“All Lives Matter”: Does it Include Palestinian Lives? A Personal Apology

Initial thoughts

I must confess that I feel anxious about writing up anything about Israel-Palestine; I worry it might, involuntarily, be offensive to some readers. I do not wish to offend anybody. I write because I have an ethical duty, as a mental health professional, group analyst and citizen, to go beyond the relative comfort zone of clinical practice and speak out in the social and political arena.

I am aware that, often, any communication involving Israel and Palestine leads to strong emotions, misunderstandings, hurt feelings, anger, and conflict. I shall try my best to avoid that, although I am unsure if it can be possible.

I also need to disclose two potential conflicts of interest:

• First, my training psychoanalyst, my training group analyst, both my clinical and research tutors at the London Tavistock Clinic, my best friends and very many colleagues are all Jewish. Israel is close to my heart.
• Second, I am committed to peace-making.

On 3 December 2023, I received a letter from Israeli colleagues that was sent to all members of the Group Analytic Society International (GASi), referring to a conflict (largely related to current events in the Middle East) that was generated in the GASi Forum. These colleagues threatened to leave the organisation altogether.

The following day, as I have belonged in the group-analytic community since 1987, I felt free to write back: I asked my Israeli colleagues to stay as members of GASi and offered some form of mediation to them, in an attempt to resolve the conflict through dialogue or, at least (as SH Foulkes put it) to keep the communication going, but to no avail.

Sadly, many Israeli colleagues left, and the conflict is still ongoing. As I am currently recovering from major lung surgery, I am taking a deep breath whilst still offering further work towards a creative resolution of this conflict.

In the wider sociopolitical context, with the support of my colleague Maria Cañete, I keep writing articles for journals (including Group Analysis) and newspapers and give talks to make a point that we should be all working harder for peace, and that both Israeli and Palestinian lives matter.

In order to be consistent with these aims, I have joined a newly created group: Group Analysis for Palestine (GA4P). I have also joined, within the British Psychoanalytic Council (BPC), a movement called Psychoanalytic Voices for Palestine (PVP): some 400 of us (with a significant Jewish majority) have signed a statement requesting an end of:

 “The ongoing slaughter and mayhem being inflicted on the people of Gaza and the West Bank”.

I would encourage as many colleagues as possible, belonging to GASi and/or the BPC, including Israeli colleagues, to join these two groups standing up for humanity.

In addition, I have started the process of convening an open workshop on “Israel-Palestine: Unresolved group trauma is an obstacle for peace”, which I very much hope will be held at the Institute of Group Analysis in London, on Saturday 29 March 2025.

Disturbing thoughts

On 7 October 2023, I vividly expressed the shock and pain that I experienced when Hamas militants took about 250 hostages and killed nearly 1,200 other innocent people. This terrorist attack is considered the bloodiest day in Israel’s history as well as the deadliest for Jews since the Holocaust. My heart broke for all those families affected by this crime against humanity. I deeply feel for them.

Having said that, I cannot turn a blind eye to the exponentially more brutal military response of the Government of Israel, disregarding international humanitarian law, which has resulted in the daily massacre of defenceless Palestinian civilians (most of them children and women), amounting to many tens of thousands so far.

Furthermore, the bombardment and airstrikes by Israel’s artillery have reduced entire blocks of flats, religious buildings, schools, and hospitals to rubble across much of Gaza, burying an additional estimated toll of tens of thousands whose deaths have gone unrecorded. This is also a crime against humanity and should not be accepted as the inevitable collateral damage associated with Israel’s legitimate right to self-defence. I deeply feel for the Palestinian people too.

To be completely honest, I should give an apology to the Palestinian Arab community, and I shall try to explain the rationale behind this.

Over four decades, I have been privileged to have treated many Holocaust survivors, and to have seen them improve through individual and group psychotherapy. Through the journeys upon which these patients and I embarked together there has been pain, resentment, anger, hatred, a strong wish for revenge, suicide risk, doubts, ambivalent attachment, hope, affection, and gratitude.

With perseverance and determination, these survivors managed to develop enough resilience and self-confidence to come to terms with a horrific traumatic past. For them, a turning point was when they felt accepted and loved by other people, Jewish and non-Jewish, in their therapy groups (including the conductor). Their unspeakable trauma perhaps was not completely resolved, but they could reframe it as vulnerability. Recognising this vulnerability, rather than repressing it, was a strength in its own right.

Unfortunately, I have not been privileged to treat Nakba survivors. I am genuinely sorry about this. Looking back, I think I could have been more proactive in trying to liaise with Palestinian colleagues, although this task is not as straightforward as liaising with Israeli colleagues – something that I have done on a regular basis. Whilst there is protective social texture and adequate support from mental health professionals (including a good number of group analysts) in Israel, the situation in the Occupied Palestinian Territories is desperate.

Even before the current war in Gaza, people in this besieged Palestinian territory had some of the world’s worst rates of mental illness. More than a full generation has grown up knowing nothing but cyclical terror escalation, a dire lack of public services and next to no freedom of movement.

Recent research shows that four out of five children in Gaza live with depression, grief and fear, and three in five self-harm (Save the Children, 2022). If things were not dreadful enough, since 7 October 2023, there has been a dramatic deterioration in Gazan children’s mental health (McKernan, 2024).

According to the psychiatrist Dr Samah Jabr, chair of Palestinian mental health, trauma in Palestine is collective and ongoing. The threat is still constant. It would be inappropriate to refer to this as “post-traumatic stress disorder”. I would argue that the real disorder would be not to experience stress symptoms under such tragic circumstances. For many decades, the situation has been one of chronic and continuous traumatic stress.

Interestingly, the concept of “continuous traumatic stress” was developed in the 1980’s by a group of mental health professionals working in apartheid-era South Africa. They were attempting to provide psychological support to victims of political violence, within a context of ongoing state repression (Striker, 2013).

I can see a parallel between the deep level of retraumatising in apartheid South Africa and the appalling living conditions imposed on the Palestinian people, in which there is constant and real threat of both present and future danger. Any hope and aspirations have been cruelly taken away from them.

This means that, in the Occupied Palestinian Territories, meaningful recovery is extremely difficult under a persistent and brutal traumatogenic context. As with apartheid, help is desperately needed at the international level.

Dr Jabr further pointed out that, currently, there are just 34 trained psychiatrists to look after the mental wellbeing of more than five million Palestinians. In Gaza, there were only six public community mental health centres and one inpatient psychiatric hospital before 7 October 2023. None are functional now (McKernan, 2024).

Having said that, Dr Jabr added, Palestinians are defiantly determined to survive and to develop Sumud, an Arabic term that is akin to steadfastness or resilience, which has become an important shared political and cultural value for them.

In this respect, I would highlight the good work of Lara Sheehi and Stephen Sheehi. In their momentous book, Psychoanalysis Under Occupation: Practicing Resistance in Palestine (Sheehi and Sheehi, 2023), they include clinical cases and reports of Palestinian clinicians, in which they expose the huge challenges of practicing psychoanalytic therapy in Occupied Palestine, within the violent dynamics of Zionist settler colonialism, the various technologies of occupation and other processes of asphyxiating Palestinian communities. In the circumstances, these clinicians conclude that, for some patients, resistance keeps them sane.

The current population of Gaza is well over two million people, 90% of whom are now displaced into overcrowded shelters, without enough food or clean water. If we care for humanity, we should not give up on them; in particular, on the one million children who live in Gaza. They are struck every day by the overwhelming difficulties they are facing. They deserve new hope in their lives.

At the time of writing, following more than 14 months of intense bombardment, displacement and the longstanding, never-ending blockade that makes freedom of movement virtually impossible, the intensification of the trauma inflicted upon the Palestinian community is beyond belief. I am sorry that I have done so little for them.

As I was polishing up this article, on 13 December 2024, I became deeply disturbed to read an online publication by Action on Armed Violence (AOAV), a Charity that investigates and disseminates evidence of worldwide armed violence against civilians. AOAV reports on a landmark study, just completed by the Community Training Centre for Crisis Management in Gaza, with backing from the Dutch Relief Alliance and the War Child Alliance.

The findings are harrowing: 96% of children surveyed feel their death is imminent, 79% suffer from nightmares, 73% display symptoms of aggression and 49% want to die. Gaza’s children are bearing the brunt of a war they had no role in starting. These figures demand urgent action, but the majority of people in the Christian West are looking the other way. And why is the so-called international community not intervening?

As a former consultant child and adolescent psychiatrist, I know this atrocious trauma will persist long after the bombs stop. My Palestinian colleague Dr Yasser Abu Jamei has long been calling for greater international support for Gaza’s youth. He argues that the long-term consequences of trauma on children’s development might reverberate through generations.

The Executive Director of AOAV, Dr Iain Overton commented on the above findings. He stated that the harm caused to Gaza’s children goes beyond statistics. Behind every number is a name, a life, and a future that is being extinguished before it can even begin. The use of explosive weapons in populated areas inflicts on children lasting physical and psychological wounds that cannot be undone:

“The psychological damage to Gaza’s children could fuel generational trauma, entrenching cycles of violence. If we truly want peace, we must protect these children from further harm … The world’s failure to protect Gaza’s children is a moral failing on a monumental scale. We must act decisively and compassionately to ensure that these children’s voices are heard and their futures protected” (Overton, in Action on Armed Violence, 2024).

Concluding thoughts

Is there anything that we might pick up from our Pleistocene, hunter-gatherer ancestors to prevent war and genocide?

Mauricio Cortina (2022) postulates that we can indeed learn from our prehistory as egalitarian foragers with non-authoritarian leadership. According to him, the original collaborative nature of the human group was essential for survival.

In a new book, Ezquerro and Cañete (2025) thoroughly describe the power of group attachment through our evolution. This included not only intragroup attachment but also intergroup collaboration: a dual capacity to develop secure-enough attachments to familiar groups and to cooperate with stranger groups.

The distinct essence of the nomadic foraging lifestyle, in the context of an environment of evolutionary adaptedness (Bowlby, 1969), promoted healthy group attachment, a powerful sense of connection to and protection from the group, key for our survival as a species.

However, since the agricultural revolution and the permanent settlements of the Neolithic, which (strangely enough) started in the Middle East, our relationship with the land that sustained us changed dramatically. New forms of conflict were generated to own and defend the land.

Attachment to land, which can be seen as a novel manifestation of group attachment (Ezquerro and Cañete, 2023), came to be a prominent feature of our individual and group mind, particularly when land was inhabited by an ethnic group over centuries. Attachment to land can be highly problematical when sacred value is attributed to it (Rozin and Wolf, 2023).

In the Israel-Palestine (land) conflict, there is a third party: the Christian West that mainly supports Israel, perhaps giving more value to Israeli lives than to Palestinian lives, condemning Hamas terrorism (as we should all do) but turning a blind eye to the terrorism perpetrated by the Government of Israel.

Going back hundreds, thousands of years, there has been some overlap between the concepts of “Holy Land”, as described during the reconquest mentality of the Christian Crusades, and of “Promised Land”, as portrayed in several verses of Genesis (the first book of the Torah). According to the latter, the Lord might have said to Abraham:

“Leave your country, your people and your father’s household and go to the land that I will show you”.

Last week, a good friend of mine (a liberal Jew) told me:

“Arturo, I do not believe in God, but I do believe that God gave the Promised Land to the Jewish people”.

At first, I thought my friend was trying to be humorous. But, no; he was deadly serious.

References

Action on Armed Violence (2024) Death feels imminent for 96% of children in Gaza, study finds. (Posted 13 December). Retrieved from Death feels imminent for 96% of children in Gaza, study finds – occupied Palestinian territory | ReliefWeb

Bowlby J (1969) Attachment and Loss. Vol 1: Attachment (1991 edition). London: Penguin Books.

Cortina M (2022) Our Prehistory as Egalitarian Foragers with Antiauthoritarian Leadership: What These Nomads Can Teach Us Today? In Maccoby M and Cortina M (eds) Leadership, Psychoanalysis and Society. London: Routledge, pp. 19-49.

Ezquerro A and Cañete M (2023) Group Analysis throughout the Life Cycle: Foulkes Revisited from a Group Attachment and Developmental Perspective. London and New York: Routledge.

Ezquerro A and Cañete M (2025) The Power of Group Attachment: John Bowlby Revisited from a Group-Analytic Perspective. London and New York: Routledge.

McKernan B (2024) ‘Chronic traumatic stress disorder’: the Palestinian psychiatrist challenging western definitions of trauma. The Guardian (14 April). Available at  ‘Chronic traumatic stress disorder’: the Palestinian psychiatrist challenging western definitions of trauma | Gaza | The Guardian

Rozin P and Wolf S (2023) Attachment to land: The case of the land of Israel for American and Israeli Jews and the role of contagion. Cambridge University Press. Available at Attachment to land: The case of the land of Israel for American and Israeli Jews nd the role of contagion | Judgment and Decision Making | Cambridge Core

Save the Children (2022) After 15 years of blockade, four out of five children in Gaza say they are living with depression, grief and fear. Save the Children International (15 June). Available at After 15 years of blockade, four out of five children in Gaza say they are living with depression, grief and fear | Save the Children International

Sheehi L and Sheehi S (2023) Psychoanalysis Under Occupation: Practicing Resistance in Palestine. London and New York: Routledge.

Straker G (2013) Continuous traumatic stress: Personal reflections 25 years on. Peace and Conflict: Journal of Peace Psychology 19(2): 209-217.

Dr Arturo Ezquerro, London-based consultant psychiatrist, psychoanalytic psychotherapist, and group analyst; senior assessor and trainer, Institute of Group Analysis; honorary member International Attachment Network, and World Association of International Studies; former Head NHS Medical Psychotherapy Services, Brent (London); over 100 publications in six languages, including Encounters with John Bowlby (Routledge), Group Analysis throughout the Life Cycle (Routledge) and The Power of Group Attachment (Routledge).

ORCID iD: Arturo Ezquerro https://orcid.org/0000-0002-9910-4576