The recent spate of correspondence over the publication in Therapy Today of ‘To resist is to exist’ by Martin Kemp and Eliana Pinto (March 2009) has raised the ire of many readers, despite the BACP statement that BACP ‘has no position or policy with regard to Middle East politics’
Notwithstanding the BACP announcement and its statement that the article related to a perspective on ‘mental health’, it appears that the publication of the Kemp and Pinto piece was contrary to Therapy Today’s own guidelines for authors, which calls for articles that offer new perspectives on current thinking, or debate practical or professional issues, theory discussions or shared experiences and best practices. Yet one would have to struggle to come up with anything in this pointedly political article that meets any of the professional criteria above. However, most egregiously, the article fails to abide by another one of the BACP’s own guidelines, namely, that the article be ‘backed up by available research’.
In a series of accusations, indictments and claims against Israel and the Israeli army, this unfortunate paper not only fails to teach anyone anything about mental health or counselling, it fails to use any research or documented sources to back up many, if not all of its flagrantly irresponsible claims and thus fails to meet minimal criteria for professional or scientific scholarship one would expect from responsible clinicians.
The article quotes Salim Shawamreh, Jeff Halper and the women of Machsom Watch, among others, without providing any contextual background for their statements or bothering to check out the factual basis of what they say. Shawamreh, Halper and the Machsom Watch group are all people I know, and all are regular lecturers to the students I teach in a program on Israel-Arab studies in Jerusalem. While their views should be heard and aired, they must also be checked against the facts and they must be held accountable for statements they make. None of that took place in this report.
It is true that Shawamreh’s house has been demolished (in fact, several times), but the reason for this is far less sinister than the article would lead us to believe. The fact that there is severe overbuilding by Arabs in East Jerusalem, illegal overbuilding that impedes the delivery of infrastructure, is not mentioned. The authors would lead us to believe that the denial of building permits is simply arbitrary, politically inspired and a tactic of ‘racial displacement’, ignoring a series of well documented reports that specify how both Jewish and Arab sectors suffer form overcrowding and a shortage of housing and how the one-sided violations of building regulations has led to an inability to supply proper schools, community centres and parks to the Arab section. The Arab population basically ignores municipal regulations while the Jewish sector has dealt with the housing shortage by simply picking themselves up and leaving the city, leading to what has been called an ‘exodus’ of Jews from a city that has had a Jewish majority since the 1800s. And as noted by Jerusalem researcher Dr Maya Hoshen, the main reason for Jews leaving is a lack of housing and employment opportunities, no different from what the Arab sector faces and certainly not something that is related to a ‘racial’ policy. 
And while the authors quote statistics that tell the story of Arab blight in Jerusalem, they fail to note a critical and perhaps overriding fact. Despite being allowed full voting privileges in the city, Palestinian Arabs fail to exercise this democratically provided means for effecting social change. Instead of voting and having their representatives serve on municipal councils and be part of the democratic process, they have abandoned the polls in droves, with only about five per cent participating in the electoral process. Unlike the old American axim of ‘no taxation without representation’, the Palestinian leadership has urged its Jerusalem citizens to abandon their democratic rights, despite the toll it takes on their social wellbeing.
But, as a visit to any Jerusalem hospital will show, Arab and Jewish doctors and nurses work together and Arab and Jewish patients are treated together and housed together in what is daily evidence of the equality afforded all Jerusalem residents. The largest Jerusalem hospital, Hadassah, was nominated in 2005 for the Nobel Peace Prize in recognition of its ethnic diversity and equality in treatment, something not mentioned in the Kemp and Pinto report.
Kemp and Pinto quote Dr Eyad El-Sarraj of Gaza and his claim that Palestinian children have been traumatised and humiliated by the Israelis. Again, they fail to explain Dr El-Sarraj’s record to their readers, including his role in a highly politicised NGO (the Gaza Community Mental Health Program) and his claims of damage to Palestinian children from sonic booms that were not substantiated by any verifiable data and contradicted by what we know about the effects of sonic booms from available research. Dr El-Sarraj, who also made this enlightened statement, ‘Are they evil by nature, these Jews? Or are they stupid, born mentally subnormal? I found after long, long thinking about it that they are not born evil. And they are not stupid. They are psycho-pathologically disturbed’ is far from an objective scientist in his observations of the effects of the conflict.
Kemp and Pinto speak of the understandable psychological damage that house demolitions cause, and again implicate a random policy by Israel directed only against Palestinian Arabs, failing to mention Israel demolished the homes of over 8,000 Israelis along with 42 daycare centres, 36 kindergartens, seven elementary schools, and three high schools in 25 communities in the Gaza Strip and northern West Bank in a matter of hours in 2005, nine settler homes in a bloody clash that injured over 200 Jewish settlers at Amona in 2006  and the homes of over 30 Jewish families in Kfar Shalem in Tel Aviv in 2007 (in that case enforcing civil regulations having nothing to do with political issues).
They also fail to note that while Israeli medical organisations and parliamentary representatives recognise the inherent psychological consequences of these actions and struggle for just solutions, neither Dr El-Sarraj nor any Palestinian mental health or medical organisation has seen the need to do so for Israeli victims of the conflict. Palestinians have suffered psychological consequences as a result of losing their homes in the conflict, but so have Israelis, a fact that is nowhere to be seen in the Kemp and Pinto report. Finally, El-Sarraj’s own recent research has noted ‘many methodological and conceptual weaknesses’ that ‘deserve criticism’, including the confounding effects that self-report and political activity has on the reporting of trauma.
Much of their report contradicts their own assertions. In one sentence they claim that ‘inner city outposts’ are threatening the daily lives of Palestinians, yet in another they describe how these so-called ‘threatening’ neighborhoods need to be surrounded by barbed wire (clearly to protect the residents of these outposts and not those outside). In fact, it is the Jewish residents of East Jerusalem who face physical threats and must have armed guards protect their homes. The authors do not cite a single case of an Arab resident of East Jerusalem who was killed by Jewish residents, yet the opposite, Palestinian residents of East Jerusalem, have been involved in repeated fatal attacks on Jews of the city.
Let us set the record straight. Yes, there are individual Israelis whose behaviour is reprehensible, and some live in the area of Hebron described in the article. I would imagine there are individual Brits, French and Germans whose behaviour is no less despicable. But the attempt to deligitimise the Jewish presence in historically Jewish areas of Palestine is accompanied by a serious lack of transparency. So when the authors speak of the ‘Ukrainian’ soldier in Hebron (actually an Israeli soldier), they again fail to note that many of the Arab families of Palestine, like the El-Masris (from Masr, Egypt) or the Houranis (from Houran in Syria) or the Zarqawis (from Zarqa in Jordan) have their ethnic origins outside of what is today’s Israel or the West Bank, unlike Jews of the Ukraine, who legitimately trace their history precisely to the areas around Hebron that Abraham lived in.
The authors cite an experience related to what appears to be a counter terrorist operation by Israeli forces in Hebron that involved a search for wanted terror suspects. In quoting a personal account of this operation by Hebron resident Rawia Mohtaseb that told of alleged ‘attacks’ on her house by Israeli forces, they fail to challenge her use of the term ‘attacked’ to describe what appears to be a standard search-for-suspects operation. They also fail to explain exactly what the suspects arrested were wanted for, and fail to provide any scientific evidence for the absurd argument that a child’s severe language delay was the result of allegedly being forced to stay out all night in the rain. More importantly, while they cite instances of Jewish violence towards Arabs, they fail to note the many attacks by Palestinians on Jews in Hebron and elsewhere in the West Bank and Israel, including one where a Jewish infant in Hebron was shot between the eyes and killed by an Arab sniper.
In another example of political and not mental health assertions, the authors unquestionably adopt the controversial views of Jeff Halper and the NGO he heads, the Israel Committee Against House Demolitions (ICAHD)  and specifically mention the allegation of medical mistreatment as a result of checkpoints as an example of purposeful Israeli policy to ‘control’ Palestinians. Again, in a failure of contextual reporting, Kemp and Pinto criticise an alleged delay of an ambulance at a checkpoint, while ignoring the documented cases of Palestinian ambulances that were used to transport terrorists, weapons and suicide belts.  In one particularly graphic video, one clearly sees the suicide belt that was discovered in an ambulance stopped at a checkpoint that transported a Palestinian woman and child who used the cover of medical care to assist in the carrying out of a terror attack. All this is ignored, as is the work of Israeli organisations that regularly treat Palestinian children and provide extensive financial assistance for medical care and training.
The calumny of Israel ‘routinely’ using torture against children in prison is presented, again without citing a single credible source or presenting any verifiable evidence. The Israeli fight against Palestinian terror presents it with serious dilemmas, not the least of which is the issue of the ‘ticking bomb’ and what methods are legitimate in preventing terror attacks against innocent civilians. This has been discussed extensively in Israel, and anyone who makes a serious effort at investigating the issue will see that few Israelis take the issue as lightly or as flippantly as the authors would lead us to believe. The justice system in Israel has come out numerous times on the side of caution, despite intense public criticism.
And as far as the Israeli prison authority is concerned, Arabs are afforded full religious freedom, including ability to worship in public and receive meals in accordance with Islamic law. Unlike Israeli prisoners in Arab territory (like Gilad Schalit) who are held incommunicado with the outside world, contrary to international law (something not noted by the authors), Hamas prisoners have had access to television, radio, newspapers, telephones and online education, along with jail canteen allowances and monthly family visits. Only recently, due to Hamas’ refusal to allow Red Cross visits or any visitation for Schalit, who has been held illegally for three years, has Israel proposed legally limiting these privileges. One particularly infamous terrorist imprisoned by Israel, Samir Kuntar, who murdered an unarmed woman and child, received degrees from the Open University of Israel and was allowed to marry while in prison. The prison authority has had to separate Palestinian prisoners from each other when it became clear that the biggest danger they faced was violence from other Palestinian prisoners and not from the authorities. These facts hardly seem consistent with the unsubstantiated accusation of ‘routine’ torture presented by the authors, without any reference to the above facts.
The authors quote Rana Nashashibi, director of the Palestinian Counseling Center, repeating her claim that Israel has an intentional policy of ‘psychological warfare’ against the Palestinian people. As can be seen in Nashashibi’s writing, her claims of psychological effects on the Palestinians ignore reports that state quite clearly that Israelis exposed to violence are also at risk. Nashashibi also makes the preposterous and unsubstantiated claim of a ‘systematic’ intentional policy of humiliation and subjugation due to occupation that totally avoids any Palestinian responsibility in sustaining the conflict. This would include the historic rejectionism of the Palestinian leadership, which for years refused to even negotiate or accept the possibility of peace with Israel, to the failure to recognise Israeli withdrawals from occupied territory in Sinai, Lebanon, and Jordan as well as from Palestinian territories under article XIV of the Oslo accords and Wye or the Palestinian failure to accept the offer of withdrawal by Israel at Camp David.
There is a distortion of the facts as it relates to the authors’ description of ‘resistance’. By mentioning Dabbagh’s contention that ‘resisting the oppression’ alleviates feelings of depression, the authors fail to note exactly what that ‘resistance’ has been. Polls taken by Palestinians show that they have overwhelmingly supported what is euphemistically called ‘military’ operations. In 2001, the Palestinian public supported suicide operations (74.3 per cent), with over 85 per cent supporting only violence or negotiations as long as a violent resistance accompanies it. The latest polls continue to show a majority of Palestinians supporting violence against Israelis and sizable minority opposing peace negotiations. Kemp and Pinto note none of this.
In speaking with Palestinian mental health professionals, the authors accept the notion that the problems among Palestinian youth and adults are solely a result of ‘Israeli policy’. Here again they fail to examine the effects of the Palestinian institutionalised promotion of violence, including self-sacrifice and suicide terrorism. Anti-Semitism and violence against Jews has been promoted by Palestinian (both Fatahand Hamas television, Palestinian textbooks and in re-enactments of terrorist operations at Palestinian universities. The authors do not note why these facts, which can be verified by anyone with access to You Tube[36, 37] were not noted in their report and thus cannot discuss how such a widespread culture of hate and violence may have an affect on the mental heath of the society.
The pattern of only seeking out one side for information continued with the description of the protests at the village of Na’alin as being non-violent. In fact, the protests are anything but ‘non-violent’ and the reason for them, the construction of Israel’s security fence, is something that has only taken place after years of Palestinian violence and the need to offer physical protection from terrorist infiltration into Israel. Here too, the authors fail to state that the Palestinian Arab residents of the area have the right to appeal to Israel’s Supreme Court. Those of the nearby village of Bil’lin that have appealed, have in fact won decisions that altered the route of the separation fence and the confiscation of land for that purpose. As to the allegation of losing land to settlements, here too the authors fail to examine all the evidence and essentially parrot the views of one side in this political struggle. While the Palestinians claim a ‘land grab’ and delineate the parameters of how much land was taken from them, the settlers themselves have claimed that the land was legally bought and paid for from Arab landowners. And there is evidence that the Na’alin area dispute may be no more than a possible shady business deal that involved both Palestinian Arabs and Israeli Jews and not one of a nationalistic ‘land grab’ by the government.
Quoting Dr Ruhama Marton as being ‘unequivocal’ in stating that the occupation has resulted in an increase in Israel in crimes against women, juvenile crime and minor disputes escalating into murder, the authors once again fail to ask for the slightest bit of evidence that supports these claims. In fact, once again, no such evidence exists. The Overseas Security Advisory Council, in discussing Israel’s largest Jewish city, states ‘Tel Aviv enjoys a low rate of violent crime compared to other major metropolitan cities’ a fact that contradicts the assertions of Dr Marton. Moreover, Israel’s murder rate is amongst the lowest in the world  and has in fact declined in recent years. Kemp and Pinto would be better off investigating the reasons for the crime rate in Britain, where 10,800 complaints are lodged per 100,000 population, as compared to only 5,000 complaints in Israel.
The authors allow Jeff Halper to speak of ‘racism being built into the state’ despite prima facie evidence on the ground that contradicts this allegation. With all the tautological and preposterous assertions of Israeli ‘apartheid’, this supposed report on mental health fails to ask how, in this evidently apartheid society, both Jews and Arabs elect representatives to sit side by side in the same government, serve in the same court system, serve in the same army, serve in the same police force, attend the same universities and work and use the same hospitals and health system. A casual stroll in the streets of Israel will show that Arabs and Jews use the same buses, buy in the same stores, and eat in the same restaurants and work side by side in many industries. Any comparison with South Africa is nothing short of delusional. The attempt to equate the petty forms of social problems that exist in all societies to a system of ‘apartheid’ simply does not hold water and lacks intellectual integrity. Again failing to adequately examine all the evidence, the authors do not mention how they account for how over a million Arabs can live safely in Israel benefiting from more civil rights than Arabs living anywhere in the Middle East. Nor do they note some of the draconian aparthied laws of the Palestinian leadership that include the death penalty for selling land to Jews and prohibit even renting property to Jews.
In a truly disturbing allegation, Kemp and Pinto make comparisons between Nazi treatment of Jews during the Holocaust and Israeli treatment of Palestinians. This is especially egregious, considering the culture of Holocaust denial that exists among Palestinians.[50, 51] To blindly accept the assertion of intentional Israeli oppression against Palestinians as fact and to then offer a banal and baseless psychodynamic interpretation that cites European treatment of the Jews as being related to it not only stretches the bounds of acceptable scientific discourse, it also defames and insults the experience of so many Jews that have either personally been victims of this terrible injustice or have parents and relatives who have. Nowhere is the history of the conflict presented by Kemp and Pinto. Nowhere do they note that for many Palestinians, including the Hamas party that rules Gaza, the entire state of Israel and not only the West Bank is ‘occupied’.
Hamas, for whom a majority of Palestinians have voted for in parliamentary elections, are on record calling for the ‘obliteration’ of Israel, are against ‘peaceful solutions’, speak of ‘Jihad’ as the only option and quote Hadith to support the killing of Jews. Yet it is only the ‘occupation’ by Israel that Kemp and Pinto find fault with. There was no occupation of the West Bank or Gaza before 1967, when Israel was attacked in acts of war by Egypt and Jordan and when the Palestinian leadership then also did not accept any Jewish presence in Palestine. Even the currently ‘moderate’ Palestine Liberation Organization (PLO) raised a people for years to reject international resolutions related to Palestine, to deny any Jewish connection to the land and to declare armed struggle as the only means for liberation. How do Kemp and Pinto ignore this background and its relevance to the national psyche of the millions of Palestinians raised under this philosophy? To blithely ignore history and turn a blind eye to any Arab responsibility for the perpetuation of Palestinian suffering is false and cynical scholarship.
This blatantly political article has no relation to mental health and has repeated assertions that, as noted above with documentable evidence, are baseless. Had the authors bothered to verify the information given to them by clearly biased sources, they may have done a service to the readership of Therapy Today. Instead, the distortions presented have led them to make the claim that the occupation not only is the sole source of all wrong in the conflict, but that it is in fact a purposeful policy that constitutes a ‘continuous assault on the mental health of the Palestinian people’.
The authors description of suffering in conflict situations is no scientific breakthrough, and their apparent ignoring of the context of the suffering and the lack of attempt to balance the reportage of this suffering is regrettable. So is their insistence on placing the word ‘terrorists’ in inverted commas, expressing a clear political statement in this professional journal. The indoctrination of Palestinian children with violence and hate, the glorification of suicide terror, the election of organisations like Hamas that subjugate women, the degradation of gay people  and the promotion of anti-Semitism  seemingly are all insignificant aspects of the conflict to Kemp and Pinto and have nothing to do with any mental health issues the Palestinian people may have. They ignore United Nations reports that clearly document Palestinian-Palestinian factional fighting as having profound affects on the population. It is all Israel’s fault, and it is all related to the occupation.
Scholarly professions deserve better than to have their publications used by political forces to promote a one-sided and biased view under the guise of science. By all means, study the conflict and study the psychological issues associated with it. But do it in a scientific and balanced manner by seeking out all the evidence and by examining and verifying information received. The Kemp and Pinto article is no more related to mental health than a discussion of alchemy is to chemistry. It should never have been published, and readers should be offered the opportunity to check each and every reference presented here to reach their own conclusions.
Irwin J. Mansdorf, PhD is a licensed psychologist both in Israel and the United States, and has been involved in studying the effects of terror. He directed workshops for Project Liberty, the post-911 crisis intervention program in the United States, currently directs the David Project’s leadership program in Israel-Arab studies at Lindenbaum College in Jerusalem and serves on the Task Force for Medical and Public Health Issues of Scholars for Peace in the Middle East.
This paper has been endorsed and supported by the following: Selwyn Oskowitz MD, Assistant Professor, Reproductive Biology, Harvard Medical School; David Siegel MD, MPH, Chief of Medicine, VA Northern California Health Care System, Professor and Vice Chair, Department of Medicine, UC Davis School of Medicine; Professor Brian Lieberman, Manchester Fertility Services; Stephen P. Stone MD, Professor and Director of Clinical Research, Division of Dermatology, Southern Illinois University School of Medicine; Stanley Schaffer MD, MS, Associate Professor of Pediatrics and of Community & Preventive Medicine University of Rochester, USA; Philip Greenland MD; Professor Harry W. Dingman, Senior Associate Dean for Clinical and Translational Research, Northwestern University, Feinberg School of Medicine; Donald P. Levine MD, Professor of Medicine, Chief, Division of General Internal Medicine, Wayne State University, Detroit; Harvey A. Risch MD, PhD, Professor of Epidemiology, Yale University School of Medicine, Department of Epidemiology and Public Health; Howard Kahn PhD, Senior Lecturer, Heriot-Watt University, Edinburgh; Lester I Sireling MBBS, LRCP, MRCS, FRCPsych, Guy’s Hospital, London; Dr John Stevens, Henderson Hospital; David Katz MD, University College London; Professor MB Pepys FRS FMedSci, Head, Division of Medicine, Royal Free Campus, Director, Centre for Amyloidosis & Acute Phase Proteins, University College London Medical School; John R. Cohn MD, Professor of Medicine, Assistant Professor of Pediatrics, Thomas Jefferson University; Judith S. Jacobson DrPH, MBA, Department of Epidemiology, Mailman School of Public Health, Columbia University; Dr Simon Nadel, Paediatric Intensivist, St Mary’s Hospital, London; Stuart M. Sprague DO, FASN, Chief, Division of Nephrology and Hypertension, NorthShore University HealthSystem, Professor of Medicine, Northwestern University Feinberg School of Medicine; Chaim Charytan MD, FACP, Chief Renal Division, NY Hospital Medical Center of Queens, Clinical Professor of Medicine, Cornell University College of Medicine; Stephen I. Deutsch MD, PhD, Professor and Associate Chairman for the Clinical Neurosciences, Department of Psychiatry, Georgetown University School of Medicine, Professor and Chairman-select, Eastern Virginia Medical School, Norfolk Virginia, Fellow, American College of Neurpsychopharmacology; Prof. Gerald M. Steinberg, Chair, Department of Political Studies, Bar Ilan University, Ramat Gan, Israel; Leonard Katz MD, Professor Emeritus, School of Medicine, State University of New York-Buffalo; Victor Schwartz MD, Associate Professor of Clinical Psychiatry and Behavioral Science, Albert Einstein College of Medicine; Edward S. Beck, Ed.D., CCMHC, NCC, LPC, Professor, Schools of Psychology and Social and Behavioral Sciences, Walden University; Leila Beckwith PhD, Prof. Emerita, Pediatrics, University of California, Los Angeles.
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