A conference for mental health professionals in Tel Aviv in early April, 2006, was billed as an opportunity for dialogue. I was invited to give an opening keynote on the family origins of prejudice, but I went mostly with the hope of learning about mental health in Israel and the Palestinian areas.

So I was disappointed when Mohammed, the lone Palestinian psychologist in our discussion group was fairly silent the first day and did not show up for the second. When he arrived the third day, as the discussion raced past us, I heard him explain why he had been absent the day before: He was late because he had to ascertain the schedule of checkpoint closings. In addition, his time at the conference for Gaza on this, its final day might be limited. Perhaps he and some other Palestinians would have to leave early because they had to time their return with the closing of the checkpoints that changes from day to day, often without warning.

Organizers of the conference, all psychotherapists and researchers, including an Anglo-American psychoanalyst, two senior Palestinian men and three Israeli women, at the conference closing

What our group had been discussing suddenly seemed trivial compared to what Mohammed and his Palestinian cohorts had to deal with, and focusing on their plight suddenly gave a new perspective to the rest of us. In the ensuing conversations with Mohammed and other Palestinian psychologists and mental health workers, it was plain that we needed to hear their voices. These are professionals who speak with moderation and concern for human suffering. They work every day with patients who are subject to many constraints and who also exhibit short sighted, self destructive behavior on personal and political levels.

This conference offered an opportunity for Israelis and those of us from the international community to hear Palestinian voices that do not often get a hearing in the American media or as far as I know, in the Israeli and Arab media. They offer a thoughtful, balanced and dedicated voice that is on the same footing as the extremely competent and dedicated Israeli professionals with whom I was already familiar. Like their Israeli counterparts, the Palestinian therapists and researchers work tirelessly and dispassionately to seek improvement for the many victims of conflict. Because the Palestinian population is itself so traumatized, it needs their help desperately, both to heal the wounds of almost daily trauma, and to keep such traumatized experience from continuing to turn the population to expressions of violence as the only salve to helplessness.

The conference, called "Imagine: Expression in the Service of Humanity," was organized by Lesley University, which has programs in the expressive therapies at campuses in Boston and Tel Aviv. The conference was designed to bring Palestinian and Israeli psychotherapists and researchers together with international contributors. As someone who has worked on the subject of malignant prejudice at other such gatherings, I was invited to participate. So it was with a mixture of interest and dread about the helplessness of the chronic situation in Israel that I prepared. Knowing that Israelis live with threat of danger every day and that Palestinians live daily with oppression, confusion and trauma of a high order, I went with some anticipation of danger, which fortunately did not materialize -- at least not while I was there.

In the three days I was there, I learned more than I taught. When we arrived, we found that organizers had worked diligently to make it possible for the Palestinians to get permission to attend, and had then carried out the complex logistics required to get them through the checkpoints, pay for their food and lodging, and make them comfortable by organizing several pre-conference meetings designed to give everyone a chance to test out their expectations and worries.

The conference turned out to offer an unexpected chance to cross the divide. I had worked with Israeli clinicians several years ago when my wife and I taught family and couples therapy there. They are well-educated and sophisticated, and although diverse politically, mostly open to understanding and sympathizing with the plight of the Palestinians and the colleagues who serve them. But this conference offered a unique opportunity for the Israeli and Palestinian groups to hear about each other's work in depth. Throughout the three days, we heard talks from Israelis and Palestinians, from universities and clinics, as well as from the imported foreigners like me. The range of work was creative and knowledgeable about similar and leading edge practices around the world. There were clinical and research programs in treating trauma, in infant mental health, in family therapy - a wide range representing any well funded and well staffed set of services in developed countries. But it was evident as we listened that the Israelis had a huge advantage in these areas: access to training, to government money, and to exchange with the wider professional world. The workers I met from the Arab Alquds University in East Jerusalem and from Gaza Mental Health Program were wary at first about the grounds of their participation, but they grew increasingly eager to tell their stories. They work with few resources and enormous daily trauma, against the odds, often in government-run clinics that are always short of training, supervision and resources.

Mohammed's discussion of checkpoints led the group to a larger discussion. Palestinian clinicians are cut off from one another because of these checkpoints in Gaza and the West Bank, and, ironically, can only meet occasionally in Israeli territory. They talk by phone, but can not meet, as the new security wall that now weaves through the Palestinian territory cuts off access between home and work, and between families.

The old market in Jerusalem

Later, an English colleague and I sat with Mohammed and his colleague Marwan, as they spoke about the difficulty of their situation, how they dealt every day with the traumatized children in the Gaza Mental Health Program. To illustrate, Mohammed told the story of a group of four 11-year-old girls, who decided that in order to do something about their situation, they would walk to a settlement hiding a knife, and call out to a guard. They imagined he would come out to talk to them, and that they would then stab him, grab his gun, and shoot as many settlers as possible. Fortunately they were overheard by other girls who told the headmaster. Still it was only as they were walking towards the settlement that they were caught. Parents were called. One girl's father was furious at her. As he was yelling at her, she said to him (in paraphrase,) "How can you be upset with me? When you watch television, you cheer at the news of a suicide bomber, and the more Israelis he kills, the more you cheer. I was only trying to live up to what you expect of our heroes." The mental health workers know how destructive this attitude is for the children, so they worked to introduce more possibilities into the girls' narrowed way of responding. They have seen, over and over, how the Palestinian children respond to their social and personal helplessness by developing a one-track idea of suicidal retaliation, the kind of mentality that leads to suicide bombing and the social support of the bombers. Eventually, through psychodramatic group intervention, these girls came up with a scheme to raise money for victims. At first the girls could only think of helping the families of suicide bombers, but then were able to move beyond that relatively narrow focus to the larger idea of raising money for all children who had lost parents, an enlarged and no longer retaliatory point of view.

Mohammed and Darwan went on to talk about how they work in isolation. They have no support from outside and work with what resources they have. They cannot get out of Gaza with any regularity, and no one comes in to supervise or teach them. The children and families have suffered multiple losses, and the mental health teams see evidence of the constraints and losses everyday. The professionals also suffer with the continuing burden of treating social and personal tragedy.

Later, I talked to a young woman doctor wearing a head scarf, who is pregnant with her first child. She lives and works behind the wall the Israelis are building. While she was born in the US, her family moved back to Israel while she was a child. She spent her young years in the West Bank, but her family decided their children were not getting the opportunities due them, so they moved back to the US where she completed secondary school, college and medical school. She has now decided she needs to give back to the Palestinians.

David in the tea room of the Old American Hotel in Arab East Jerusalem

Her Palestinian husband is also a professional, and yet, can not fully understand her situation, caught between American values and a dedication to helping. She spoke with a kind of altruism many Americans would share, yet she feels she does not fully belong in either culture. In choosing a Palestinian identity, it seemed to me that she has not yet faced the kind of situation with her own children that caused her parents to move back to the US for her education. She is young, idealistic, with a nomadic quality to her identity, hungry for people to understand. She feels she does not quite belong anywhere, not fully as an American nor yet as a Palestinian. She voices many of the values I would expect to see in American women professionals who grow up expecting to be productive at work and full partners in marriage. Yet in wanting to assert her identity as a Palestinian, and to be able to help Palestinians directly, this young woman has no choice but to encounter the different social demands of a culture that calls on women to be subservient to men.

In America, this woman would not necessarily stand out, but she could be liberated. In her new home, she must be constrained by custom and culture, but she has a chance to make an enormous contribution. I admire her, but wonder if she will accomplish more in a culture of constraint, than she could by staying in the US and taking an easier road.

David outside the Old American Hotel in Arab East Jerusalem

(David's email address is davidscharff@mindspring.com.)