If psychiatry is a Western construct, how does a psychiatrist practise outside the West? For Palestinian psychiatrist Dr Samah Jabr , the question is not theoretical. Her work unfolds under the shadow of geopolitical violence, where Israeli occupation, siege, and systemic oppression shape the lives she treats. Yet she navigates tensions that exist within her own field: if psychiatry is built on Western norms, how can it speak to experiences shaped by trauma in Palestine? And in turning the lens of pathology outward, how does one avoid under-pathologising what is genuinely abnormal?
In her book Radiance in Pain and Resilience , Dr Samah reflects on the psychological toll of Israel's genocide and ongoing war in Gaza, offering a vision of resilience that transcends context. The psychological toll of Gaza's decades of conflict and occupation is profound, with adults and children alike enduring depression, anxiety, post-traumatic stress, and the chronic stress of living under constant threat. Experts describe the region's trauma as "continuous traumatic stress," a condition shaped not by isolated events but by the relentless rhythm of violence, displacement, and loss. Dr Samah's work challenges mental health professionals worldwide to reckon not only with the limits of their frameworks but also with the realities of pain experienced in conditions far beyond the clinic walls.
"The current moment in Gaza and the West Bank represents an intensification of colonial traumatic stress reaching its most extreme form," Dr Samah tells The New Arab. " In Gaza, where entire families are erased in [Israeli] strikes and where survival is precarious, the psychological impact cannot be conceptualised within conventional trauma frameworks designed for time-limited events. What emerges is a state in which the mind is forced to adapt to the ongoing possibility of annihilation," she explains. Israel's genocide in Gaza has killed or injured around 10 percent of the territory's population since October 2023 and led to the destruction of most of the Strip. At least 72,562 people have been killed in the onslaught and another 172,320 wounded, according to the latest ministry figures.
Despite a ceasefire, Israeli forces have violated it hundreds of times since it came into effect in October last year, killing and injuring more than 3,000 people.
"The mental life of Palestinians today is shaped by a persistent oscillation between grief, anticipation of loss, and emotional numbing — a set of psychic states that are not signs of individual breakdown, but of prolonged exposure to existential threat. In this context, even basic psychological functions such as mourning, sleep, and emotional continuity become disrupted by the scale and constancy of violence."
Meanwhile, Israeli military operations in the West Bank have intensified , forcing thousands of Palestinians to flee their homes amid airstrikes, raids, and demolitions
"In the West Bank, where military incursions, arrests, movement restrictions, and settler violence structure daily life, the quieter but equally corrosive effects of chronic humiliation and unpredictability occur. These conditions erode the sense of safety and continuity necessary for psychological integration, producing a population that must constantly reorganise itself around disruption," Dr Samah says.
"This suffering must not be read solely through a clinical lens of pathology. To do so risks obscuring its political production. Instead, the Palestinian distress is a normal psychological response to sustained structural violence, while also we need not reduce Palestinians to their trauma. The task of mental health professionals is to hold both realities at once: to witness the depth of psychic injury without collapsing the subject into victimhood, and to recognise survival itself as an active, collective form of resistance."
On 30 March, Israel's parliament passed a sweeping death penalty law targeting Palestinians, triggering widespread international condemnation.
The bill, approved by 62 of the Knesset's 120 members with 48 opposed and one abstention, will instruct military courts to impose capital punishment on Palestinians convicted of killing Israelis in acts defined as "terrorism," but does not apply to Jewish Israelis convicted of the same crime.
Speaking about the death penalty, Dr Samah shared, "This law does not create a new reality; it formalises what many Palestinians already feel — that their lives are unprotected and expendable.
"The aim of the law is to deepen a collective sense of fear and helplessness. When death is codified in law for a specific group, it sends a powerful message of intimidation: that violence against them is not only possible, but legitimate. This produces a climate of chronic anxiety and anticipatory dread, where people should abandon their struggle for freedom," she explains. "Yet history reminds us that such measures do not extinguish a people's struggle. The use of execution during the British Mandate did not end Palestinian resistance. Just as trauma can be transmitted across generations, so too can resilience. Palestinians inherit not only wounds, but also a deeply rooted capacity for steadfastness." Trauma exposure In a 2021 essay, Dr Samah wrote critically about the widespread publication of traumatic imagery, arguing that it contributes to the psychological warfare waged against Palestinians by inducing numbness and inauthentic emotional processing.
"I work a lot with victims of political detention and torture. If you ask them directly, 'Have you been exposed to torture?' they say 'no,'" Dr Samah shares. Having witnessed others endure worse, "they don't consider that what they went through counts as torture"; the self and its pain are subsumed by identification with the collective, she adds. In the years since October 2023, the macrotrauma against Palestinians has been consumed by global witnesses and digested into the daily microtraumas on our screens.
In distant, individualist societies, the cost of exposure to traumatic imagery has become a relatively small price for the advancement of the Palestinian cause – and perhaps for our own sense of identity as global citizens.
Individuals in Palestine have already conceded much of themselves for the sake of community, and this continues to be exploited to the point of psychic collapse. In her book, Dr Samah writes about a patient with a history of torture. His diagnosis, psychosis, is sometimes discussed in terms of an overly permeable ego boundary, and the account in her book reads as a deliberate assault on this.
By violently breaching his physical boundaries, a model of infringing on the self's fortifications is established, and a man becomes alienated from his own mind. Fractured structures From Dr Samah's work, psychological health appears to be attacked at every level of psychosocial structure. Intra-psychic boundaries are toyed with, collective identity is vilified, and in between, the family unit is hacked away. Children become orphans yearning for a parent's guidance.
Boys are especially vulnerable, prone to experiencing authority as paternalism. Having spoken with former Israeli soldiers, she has heard how they were "instructed to humiliate the fathers in front of their children." A patient of hers, a young man previously detained, illustrated the bitter result of such orders. "I think that the Israeli occupation targets the father figure," Dr Samah reflects, resulting in a widespread distortion of social roles — where we might expect parents to protect, lead or resist, we find children instead.
In their work, Dr Samah and her colleagues rely heavily on the social scaffolds that hold up their community. "It is unrealistic to provide help for everybody who suffers in Palestine, given the small number of professionals capable of providing individual therapy," she explains. As of early 2026 , the World Health Organization (WHO) and other bodies report that at least 94% of hospitals in Gaza have been damaged or destroyed, with only a fraction, around 10–17 of the original 36 hospitals, partially functioning.
Over 1,400 health workers have been killed since October 2023, hundreds are detained, and hundreds of medical facilities have been attacked. Sometimes she provides care in groups out of practical necessity — cost, resource scarcity — and sometimes because it is the therapeutically preferable approach. "Referring them to a group of people with the same experience can be empowering, as much of the suffering caused by political violence damages their sense of agency," Dr Samah adds. Dr Samah and practitioners like her have much to teach, and the principle that "you take care of yourself when you take care of the community" should take precedence in mental health care worldwide. Dr Christiana Boules is an academic psychiatrist and freelance writer based in London Follow her on Instagram: @drbouwhou