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ОглавлениеCHAPTER 1
The Grammar of Suffering in Occupied Palestine
From the late autumn of 2007 through the end of winter the following year, five women married to long-term political detainees met every Wednesday at 11 A.M. in a chilly meeting room at the town hall in a sleepy West Bank village. The group was facilitated by a female therapist, Muna, and her assistant, both from the Prisoners’ Support Center.1 The five women participating in the two-hour sessions appear throughout this book, less however as therapeutic subjects than as wives, mothers, and daughters who are living through the absence of their husbands.
Even before they participated in the group therapy, the women knew each other. They all live in Dar Nūra, a village of around five thousand inhabitants, and are related to each other through either consanguine or affinal kinship, or, in most cases, both, as patrilateral parallel cousin marriage is the preferred form of marriage in the village.2 They are thus folded into each other’s lives, and know of each other either through firsthand accounts or, more often, rumors and reputation. The knowledge shared in the therapeutic group was therefore anything but confidential. None of the women ever risked her reputation as the proud, dutiful wife of a heroic detainee.
On the first two occasions, the group met downstairs in the library of the town hall. With children browsing through books and playing, and secretaries working with open doors, the library was not an appropriate therapeutic space, the therapists found. Since one of the participants, Aisha, enjoyed considerable social esteem in the village, the group was thereafter allowed to meet in a more private room. Moving two floors up and under the auspices of the town council, we were served tea and coffee by the council’s cook at every meeting. When the women who formed part of the group met and asked each other whether they would attend the next session, they would say “bt-rohiila al-baladiyyeh?” (Are you going to the town hall?), rather than referring to it as either a women’s or a therapeutic group.
In this way the women distanced themselves from the fact that they were involved in a process that problematized their relationship to the detainees. Local assumptions hold that being a relative of a detainee inspires a sense of honor and feelings of pride for those who are active against the Israeli occupation. Among Palestinians, being the wife of a detainee is therefore not considered a genuine reason for distress proper, save for the affliction that the wife may feel vicariously on behalf of her detained husband. That life as a detainee’s wife is not in fact lived exclusively in the glow of derivative honor is no surprise to fellow Palestinians or international observers of Palestine. Nonetheless, there are difficulties in acknowledging that “form of life” for the very same Palestinians and foreigners alike, difficulties that are the theme of this chapter.
Muna, who was facilitating the Dar Nūra town hall group, hoped to create a social space in which these women’s lives and suffering were recognized. During the span of the therapeutic group project, the Prisoners’ Support Center hosted a training course in group therapy on its Ramallah premises for twenty Palestinian counselors. Two Spanish psychotherapists led the course. A vital element of the course concerned how to enable clients to establish what is termed “a safe place,” in therapeutic vernacular. A safe place refers to both a state of mind and a physical space or a material object that evokes a feeling of comfort and safety in the client. Ideally this personal space is established for the group members before they express their traumatic experiences. During the training course, Muna raised her hand to voice a concern. She was already halfway through the group therapeutic process for the detainees’ wives. Muna asked, “What if the clients do not have and cannot create a safe place?” The teacher replied, “We have to help them establish a safe place.” Muna continued, “I have a problem with a member of this group, Amina. She feels more victimized than all the others. How can I deal with that?” The teacher answered, “The feeling of victimhood is a feeling that ‘no one can understand me.’ You could try asking her how she would feel if someone actually understood her. Because she thinks that she is not allowed to be okay. She reacts like she expects her husband to prefer that she is not okay. Ask her to look toward the future. Because she’s not staying the same: life changes.”
Later in the day’s packed training schedule, the participating therapists were asked to enact a situation from their therapy using the therapeutic intervention of psychodrama. This form of therapy is based on the work of the Brazilian psychotherapist Jacob Moreno (1946). His central idea is the powerful potential of reenacting a psychic conflict in front of an audience. Ideally, this performance will transform a traumatic experience into something that can be shared and thereby externalized from the inner, allegedly ineffable register of the traumatized person.
As a therapeutic method, psychodrama enjoys widespread popularity across Gaza and the West Bank. It is an intervention believed to be well suited to clients, such as women and children, who are not quite comfortable in providing coherent narratives of past and difficult experiences (Burmeister and Maciel 2007; Moreno 1946). That psychodrama also figured in the training program for group therapy is no surprise, since psychodrama and group therapy both emphasize collective sharing as a way to heal painful experience.
During such an exercise in psychodrama, Muna enacted the role of Amina, whom she represented as feeling too much like a victim. Still shaken, Muna told me afterward, “When I played the role of Amina and told the audience why I felt like a victim, I started crying and I could not stop; I just cried and cried. I felt for that moment that I was Amina. Esmail [Muna’s husband] is also political, he could just as well be in prison.”
Why did the enactment of Amina cause Muna to cry? The training session for the Palestinian therapists appears to convey at least two modes of understanding distress. One is a Palestinian moral discourse on suffering captured by Muna as the concerned wife of a politically active and potentially heroic husband at risk of both violent death and detention in Israel. The local idiom of perseverance, sumūd, summarizes this discourse. By this understanding, women like Amina are praised as the patient, supportive, and proud wives of heroic husbands, suffering as spouses, albeit differently according to the gendered division of labor in the Palestinian project (see Peteet 2005; Jean-Klein 2003). The second, underlying concept of suffering is the one offered by the Spanish trainers, an idea of victimhood as an emotional experience that one can recover from with time. This framework grounds affliction on the psychological terrain of trauma (Fassin and Rechtman 2009; Argenti-Pillen 2000; Leys 2000). The two modes of understanding anguish, both demonstrated in the vignette, together constitute how suffering is addressed and understood in the occupied territory.
This compound framing of affliction resembles what Didier Fassin has termed the hero-victim subjectivity, but there are important differences between his and my engagement with trauma among Palestinians. Fassin’s work (2008) is primarily based on professional immersion as well as fieldwork among medical and management staff in the organization Medecins sans Frontiers in Paris and its programs for Palestinians. In contrast my analysis privileges the view from rather than on subjectivities, in the sense that the bulk of empirical data is based on fieldwork in occupied Palestine among people who are labeled as traumatized and their therapists. This ethnographic premise allows me to ponder how the experiences of wives of Palestinian detainees are not adequately contained in the framing of their suffering as either trauma or heroic sacrifice.
By asking why Muna was crying as an initial question, this chapter offers both an ethnographic analysis and a conceptualization of the problem of experiences that evade what Sally Engle Merry and Susan Bibler Coutin (2014) term “commensurability.” This term refers to the globally circulating indicators used to register, for instance, suffering in the shape of violence, sexual assault, or poverty and the lives that can get lost in this registration. This chapter brings to light how the forms of affliction for detainees’ wives are incommensurate with, and elude, the languages of these indicators.
What Counts as Suffering in Palestine
Muna’s difficulty with Amina’s case suggests precisely the degree of incommensurability between the therapeutic premise of change and the uneventful life it is supposed to heal. This premise emerges in the Spanish teacher’s presentation of Amina’s inability to engage in life as related to the onset of an event—her husband’s imprisonment—to which Amina responded with an immediate show of overwhelming emotion. Following an emotional response, Amina was supposed to recover. By this understanding, suffering is caused, and defined, by an extraordinary human experience that befalls an individual. The problem with women like Amina, however, is that while they are included in therapy because they are wives of potentially traumatized men, and witnesses of potentially disturbing events of detention, these women’s experiences are arguably not “events” set apart from the ordinary, nor do they unfold in a temporally linear fashion with an onset, an emotional response, and an aftermath in which recovery can occur. Muna speaks about her client Amina by using the vocabulary of therapeutic progress, while identifying with Amina’s situation of being the wife of a man who is politically active. Muna thereby employs a language of affect that merges psychological jargon with Palestinian modes of knowing affliction. The complex resonances3 between these two modes of knowing suffering together form what I think of as a “grammar of suffering.” This grammar merges a global psychological understanding of suffering as trauma and a Palestinian moral discourse on suffering expressed in terms of events, heroism, and endurance in the face of hardship.
The Palestinian moral discourse of suffering is polyvocal. Khalili’s triad of heroic, tragic, and sumūd narratives captures the three main genres in which Palestinians tend to recount their experiences, depending on whether they are recounting a heroic past or current stories of tragedy and suffering (2007: 224). Heroic narratives, Khalili argues, are those that privilege the courageous aspects of a person or an experience, leaving, for instance, the cost of such courage unspoken. More often than not, heroic narratives are set in the past tense. Tragic narratives on the other hand increasingly have become part of the Palestinian narrative repertoire, as instances of loss and consistent discrimination against Palestinians in Lebanon, Palestine, and Israel are extremely common. Lastly, what Khalili calls sumūd narratives tend to describe a range of experiences not easily accounted for. At first glance, sumūd narratives would seem to sum up and include the experiences of, say, detainees’ wives. As this chapter proceeds, however, it will become clear that I am hesitant to agree with Khalili’s point that the value and efficacy of the sumūd narratives is that they allow their narrators a breathing space. Drawing my inspiration from Deleuze’s thoughts on convergence,4 I suggest instead that breathing space is precisely what is missing for detainees’ wives due to a convergence between knowing the Palestinian predicament as trauma, on the one hand, and local ways of acknowledging suffering by the criteria of event and relation, on the other.
As we shall see, however, these criteria are not equal. Event is given emphasis in the convergence of Palestinian and psychological ways of understanding suffering, while relation is considered secondary, or at least derivative. In the second half of the chapter, I analyze how these criteria and their internal hierarchies fail to recognize the less clear-cut aspects of Palestinian affliction.
The Criteria of Event
In their book The Empire of Trauma (2009), Fassin and Rechtman map out how knowledge production about suffering and interventions in the occupied territory have altered in scope and focus since the second Intifada in 2000–2003. The orientation of international donations has shifted from providing medical assistance to people who were wounded in direct violent clashes, during the first Intifada from 1987 to 1993, to the broader, allinclusive category of conducting psychosocial interventions with the people affected by, for instance, house demolitions, violent clashes, home invasions, and the loss, wounding, or death of family members. Rather than following the precise diagnostic criteria for evaluating a client’s mental state, interventions and representations of suffering slide into a witnessing of the general situation of the Palestinians. Fassin and Rechtman term this phenomenon “humanitarian psychiatry” (209).
Against this backdrop, Fassin and Rechtman suggest that a focus on direct violence and the events that cause traumatization have been replaced by an emphasis on the clinical narratives of clients, their general life circumstances, and mundane suffering (2009: 201). While their analysis brings to the fore central tendencies in how adversity is understood in the occupied territories, I would argue that the notion of “event” has in fact retained its centrality. As will become clear in the ethnography that follows, “event” serves as a marker for suffering across diagnoses, narratives, and representations, even when the suffering is not related to an actual event. This was brought to light early in my fieldwork: When I asked the staff in the Prisoners’ Support Center to meet those among their clients who were wives of prisoners, the therapists instead urged me to meet with widows and mothers whose relatives had been martyred and who were therefore able to express their experiences in terms of “events.”
The lure of violent events as markers for suffering emerges clearly in the Prisoners’ Support Center, where documentation of the physical consequences of torture and detention occurs in tandem with the psychological diagnosis and treatment of ailments. Since the early 1990s, in similar zones of protracted conflict across the world, emphasis on the psychological effects of violence has perpetuated psychosocial theories and practices of alleviating the effects of violence (Fassin 2008; Pupavac 2001; Summerfield 1999). As an employee of a Swiss development organization said about the omnipresence of psychosocial intervention; “Is it not what we all do these days?”
One expression of this “empire of trauma” is the sheer number of scientific articles, studies, and statistics, written and collected by both Palestinian and international scientists, about the prevalence of traumatic events and posttraumatic stress disorder (PTSD) among Palestinians (Peltonen et al. 2010; Abu Hein et al. 1993; Salo et al. 2005). In the main office of the therapists at the Prisoners’ Support Center, a faded photocopy on the wall displayed the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) checklists for PTSD, anxiety, obsessive compulsive disorder, and depression—which is remarkable, given that none among the staff were clinical psychologists or psychiatrists. The presence of the DSM-IV photocopy next to ads for favorite takeout restaurants and Naje al Ali’s iconic drawing of Handala encapsulates how therapists imagine their clients’ suffering: it is about a violent event that is direct and detectable through psychiatric diagnosis, despite the fact that the aim of the interventions and the mandate of the organization were more along the lines of local support to prisoners and their families. In a similar vein, the former director of a major health NGO, Dr. Issa Nejmeh, told me how the trope of traumatization was a mode of imagining the plight of the Palestinians and the mental effects on the wounded victims of the first Intifada from 1987 to 1993: “The notion of trauma was related to the people injured in the Intifada, and is completely different from what was later called PTSD. It was a direct physical pressure or manifestation, say, if a resistant lost an eye or ended up in a wheelchair. It was a psychological phenomenon related to a physical happening. Secondly, people became aware of physical problems that were a result of psychological problems.”Nejmeh’s drawing attention to how PTSD in Palestine was related at its inception to a physical phenomenon indicates that the move from physical injuries to psychological distress was circular rather than linear. PTSD was crystallized as a mode of presenting the suffering of the Palestinians (and those in other conflict zones around the world) as on par with human rights violations (see Young 1995; Fassin 2008; Allen 2012), to both the political world and to “eager, but uncaring donors,” as Nejmeh said dryly. Elaborating on the counterintuitive lack of care among international institutions and organizations that channeled large amounts of funding to the Palestinians, Nejmeh offered the well-known fact that, whereas projects concerned with the effect of the conflict are sure to attract generous funds, the political will to change “the situation” have evaporated with what he saw as the post-Oslo depoliticized relationship between Palestinians and their donors.
During our conversation, which started in his clinic in 2007, continued in his living room, and was taken up again in a Bethlehem café in 2011, he elaborated his point by analyzing the main Palestinian actors who work under the umbrella of trauma and psychosocial interventions as a response to violence. These were centers established to help those perceived to have been most severely afflicted by the occupation, namely, the detainees, the torture survivors, or those suffering from physical disability caused by what are considered heroic acts of resistance. It is violence, and thus events of radical negative change, rather than general health, that preoccupies all these local institutions.
Western donors and experts, and their financial aid and knowledge, have been instrumental, though not exclusively so, in shaping how the Palestinian psychosocial organizations have grown, and have set the benchmarks in the Middle East and internationally (Hanafi and Tabar 2005). Though the Psychosocial Bill was pushed by the Ministry of Health in 2009, there is little doubt as to where the best counselors go: to the generously funded NGOs. Therefore the Ministry of Health looks to them, as well as the World Health Organization in Palestine, when it wants to establish so-called best practices.
The infrastructure of psychological care in Palestine is thus remarkably different than elsewhere in the Levant or the Middle East in general. There is most certainly a space for the local sheikhs in offering assistance to the distressed, at least in the countryside and in the more conservative parts of the West Bank and Gaza. But such traditional healers arguably play a less significant role than, for example, in the contemporary Egypt that Amira Mittermaier and Paola Abenante describe in their powerful work (Mittermaier 2011, 2014; Abenante 2012). In Palestine, there is a general familiarity with Western psychology due to Palestine’s colonial past and the ways that European and American concern about the Palestinian plight has been expressed in psychosocial interventions for a traumatized population. Consequently, there is a receptivity, however minimal, to understanding the effects on the psyche that the military occupation may have had. One might go so far as to say that psychology, counseling, and psychiatry have become close to household terms due to the massive effort to raise awareness about the psychological consequences of violence. The largest effort was spearheaded by the late Palestinian psychiatrist Eyad al-Sarraj, whose Gaza Community Mental Health Program has educated and provided services to many a Gazan since the 1990s (Fischer 2007; Perdigon 2011). More than any other, Sarraj’s approach embodies Fassin’s notion of a humanitarian psychiatry, and his approach to the effects of the occupation on Palestinians has been tremendously significant in terms of how the language of trauma, like that of human rights, has become the language of Palestinian victimhood (Allen 2012).
Organizations with a psychosocial mandate thus employ an ever-growing number of the educated Palestinian middle class of health professionals. Nejmeh nonetheless pointed out that indicative of these professionals is “a lack of human resources: we don’t have psychiatrists. Instead we have people who study psychology and then they act as psychological consultants. And we have social workers who have had some training in psychology and sociological behavior.” Whereas therapists have earned BAs in psychology and education, generally from Birzeit University, specialized training is given within the NGOs. These courses are funded and negotiated by the centers’ donors. As the research coordinator of the Prisoners’ Support Center told me, “We follow the fashion. We might want a course in family therapy, but in Europe or the US, EMDR or CBT is on everybody’s lips and thus on the list of training courses that, for example, the EU want[s] to fund because it is evidence based.” The bulk of Palestinian therapists I spoke to described their therapeutic approaches as eclectic, comprehensive psychosocial programs that take into consideration the entire human being and his or her lifeworld. However, access to the treatment and services offered by the centers mentioned above are allocated according to clients’ scores on the Harvard Trauma Questionnaire and other mental-health-ranking instruments. These scores determine whether the client shows symptoms of anxiety disorder, depression, or PTSD. Hence, what seemed initially to be peripheral to the psychosocial services available to prisoners and their families—namely, trauma—proved in fact to be at the very center of such services.
The complexity of diagnostic practices dawned on me when I joined the newly educated therapist Ahmad at a school in Salfit, where he was to undertake psychosocial interventions. The visit to the school is part of the so-called outreach work, which recognizes that many clients are not able to come to the center’s offices for treatment due to financial constraints or fear of stigma. Outreach work is popul ar among psychosocial organizations, among the target group of clients, and not least among the donors. It is taken as a sign that the organizations, far from being elitist, are committed to helping beneficiaries who are most in need. At the Prisoners’ Support Center, well over half of the consultations took place through outreach work. The work is often done by the newest employees in the organization and thus often by those who have the least clinical experience. In the morning, the therapists travel to the village targeted for that day’s outreach work. Either they are driven by the center’s driver in its car or they take as-servīs (a minibus). Upon arrival at the villages or refugee camps, the therapists are dropped off at their clients’ houses. The driver then waits for two or three hours while the therapists finish their work.
Therapists often dread outreach work. It involves the hassle of a long journey, few or no breaks, and the frustration of not being able to do proper therapy. When the therapeutic space is the home, the client’s family, children, and guests frequently walk in and out of the sessions. At the end of the day, the weariness of the car full of therapists is palpable, and the ensuing hours of recovery long. Many of the therapists I spoke with doubted the efficiency of the outreach work, but donors like it. Given the pressure of being able to prove that services are effective and reach as many people as possible, the outreach teams I met were often under pressure to see as many clients as possible during their trips. Thus after a long car journey on the Palestinian by-roads, Ahmad, the driver, and I reached the school, where we went straight to the director’s office, outside of which three children were waiting. Ahmad asked one of the children to join him, and the other two had to wait. The case concerned a young boy who had witnessed his father being injured by Israeli soldiers in the street. The father had survived, but apparently the child suffered from concentration problems. Closing the door behind us, Ahmad took out his papers and went through the checklist for symptoms for around twenty minutes, during which time curious children constantly banged on the door and pushed it open with roars of laughter. The boy then left the room and Ahmad told me that he had PTSD and listed the symptoms from the DSM-IV. The examination of the two other children followed the same procedure. After the three consultations, we left the school and got into the car to go back to Ramallah.
The point here is not to expose Ahmad as a therapist who is not quite at home with the difficult work of diagnosis, but, rather, to reveal how the notion of trauma is, in practice, employed under the umbrella of psychosocial interventions. Psychosocial intervention is common, and would not raise eyebrows in the West Bank and Gaza, but it is worth underscoring that in its combination of an individual and social approach to the suffering person, it is based on a conceptualization of suffering as an individualized and biomedical trauma. Ahmad’s translation of the boy’s concentration problems into the language of trauma was a way for the therapist to know the boy’s affliction and therefore help ameliorate his distress. Trauma here serves as a useful proxy of suffering, and one that is a result of the many factors that influenced the therapists: donor pressure, the lack of clinical training, burnout, and the fact that the therapists often share the experiences of their clients.
With an eye to current and potential donors, the diagnosis of posttraumatic stress disorder is therefore important to Palestinian organizations because it allows them to document their activities with so-called evidence-based therapy, among them cognitive behavioral therapy (CBT). The effectiveness of CBT and narrative exposure therapy have been tested through randomized control trials of victims of rape, American Vietnam War veterans, victims of terror attacks, and British victims of traffic accidents (Bisson and Andrew 2009; Bisson 2008; van der Kolk and Blaustein 2005; Gersons and Olff 2005; Basoglu 2003). Hence, donors assume these methods will be effective among traumatized Palestinians, too.
The fact that Palestinians have to have experienced a traumatic event in order for their distress to be acknowledged goes beyond the issue of therapy. Consider Maryam, whose life figures in more detail in Chapters 4 and 5. She is the mother of three children, and her youngest son was only three when we first met. Maryam recounted how he caused her endless distress, to the point where she actually had to have him on a leash in his room in order to take care of her other children and household chores. Her mother-in-law scolded her, saying that his behavior showed she had failed to discipline her child appropriately. Two years later, she told me with relief that her son had been diagnosed with autism and that he had made fantastic progress with a new program for autistic children that Maryam herself had helped establish. With the diagnosis of her son, everyday life for her and her children had become much easier. Socially, the countless visits to her son’s doctor were no longer cause for gossip about the whereabouts of a woman with an absent husband, but rather the actions of a concerned mother caring for her child. Nonetheless, autism and other forms of congenital illness, in pariticular mental disorders, fail to attract anywhere near the same attention or funding as do disorders and traumas that are results of the occupation. And despite the historical presence of a language of psychology to acknowledge mental distress, congenital mental disorders are considered a stigma in Palestine. This uneven recognition is evident in the difference between the glitzy premises of the Prisoners’ Support Center and the “clinic” to which Maryam took her autistic son for day care, and where she volunteered three times a week: a small, shabby room adjacent to the nursery for the other children. The contrast reveals how event-based trauma is acknowledged and addressed, as opposed to the lack of recognition afforded what is described by Povinelli as the painstaking uneventfulness of chronic suffering, such as that caused by stigmatizing mental disorders (2011: 146).
Importantly, the contrast between the two is specifically owing to the presence of a violent event that enables the recognition of suffering (for an elaboration, see Mittermaier 2014). This brings to mind Das’s identification of a critical event after which “new modes of action came into being which redefined traditional categories such as codes of purity and honor, the meaning of martyrdom, and the construction of a heroic life” (1997 6). Violent events in occupied Palestine offer precisely that nexus of new modes of action and the acknowledgment that comes with being either a hero of political resistance, a martyr’s widow, or a traumatized victim.
The Force of Eventful Suffering–Immediacy and Immediation
Priority in allocating grants is given to projects providing direct medical, psychological, social, economic, legal, humanitarian, educational or other forms of assistance, to torture victims and members of their family who, due to their close relationship with the victim, were directly affected at the time of the event.
— United Nations Voluntary Fund
for Victims of Torture (2007)
Alongside the European Union, the United Nations Voluntary Fund for Victims of Torture (UNVFVT) is a major global funder for centers that offer assistance to torture victims and their families. In its 2007 round of funding, the UNVFVT had a total budget of USD 9 million. The above excerpt about the criteria for receiving funds forms the basis for the evaluation of applications and, as two members of the UNVFVT staff said during a meeting in Palais Wilson in Geneva, they continuously stressed these criteria when they had meetings or missions to visit or evaluate projects. The UNVFVT workers repeatedly emphasize to beneficiaries that the assistance must be directly allocated to the actual, immediate victims of torture.
During fieldwork in the West Bank, I joined a meeting between the Prisoners’ Support Center and a representative from the UNVFVT. The communications manager of the center initiated the meeting with a PowerPoint presentation that displayed numbers of violations and of people treated at the center during recent years. According to the tables and graphs, a growing number of clients were the relatives of detainees and martyrs. The presentation ended with pictures of the physical wounds on the bodies of torture victims, dead children, and lamenting women. After the presentation, there was a discussion about uncertainties concerning the identity of the organization’s clients. The representative from the UNVFVT said, “I need numbers of how many of your beneficiaries … are actually torture survivors or direct family,” to which the director firmly replied, “All of them are survivors of torture—they are captives in Israel!” This point was ignored for the remainder of the meeting. However, the representative of the fund said again in front of the employees of the organization, “It is important that when you make projects for the families, it has to be families who were directly affected. For example, ordinary domestic violence is not torture or to be directly related to it. It does not count.”
During the meeting with UNVFVT in its European headquarters, I asked the representatives how they identify direct victims affected at the time of the event. One answered, “No one can distinguish between someone who is tortured and the one who witnesses torture.” Both the fund and its beneficiary projects are thus intimately aware of the pitfalls and permeable boundaries of the definitions they constantly draw and redraw. It is interesting here to think in terms of Deleuze’s idea of convergence, described earlier. Within this line of reasoning, there are at least two points of convergence between the language of the European donor and the Palestinian center’s mode of expressing the suffering of its clients, the detainees, and their families within a framework of the Palestinian plight: immediacy and relation.
Immediacy is the first and primary point of convergence. Immediacy saturates the language of the representatives of the fund in their invocation of the terms “direct” and “directness” in the UNVFVT guidelines. “Direct” refers both to those who have undergone an event of torture, limited in time and space, and also to the insistence that the relation to that event must be “direct.” Immediacy was further expressed by the Prisoners’ Support Center through the director’s outburst that imprisonment equals torture, and the graphic portrayal of physical wounds and lost limbs in the PowerPoint presentation. As Allen asserts, a “politics of immediation” currently permeates Palestinian political discourse and social relations as well (2009: 163). The “politics of immediation” is an affect-driven discourse that is embedded in the Palestinians’ call to the world to pay attention to the immediacy of suffering—to the visceral aspects of the conflict—by insisting that images of fragmented bodies be displayed in the Western media, in addition to the Palestinian Maan News, al-Aqsa channel, or pan-Arab channels like al-Jazeera. Allen (2009) underscores that visualization plays a crucial role in the representation of the Palestinians as deserving victims who are worthy of recognition. In late summer 2014, for example, international news and social media were dominated by images of corpses, wounded children, and weeping mothers from Gaza during Israel’s Operation Protective Edge. Displaying the human body, Allen (2009) argues, is a way of sidestepping the mediating elements that are thought to obscure the message of the humanness of the Palestinians. Of particular significance here is that such visual displays are imbued with invocations of violent events as a cause for suffering, and in this way can be seen as an imperative call to action on the part of witnesses.
A focus on immediate suffering also figured at a women’s mosque meeting initiated by the Prisoners’ Support Center. The counselor opened the meeting by introducing the center and its services, after which she said, “I want to start with a new subject today: ’Azme [crisis]. I want to know what sadme [shock] means to you.” Various women quickly responded, “a disaster,” “problems and worries,” and “mašākil fi d-dār” (problems in the home). To these responses the counselor said, “Let me tell you what ’azme or ṣaḍme mean: if I knock on your door, how will you respond to that? You will open the door, right? It’s a reaction to a particular event. When I knock on the door, you will respond to this action by reacting to this event…. Who else has something to say? Imm Amjad, tell us what happened when you got the news that your son had been killed?”
Addressed so directly, Imm Amjad replied, “Oh, you want me to cry now?” The counselor replied that she would feel better if she cried. Imm Amjad began to describe the death of her son:
It was the twentieth day of Ramadan, so I was fasting and praying all the time. So on that day when they killed him, my brother came to tell me about it, he was telling gradually. He told me that my son was in the hospital, so I asked him why, and he told me that the Israelis had shot him. I told him, “Please ask them again, maybe you are not sure, or someone told you that he died, but we are not sure. Let’s wait to be sure,” but he told me, to be sure, and that he saw him. Then I felt like I was unable to stand up, I couldn’t even cry. But at the same time, I was saying that everyone wishes to die as a martyr, so my son got it and I shouldn’t feel bad. Thank God anyway.”
The counselor approached the sorrow of the bereaved woman as well as the other women’s experiences of affliction through a language of acute crisis. Moreover, she tied their experiences to the onset of an event to which the women respond with immediate affect. The therapist’s decision to focus on a woman who lost her son to martyrdom illustrates how the emphasis on immediacy permeates psychosocial intervention, as it does the manner in which this woman shares her grief with the other participants. During the session in the mosque, a focus on experiential wounds that are discrete, visceral, and delineated in time and space eclipsed long-term suffering. The converging point of immediacy is an expression of the assumption that an event occurs in a moment. It is directly experienced by a victim or a witness, and it can only be ameliorated by the presence of an other, in this case the specific other of direct psychological, medical, psychosocial, or legal assistance.
There is a similarity here to the ethics of immediacy that, according to Mittermaier, suffuses the “Tahrir Square state of mind,” the hopeful intentionality of the demonstrators in the square in Cairo during the Arab Spring as well as the khidma, a Sufi place in which a meal is offered free of charge to those in need in downtown Cairo (2014: 55). Based on fieldwork at the height of the Arab Spring, Mittermaier says that an ethics of immediacy revolves around a set of embodied practices that call for tending to those in front of us and around us (55). The politics of immediation in occupied Palestine are not the same as an ethics of immediacy in contemporary Egypt, but it seems that they share the appeal of that which is right before us—for example, a tortured person or a human being in need of a meal—and how that person calls forth action on the part of an other. Immediacy has an inherent urgency and as such immediacy surfaces as a crystallization of the forceful lure of life marked by events, albeit tragic. In contrast, the lives that lack this eventful, immediate criterion are easily missed.
The Criteria of Relation
The second point of convergence in the grammar of suffering is “relation.” This point is reflected in how the fund representative emphasized that a relation to the event of torture, either through witnessing it or by “being directly connected” to the torture victim, is the most significant criterion when choosing projects to fund. For the Prisoners’ Support Center, the importance of relation is premised on the fact that the relatives of torture survivors form a major client population. Emphasizing a relationship to the torture victim or the detainee includes this client population among the deserving victims through a language of secondary victimhood or secondary traumatization.
The DSM-IV diagnosis of PTSD emphasizes both the occurrence of a traumatic event and the ensuing emotional response of traumatization (APA 2000). It is considered a fact, and a source of puzzlement, among researchers and mental health professionals that women universally and in the occupied territory display higher PTSD scores than men, despite the fact that women rarely experience so-called traumatic events of torture, detention, direct violence, or the like (Helweg-Larsen and Kastrup 2007; Giacaman et al. 2009). Women are admitted to rehabilitation programs due to their classification as secondary victims because of their relationships to the primary victims (Solomon et al. 2004). An Israeli study of wives of prisoners of war by the well-known psychologist Zahava Solomon (2007) and her team showed that compared with women who had lost their husbands, the wives of prisoners of war showed higher degrees of traumatization.
The challenges of working with secondary victims were the topic of a conversation with the Palestinian therapist Muna, introduced earlier. I asked her why she employed cognitive behavioral therapy in her group intervention to the detainees’ wives. She replied, “They need CBT, they need many things during the day, they are under the pressure of society, or they suffer from traumatic events and maybe there are irrational thoughts in their minds like, ‘I’m a wife of a detainee, I can’t go out, I can’t do anything.’ This is irrational beliefs. With CBT we can work with these beliefs through working with relaxation techniques.” Noting Muna’s description of the wives’ afflictions as traumatic events, I asked her which precise events she was talking about. She replied, “I want to remove the traumatic events from their lives. During the session, the women said, ‘Oh, I am not alone, there’s another woman like me.’ When some of them said, ‘I feel like this and like this, another one said I feel the same, I suffer like you, I am not the only one who feels that.’ They learn from each other, how to deal with problems like the children and the family-in-law.”
How Muna frames the distress of her female clients as the result of traumatic events that have befallen them illuminates how a relation to a direct victim—political hero is a criterion for having one’s suffering acknowledged, in addition to the occurrence of a traumatic event. That these criteria are at times indistinguishable was revealed when Muna explained to me what she meant by “traumatic event”: she recounted intricate, ongoing situations of relational injury from the women’s social relations, rather than singular happenings. Significantly, these at times implicitly wounding relations do not include the secondary victim’s relationship to the primary victim. This confounds the criteria for the recognition of suffering, as well as the fit between therapeutic measures and the kinds of suffering these measures attempt to describe and ameliorate. The discrepancy between the language available for knowing suffering and the experiences the therapist tries to heal is evident with individual therapists. It is also evident in the institutionalization of a psychosocial approach to suffering in Palestine. Muna’s comments point to two parallel concepts of suffering: one in which the immediacy of the traumatic event and a relation to a primary victim are the criteria of knowing suffering, and a second that is an acknowledgment that the object of amelioration is actually not the reliving of a traumatic memory of a violent event at all. Rather, it is the uneventful everyday life as a detainee’s wife, folded into potentially harmful or challenging social relations.
How to think about the apparent incomprehension of what it means to be in the shoes of a detainee’s wife can be aided by paying further attention to the notions of knowing and acknowledgment respectively. To know, argues Cavell, means to read others and to allow oneself to be read by others. It is “a process of being read, as finding your fate in your capacity for interpretation for yourself ” (1988: 16). Being known as a human being thus allows for a language for speaking and thinking about oneself and one’s experience. Cavell, however, underscores the discrepancy between knowing (reading) and experiencing. Following Cavell this leads us to Martin Heidegger, who in Being and Time argued that, although language straightens out experience, experience can never be straightened out “except through existing itself” (1962: 33). This process of straightening out experience unfolds, in this example, with reference both to the global psychological discourse and a Palestinian moral discourse on suffering. Through resonance between the two, the criteria of violent events and relations are concretized and become the criteria, per se, on which knowledge about bereaved women rests. Importantly, “knowledge” here is not the same as “acknowledgment.” Cavell argues that acknowledgment goes beyond knowledge. It includes a moral dimension formulated as “recognising what I know” and acting upon it (Cavell 1979: 428). This distinction figures in Kelly’s recent work (2011) on torture. He concludes that our failure to acknowledge the event of torture and the marks it leaves on its victim is not a result of the inexpressibility of pain. Rather, lack of acknowledgment comes from our failure to see and listen to the pain right in front of us (4).
The distinction between knowledge and acknowledgment helps us get closer to what is in fact lost in the “straightening out” of the experiences of prisoners’ wives. Relation as the second criterion of suffering, to be sure, includes and acknowledges detainees’ wives. Yet this is a frayed, partial inclusion. In the straightening out of experience, not all relations are valued: the grief of mothers who have lost someone through a violent event is recognized, whereas that of wives who experience only absence is eclipsed. Desolation is recognized only through relations to the figure of the hero and primary victim. In fact, however, the relations that seem to distress the wives of the detainees most are those with the people who help make do during their spouse’s confinement: the family and the husband’s family. This gestures toward a hierarchy of the two criteria, in which event is privileged, and relation downplayed.
Revisiting Muna’s Tears
Let us return here to Amina, for whom Muna shed her tears. Amina was included in the category of the secondary victim, and on this premise was admitted to the therapeutic group for detainees’ wives described earlier. Amina was present when the Israeli Army detained her husband fifteen years ago in their home. Her family home was destroyed due to her husband’s violent acts of resistance against Israel. She raises their four girls and lived with her mother and sister for ten years until she moved to a single-unit family home. Amina is under close surveillance by the village community because she is married, yet living as a single woman. Amina embodies the idea of a secondary victim because her husband is in prison. The question worth posing, however, is the extent to which her actual experience is knowable through the criteria of “event” and “relation.” At first glance, Amina’s life is translated by counselors so that it overlays the criteria by which suffering in Palestine is known through relation to a violent event or as a direct victim of a violent event. Amina’s experience, in other words, is “straightened out” so that it matches the criteria necessary to know and acknowledge it for fellow Palestinians as well as therapists. In Amina’s case, however, an apparently inclusive language of acknowledgment does not in fact enable one to read her experience.
The misreading occurs because the criteria of acknowledgment are imbued with the eventfulness of violence. They emphasize how some relations are intrinsically more wounding than others, as is true in the difference between a mother’s loss of a son and a wife’s experience of an absent husband. Interestingly, such understandings of suffering mesh with how physical injury was known in the wake of the first Intifada.
Muna’s frustration with the lack of progress in the group therapeutic project suggests a gap between the experiential realms of the detainees’ wives and the available therapeutic method. This gap is what made Muna pose the question to the teacher during the workshop on group therapy: what could she do to help her client, who did not feel better after several months of therapy? The teacher interpreted Amina’s case in the following way: “She reacts like she expects her husband to prefer that she is not OK.” His framing of Amina’s feeling of victimization may suggest a failure on his part to acknowledge that the circumstances of Amina’s life might actually be enough for her to feel anguished, regardless of whether her husband agrees. The teacher’s comment resonates with the use of an event as a criterion for the recognition of affliction: he tells Muna that Amina’s life is “not staying the same; life changes.” Implicitly, the teacher compares Amina’s situation with that of her husband. Seen in that light, Amina is out of prison, whereas her husband is the one whose liberty has been taken away. The words of the teacher therefore suggest that Amina can quite easily break free of her victimization, whereas her husband is the one who is still marked by a violent event—his incarceration.
The teacher’s assertion that “things change” resonates further with the criterion of a traumatic event, something that is limited in time and space. His advice to Muna assumes that suffering eventually ends. One of the criteria to be fulfilled in the diagnosis of PTSD is the experience of a traumatic event. Were we to think about Amina in purely psychiatric terms, she shows the symptoms of a disorder, but she lacks a traumatic event to explain her symptoms.
Muna embodies the resonances and convergences between the therapeutic and nationalist modes of framing affliction. Her representation of Amina’s case converges between her position as a therapist trained to think within a psychological mode of reasoning and her status as a Palestinian who also thinks about her clients within the national notions of suffering outlined earlier. By posing the question to the teacher regarding Amina’s claim to victimhood, Muna presents Amina’s reactions as excessive. However, at the moment of her breakdown, Muna appears to reconsider, as she herself feels the excess of suffering that is not supposed to be there. In other words, Amina’s relationship with her husband does in fact allow her suffering to be translated into the grammar of suffering in occupied Palestine. Notably, though, her experiences fail the criteria of event-based suffering. It is at this point that we need to attend to the internal connection and hierarchy among the two criteria, which help explain why Amina is not “supposed” to feel like a victim, despite the apparently straightforward translation of her situation into the grammar of suffering: The criterion of relation is an optional criterion, whereas the temporal criterion of event is in fact obligatory. This is why Amina’s experience is not fully acknowledged, either by Muna as a therapist or by Muna as a Palestinian.
The moment of Muna’s identification with Amina is one in which Muna reads Amina and thus acknowledges her. By allowing herself to read Amina’s experience, Muna comes to know her suffering on different terms than the available grammar of suffering by which affliction is known and acknowledged in occupied Palestine. Acknowledgment requires a moral inclination to act on one’s knowledge, which is what Muna does by addressing it during the course, and by breaking down when she recognizes her inability to effect change in Amina.
Muna’s recognition invites us to think further about an anthropological wording of experiences of hardship that do not fit into the grammar of suffering in contemporary Palestine, even though this grammar does, indeed, encompass a wide range of experiences, as this chapter has shown. The criteria for the recognition of suffering are in fact so powerful that they constitute what I think of as a standing language. I propose the idea of a standing language in order to acknowledge, along with Khalili and Sylvain Perdigon, that the Palestinians themselves have developed a fine-grained vocabulary to articulate the diverse experiences their statelessness imposes on them. Yet I hesitate to assume that such a language offers a wording of suffering truer to the Palestinian experience than, as Fassin and Rechtman argue, a Western language of trauma, because of the circumstances of post-Oslo Palestine and the criteria of suffering described here.
A standing language is not simply psychological, national, and religious representations of suffering that morph into a grammar of suffering. That grammar includes the tripartite set of heroic, tragic, and sumūd narratives that Khalili finds among Palestinians in Lebanon and the psychological discourse of traumatization that has proliferated in Palestine. In order to flag the difference between this grammar and a standing language, I turn to Wittgenstein and more specifically Das’s reading of him (2011; see also Han and Das 2015). The premise of a standing language includes agreement over criteria as to what forms of life are human. What makes such an agreement about criteria relevant in the context of gendered expressions of suffering in contemporary Palestine is the question of whether all forms of suffering experienced by Palestinians can actually be seen to belong to a particular form of life reflecting agreement about the criteria of what it means to be human. How the experiences of prisoners’ wives fail both knowledge and acknowledgment in the grammar of suffering in contemporary Palestine reads to me as a reformulation of that question. The experiences of the prisoners’ wives cannot be embodied in the standing language: There are simply no words for what it means to be in their situation. Muna cries when she realizes the inadequacy of the standing language to allow her access to the slow grinding of Amina’s lived life, a grind so finely textured that it slips away from the criteria that have been put in place to know and acknowledge it. Amina’s feelings reflect the unsettling, continuous situation that is a predicament for all the women who are married to long-term detainees in contemporary Palestine.
The question is how the slow grind of Amina’s life relates to the slow grind of ordinary life for the majority of Palestinians (Kelly 2008), a condition eclipsed by the standing language of suffering, but that produces adversity, nonetheless. The argument I make in this book is that the unsettling effects of everyday occupied life are in fact so grave as to bring Palestinians to profoundly question the national project and the cost of endurance (see also Buch Segal 2015).
How do a grammar of suffering and the idea of a standing language help us better conceptualize distress? Why not simply analyze the complexity of the idea of trauma, as has been done sensibly by, for instance, anthropologist Rebecca Lester in her merging of anthropology and psychotherapy? I am hesitant to employ the language of trauma as an analytics of ethnography, but not because I am suspicious of the notion of trauma laid out by Fassin and Rechtman. The resonances between a psychological discourse of trauma and a Palestinian moral discourse of suffering lead me to think of the grammar of suffering in contemporary Palestine in terms similar to Nils Ole Bubandt’s (2008) work on psychological distress in North Maluku. Bubandt argues that “the introduction of trauma to north Maluku has given rise to new forms of meaning that make perfect sense to people, even if they are patched together from global flows of media narratives and development practices” (293).
It is precisely this merging of the global and local in language and action that constitutes the grammar of suffering in contemporary Palestine. We thereby see that there is no “authentic” language in which distress can be vocalized, either through a discourse of trauma or through the words available in Palestinian moral discourse. Not only do internationally circulating discourses rooted in trauma naturally fail to cover all forms of global affliction, so, too, do the local vernacular discourses. This is perhaps the most radical conclusion of the book, since there is a strong tradition in anthropology that documents how local vernaculars of pain encompass and console by providing words to talk about difficult circumstances that the Western trauma idea does not. As will be clear in subsequent chapters, Palestinians have a reason to make ineffable particular experiences that occur as a consequence of the struggle for national recognition, and this discourse is therefore not all encompassing of suffering, either.
However, the fact that Muna, as both a therapist and a Palestinian woman, at one point acknowledges Amina’s suffering may suggest the potential of shifting from a register based on distance, heroism, and objective diagnostics to an affective register that eschews the comforting armature of scientific and national terminology alike. As Das observes, this alternative vision requires that the eye be not an organ that sees, but an organ that weeps (2007: 62). Only in Muna’s tears was Amina’s suffering acknowledged in a way that transcended spoken expression. This could be read as corroboration of a point that underlies both notions of trauma and an anthropological literature indebted to Elaine Scarry’s argument that some forms of pain defy language (1985). What I have tried to show is in fact the opposite. Wittgenstein writes on the relationship between pain and words: “So are you saying that the word ‘pain’ really means crying? On the contrary: the verbal expression of pain replaces crying, it does not describe it” (1953 [2009]: §244). Muna’s tears and the words she uttered simultaneously force us to think closely about the imbrication of language and the suffering it tries to describe.
