Dr. Samah Jabr, Liberatory Psychiatrist
“I try to help them explore the battlefield that is their reality, before they make an informed choice within their own struggle to speak sense to power.” - Dr. Samah Jabr
Today, across Canada, people are talking (sometimes with a huge advertisement budget) about mental health. I thought it’d be the perfect time to talk about the mental health of our neighbours in Palestine, and for a while I’ve been looking forward to talking about this particular neighbour.
Today I’d like to introduce you to Dr. Samah Jabr! Dr. Samah is a consultant psychiatrist from Jerusalem who has decades of experience in psychiatry and mental health, including 9 years of service as the head of the Mental Health unit at the Palestinian Ministry of Health. In her time, she’s met with so many in her communities whose minds are scarred and in need of relief—patients who are suicidal, who live with profound and constant depression, who fear to even have their names written on her chart because something bad might happen to them. In other spaces, these symptoms might be treated as signs of PTSD, Major Depressive Disorder, or Paranoia, but Dr. Samah is quick to point out the nuance in the situation.
See, the thing is, a lot of modern psychiatry is based on treating disordered thinking and behaviour. Maybe you’re anxious even though there’s no real danger, or depressed even though you have lots of loving support. Whatever it is, the way you’re feeling and acting doesn’t match up with the stimulus around you, so you need a doctor to help figure out which wires are crossed. It’s about an incongruity—everything on the outside is normal, but you still feel bad, so there must be something going wrong on the inside. But for so many of our neighbours, that incongruity just isn’t the case.
In those brief examples of patients I gave earlier, we can see this clearly. Save the Children found, in 2022, that four out of five children in Gaza say they’re living with depression, grief, and fear (I can only wonder what that percentage is now) as a result of being blockaded and besieged. In an article for Middle East Eye, Dr. Samah shares the story of an elderly man who was suicidal due to the fact that the Israeli occupation had forced him “to demolish - with his own hands - the home he had built 20 years earlier.” In the same article, she tells of the patient who wouldn’t let her write their real name on their file, not from a paranoid delusion, but because occupation forces might reasonably be expected to spy on a famous doctor’s records.
Likewise, Dr. Samah spoke to the Guardian last year about PTSD (post-traumatic stress disorder) and how this medical model relates to the trauma experienced by our neighbours in Gaza—or rather, how it fails to account for how there’s really no “post” to their trauma:
“The clinical description of PTSD captures the experience of, for example, a soldier who goes back home…Trauma in Palestine is collective and continuous. PTSD is when your mind is stuck in a traumatic loop. In
Palestine, the loop is reality. The threat is still there. Hypervigilance, avoidance – these symptoms of PTSD are unhelpful to the soldier who went home, but for Palestinians, they can save your life. We see this more as ‘chronic’ traumatic stress disorder.”
As we enter into a period of ceasefire (in Gaza at least), we may imagine that the trauma is past. But for Palestinians who know that this semblance of calm depends on the whims of the powerful—for Palestinian children who can count their age by how many wars they’ve lived through—the threat is never really gone. What do we say for our neighbours who are suffering in mind and spirit, even if it’s not all creditable to an imbalance of serotonin? Don’t they deserve to be well, too?
While our neighbours in Palestine experience a particularly acute form of this phenomenon, the truth is, all of our mental health is wrapped up in systems of power. It’s not surprising when the person who experiences racism struggles with depression, or when someone in poverty has an addiction, or when a closeted trans child has suicidal ideations, and these aren’t things that you can so easily solve with Cipralex and CBT. In Canada in particular, our own colonial project gives us one particularly salient example: the reason there’s a mental health crisis among Indigenous youth in the North isn’t because it’s dark up there; it’s because of decades of chronic underfunding to (and resource extraction from) Indigenous communities, and the ongoing generational trauma of residential schools, the sixties scoop, and the millennium scoop, just to scratch the surface.
And of course, even those who don’t experience the most direct harms of these systems of oppression can find their mental health challenges rooted in the harm these systems do. Just look to the street outreach workers who have to watch their friends and neighbours die due to evil drug policies, or the nurse who’s burnt out from back-to-back shifts because her government chose to spend less on healthcare and more on campaign ads. Look to the Palestinians in the diaspora and their allies who’ve had to watch a genocide for the past 15 months…and then get asked “how’s it going?” If you don’t treat the root causes, there’s only so much ‘better’ one can get.
For Dr. Samah, operating humanely within this cruel framework requires acknowledging reality and rejecting dominant and dominating approaches to psychiatry and wellness:
“As a psychiatrist, I have the power to side with power, to give diagnoses, and to medicate. If necessary, I can write a report to hinder or exempt people from legal responsibility.
Many times, I must summarise a patient’s complex story into the simple code of the International Classification of Diseases, because the establishment understands only the code. But I take the risk to speak sense to power.” (Middle East Eye)
While she knows that she as a psychiatrist can’t overcome the root causes behind a patient’s suffering when they are found, as they so often are, in systems of oppression. But she also acknowledges that there is much value in truth telling and in strategizing. Her practice is one of helping “people make sense of their painful experiences by creating an explanatory, validating narrative that gathers the complexity of their situation and negotiates their conflict with oppressive powers, rather than labeling them with a diagnostic code.”
In a way, while it might not hew exactly with the Diagnostic and Statistical Manual, this too is a process of diagnosis. If we know the sickness, then maybe we can find a cure. For our neighbours in Palestine, this can help them resist the crushing weight of oppression—to help them survive the forces that seek to shrink, hide, remove, and kill them, and also to help develop creative ways of dismantling these forces.
For us on the outside, it’s a reminder that all our liberation is intertwined. If you’re broken down and miserable over the state of the world—well you’re absolutely right to be! The solution isn’t to warp yourself by apathy or individualist thinking into the small space you’ve been given. It might be easier, but it is not better. If we want to find real healing, in ourselves and our communities, we need to commit to the slow work of changing our world for the better, relying not on our own strength, but on each other.
“Giving people who lost their humanity, people were reduced to nothing, giving them their dignity back…Psychologists can’t do that alone. We need responses at state and international level. We need the rest of the world to stand with us.”
With your heart: Pray for Dr. Samah as she continues her work, helping our neighbours find sense, validation, and direction in the midst of unimaginable hardship. Pray for all those in Palestine for whom trauma is never too far; pray that they would be able to find comfort and strength in the short term and liberation soon after. Pray for courage, determination, and solidarity as we all seek to find collective healing by tearing down systems of oppression.
With your voice: #LetsTalk about how mental health is intrinsically connected to systems of power, and how we all have a role in building a healthier world through solidarity, not apathy.
With your hands: Join me at Trinity-St. Paul’s United Church at 10:30 am this coming Sunday (January 26) for “The Land Still Speaks: Reading, Seeing, and Living Scripture in a Time of Genocide” presented by Shadia Qubti (virtual option available also) — I’ll be there with some copies of the Imago Palestina magazine!
Sources in bold were quoted in the text.
Find more writing from Dr. Samah Jabr here. Some selected articles include:
“Israel launches major offensive in Jenin days after Gaza ceasefire” at Middle East Eye
“Four Wars Old: Fourteen Years of Childhood in Gaza” Infographic at Visualizing Palestine
Another good read!! Keep writing my friend.