Rana Nashashibi: I'd rather build a house than offer counselling

The shortest and most exacting sentence in the Palestinian literature on mental health during this war is not a diagnosis. It is a refusal, spoken by a working counselling psychologist, and it was put on the record by her own co-authors.

In BMJ Global Health on 30 September 2024, a commentary written by clinicians and researchers from Birzeit University’s Institute of Community and Public Health, the Palestinian Counseling Centre in Ramallah, the Gaza Community Mental Health Programme, King’s College London and a systemic psychotherapy practice in Oxford, made an argument about what recovery would actually require: “What is needed is rebuilding the material, social and inner life worlds to support personal, communal and intergenerational recovery and healing.” They then illustrated it by quoting one of their own. As the paper puts it: “This argument is illustrated by one of our coauthors, Rana Nashashibi, a counselling psychologist, who stated: ‘Next time I go to Gaza, I won’t go as psychologist. I will go as a builder. What is needed is rebuilding. I’d rather build a house than offer counselling to individuals’.”

It is worth being precise about what she is and is not saying, because the line is easy to soften into a slogan. She is not saying that psychological care is worthless, and she has spent a career providing it — the Palestinian Counseling Centre is one of the principal providers in the West Bank. She is saying that offering individual counselling to a person with no house, no water and no safety is a category error about where the injury is. The same paper spells out the reasoning: recovery requires “safety through the immediate and permanent cessation of warfare and violence”, and requires that Gazans have “the capacity to rebuild their own lives, human resources and infrastructures rather than being reduced to ‘recipients of aid’.”

The line is also a warning to everyone at a distance who wants to help and reaches first for the therapeutic register. A genocide is not a mental health emergency that happens to have a military cause. The mental health emergency is downstream, and it does not resolve while the cause continues. That ordering — the conditions first, the treatment second — is the consistent position of Palestinian clinicians from Eyad El-Sarraj’s generation to this one, and it is stated here in eighteen words.

Sources

• Unbearable suffering: mental health consequences of the October 2023 Israeli military assault on the Gaza Strip — Kienzler, Daniel, Hammoudeh, Nashashibi, Abu-Jamei and Giacaman, BMJ Global Health, 30 September 2024