Fox, 2009). We regard such activities by our fellow psychologists as undoubtedly reprehensible and unacceptable. Guided by values of social justice and human rights, our concerns are primarily with oppressed communities and societies. Such concerns require resistance to oppressive forces, using the skills and technologies that are available. To this extent psychological work is political, indicating support and solidarity.
Mainstream psychology has been largely silent on political matters, even though silence is itself a political stance as it suggests complicity with the status quo (Guillaume and Schweiger, 2018). Indeed, silence on the part of those who possess epistemic power such as degreed and credentialled professionals is especially insidious as it provides an unspoken endorsement of social injustice. Yet, as shown in the examples of the APA and Israeli Defence Forces (IDF) psychologists, mainstream psychology has been marshalled in the service of political repression which suggests a pretense of neutrality and objectivity. Marshaling science in the service of social justice is an ideological position but one which we believe can be defended and advanced.
There is an unspoken subtext in our work in Gaza and we accept that from a certain point of view we may fall into the trap of maintaining the status quo in this society. It can be argued that intervening in communities that experience social adversity helps them to adjust and adapt to their state of social oppression rather than encouraging them to overcome it. To this extent, we constantly examine whether our efforts in training mental health professionals and conducting research actually help people adapt to and cope with a political context that is itself severely dysfunctional. If psychological treatment such as cognitive psychotherapy and family therapy successfully ameliorate psychological symptoms (e.g., Fordham et al., 2021), this is certainly a positive outcome from the perspective of clients and clinicians. Yet, these symptoms are sociogenic, that is, they come into existence as a consequence of political oppression, the siege, overcrowding, constrained resources, constant surveillance and bombing by Israel and the historical dispossession of Palestinians from their land (Diab et al., 2020). To negotiate this apparent paradox, we see our work in helping to ameliorate psychological distress in the service of freeing people to engage in resistance through developing a critical consciousness.
Critical consciousness as a concept seeks a deep political understanding of the world along with the dynamics of power at play, both historically and at a given moment (Seider et al., 2020). Critical consciousness also includes engaging in activism against oppression that are informed by such an understanding. Yet, resisting the Israeli occupation has been both hazardous and challenging as activists are routinely killed or imprisoned by the Israeli state (Shorrab et al., 2024). The hazardous nature of resistance is exemplified in the repression of those in Gaza who participated in the Great March of Return at the border with Israel which started in 2018 to demand the end of the Israeli blockade and the right of return for refugees (Wispelwey and Jamei, 2020). These protests were largely nonviolent and attended by mainly unarmed protestors. Israel used tear gas, rubber-coated bullets and live ammunition to quell these demonstrations, resulting in scores of severe injuries and casualties. The death toll, disability and injury placed further stress on the population of Gaza. Families had to take care of disabled and injured demonstrators who were no longer able to attend to their activities of daily living, thus creating an additional burden on household resources (Wispelwey and Jamei, 2020).
Ameliorating psychological symptoms is certainly one of the objectives of psychotherapy and counselling even though the political context might remain unchanged. We reason that if psychological treatment can provide people with the opportunity to function and attend to daily tasks such as working, caring for children, preparing food, studying and socializing then it certainly has the potential to contribute to enhancing quality of life, even under conditions of severe oppression. The paradox of our work emerged in the context of Dr Veronese’s work in a millionaire project, a project of an international nongovernment organization, to rebuild the mental health system in Gaza and funded by US aid money after the 2012 and 2014 attacks by Israel. Quite rapidly, resources shifted to Syrian refugees. Public mental health centers in Gaza disappeared, leaving dozens of trained and qualified mental health providers unemployed and unable to provide services. Mutatis mutandis, in the context of the 2024 crisis, we have witnessed our colleagues in Gaza struggle to find food and water while surviving the systematic killing of the Palestinian intelligentsia. The headquarter and three centers of the organization were destroyed in the relentless Israeli attacks.
Does this signify our failure? The answer lies in the assertion that there cannot be mental well-being and relief without social justice. The removal of the political and social antecedents and determinants of individual and social suffering in Gaza (or anywhere) is the only path to mental recovery and wellness. Until our psychological models, tools and theories challenge the oppressive status quo, they will remain either useless or complicit, and thus colonial.
Intersectionality in the context of human rights work
We endorse an intersectional approach (Keith and Brown, 2018) to human rights work in the context of Palestine. Resisting the oppression that Palestinian people have endured is part of a broader commitment to social justice that includes resistance to any form of oppression such race, disability, gender, sexual orientation and national origin, among others. To this extent, our political positioning is both critical and practical. The question of the rights of the queer community is a case in point. As Gaza is a highly religious and conservative society, we imagine there will be instances where some in the society may express sentiments that are critical of same-sex unions. This matter requires some navigation as any form of discrimination is unacceptable from a social justice point of view. For example, if oppressed people themselves discriminate against others on the basis of race or gender, such injustices should be addressed and processed (Grzanka et al., 2020). In our view, the same applies to the rights of queer persons whose oppression is both visible and invisible in most societies (Altman, 1993). Yet, we also are wary of the phenomenon of pink-washing, which occurs when governments selectively agree with the claims of sexual minorities but exploit these claims to justify racism and xenophobia. Pinkwashing is the strategy of deploying messages that are sympathetic toward the LGBTQ community for political ends that have little to do with LGBTQ equality or inclusion, and in fact has an exclusionary agenda (Ritchie, 2015). Campaigns to protect human rights can in some instances be a masquerade for imperial aggression (Perugini and Gordon, 2015). Our task is to confront these paradoxes while simultaneously maintaining a paradigmatic approach of intersectionality, which is to resist oppression on all fronts, including homophobia. This example is indicative of the challenging nature of maintaining a decolonial stance while simultaneously being intersectional. Where paradoxes occur these need to be confronted at theoretical, ideological and practical levels.
We need to be critical, as intersectional mental health practitioners, of the Western rhetoric that depicts Palestinian society as homophobic and misogynistic (Alqaisiya, 2020), as such a position can become a pretext to export oppression and war against civilians in the name of democratizing and civilizing people in this region. An intersectional and feminist lens must guide mental health scholars to clearly highlight the colonial and political nature of the collective suffering of Gaza’s people, including women and LGBTQIA+ individuals. Yet, simultaneously, it is necessary not to diminish the urgency of embracing the struggle for women’s and nonbinary people’s rights in Palestine (Atshan, 2020). Instead, we call for genuine attention by the psychological disciplines to empower and foster indigenous pathways to liberation from colonial power. Solely focusing on women’s and nonbinary rights in a fragmented manner often serves as an excuse to promote oppressive and externally imposed colonial agendas under the guise of gender equality and Western human rights.
We call for the need to support and amplify the voices and efforts of Palestinian women and LGBTQIA+ individuals within their cultural context, thus ensuring that our interventions do not become tools of further oppression. It is crucial to understand that their struggles are intrinsically linked to the broader fight against colonialism and occupation (Darwich and Maikey, 2014). Thus, our role is to assist in creating spaces where indigenous ways of liberation can flourish, ensuring that any efforts toward gender equality and human rights are genuinely aligned with the needs and aspirations of the Palestinian people, free from external imposition and violence.
The role of psychology since October 7, 2023
It was impossible for the people of Gaza to have prepared for the horror that unfolded in their society after the Hamas attack of October 7, 2023. None of the work undertaken by medical professionals, psychiatrists, researchers and scholars could have prepared people for such an onslaught given its unexpected nature and because there has been no way to withstand the Israeli onslaught. Describing the Palestinian people as resilient sounds hollow at this point. Resilience refers to an individual’s ability to withstand the duress they are experiencing or the overcoming of stress or adversity (Vella and Pai, 2019). It is very much a concept rooted in individualism and absolves society from its role in creating unacceptable living conditions. Sumud, or steadfastness, on the other hand suggests resistance at both the personal and societal level (Meari, 2014). Yet, invoking both resilience and steadfastness may inadvertently serve the purpose of absolving the guilt of outsiders who are sympathetic to the Palestinian cause but feel profound helplessness while watching the genocide take place. The people of Gaza have been annihilated by starvation, the risk of infectious diseases, the destruction of their built environment and the total destruction of their cultural and religious heritage, and yet no government or state has intervened. Referring to the sumud of the people of Gaza can be a way of reducing the emotional burden of seeing people suffer while at the same time acknowledging this suffering at a cognitive level (Giacaman, 2020).
It may be argued that under the conditions of the 2023–2024 crisis, psychology and mental health services have little relevance. At the time of this writing, it has been estimated that up to 186,000 have been killed or have died due to disease and starvation (Khatib et al., 2024). People currently live in tents and are forced to flee when an attack is forthcoming. Under these circumstances it is understandable for social and psychological services to be eclipsed by other existential needs such as physical safety, medical services, food and sanitation. Yet, the consequences – physical, existential and psychological – of the current onslaught on Gaza will be experienced long into the future. To this extent mental health professionals have a significant role to play in helping the population process their grief, trauma, anxiety, depression and anger. From conversations with colleagues who are still in Gaza at the time of this writing, it is apparent that the clinicians themselves – counsellors, psychologists and psychiatrists – require support. Several have lost family members, colleagues and friends and have themselves experienced loss, trauma and grief. The process of rebuilding Gaza after the current onslaught will have several dimensions, one of which is attending to the psychological needs of the population.
In addition to the loss of human life and the destruction of infrastructure, it is apparent that scholasticide, educide and epistemicide are also being perpetrated by the Israeli forces (UN OCHA, 2024). Part of our responsibility is to fashion a role for scientists and scholars in the rebuilding process, including rebuilding the intellectual life, the culture of research and scholarship and the epistemic power of institutions of learning.
From a personal point of view, the genocide in Gaza has been front and center in terms of our attention. While the siege was in place before October 7, the level of destruction since that date has been unprecedented. Inasmuch as the Hamas attack was unpredictable, it stands to reason that if 2.3 million are imprisoned for an indefinite period, with no resolution in sight and no political will to find a resolution, a prison revolt should not be surprising (Lustick, 2023). The Israeli body politic also assumed that the Palestinian question had been solved. Popular protests in Israel before October 7 were in response to the government’s push for a wide-ranging judicial reform aimed at assuming control of the Supreme Court and court decisions which became a central issue in 2023 (Gidron, 2023), not for Palestinian rights. At the same time relations between Israel and various Arab states were on track to being normalized. At risk of the Palestinian question being forgotten by history, Hamas launched its attack.
The destruction of the built environment is also of considerable relevance to psychology. Much of how humans make sense of themselves and the way in which relationships between people develop occurs in the context of the built environment (Mahmoud, 2018). With the destruction of homes, schools, universities, government buildings and cultural centers, the built environment takes on a new meaning. Basic functions such as going to the bathroom, intimacy or being examined by a doctor can no longer be private. In the context of buildings reduced to rubble, the essence of what it means to be a human being, including the need for dignity, privacy and safety are at stake. In the forthcoming rebuilding project, physical construction will need to be accompanied by the building of psychological and emotional safe spaces.
Gaza’s stark reality forces us to question the immediate and long-term utility of our contributions. Are the tools and knowledge we provide still relevant and useful in such extreme circumstances? Can our previous work offer any solace or practical assistance during these horrific times? It is natural to have doubts about the usefulness of our interventions under the current conditions. However, it is also an opportunity to learn and adapt. We need to engage in open, honest dialogue with our colleagues and the community in Gaza to understand their needs and perspectives. This means being willing to listen, to admit our limitations and to reframe our approaches based on their feedback.
Concluding comments
Prior to October 7, our engagement in Gaza was already fraught with complexities, and the recent escalation of violence has only amplified these issues. We continually ask ourselves how our presence and actions have influenced the situation, and how they are perceived both by the local community and in the broader geopolitical context. Reflecting on our work before October 7 involves evaluating the impact and relevance of our research, supervision and training. Were our efforts truly beneficial and sustainable, or did they inadvertently reinforce existing power dynamics and dependencies? Did our interventions support genuine liberation, or were they seen as another form of external imposition?
Our future presence and work in Gaza must be reconsidered with these insights in mind. We should strive to be allies who support local initiatives and respect indigenous knowledge and practices. This involves not only providing resources but also standing in solidarity with their struggles, advocating for their rights and challenging the structures that perpetuate their suffering. Ultimately, our goal should be to contribute to a framework of mental health and well-being that is rooted in justice, equity and self-determination. This may mean stepping back and allowing local voices to lead while we offer support in ways that are requested and deemed appropriate by the community itself.
The current situation compels us to reflect on the limitations and potential of our disciplines. Science, particularly social and psychological science, often falls short in the face of political and humanitarian crises. This recognition might suggest that our efforts should not solely focus on traditional scientific interventions but also on advocating for systemic changes in international law and human rights enforcement. Our role, if any, may lie in bearing witness, documenting atrocities and amplifying the voices of those affected. It may involve challenging and deconstructing the imperialist and patriarchal frameworks of our disciplines. We must seek ways to contribute to the dismantling of oppressive systems and to support grassroots movements that aim for justice and liberation. In this light, our future role may be less about providing direct interventions and more about supporting the broader struggle for justice, advocating for international accountability and fundamentally rethinking how our sciences can contribute to genuine liberation and decolonization efforts.
Reflexivity, active self-awareness and dialogue form part of our own interpersonal processes to clarify our own perspectives, unspoken prejudices and alignments. As nondisabled, heterosexual, men who are empowered, educated and well-resourced, we operate from a privileged position in ways that local Palestinian people may not. Our role has been to listen, ask questions and constantly check out our understanding. By adopting such an approach, we seek to avoid a stereotyping gaze about Gaza society, including showcasing faults and flaws in the local indigenous population.
If conducted thoughtlessly, even the process of capacity building can potentially be read as being condescending and patronizing. Those in possession of skills and expertise have capacity while who do not have such skills and expertise do not. As Freireans, we are critical of framing capacity building as the transfer of information. Indeed, as facilitators in the process of knowledge, development is dynamic and mutual, seeking to create a synergy of understanding. Thus, for example, while we indeed bring skills, methodological skills and statistical knowledge, we have also learned about the limits of these in the local context and importance of local indigenous epistemological assumptions that inform the way in which people create knowledge and understanding.
We live in dangerous times, navigate troubled waters and are trapped by the fear of losing our privileges. This fear is masked by the guise of white fragility in the Global North and covered by the illusion – the white masks (Fanon, 1967) – that being co-opted into power and privilege will make oppressed black skins happy and self-actualized. Thus, exporting knowledge, technology, democracy, gender equality and mental health to Gaza risks perpetuating the master narrative of white masks on black skins, reproducing the so-called harmony of illusion, wherein those who created the problem claim to provide the most suitable solution. It is a dynamic about which we are constantly aware.
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Corresponding author
About the authors
Guido Veronese is based at the Department of Human Sciences, University of Milan–Bicocca, Milan, Italy and Department of Psychology, Stellenbosch University, Stellenbosch, South Africa. Guido Veronese is a psychologist and academic known for his work in the field of community psychology, particularly in conflict-affected regions. He is an Associate Professor in the Department of Human Sciences for Education at the University of Milano-Bicocca in Italy. His research focuses on the psychological impact of political violence, trauma and resilience, with a special emphasis on populations in the Middle East, including the Gaza Strip. Veronese's work often involves integrating liberatory and humanistic approaches to enhance well-being and agency in marginalized communities. He has published extensively on these topics in academic journals and books.
Ashraf Kagee is based at the Department of Psychology, Stellenbosch University, Stellenbosch, South Africa. Ashraf Kagee is a prominent psychologist and academic specializing in health psychology, trauma and mental health. He is a Professor of psychology at the Stellenbosch University in South Africa. Kagee's research focuses on the psychological and social aspects of health and illness, with particular attention to the effects of trauma, stress and adversity on mental health. He has been involved in research related to post-apartheid South Africa, examining issues such as the psychological impact of political violence and the mental health needs of marginalized communities. Kagee is also known for his work on improving mental health services and policy in low-resource settings.