The Center for Mind-Body Medicine

Depression’s Upside: A One-Sided View

Some thoughts on Jonah Lehrer’s article from The New York Times Magazine, February 25, 2010.

In his article on the possible evolutionary purpose of sadness, Jonah Lehrer, a talented writer and knowledgeable scientists confuses an adaptive mechanism –the capacity for greater focus that the rumination of depression may afford – with a therapeutic one.  Even more important, he does not address the causes of depression and, in accordance with his emphasis on enhanced problem solving, limits his discussion of therapeutic efforts to cognitive change.

Work with many hundreds of depressed people in my psychiatric practice and tens of thousands more in war, post-war and disaster situations around the world gives me a very different perspective and leads me to different conclusions.  So many of us are depressed because we are living at variance with both our genetic programming and our need for meaning and purpose.  We are affected so dramatically by losses of relationships, jobs, etc. because we are not sustained by the adequate social support that is a hallmark of traditional societies.  We are subject to an unprecedented level of stress and overstimulation in our environment, to toxic food, and sedentary ways of living that are anathema to our evolutionary development and detrimental to our mood.  Many of us lack a sense of purpose in our lives, a connection to something greater than ourselves that gives human life meaning, and can give us hope in difficult times.

The symptoms of depression – both the rumination on what went wrong and why that Lehrer focuses on, and the lethargy, hopelessness, decreased interest in sex and food that go along with it – are best understood and responded to not as an evolutionary advantage but as a wake-up call.  They let us know that it is time to address the conditions that are creating the imbalances in our lives; to use food and exercise, meditation and imagination to improve our biology and enlarge our perspective, and to reach out to others—therapists, clergy, family and friends—who can help us.  The true purpose and challenge of our depression is to wake us up to what is wrong in the way we live, to point us toward ways to become more fully human.

On Our Way to Haiti

Dear friends,

We’re on our way to Haiti now, via the circuitous route that the damaged Haitian airport and the daunting US weather demand. We’ll be arriving on Thursday to begin working with people on the ground and exploring partnerships with the Haitian government and local and international NGO’s, churches, schools, and other community groups. I’m going with Rosemary Murrain, our Director of Administration and Finance, who has worked in Haiti, and Star Myrtil, a young Haitian woman who has been a Program Manager for NGO’s and speaks Creole as well as French.

We’ll let you know more when we’re on the ground; meanwhile, here’s a brief description of the work we hope to be doing.

All my best,

Jim

"Healing the Wounds of War" in Christian Science Monitor

Dear friends,

The Christian Science Monitor featured an article on our Healing the Wounds of War program in the Middle East! Ilene Prusher interviewed some of our Gaza trainees, and myself, to write this thoughtful piece. She also notes that it is the one-year anniversary of the Israel siege on Gaza, “Operation Cast Lead,” which devastated the people and landscape of Gaza, and from which they are still struggling to recover a year later.

Here is an excerpt of the article, but I hope you check out the original, with some pictures  and related stories on Gaza and the Middle East, here.

Gaza war anniversary: How one group helps victims overcome trauma

By Ilene R. Prusher Staff writer / December 28, 2009

Jerusalem

Rawya Hamam was watching her son deteriorate. Hisham wouldn’t sleep, clung to her incessantly, and said he wanted to go back into her belly so he’d be safe. “Grandma is lucky she died so she doesn’t have to live here now,” the boy told his mother.

It’s not a normal statement to expect from a five-year-old child, but neither were these normal times. A year ago, at the outbreak of war between the militant Palestinian group Hamas and Israel, anything resembling a normal life disappeared into a violent maelstrom that wreaked unprecedented destruction on the Gaza Strip. More than 1,400 Gazans were killed, according to a Palestinian count, in a campaign the Israeli army named “Operation Cast Lead,” with the aim of getting Hamas to stop the daily launch of occasionally fatal rockets onto Israeli communities. Thirteen Israelis were killed in the three-week war. . . . keep reading

We’re so thankful for the recognition of our work in Gaza, alleviating psychological pain and suffering, and all of the work we do, both in the Middle East and here in the US teaching health and mental health professionals to learning to handle their stress and incorporate mind-body techniques into their practice through our Mind-Body Medicine Training as well as our Healing Our Troops program. These warm, caring professionals we train use their skill and wisdom to help families recovering from disaster, like those who survived Hurricane Katrina,  as well as working with troops returning from Iraq and Afghanistan and their families.

(If you kept reading my post, don’t forget to check out the rest of the original CSM article with pictures  and related stories on Gaza and the Middle East, here.)

Jim

Day 7: The Gaza Training Ends

“We have been on a journey,” says the psychologist who is leading the final session of Mohammed’s group. She sits comfortably cross-legged on the floor, in her long coat and headscarf, next to the young man who is her partner on this last day. “We have come to know each other in a way that is not usual here in Gaza,” she goes on. “men and women speaking together from their hearts, all of us finding new friends.”

This is our last group and, as we check-in, and while my translator summons up her English, I find myself pondering old mysteries and contemplating new wonders. The dress of the woman’s co-leader: He is wearing a sport jacket and slacks, neatly pressed, and a tie, secured with a Windsor knot, a professional code of dress that many of the men favor. How much effort, I wonder, does it take to maintain such self-respect amid Gaza’s crushing, demoralizing constraints? And how does he do it with the dearth of dry cleaning facilities and the scarcity of solvents?  I am impressed once again by the intelligence, dignity and, yes, elegance of a woman who, except for a tiny slit for her eyes is completely covered. Her assessment of herself this last day is so open, unsparing, witty – “I want to thank all of you,” she begins, “I realize now I have been too rigid, and often wrong, in my judgments; and I have been unnecessarily covering my feelings, not just my body.” I too realize once again – what a grace of these groups – that I have much to learn about my own preconceptions and judgments.

In this session we do drawings similar to the ones we do on the first day of the first training, pictures that often show us how much – sometimes how stunningly, satisfyingly much – we have changed since that opening group. The wires of a cage that contained an irritable, frustrated physician have turned into steps on a ladder which will bring him to a place of peace, among trees in his yard and within himself; a psychologist’s family members scattered across the landscape by misunderstanding in day one’s picture are now gathered in a comforting circle in which they are, like members of the mind-body group she is addressing, “sharing their feelings.”

Our leader has brought us candies wrapped in red foil, to celebrate our time together, and to mark its end. “I Love You” is written across them in silver. Another woman has brought us all pens “to remember this group when you write.” A third has baked a cheesecake, its top speckled with many colored candied glitter, with a single candle. “This is,” she announces, “to celebrate our journey and also,” she adds, “the Prophet Mohammed’s hijra,” his journey from Mecca to Medina in 622, “whose anniversary falls on this day.”

It was in Medina, I remember, that Mohammed created the umma, the spiritual community that is the model for Islamic society. It provides Muslims with the opportunity to gratefully practice the prayers and manifest the precepts and the code of conduct that Mohammed brought to them.

As our leader carefully divides the cake in squares I hear, as clearly as if he were once again standing in front of me, the closing comment of a young psychologist in our previous training nine months before. A tough, pale, earnest, bearded young man, he had spoken with some formality: “I did not know what to expect when I came; these techniques, it seemed to me, were foreign to Gaza. But as I have been here these days I have been so impressed. You and your faculty are so knowledgeable and such good teachers, and I have learned so much about myself as well as psychology. But even more important” – I can hear again his voice lowering, more intimate now – “you have all been so kind to me and all the participants, have made us feel so much at ease. I believe,” – I knew he was getting ready to conclude, but never could have imagined what he would say – “that this is what it must have been like in the time of the Prophet Mohammed.”

Our leader hands us plates, and we eat our cake and savor each other’s company. There is general sadness at “concluding this blessed vacation with ourselves,” as one woman observes, to general agreement. But there are also commitments to “meditate daily” and “shake and dance with my children when we are feeling overwhelmed, or stressed.” Everyone expects to “start mind-body groups for patients on the first of the year.” There are promises all around to be in touch in the months ahead – in the supervision groups that Mohammed and the rest of our faculty will be leading every week throughout Gaza, and less formally too. Phone numbers are exchanged and a paper passed around for email addresses.

And then our leader in her long coat and head scarf reaches over and turns on the CD player and stands and claps, and sways a little, while her young colleague in the sports coat, his collar open and tie now loosened, rises and steps to his right toward Mohammed and the other men, and begins the steps that will take them and me too, our arms on each others’ shoulders, in a small happy circle, around our room.

Open Minds, and Warm but Troubled Hearts in Closed Gaza

Gaza City, December 16, 2009

Day 5

As the days pass, our participants discover and discuss new possibilities of psychophysiological self-regulation – breathing deeply to relax in spite of the anxious anticipation of leading a group for the first time, or to find a calm place from which to encounter memories of family members “martyred” by violence. They find in the creative imagination of guided imagery unexpected ease: “When I go to my imaginary ‘safe place’ I discover it is my home – I would not have believed it because we are close to the border and have often been shelled – and I thank God for my family and for seeing the green of the trees every day.”

Sitting in the circles of our small groups we move more deeply into each others’ minds and hearts. Experiences and feelings that are rarely if ever publicly revealed in tradition-saturated Gaza are shared; long suppressed emotions and conflicts emerge.

We hear about the ways that the frustrations of men, deprived in the Nakba – the “catastrophic” loss of homes and villages of 1948 – of their patrimony, unable to maintain their self-respect without jobs or freedom, have manifested in the self-righteous abuse of women and children. Her late arrival after difficulty navigating the streets during a Hamas demonstration reminds one young psychologist – gentle, always smiling, pale in her long black coat – of her father’s fury at an elder brother when one evening years ago he came home late: The old man burned the boy’s arm with a stick glowing with red heat, and turned the instrument on his wife when she pleaded for mercy. The girl watched. A university professor cries with shock and pain for her young colleague, and recalls her own father’s contrasting kindness. Then it is the turn of a large young man, a gentle giant I think, who is also a psychologist. “I have not spoken of this before,” he begins. When he and his brother were six and five, their father forced them, out of, the psychologist now believes, some warped idea of discipline and manliness, to walk 10 kilometers to school each morning before dawn; the young man remembers, his face softening in hurt, his hands opening in incomprehension, how furious his father became when one day, attacked by dogs, the boys ran home. The participant who is leading the group today suggests we stand and hold hands. He asks us, so wisely I think, to “Feel the support of the group,” The pale young woman, quietly tearful, nods with relief and release; the young man thanks us – “Shukran” – and tells us he has vowed always to understand and be kind to his own children.

The ways of Gaza are ancient, sometimes painfully problematic, but also rich and in many ways still sustaining. The closeness to families that can under pressure constrict can also hold up people who should by all ordinary reckoning have collapsed. Mothers, fathers and especially grandparents appear in another imagery exercise – the summoning of a “wise” or “inner guide” with a frequency I have seen nowhere in the Western world. “My grandmother was strong and kind” one young woman announces, emphasizing the conjunction. “she was always there for me.” Another says his long dead, imagined grandfather counseled him not to throw stones at Israeli tanks; “It is a waste, he says to me. True courage will be in caring for your children and your wife.” When a young psychologist – unusually lithe and natty, a “dead ringer” I am told for a Turkish movie star – tells me I remind him of his grandfather. I’m at first taken aback, ready to protest – “I’m much too young,” I think. When I look again and see the sweetness of his face, the tears in his eyes, I am aware of the foolishness of my reaction, and accept the honor he is giving me.

Each day the nature that remains free from overcrowding, the destruction of artillery shells and fear of Israeli patrols appears, vital and hopeful, in mental imagery, check-ins and reminiscences. In the drawings participants make of “how I want to be” and “how I will achieve it,” there are palm trees with ladders- steps to a more hopeful future- leading upward; small patches of green issue gracious invitations; many colored flowers represent “all the brightness of experience;” birds of free thought and feeling fly at the top of pages; the sun warms tired heads and softens hunched, burdened shoulders. Often the sea that borders Gaza appears, deep and ever present, calming troubled minds.

Video from Days 4 & 5 of Gaza Training

Dear friends,

Here’s another video update of our 2009 Gaza Advanced Training Program (ATP)! You’ll see another technique we use, chaotic breathing, a form of very “active meditation” illustrated at minute :37. You’ll also see the introduction to the “fishbowl,” in which we demonstrate to the trainees the small group model, at 1:24. (Small mind-body skills groups meet privately, so this demonstration during training is the best way we’ve found to show the health and mental health professionals attending how to lead their own groups.)

Jim

Video from Gaza Day 3

Hello all,

Here’s the video I promised from Day 3 of the training. I think it gives you a good feel for what life in Gaza and our training is all about.

You’ll see the training participants practicing the “shaking and dancing” technique at minute :50–and then check out all the smiles.

Jim

Gaza Blog Day 4

Gaza City, December 15, 2009

Day 4

Hello Friends,

The Advanced Training Program (we call it, and so do the Palestinians, “ATP”) has a complex structure that is at first a bit daunting. Our 15 Gaza faculty coach the participants in leading the same kinds of small groups that they first experienced in the initial training. The international faculty, passing from group to group provide feedback, later, in supervision, on how the Gaza faculty has helped the participants and what they could do or say more appropriately, clearly or concisely; where they could have been more sensitive to the spoken or unspoken needs of a group member; how their own reticence or preconceptions may have inhibited or biased them in their advice to a participant-leader. “Be honest with us,” our conscientious Palestinian team had repeatedly insisted. “We want to do the best job for our people. We are thirsty for learning.”

The participants lead the ATP groups in pairs; there are ten people in each group and five sessions. Hugely nervous at first, in spite of a day of reassurance and coaching, they conduct the opening meditation, and lead the check-in in which they and the other group members say how they are doing and what they are feeling at the present moment. We have encouraged participant-leaders to let go of self-conscious professional distance, to be honest about their own feelings, to be “real people as well as leaders.” Some do this with admirable courage and humility: “I am a professor at university, but at this moment I feel like I am back in grade school.” Others are more guarded. Everyone in the group speaks in turn – no interrupting, analyzing or interpreting allowed.

The participant-leaders then teach didactic material about, for example, the fight or flight and stress response that are activated by the sympathetic nervous system, and the use of slow deep breathing (which mobilizes the parasympathetic nervous system) to balance this state of hyperarousal which is so common in deeply traumatized and uneasy Gaza. Then they lead an experiential exercise – it could be guided imagery, or drawing one’s problem and its solution or quiet meditation that brings about relaxation or an active meditation of fast deep breathing or shaking and dancing, designed to raise energy in the depleted and depressed and break up fixed patterns of thought and feeling. Then they ask group members to report on their experience: “I feel like a burden is lifted” says one young, bearded school psychologist, after six or eight minutes of charged up, bellows-like arm pumping, deep breathing. “I feel free for the first time since the war to breathe the breeze from the sea.” They conclude each group with a quiet meditation. Afterwards the pair of participant-leaders say how they feel they have done and the other participants share what the experience was like for them; the Gaza faculty member concludes with his or her assessment.

This will go on for five two-hour groups over four days. It is designed to equip our participants to take our model back into their work places where they will offer it to kids and adults, the elderly and the deaf, former prisoners in Israeli jails and ambulance drivers, abused women and confused men, the anxious and angry, those bereaved by violence and those fearful they will be. In a society in which psychological problems are stigmatized and psychotherapy is often viewed, if it is considered at all, with suspicion, our model has wide appeal. It is offered as a way to develop skills and strengths, of mind as well as body, an opportunity to come together without fear of analysis or interpretation, a modern version of traditional, honored communal gathering and healing.

Each day we have a panel where Gaza faculty answer questions from the entire group of participants about the challenges of leading groups and working with individuals, about balancing the need to maintain order in the group with an openness that invites sharing, about presenting didactic material in a way that is accurate but easily comprehensible. In Gaza the questions have a special urgency and poignancy.  One male psychologist, slender and graying unfolds slowly from his chair. “How do you,” he asks soberly, “deal with a situation in which during a mind-body group bombs are going off?”

“This has happened to me several times,” replies Mohammed, the psychiatrist, “You find out what is happening – I don’t want to say who is shooting,” he adds to some laughter. “You make sure your group is as safe as it can be. Then you discuss feelings so everyone can get some relief. Then do deep breathing to help everyone, including yourself, to relax. Then continue the group.”

“I was working with kids one time,” Jamil adds. “Every time there was shooting we got up and shook our bodies. Every time a bomb went off we all yelled loudly. It worked pretty well.”

“What about if you are a leader and someone says something that is very tragic and you feel like crying? Is it permitted?”

“In the war terrible things happened” responds Abdel-Hamid, “and the people come to us to talk about it: Women in my groups whose children were killed, men who saw their wives and daughters dying from burns, and I remember the things I myself saw. It is only human for us to cry as well.”

Gaza Blog Day 2

Gaza City, December 13, 2009

Hello Friends,

Day 2

Our faculty gathers in a circle in high backed chairs in the ballroom of the Commodore Hotel – physicians, psychologists, a couple of social workers – 15 in all. Many of the men, who are mostly in their forties, are in suits and ties. The women, young and middle aged, all wear scarves, their heads covered as are those of ninety-five percent of adult females in Gaza; most are also in the long shape-shielding coats they wear even in the summer heat. The feelings of all of them, for one another and for us, are, however, easily visible, even palpable; the room warms with affection, hums with connection, as each one of us, in turn, “checks in.”

“My colleagues,” says Naima, a dark skinned Bedouin from Rafah at the southernmost tip of Gaza’s twenty-five mile long strip, “are not just friends but family. When the international team is here, the family is complete.” She really means it; she has returned early from her honeymoon to be with us for the training. Others have made sacrifices too. Mohammed the psychiatrist who heads up public mental health services in Gaza, made the “difficult decision” not to go to a meeting in the West Bank: “I want” as does everyone of Gaza’s penned up one and a half million people, “to get out of this prison, but I prefer to be with all of you. You are,” he adds, lightening the mood, “the best antidepressant.”

And there is more humor, as always in Gaza a crucial ingredient of the savor that makes life more than survival:  A spontaneous, slightly exaggerated romantic song for Shaher who is celebrating his twentieth wedding anniversary, Abdel Hamid’s confession that “even with two wives” he is “well”, gentle teasing in untranslated Arabic of Naima about her interrupted honeymoon.

Four and a half years ago when we began the “mind-body medicine training” of 90 Gaza clinicians, most of these people didn’t know each other at all. In the time since then these “leaders,” whom Jamil has chosen, have conducted hundreds of ten week long mind body groups themselves and supervised colleagues who have led many hundreds more. Altogether 7000 children and adults of every age and social class have participated in these intensive groups and our Gaza team has worked individually, in families, and in brief groups and classroom sessions with at least 15,000 more Gazans. The research we’ve done (on 500 kids and 500 adults) shows very significant decreases in symptoms of post-traumatic stress (up to 80% in those most traumatized) improvements in mood, decreases in anger. Amidst massive Israeli attacks and civil war, in the face of pervasive, indiscriminate and violent death, poverty, isolation and confinement, we have found in those who have participated in our groups an enduring (at six months follow-up) enhancement of hope and optimism about the future.

Day 3
Our team and the people they have worked with, and the changes that are so obvious to and in them, are the magnets that have drawn participants to the training that begins the next day. Eight months ago 150 of them (chosen from some 500 applicants) learned the basic techniques of our approach, and the science of stress and its reduction, and experienced the surprising comfort and intimacy of our small groups – “the one place in Gaza where everyone can take off their masks, relax and be themselves,” is the way Mohammed, who has led similar groups for professional colleagues, old men with chronic illness, war-traumatized children and patients on the psychiatric ward, describes these utterly confidential, tenderly led gatherings of 8 to 10 people.

When they check in their first small group our participants recall the experience of the first training: “I was so happy’” “It was like a vacation to me,” “It changed my personality, my life 180 degrees – I am no longer sick with colds and stomach upset. My doctor asked me what medicine I took”. During and after those five days many have begun to act differently – more assertive toward overbearing and arbitrary bosses; more sensitive to other people and, indeed to their own emotions:“it is not unmanly to cry when one witnesses the horrible suffering of our people”; more willing, even when it conflicts with cultural norms, to trust their own intuition: several young people whom I hear personally (I wonder how many more there are) have told their well-meaning parents that the bridegroom or bride selected for them was not a good match, and calm, sincere, and convinced, have prevailed.

During the intervening months they have met every four weeks with their group leaders – “strengthening our family” – to practice the meditations and the guided imagery, to do the drawings that express their feelings and summon up imaginative solutions to daily stress, to share the losses and frustrations that shadow the lives of every Gazan and to celebrate the joys – of jobs well done, and birthdays arriving and weddings to come – that persist. Still, so many of them say they have been “missing” (a word that I hear so often and that seems so apropos in locked in Gaza) us and waiting anxiously for the training.

In the lectures they bend over notebooks, eager to record information that will help them successfully lead, with our faculty’s supervision, small groups – the major task of this training. After they have finished they will offer these groups and use our model with individuals and families in the Ministries of Health, Education and Social Welfare, in the UN health and education programs, at the Red Crescent, and in hospitals, clinics, universities, and community based organizations from the Erez crossing into Israel in the North to Rafah, abutting Egypt in the South.

Lunch is grilled chicken and chicken curry, rice with almonds and raisins, the mix of mezzes – appetizers like hummus, babbaganoush, and spicy “Gaza salad” that are traditional – with fruit for dessert, a wonderful improvement over the GI challenging food of five years before. The participants – university professors and physicians who have taught some of our faculty and just graduated psychologists and social workers who are young enough to be any of our children – are clamorous with the good feelings and high spirits of reunion, old jokes and new intellectual challenges.

Gaza 2009 Blog, Day 1

Gaza City, December 12, 2009

Hello Friends, Many of you have asked and many more wondered, what goes on when you guys are over there in the Middle East, in Israel, and especially in Gaza, a strip of land that most of the world, including those parts of it that are closest, ignore or misunderstand, a shabby, beleaguered, always surprising territory where we have been working for more than seven years. What’s it really like? So here goes, with the first of what I hope will be communications every day or two until just before Christmas.

My room in Gaza City’s Commodore Hotel looks out on the Mediterranean, its small waves, falling coolly, brightly, and predictably this early morning. On the spit of land that points toward the open sea where Israeli Navy, vigilant for errant or desperate Palestinian boats, patrol, a dozen Hamas security men, are drilling – lining up in formation, jogging. Tomorrow our Gaza leadership team – sixteen health and mental health professionals of considerable, hard earned skill, sweet dispositions, wry humor and luminous goodwill – will gather downstairs for the faculty preparation that precedes the “Advanced Training” in Mind-Body Medicine of 150 more clinicians.

It’s our first day in Gaza after one in Israel – for me and our US team a long evening filled with meetings with Naftali Halberstadt the psychologist who directs our program there, Rhonda Adessky, the Hadassah Hospital researcher who is our clinical director, Smadar Shmuel our administrator, Danny Grossman the retired Israeli fighter pilot who supports all our healing efforts in the region, and the rest of our Israeli Board.

We’ve trained 300 clinicians, educators and community leaders in Israel – from heads of departments of psychiatry and leading academic psychologists to family physicians, police and the Zaka, the stalwart Orthodox men who gather the body parts of victims of violence for burial, and inform their families of their deaths. The mental health and health professionals use our model – of self-awareness and self-care, of mind-body skills like meditation, guided imagery and biofeedback; of self-expression in words, drawings and movement; and small group support – in hospitals, clinics and universities. The Zaka now bring our meditation techniques and our teachings of awareness and acceptance to the scenes of bombings and car accidents and into the living rooms of overwhelmed, suddenly bereaved families.

Over 120 Israeli school psychologists and school counselors have graduated from our program. They are using our model in schools everywhere, but especially with kids traumatized by shelling in and around Sderot in the South and in the North where Hezbollah’s missiles fell. A third of our Israeli trainees are Arabs, many of whom identify themselves as “Palestinians.” At our meetings in Jerusalem we discuss expanding our work in the South, developing more joint programs for Israeli Jews and Arabs (co-led by our Arab and Jewish graduates) and working with disabled military veterans. We’ll continue the planning when we return from Gaza.

Right now we’re “checking in “in my room at the Commodore, catching up on the time since we and our Palestinian colleagues began, last March, to train this committed and enthusiastic cohort of Gaza clinicians, sharing our feelings of gratitude for the opportunity to be here in Gaza, once again, in what its inhabitants call “the world’s largest open air prison.”

We are enjoying being in Gaza. You may wonder about that word “enjoy.” Actually, the feeling is much rounder and more robust, and, of course, more complex as well. Gaza is, in spite of some much needed UN sponsored cleanup of rubble from the Israeli attacks of last winter, a bleak place, terribly diminished by the severe restrictions on material coming in and exports (chiefly food and flowers) leaving, by overwhelming population density and pervasive poverty, and by the widespread – and still unrepaired – destruction of farms, fields and factories, of mosques, public buildings, and private homes. And yet Gaza is to me and to our team a place that is at least as blessed by its people as it is cursed by conflict.

As we sit in a circle each of us recalls, along with the terror of times past – days training our Palestinian colleagues in 2007 while Hamas and Fatah fought in the streets not far from our hotel, nights of Israeli planes’ building shaking, glass breaking sonic booms, the bodies of children lying in the streets – a sense of satisfaction, and, yes, love, that far outweighs it and draws us back over and over. Amy Shinal our clinical director, Afrim Blyta and Yusuf Ulaj, Kosovo psychiatrists I began to work with ten years ago during the war there, Dan Sterenchuk and Lee-Ann Gallarano, our administrative team, and I all feel it and say it each in his or her own accents: Our Gaza team feel like our family, instantly recognizable and available, and accepting and caring in a way that recalls the embrace of those bound to us by biology. We are there to teach them – about mind-body skills, and being aware of the thoughts and feelings that arise each moment, and the uses of the imagination, and about skillfully leading groups – and they inevitable teach us so much more, about generosity arising in the midst of the greatest tragedy, openheartedness to strangers, the power of community and of love for one another, the possibility of hope in the darkest of times, endurance, patience, tolerance, humor.

At lunch we eat a meal of seafood on the terrace – it is late spring warm, if breezy on this December day- of the Lighthouse restaurant with our Gaza coordinator psychologist Jamil Abdel Atti. We toast – with lemonade in dry Gaza – Chuck Feeney the Chairman of The Atlantic Philanthropies who has funded our work for five years and Don de Laski my always generous US Board member: The sufferings of Gazans, and first the promise and later the effectiveness of our work have touched them deeply. On the coast road cars and motorbikes flying green flags chug by celebrating Hamas’ birthday. We have coffee and ready ourselves for the training to come.

Jim

(Film to follow in days ahead.)

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