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Israel and Palestine need Trauma Therapy.

Here are my thoughts on why it’s imperative to recognize the role of trauma and its consequences when negotiating peace. What we know about trauma is that it affects emotion regulation. We have research that suggests that serving in war, being traumatized as a child with violence or sexual abuse, witnessing violence in a violent home, all contribute to problems with emotion regulation. Emotion regulation – trauma and the brain. Whether a country can develop a mental illness or sequelae of symptoms is not often discussed, but isn’t it feasible that a country that is living in chronic fear, and instability, where people have suffered violent losses for many generations; that this might have an affect on the psychology of the people living with the trauma? Isn’t it possible that a country living in chronic trauma might develop a generalized world view that is more like a victim of trauma than not?

One of the foundational components of DBT developed by Marsha Linehan, is the concept that trauma alone is not the problem but that these problems become intractable when they are combined with what Linehan calls an invalidating environment. Linehan refers to a pervasive invalidation as an important component in the development of treatment problem when treating complex PTSD or Borderline Personality Disorder. An invalidating environment is defined as a pervasive message from the environment that personal experiences of events are not valid. One prime example of this occurs where there is abuse. Minimize, deny and blame are the behaviors of most violent perpetrators. Rapists, child abusers and violent spouses use this coping to augment the shame they have or to deny culpability for violent or harmful behavior. This creates an invalidating environment for the victims of the behavior and undermines self trust. Furthermore, if emotional reactions are not validated, emotion regulation is not modeled or learned. Instead what is learned is a method of pushing away or avoiding emotions, which leads to further complications.

When emotions are denied or invalidated and then pushed away, victims seek other means to cope with the discomfort of these emotions. Over time the emotions well up and must be pushed back in some way. What often develops out of coping like this is mood swings and then impulsive behaviors to distract from uncomfortable emotions. These behaviors are often linked to addictions, substances, eating disorders, sexual addictions or spending problems. Obviously at this point a cascade of problems spiral. With these addictions and mood swings comes interpersonal problems, and to cope with shame, cognitive dysregulation. . The result is that the individual develops problems in coping that are extremely debilitating in the all aspects of life. These folks have trouble at home and at work. They have trouble maintaining healthy relationships, they have trouble keeping jobs, they often vacillate between feeling like a victim and feeling shame for acting out against the discomfort in their lives.

Dialectical Behavior Therapy was developed because many therapists had trouble working with these clients. Often times the therapists would become angry because these victimized clients often exhibit something Linehan calls "active passivity". That is that they frequently wait for others to change instead of changing themselves and are often quite passive in regard to changes within. To change the self invalidates the trauma and suggests to many with the disorder that they are "wrong". This triggers invalidation and acting out. These clients have a tendency to put the therapist on a pedestal one moment and then be completely intolerant when the therapist makes a mistake. The black and white thinking exacerbates this and makes it very difficult for the client to heal and change. At the same time the therapist often begins to feel ineffective and then blames the client. Sometimes the therapist gets defensive and judgmental and is unable to hold themselves accountable as a role model to the client. This results in a spiral that often ends therapy. This dynamic is typical when working with these clients. Linehan’s program treats the client and the therapist. DBT requires that the therapist attend a consult in which the skills taught to the clients are also used and practiced by the clinician.

To counter the dichotomous thinking associated with victimization and trauma, Linehan suggests the use of the "dialectic" as a foundational component of DBT. This is the idea that all things in life are combined in polarities. So water is soft and hard, the sun is healthy and unhealthy, mold is healthy and unhealthy etc…In DBT the clinician uses and role models the dialectic to encourage flexible thinking. This increases the repertoire of thoughts that might be fueling emotional reactions. It changes significantly the landscape for both clinician and client. World views are changed. One might theorize that the paradigm changes from one of victim to empowerment and accountability, for both the client and the therapist.

The therapist and client acknowledge the dialectic between validation for suffering and healing. It is acknowledged that to heal from victimization feels invalidating. And often times feeling invalidated is a trigger for "reacting" instead of finding effective long term solutions.

The suggestion here is not that Israel has a personality disorder, or that Palestine has a personality disorder per se, but that as a whole these cultures are engaged in an ineffective cycle that needs to be changed. It is a fact that this cycle has been going on for decades, and that normal diplomatic formulas have not been effective in reversing the cycle. It is also true that the dysfunction of intervening countries and diplomats has an influence in the process as well. Sometimes this influence has been effective and sometimes not. The United States in the role of therapist has sometimes engaged in ineffective role modeling and sometimes has reinforced behaviors that were not effective. The therapist who over-validates the victimization or damage is as ineffective as the one who invalidates it.

The dialectic used by both client and therapist resolves this tension so therapy or "change" can continue.

The United States is in a unique position to serve as role model and to reinforce effective behaviors. Unfortunately, the United states has engaged more as a "victim" since 9/11 than coming from a position of empowerment, healing and effectiveness. This has resulted in reinforcing positions in other parts of the world that may be more about "reacting" and "acting out" than effectiveness. If the United States of America could role model, accountability, the use of the dialectic in regard to 9/11, emotion regulation in regard to the fear and anxiety caused by the trauma, interpersonal effectiveness in regard to our communication across the world, perhaps we could affect a lasting change in the Israeli/Palestinian relationship. If we could validate by using facts and a nonjudgmental stance, if we could engage these leaders in learning to use new skills that heal trauma rather than perpetuate it, we might be able to change together.

Regardless, it seems that it is time for us to acknowledge the valid damage caused by violence. We need to start looking at the effects of trauma on collective cultures and seeing how trauma and fear based reactions might impede effectiveness for our long term survival. This needs to be part of the diplomatic dialogue and part of the process. WE cannot live outside of the culture we are in, as a result it seems that the most effective way to cope with this is to agree on the skills and process forward instead of trying to find agreement on the context, which is undoubtedly tangled in culture and interpretations that might be tied to collective traumatic experiences that have not healed.

In order to move toward world peace, we must each of us, have the skills to role model the process of peace within. Until we have leadership that does this and can teach it, there will be no peace. If we do not consider not consider the valid impact of trauma on people and cultures we cannot find solutions to the conflict and long term consequences that result. It is our denial about this, our invalidation of this truth that allows the behavior to continue in humanity.

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I am a licensed mental health counselor specializing in the treatment of trauma. My twenty years of experience in treating survivors of domestic violence, childhood abuse, sexual assault and war have increased my desire to participate in studying the invariant relationships related to violence. My current pet theory has to do with denial and truth. The invalidation of those who suffer from trauma, has created symptoms that plague our society. The most serious symptom being the perpetuation of violence in our denial of it's consequences.

The truth shall set you free. But it takes skills (emotional intelligence) to handle the truth...because most of society...
"can't handle the truth."