An Exploratory Conversation of African American and Palestinian Historical Trauma and Healing: A Comparative Qualitative Case Study of Indigenous Perspectives

Gerald Fonville¹, Mukhayyo Azamova¹, Nanak Hikmatullah¹, Ghassan Abdullah², Jonique R. Childs¹ and Ian Barron^1*
*Correspondence: Ian Barron, Center for International Education, University of Massachusetts, Amherst, MA 01003, USA, Tel: +1-413-302-7749, Email:

Keywords

Trauma • Indigenous • Transgenerational • Mechanisms • Oppression

Introduction

The connection between the African American and Palestinian communities has deep historic roots. Despite cultural, geographical, and religious divides, they have remained relatively strong throughout African American modern history. From the Black Panthers Party's support for the forming of a Palestinian State; to Andrew Young- the first African American U.S. ambassador to the United Nations- being asked to resign after secretly meeting with representatives of the Palestine Liberation Organization; to the Black Lives Matter (BLM) movement incorporating Palestinian liberation as a guiding principle of the organization [1]. African Americans and Palestinians have joined forces to fight for liberation from occupying forces [2,3]. An elucidation of the philosophical ties that bind the two communities was provided by a BLM activist, who affirmed, “We [African Americans] know the occupation, we know colonization, we know police brutality” [3]. This once again clarified part of the African-American-Palestinian connection. It spoke to the shared political reality of both groups. Not explicitly stated, but inferred in this statement, is a far more significant part of the shared experience of the two groups.

Complex trauma is the cable tow that binds the African Americans’ and Palestinian experiences. The National Child Traumatic Stress Network (NCTSN) defines complex trauma as:

“…Children’s exposure to multiple traumatic events-often of an invasive, interpersonal nature-and the wide-ranging, long-term effects of this exposure. These events are severe and pervasive, such as abuse or profound neglect. They usually occur early in life and can disrupt many aspects of the child’s development and the formation of a sense of self. Since these events often occur with a caregiver, they interfere with the child’s ability to form a secure attachment. Many aspects of a child’s healthy physical and mental development rely on this primary source of safety and stability” [4].

Complex trauma impacts the individual and the group in predictable and measurable ways. Individuals who have experienced childhood trauma are more likely to have learning disabilities; an increased risk of serious mental health issues; increased risk of substance abuse; increased somatic illness; failure to launch; increase difficulty in forming interpersonal relationships; and increased aggression [5-8]. While the enormity of this list is prodigious, it is not an exhaustive list of the myriad of ways that complex trauma impacts the development of its host.

In 2021 the unemployment rate of force-ready Palestinians was 26% [9]. During the same period, the Israeli unemployment rate was 4.6% [10]. The African American unemployment rate was 8.6% versus a 5-6% national unemployment rate [11]. These statistics provide insight into the number of people suffering the pangs of poverty. While previously not a significant concern illicit drugs and alcohol use is becoming more prevalent in Palestine. Individuals cited stress, anxiety, and lack of access to counseling resources as the significant causes [12]. Additionally, it has been estimated that a third of Palestinians need mental health interventions [13]. Statistics in the African American community reflect a similar narrative. In 2019, 7.6% (2.3 M) of African Americans had a substance use disorder. In that same year, 17.3% (5.2 M) of African Americans had a mental health disorder [14]. Rates of poverty, substance abuse, and mental health concerns demonstrate communities yoked by complex trauma. Communities are in a constant struggle to thrive.

The other narrative of these statistics is that within these communities there are those who are succeeding. Moreover, many are excelling. It brings to mind the question, ‘What are those factors which increase resilience against complex trauma in these communities? What factors are endemic to culture? Can these protective factors be replicated and taught to others of a different culture?’ A research search of the literature yielded no studies that used a cross-cultural framework to answer these questions.

Our current study then sought to explore the commonalities and differences between African American and Palestinian oppression, trauma, and healing strategies. In addition, the study aimed to understand the mechanisms underpinning trauma and resilience common to both communities. It is our hope, that this exploratory study generates further research in the crosscultural analysis of complex trauma.

Methods

Research design

The research design was exploratory in nature and aimed to identify a wide range of issues from insider perspective to enable a rigorous analysis to be conducted into the nature of traumatization and healing for African American and occupied Palestinian children and adolescents. Both settings have historic as well as ongoing contexts of adversity, racism, discrimination, and violent traumatization. The primary research question was ‘‘what are the perceived differences and similarities in traumatization and healing for African Americans in the USA compared to children and adolescents in occupied Palestine?’ This was broken down into two sub-questions, that is:

1. What is the perceived nature of the harms and resultant consequences of trauma exposure in both communities?

2. And what are perceived understandings of trauma and healing for each community?

Ethical approval as granted by the Institutional Review Board of the University of Massachusetts, Amherst.

Research team & positionality

The research team involved two research assistants (RAs), both doctoral students in a College of Education. One is from Uzbekistan, studying international education, and the other is from Indonesia studying education. The RAs were purposely selected for their affiliation with the University’s applied research center, their differing backgrounds, their knowledge of qualitative methods, and their outsider positionality, the latter, a contrast to the insider perspectives of the participants. The principal investigator was the director of the research center, who had conducted two decades of international research in child and adolescent traumatization and empirically-based interventions to healing.

Participants

Participants were two indigenous trauma scholars invited to present seminars on historic and intergenerational trauma at an American university research center. One participant, a director of an applied research center in Ramallah, West Bank, occupied Palestine, and the other, a Black American scholar, in a College of Education at an American University. Participants were purposefully selected for the study [15], because of (i) their insider perspective, (ii) their expertise and depth of knowledge, (iii) their experience of their traumatized communities, and (iv) a result of a stimulating debate in one of the seminars where the similarities and differences between Black American and Palestinian trauma were discussed.

Approach and interview questions

The two scholars were invited to two collaborative interview sessions to answer and discuss a series of questions on historic and intergenerational trauma and healing for children and adolescents in the African American and occupied Palestinian communities. The first session focused on the nature of historic and intergenerational trauma exposure and the second session was on trauma healing. Four superordinate questions (2 per session) were developed from the research literature and from the practice wisdom previously shared by the two indigenous participants during the research seminars.

In session one, the two questions were: (i) what is unique about the nature of trauma for People in occupied Palestine and Black Americans? (ii) The understanding of trauma tends to be westernised and individualistic – what do you think your cultures bring to conceptualizing trauma and healing in contexts of adversity? In session two, the two questions were: (i) where do trauma, healing, and social justice intersect in education in crisis and context settings? (ii) In contexts where helplessness is an intended aim of the oppressor – what are your community’s ways of keeping your humanity and instilling hope? It was anticipated that a series of other pertinent questions would be generated by each of the scholars during the interviews.

Procedures

The two semi-structured interviews (two hours and forty minutes in total) were held via Zoom involving the two indigenous participants from each community answering the semi-structured questions and engaging in discussion. The principal researcher asked the interview questions. For data collection, the two interviews were recorded and transcribed in Zoom with backup notes by one of the research assistants. Data analysis consisted of three components: (i) a six-step thematic analysis by two independent (outsider) coders; (ii) a measure of inter-coder reliability of the two independent coders, and (iii) expert analysis of the two independent coder’s analyses, conducted separately by the two indigenous scholars.

Data analysis

Data analysis followed Braun V and Clarke V [16] six steps of thematic analysis, selected for its flexibility, given the open-ended nature of the research questions, the small participant sample size, and the analytical approach to meaning-making. The thematic analysis aimed to identify codes, small meaningful units extracted from the data, to develop themes, and whether the codes and themes suggested a theoretical orientation. Steps in the process involved (i) familiarization with the data, (ii) generating initial codes, (iii) the search for themes, (iv) reviewing codes and themes, (v) naming codes and themes and (vi) drafting the analysis report that enabled another round of analysis. The indigenous scholars analyzed the analysis report with access to the data transcripts.

Inter-Coder Reliability (ICR)

Once the coding process was completed by the two independent researcher’s coders, they met to discuss their findings, compare the codes, and noted agreements and disagreements. ICR following O’Connor C and Joffe H [17], protocols to ensure the systematicity and transparency for contestability of the coding process between the two coders. ICR is a numerical measure of the agreement process between coders on how data should be coded and represented in a numerical measure. The unit of analysis was segmented chunk by the chunk of meaning, by both coders. All codes, themes, and statements were discussed. A record was kept of what was and was not agreed upon. Cohen's kappa coefficient was utilized within NVIVO for the statistical measure of inter-coder reliability. The refining was conducted on codes and themes and was supported by a rationale for changes.

Expert analysis

Following the analysis of the data by the two independent (outsider) coders, the two indigenous scholars (insiders) independently analyzed the coders’ data analysis for validity and reliability of the identified codes, themes, and exemplar quotes. Disagreements between coders (outsiders) and expert analysis (insiders) led to further negotiation of codes, themes, and quotes. Finally, the results were analyzed by the indigenous scholars to give meaning to the analyzed results and identify the mechanisms of oppression and healing (see discussion section).

Results

Inter-coder reliability

From the total of 14 questions, there are 80 codes. Coder 1 generated 41 codes, and Coder 2 generated 39 codes. In question 4, however, coder 1 has three codes while coder 2 has only one code; thus, we could only compare one code, while the other two codes were not reached due to not having the equivalence. Of 78 total compared codes, 74 codes were agreed upon (94.87%), and four disagreed (5.13%). The ratio of agreement and disagreement is 37:2. The percentage of agreement is high, which assumes a high intercoder reliability rate. However, there is no universal rule on a solid

intercoder reliability rate. However, we stick to Kolbe RH and Burnett MS [18], by reporting the percentage of agreement.

Similarities and differences in traumatization

The current study aimed to understand resilience to complex trauma in occupied Palestine and African American communities. The primary research question was ‘‘what are the perceived differences and similarities in traumatization and healing for African Americans in the USA compared to children and adolescents in occupied Palestine?’ Inter-rater analysis of the interviews revealed four themes along with their category and subcategories that describe the perceived differences and similarities in historical and intergenerational traumatization and healing in both communities (Table 1). The analysis also identified examples of the nature of healing for both communities.

Oppression across communities

Oppression refers to the prolonged cruelty and unjust treatment in the community of Palestine and African Americans. While they have different natures of oppression (i.e., the Palestine community experienced a long occupation, whereas the African American community was brought into the USA through slavery), the mechanism of oppression is perceived to be similar and systematic. This mechanism was articulated by the participants in three phases. It starts with (i) land occupation, (ii) social demoralization and disembodiment, and (iii) wealth displacement and lack of job security. It is more apparent in the case of the Palestinian community, which the participant referred to as “a strategic plan.” GA (pseudonym) from Palestine said, “Since before the Nakba, the Zionist movement put like a strategic plan how to take over everything in the area here.”

Nakba is the example GA mentioned that refers to the land occupation of Palestinian in 1948 and continues to the present day known as the displacement of Palestinians from their lands. Land occupation is perceived to be the first phase by occupying as much land as possible to the point that it goes beyond the Palestinian jurisdiction to extend to neighboring countries, “When I say everything, it's not only Palestine. It also goes to Jordan, Syria even to Iraq.” GA.

The strategic land occupation can also be seen to operate in a “smart” way. The oppressors claimed lands rich in natural resources and affiliated with their religion. For instance, the oppressors were interested in the Jordan Valley as it is among the richest agricultural areas in the Middle East. West Bank and, recently, Jerusalem is the focus of the occupation. Jerusalem, particularly, has been their interest for its religious centers such as Sheikh Jarrah, High Silwan, and Milhava. This was explained by GA,

“After they confiscated thousands of hectares in the West Bank, they are now focusing on Jerusalem. We have three areas in Jerusalem that they alligate because of Jewish religious affiliation, so they want to displace the Palestinians from Sheikh Jarrah, East Jerusalem, High Silwan, and Milhava, from the east side of Jerusalem.”

The land occupation does not stop there and is instilled in young Israelis through education. GA mentioned that it is common in school textbooks to tell students about their country's borders, including the Palestinian territories and the neighboring countries, “they (the oppressors) have textbooks, that teach their children that our present borders are now the Jordan Valley but in the future, it will extend to Vigla, Syria, and Iraq.”

Given the expanding nature of the occupation, Palestinians have often been left no choice but to protect their lands and houses. “We have no other place to go to, that's why they keep in their homes.” This resistance, however, comes with consequences such as violent confrontations with the settlers. This situation of being “trapped” in their own homeland also means that Palestinians have to live in often poor living conditions,

“... the people are living there and that more than the disturbing conditions, but they are not leaving the areas, because they have no other alternative. Where are they going to go to? Jordan is not allowing them to go. Syria is not allowing them to go. So, either they keep living in this land if they pass away or they go and they have violent confrontations with the occupation.” GA.

Another consequence that Palestinians face is housing demolition. Thousands of Palestinians’ houses are being and will be demolished as a punishment for their resistance. “The occupation is applying houses destruction as the punishment procedure to, to stop the Palestinian resistance to the occupation.” He even mentioned his house is among those that are about to be demolished, “there are 20,000 houses in Jerusalem, Ramallah, Hebron areas that are facing being demolished. And my apartment we are living in is one of those 20,000.” GA.

The next phase is social demoralization/ disembodiment and wealth displacement when the lands have been occupied. This phase refers to making Palestinian people distinct individuals, separating their society, and taking away their belongings. Under such living conditions, Palestinians cannot function as a healthy society. Their daily lives are filled with violence and aggression, and they have no time to care for each other. There is growing dissent among the people, “People have become indifferent. They do not believe that there is a hope or a future for themselves and their children, and they are becoming indifferent.” GA.

What was known as a friendly community has turned into a community of resentment and aggressive relationships. GA provided an example of how Palestinians were used to having a strong sense of community. When a community member dies, people will line up in their houses, showing their grief and condolences. But this kind of culture starts to diminish. One reason is that building a relationship might lead to problems, “they avoid having social relations with others. I don't want to call it dissociation, but it is a kind of or form of dissociation. They prefer not to keep in touch or not to build relations so they will not have new problems and crises.”

Such living conditions also mean that the Palestinian younger generations do not have the means to achieve their promising futures. It is common for them to drop out of school and live unemployed. One of the major reasons is that going to school is not a safe journey anymore because child abduction and murder have been a concern of parents, “... parents tend not to encourage their children to go to school, because they are afraid that their child might come back to them, being shot by the Israeli occupation.” GA.

GA describes such horror with his neighbor’s child, who was abducted and later killed.

“He was living with his family not far away from our home, here. He was kidnapped early in the morning while he was going to school. He was kidnapped by the settlers, and the settlers put him on fire and it took the family about 3 days to discover his burnt body.”

Within this condition, it is expected that unemployment rates will increase among Palestinians of productive ages. With a lack of schooling, particularly vocational education, as the prerequisite to getting a job, young Palestinians are losing their future. Even though they can go to school, they lose the motivation to study. GA mentioned that before 1967, the Palestinians were known as among the most educated people in the Middle East, but since the occupation, they have been among the most illiterate.

“Children who go to school are losing the motivation to achieve academically. They are not paying enough attention to education while, before 1967, it was well known all over the world that the Palestinians are the most educated people in the Middle East.”

GF, a participant from the African American community, agreed upon such a mechanism of oppression. Although they have different initial occupation histories, GF mentioned that the oppressors did not invent any new mechanism in their practice. They displace people from their lands, separate them from their community, and demoralize the people, or what GF terms as separating a person’s body from their soul. This approach not only destroys the materialistic possessions of the people but also their psychological development. “For me, what resonates is that the oppressor really has not invented anything new. It seems like the same kind of mechanisms that have been in place in Palestine are many of the same mechanisms that they use and have used in America.” GF.

In the context of the African American community, land occupation happened through socio-economic mobility restrictions. For instance, it is common for African American people to be separated by boundaries, so they would not be able to cross over the country's towns to develop their social and economic practices. Murders can be the consequence if that is to happen. “We were separated by very strong boundaries. You didn't crossover into this part of town or this part of the country because of the fear that you would be killed if that occurred.” GF.

Such a restriction was very common during slavery, and yet it continues in the post-slavery period in which African Americans gained their rights to be free and independent. While the US is often established under meritocracy and liberty, where people can choose what they do, the African American community remains restricted. The American Dream is far from them as they cannot perform and develop their own social and economic practices. Even though they could be successful, the person and the community are often subject to murder and destruction. This was explained by GF in the interview.

“There was this myth that you could grow. You could prosper; you could fully exercise yourself in most parts of American Society. The reality is that, if you were too successful, if you were to be successful, you were subject to be killed. You were subject to be destroyed and not just you as an individual, but your whole community” GF.

GF gave an example of the Tulsa Massacre, the destruction of a relatively successful black community in Tulsa, Oklahoma, due to racial sentiment in 1921. It is the sentiment that GF mentioned as the racist tropes, that is, the idea that black people are socially and cognitively inferior and that their existence could threaten the white population.

“... This idea that black people were less than human, that we somehow endowed certain powers, certain characteristics, we were less intelligent, and so that meant that we needed to be controlled, not just to protect us from ourselves, but also to protect us from the wider white population” GF.

For GF, the Tulsa Massacre is an important point of the persistence and growing deficit view towards African Americans that can be seen today in the form of social demoralization. They are constantly living in fear of violence and murder. Ironically, this fear comes from state agents such as the police who were supposed to be their protectors. Violence against black people by police officers is increasing. As such, it is common among young African Americans to have conversations about how to face state agents instead of schooling or other teenager-related activities. Such conversations have been internalized by young African Americans and this is not normal for teenagers in a developed country like the US.

“You know often when we talk about the talk in America, it's about teaching teenagers responsible interactions and trying to make sure that there's no out of wedlock births. Those kinds of things, but in an African American community the conversation is how you have to behave in order to survive interactions with the police. You know the fear that parents have of children leaving and not returning the way that they left, is still rampant in our community at this point” GF.

The people of Palestine and African Americans have been living under constant occupation, violence, and murder. While they have historically different kinds of oppression, the mechanism remains the same. They are forced to relocate their lands and restricted from performing economic activities. Their community is being destroyed from within through constant fear, violence, and assassination. Under such living conditions, people experience different kinds of trauma.

Resultant symptoms across communities

Living under constant violence and systemic racism, it is expected that both communities experience many kinds of trauma symptoms, such as posttraumatic stress, depression, and anxiety. Trauma was defined by participants as events that cause distress to the physical and mental health of an individual. Due to the long nature of the violence, both communities experience intergenerational trauma, the kind of trauma that lasts for generations.

In the context of Palestine, ongoing violence such as murder, kidnapping, and house demolition, among others, have been part of their daily lives, and the effect has been so massive that it practically destroyed the community. GA mentioned that around 80% of the people experience traumatic events, and the number is worse in areas with constant conflicts, such as the West Bank and Gaza. “Eighty-three percent of Palestinians experience traumatic events according to a recently published study, not less than 92% of the Palestinians in the West Bank, Gaza is suffering from traumatic events.” GA.

With such magnitude, people tend to lose hope and become indifferent. They do not believe that the future is in their favor and that their social interactions in the community are forsaken. In other words, as has been mentioned before, the life of the Palestinians has changed in the worst possible way. Some traumatic events have become endemic, particularly in the older generations, due to a lack of trauma healing and awareness.

“Traumatic events in Palestinian have become endemic and it's more difficult to cure such indirect traumatic events, mainly with the old generation. ... the reason it has become endemic is because of the semi-absence of public awareness about the need and the importance of mental health. The second is the shortage of trauma recovery techniques in the Palestinian Community.” GA.

Within this condition, poverty is inevitable. As a mental health advocate, GA described the struggle in the community by mentioning the lives of the Bedouins who live in Aqbah. In this place, it is common to see young boys without clothes. “The children you work with come to you without underwear, imagine, without sandals, without shoes. We have 40% of unemployment in the Palestinian Community.” GA.

Apart from this appealing living condition, GA was optimistic. He mentioned that many Palestinians do not surrender and believe a better future will exist. As a mental health activist, he is working hard to help the people and at the same time show the world that the people remain hopeful. “I don't want them (people of the world) just to see unpleasant things because we, the Palestinians, we do have also pleasant things and we are eager to live our lives increased like other human beings.” GA.

In the context of the African American community, their trauma largely comes from systemic racism. It refers to unfair treatment based on racial prejudices that are deeply embedded in systems, laws, and written and unwritten policies [19], and this occurs because African Americans are considered inferior. Such deficit ideology of the African American community still persists in American society. For instance, GF mentioned the destruction of the black community in Tulsa that up to this day, there have been neither formal acknowledgment from the government nor reparations paid to them “That community was completely leveled and up until this day, the government has never given reparations to any of those individuals who survived it. They have never given reparations. There has never been an acknowledgment.” GF.

While other ethnicities in the US such as Japanese received one, the African American communities are excluded. “There have been reparations paid to the Chinese but despite repeated requests and legislation and argumentation and protests, there has been no acknowledgment by the US government that they should pay reparations to anyone, in the African American community.” GF.

Such past violence denials leave a profound impact on the physical and mental growth of the people. GF stated that there seems to be a mechanism to traumatize African Americans that impact their future selves.

“To traumatize African Americans, some of those same techniques that sort of disembodiment that I feel when we talk about the historical trauma and how historical trauma builds into the current circumstance to the current context of existence and how it dictates how future generations will behave because we pass those traumas on. Mechanisms are so much… so similar, many of them the same when we talk about.” GF.

The effort to disembody African Americans is worsened by the fact that the people have little access to trauma healing programs. For a wealthy country such as the US, health care is still an exclusive product that not everyone, such as people of color, can afford.

“We know those are key elements that you would expect in any country that is as wealthy as the United States, that all citizens would have access to trauma healing programs - that has not been the case with African Americans.” GF.

GF further mentioned that, even though there are some trauma healing programs, they tend to be Eurocentric and do not work for the nature of trauma experienced by people of color and black people in particular. “The vast majority of professionals and mental health and the United States is, you know, they're European Americans.” GF.

It can be concluded that Palestine and African American communities suffer historical and intergenerational trauma due to long-term violence and aggression. Such trauma has impacted their daily lives and dictated their future. The Palestinians, both old and young, suffer traumatic events, live in poverty, and generally lose their hope of having a good life and functioning properly as a society. The African American communities suffer historical trauma denials and limited access to trauma recovery programs that are based on African American cultures. They are still seen as a second-class citizen with restricted access to resources. While both communities require comprehensive trauma healing, the results show that their trauma understanding can become both barriers and facilitating factors. The next section will discuss trauma understandings in both communities and identify potential trauma healing approaches that may work.

Comparative barriers to understanding trauma

In the process of understanding the trauma, there were numerous barriers identified. Dogmatic religious beliefs that at times undermine rational thinking and a lack of public awareness in the Palestinian community were examples. People cope with their traumatic experiences by placing their fate entirely on God’s will. In many cases, there is no solution to the systematic and institutionalized oppression that the communities experience which leads to a sense of a person’s helplessness. Thus, personal power and autonomy have been shattered by the ongoing oppression and people have no other options but to choose to rely on the higher being that can cure and/or rescue them. “This is not an issue made by man. It is something from Satan, and it is their destiny. And it's only God who can rescue her hand or cure them.” The same barrier of struggles to obtain power over one’s life and striving for personal agency remains persistent for African Americans. “How do we help people understand that they have control over their life when everything that has been done tells them differently? When all their experiences tell them differently”. While in the Palestinian community faith and religious beliefs served as a tool for coping and at times denial, in African American community, faith has been used as a tool of oppression. Many African American slaves were taught Christianity by their masters focusing on the concept of obedience. The message African American slaves received was that “this earthly paling is not where we should seek our validation; ultimately our validation is in heaven.” The oppressor taught that part of the process of getting to heaven was linked to being obedient. The goal for the masters was to ensure the slaves' adherence to the dogma and doctrine and not the spiritual that could lead to empowerment. Religion was not used as a tool of empowerment and healing but as oppression and obedience.

In the environment of constant murders and lynching, such invisible injuries as psychological trauma become secondary. That leads to another barrier which is a lack of understanding and awareness of the importance of mental health. Despite the ubiquitous and chronic depression, Post-traumatic Stress Disorder (PTSD), and other related mental health struggles related to loss of hope and motivation as well as a rapid decline in academic outcomes for the children, it is still not common to seek mental health assistance in the Palestinian community. “What makes it more difficult in my community here is the shortage of public awareness and the need to cure not only physical injuries but also psychological injuries.” The interviewee also noted, “We need to start with convincing the majority of the Palestinian community that healing is something that may lead to positive outcomes. Because unfortunately the majority still believes that it is not fruitful at all”.

Domestic violence and internal injustices, such as illegal prosecutions of political opponents also take secondary nature in the face of horrendous chronic slaughters and mass killings. The community prioritizes children and women's safety and survival above all, thus violence against the adult population and their emotional well-being often is not a priority. There is also an internal rivalry between the Palestinian political opponents that can result in the illegal house raid and execution of the families, including the minors. However, even such cases are set aside as the Palestinian people have to prioritize the occupation and traumatic events as well as keep children and women safe. “This last June we had 28 children who were killed just in one month. So, this is the priority for the Palestinian community, how to deal with traumatic events caused by the occupation and they are putting domestic violence aside”.

Access to quality health and mental health services has been a long struggle for African American community and a residual effect of the longstanding historic oppression. Up until the adoption of the Affordable Care Act, such services were a privilege of wealth and disproportionally affected communities of color’s ability to receive much-needed help. However, the lack of access to healthcare is just one side of the coin. The other one is the unavailability of appropriate competencies and tools to deal with historical and intergenerational traumas of African American people in the United States. Most interventions are designed for American people of European descent and mental health professionals being trained in order to deliver services to European Americans. African American people were mostly treated as “dark-skinned European Americans” while such powerful aspects as culture and community-specific traumas were dismissed. As a result, most of the interventions were not as successful when applied to African American people as they were to European Americans. The interviewee highlights the importance of applying an ecological lens, understanding the needs, and adapting such vital tools as Cognitive Behavioral Therapy to the needs of the African American population to address stress, anxiety, and depression. “While that information is out there, there is not a whole lot of work or research looking at how we adapt something like CBT to make it more receptive in the African American community?”

The African American people were historically mistreated and betrayed by the state agents who led to mistrust and fear of being prosecuted by the state agents. Sharing information with an external person such as a counselor that is in many cases associated with state institutions does not make African American people feel safe. It leads to unwillingness to seek mental health assistance, thus creating an additional barrier to the path of healing. Similarly, constantly living in survival mode and a state of danger makes it difficult to concentrate on healing. The priority is staying vigilant and surviving interactions with state-sanctioned agents. Interactions with state officials lead to such consequences as being beaten up or killed. Such instances shape the way the African American people construct their conversations with their growing-up children that primarily revolve around survival. That is not a norm for European Americans and should not be a norm for African American people. “I can remember as a child the conversation that was had with me, and it is a social script that's run over and over. Don't look them in the eye. Say yes, sir. No, sir, don't ever pull off into a part of a highway that is not well-lit. Make sure if the policeman stops you, you go to a well-lit spot, or if you can, or a well-traveled spot.”

The barrier of unaddressed trauma interventions does not only stand in a way of healing for adults but also in a way of proper development of the children who were born and raised in a state of chronic trauma. It is particularly difficult to expect a traumatized child to learn, develop and succeed while not addressing the underlying issue. As a result, such children do not perform well in school which leads to less-than-optimal life outcomes. “Without being given this proper support and unpremeditated trauma, how can we expect that children are going to perform at the same level? Matter of fact, we penalize them based upon culture.” “That's the intersection between trauma and education leading to life outcomes. And what does that mean for not just this generation, but future generations? If we cannot remediate that trauma at this point, how can we expect better for our children and our children’s children? We can't expect it”. During the interview, one can observe the deep feeling of grievance over lost opportunities for the youth and the heartbreaking issues that have become an abnormal norm in African American communities. The interviewees shared that those other children while growing up have conversations with their adults and mentors on how to successfully function in school and how to be proper and upright gentlemen or young ladies. While all these values are important in African American communities as well, the priorities and conversations are shaped around survival instead of prospering. “You know the fear that parents have of children leaving and not returning the way that they left is still rampant in our community at this point”. “So those are some of the ways in which you know there is this programming and conversation about how we survive. How do we survive interactions with state-sanctioned agents?”

Approaches to healing across communities

In discussing healing, interviewees identified indigenous approaches in healing. One of the interviewees brought up a proverb that demonstrates the centrality of women in the healing process of communities, “to catch the moon, we have to throw the arrows to the moon, and the stars around the moon.” The Palestinian mental health practitioners focus on recruiting women within the targeted group for training as they are the ones who ultimately disseminate trauma recovery techniques to their families. “Women in my community are playing an important impact, at home with their families and husbands. So, the time we succeed to create this impact on women and mothers, we may succeed in widening the circle of family and public awareness.”

Another centrality of women's pattern was identified while analyzing the story of the African-American community representative about his grandmother, “When I think about education, I think about my own family and I think about my grandmother.” The interviewee’s grandmother instilled a love and appreciation for education in her children and her grandchildren. While she herself had no access to education due to financial circumstances, deeply rooted practices of social injustice, and unfair access to education, she raised them with the notion that the most important thing was to get an education, because education will lead to better life outcomes. The woman believed that everyone should have access to education, and while she alone could not change the system, she instilled an appreciation for education in several generations of her offspring. It is fascinating to see that her grandson is working on fair access to education for children in communities of color, directly fulfilling his grandmother’s belief. The interview concluded that while this story is deeply personal for him it is not unique, affirming the pattern of the centrality of women in the healing and empowerment process.

Discussion

Comparison of trauma exposure

The current research provided a unique case study comparison of the perceptions of trauma and healing from two scholars from the African American and occupied Palestinian communities. The study found that both communities experienced pervasive and endemic intentional trauma exposure inflicted by their oppressors. A common finding for other communities that had experienced colonism [20]. Racism, extreme violence, murder, kidnapping, incarceration, torture, and abuse were all reported for the Palestinians and African Americans. Land occupation, house demolition, social mobility restrictions, lack of security and safety, wealth displacement and poverty poor living conditions, and lack of opportunity for employment were also common features of their communities’ living conditions.

Resultant consequences of intentional trauma

As a consequence, indigenous scholars observed pervasive complex trauma occurring across the generations. The majority of children and adults were reported as presenting post-traumatic stress, loss of hope and depression, prolonged grief, anxiety, a range of dissociative conditions, physical health problems, and problems of self-identity and self-concept. Such a pervasive and enduring impact of intentional trauma is supported by numerous studies for both communities [13,21,22].

Barriers to understanding trauma

In relation to the communities’ understanding of trauma exposure and its connection to symptomology, the indigenous scholars reported a range of barriers and facilitating factors. The Palestinian expert emphasized the role of a fundamentalist interpretation of religion, the stigma of mental health as a concept, and the avoidance of addressing domestic violence and intra-community conflicts in response to the overwhelming challenges of occupation. In contrast, the African American scholar emphasized the lack of culturally attuned therapeutic programs and discriminatory barriers to accessing therapy, and the omission of a rite of passage for youth to adulthood caused by a disconnect to cultural and geographical histories. Another barrier for African American children, youth, and adults was the explicit teachings they experienced on how to respond to the police. Strategies tended to emphasize compliance rather than a deeper understanding of how to address oppression and trauma. Previous studies have identified a range of systemic barriers in African American and Palestinain including non-attitudinal factors such as financial difficulties in accessing treatment [23,24].

Facilitating trauma understandings

Both scholars emphasized positive examples of the way in which community understanding of trauma was facilitated. Although there was a high level of commonality, in Palestine, the emphasis was on the efforts that had been made to promote mental health awareness through public health campaigns, and the persistent delivery of trauma-specific interventions, especially with children and youth as well as with the counselors themselves, who shared the community trauma experience. Indications were that progress is being made in community understanding of the causes and consequences of trauma. Further, despite the context, the Palestinian scholar spoke of these strategies fostering resilience and instilling the feeling of security as well as a “never give up” attitude. In contrast, the African American scholar emphasized the importance of African Americans valuing themselves and their communities through Afrocentric thinking and its connection to the growth of self-concept and identity. Similar to Palestine the need for pro-active active public mental health awareness campaigns was emphasized. Such an approach builds on prior initiatives in raising public health and human rights approaches [25].

Community healing practices

In comparing community healing practices across communities, the Palestinain scholar focused on the centrality of women. Women were seen as having the power to educate and shape attitudes toward mental health and healing behavior. Because of this, psychosocial and trauma training and interventions were predominantly focused on women and children. Women were seen as a resource for informal community connectedness that builds upon their greater capacity to express empathy compared to Palestinain males. The African American scholar focused on whole families and communities, and the role of both males and females. Similar to Palestinain communities, importance was given to recognizing trauma, however, greater emphasis was given to the impact of trauma on self-concept and the need for healing to address both individual and community racial socialization. To address treatment efficacy, recent studies have also called for their inclusion of racial socialization into traditional Eurocentric and North American therapies such as cognitive behavioral therapy [26].

Ongoing community needs

The Palestinian scholar spoke of the importance of the need for the international community to provide tangible help, the need to culturally adapt healing approaches from the West, and to keep the primacy of focus on women and children. The African American scholar also spoke of cultural attunement, a focus on local contexts, and traditional healing practices, setting this within a historical and ecological perspective. Specifically, there is a need to adapt Western trauma recovery models to enable their efficacy with African Americans, fitting better with African American epistemologies. For example the inclusion of historic trauma in therapy delivered by white therapists [27]. At a social level, there is a need to increase fair and equitable participation within US society and culture for African Americans through addressing racism including the building of allies.

Mechanisms of intentional trauma

Both scholars situated the enduring adversity experienced by their communities as “intentional trauma” which they defined as “the type of trauma that results from the purposeful acts of implicit and explicit acts of violence and oppression from others.” The scholars noted that the etiology of their communities’ trauma is cultural, racial, ethnic, and religious, and is effectuated at the individual level. Furthermore, intentional trauma was understood as increasing the likelihood of self-concept fragmentation [28]. Both scholars referred to increased PTSD prevalence rates among individuals who have been exposed to intentional trauma. They viewed intentional trauma as a practice used to dominate and control the populations of their people and highlighted the power intentional trauma has to shape cognitions, intra and interpersonal interactions, and life trajectories not only in the primary generation but in successive generations [29-31]. The mechanism of intentional trauma was described as “becoming the cognitive representation of the traumatizer which serves as a conduit to attack the self-concept of the host. The internal cognitive structure is reinforced in the physical milieu by institutional violence that targets self-concept. This system of control usually remains in effect until the traumatized, over many years and often generations, physically and symbolically remove the traumatizer and all surplanted mechanisms of trauma.”

These mechanisms along with institutional violence were seen to stabilze, propogate, and calcifyies that which is the result of the disunion of self, hindering individual and group actualization. The scholars referred to viewing the effectuation of trauma compontentially, i.e. “primarily, there is the exposure to the trauma; secondly, there is the imparting of the mechanism of trauma, and lastly, destabilization of self-concept reinforced by institutional violence.”

Studies from both communities suggested a multiplicity of ways that trauma is maintained [32]. While the oppressor/tormentor originally inflicts the trauma, through a variety of mechanisms and behaviors that has become negatively valanced and maladaptive, the traumatized aid in maintaining the traumogenic state, primarily through a lack of understanding of trauma and its many manifestations. The scholars viewed trauma as encapsulating the being of the individual, “as trauma becomes normal, and maladaptive behaviors are explained away.” Indeed intentional trauma becomes expected and accepted as the appropriate method of interaction with self and others. It becomes the preferred method of dealing with those most close to you, spouse and children. Domestic violence becomes the modus operandi of family disagreements.” The data elucidates the propensity of intentional trauma to be turned inward. In both communities there have been increases in illicit drug use, school attrition, and increases in suicide. Both communities spoke of the completely vulnerable feeling when the states sanctions and perpetuates violence against the community. As GF put it, “It is particularly disembodying when the state that was meant to protect attacks an individual or group based upon definitional principles-race/ethnicity, religion, and geographical location”.

Limitations

The current study was an exploratory case study aiming to generate future research questions rather than generalization of results. There were only two interview sessions and therefore questions and issues were not exhaustive; many more issues are relevant and need exposed. Other indigenous scholars may have produced a different set of priorities, needs and vision. The use of insider and outsider analyses provided a mechanism to test validity and reliability; however, a more participatory research approach may have yielded more of an indigenous analytical lens and resultant narrative.

Conclusion

Despite the very different contexts of occupied Palestine and the postslavery discrimination and violence towards African Americans in the USA, the current study found a high level of commonality of trauma exposure, and resultant symptoms, the latter, captured by the concepts of historic trauma, intergenerational trauma and complex trauma. Both exposure and resultant symptoms were seen as the consequences of ‘intentional trauma’ by oppressors. Despite the enduring oppression, both scholars highlighted the centrality of hope and the community commitment to never give up. Both took a strength-based, resourceful and culturally attuned perspective to their communities healing through identifying facilitating factors to overcome the many created barriers of intentional trauma as well as traditional healing practices and the building of allies beyond their communities.

Recommendations for Future Research and Practice

Research is needed to explore a wider range of issues between African Americans and Palestinians than were able to be identified in this study. The issues that were identified in terms of exposure, symptoms, barriers and facilitating factors as well as traditional healing and the adaptation of western model of therapy all need further study. It is recommended that a range of robust methodologies are needed including participatory action research which provides a liberating and emancipatory approach for communities that have experienced intentional trauma.

Acknowledgement

Dr. Mohamad Rabaya, Assistant Professor of Education and Mrs. Shaden Abu lei, Doctorate student, Arab American University for their review of the data analysis.

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