Palestine and the Ease-Disease Continuum

The current conflict between Palestine and Israel brings interesting developments to disability theory. Theorists of psychiatry are starting to focus on the effects of political, social, and racial oppression on the well-being of people, rather than solely focusing on the individual and their “indigenous mind”. In my opinion, this is the right approach. By taking this approach, it takes the onus and blame off of the individual and redirects it back towards society. Instead of saying, “Something is wrong with him.”, this approach says, "What is wrong with the structure of society such that these people are feeling these ways?", i.e. the structure of society might not be the most advantageous for his health.

Arab societies have a long tradition of caring for the mentally ill in hospitals and in the community. In the early 20th century, the primary responsibility for mentally ill people rested with families. However, British and French colonialism brought an intolerable approach towards mental illness. They believed in treating the individual. “This treatment modality assumes that the pathological effects of war are located inside a person, and can be cured through individual treatment, as if the individual was recovering from an illness rather than suffering from the long-protracted consequences of historical and contemporary political injustice." (Summerfield 2002).Steadily, this approach became more popular, and is presently the dominant approach. This western approach is used to treat Palestinians today. While I believe this is a short-sighted approach, it has only been heavily used because over the years no other legitimate alternatives have been established. Those trying to help Palestinians, have been doing so the only way they know how to. For many Palestinians, one-on-one counseling is an imported and culturally unfamiliar practice. They don’t believe that these counselors know the root of their problems, never mind, knowing how to fix those problems.

Many of you may have been wondering why I put that odd looking chart above. How could this possibly relate to Palestine? My friends, that chart is the Ease-Disease continuum. Palestinian researchers have spent the past decade developing this scale. Not only does it not exclusively rely on medical symptoms, but it links mental health indicators to social well-being and quality of life. Expressions on this scale include: something is wrong with him, wilted, not happy, not able, low energy, no energy to complete daily activities, down, tired, broken/achy, and sick. (Giacaman 553) Most Palestinians oscillate back and forth on this scale because they live in constant trauma and fear. I love this scale because it accomplishes two goals. Not only does it distinguish mental illness from social suffering, but it also establishes a social and political response to mass suffering with the “reversal of historical injustice as its primary aim.” (Giacaman 555)

Studies have shown that Palestinians’ mental health has worsened since the turn of the millennium. However due to the conflict, their quality of life has worsened. My point is, all of these “diseases”, might have more to deal with societal oppression, than individual psychology. It is one matter if a particular group has these disorders, but a whole nation is another matter.  As Giacaman states on pg. 555, “Palestinians have seen their social suffering (mis)diagnosed as clinical pathology.”

  

If anything this new approach can be related back to our own country. I wonder how many people have been misdiagnosed in this country. For instance, how many children diagnosed with Attention deficit-hyperactivity disorder (ADHD) are simply a little hyper or just “bad”? Misrepresentation of true disorders vs. feelings or symptoms is definitely a legitimate possibility. Certainly this ground of diagnosis will always be shaky, but new approaches have given us an alternative way of thinking about a person's mental well-being.

References:

Giacaman, Rita et al. 2011, "Mental health, social distress and political oppression: The case of the occupied Palestinian territory" Global Public Health 6(5), 547-559