Dr. Lama Khouri, a Palestinian psychoanalyst, sees patients having trouble eating and sleeping right now.
“They’re just shocked by the sadism,” said Dr. Khouri, who is also the clinical supervisor of the Arab-American Family Support Center, which has several offices throughout New York City.
Diaspora communities across the boroughs struggle with their mental health as the humanitarian crisis in Gaza enters its sixth month. With daily reports of death and destruction in their homeland, Palestinian Americans feel helpless and betrayed. Jewish therapists, too, note heightened despair over antisemitism and difficult conversations with family and friends. Then there’s the matter of how much issues of identity and stances on social justice affect the therapist-patient relationship.
“I think for many of us, we know where we stand,” says Dr. Khouri, “that America doesn’t protect you.”
At the same time, this can feel “liberating” for some. That reckoning can sometimes lead to existential thinking, she noted. “I find a lot of the young people are questioning where they are in life,” Dr. Khouri said.
This comes as Arab Americans say it’s been tough for them to stomach the U.S. relationship with Israel. Palestinian Americans say the turmoil poses significant challenges to their physical and mental health.
“It makes me very frustrated watching the news, seeing children dying, women dying, and I cannot do anything,” said Zein Rimawi, the Palestinian-born founder of the An-Noor Social Center in Bay Ridge, Brooklyn. “And who’s helping? Who’s killing these kids and these women? It’s my country, the United States.”
Arab Americans say this feels similar to the retaliation they faced post-9/11. Like then, Rimawai wishes for more nuanced, honest coverage of Gaza in U.S. mainstream media. This has an effect on New Yorkers’ everyday perceptions of their Muslim neighbors. (See our story on how to deal with people who hate us.)
“After October 7th, women with their children would be harassed,” Dr. Khouri said. “They’re afraid to go to work. They’re afraid to send their children to school,”
Identity and conflict among Jewish New Yorkers discussing Israel, too
As Islamophobia surges in NYC, so does antisemitism. As Jewish New Yorkers deal with increased hate, they are also navigating having tough conversations with friends and families about Israel.
Brooklyn-based psychotherapist Rousz DeLuca, who is Jewish and specializes in trauma-based therapy, has been hearing a lot about the intergenerational divide over Israel in sessions.
That can result in “a lot of pain and betrayal,” they said.
“Older generations of Jews have really been raised to believe that like the State of Israel – or the Zionist project – is necessary to keep Jews safe from another Holocaust,” DeLuca said. “Whereas younger generations – and also older anti-Zionist Jews – have, I think, taken a more intersectional approach.”
Younger Jewish people have experienced fearing antisemitism “but also have experienced increased acceptance over the years of Judaism and an awareness of differentiation between Jews and Israelis and Zionists,” DeLuca said.
The therapist has seen a lot of grief, anger, and anxiety within New York City’s Jewish community lately.
“As well as a sense of helplessness around watching Jewish intergenerational trauma be weaponized to justify genocide,” said DeLuca.
DeLuca mainly works with queer and transgender patients and has noticed “that there’s definitely anger” around the pink-washing of Israel. Pink-washing – sometimes called rainbow-washing – is when an institution or state uses its pro-LGBTQ+ stance to divert attention from its wrongdoings.
It’s especially frustrating when the person arguing that Israel is more LGBTQ-friendly (a common assertion of pro-Israeli content creators on social media) “is not ordinarily concerned for this person’s safety as a queer or trans person,” DeLuca said.
Plus, some queer New Yorkers have developed a “sense of solidarity with Palestinian queers who are kind of erased in that comparison,” according to DeLuca.
Therapy’s political divide: when counsel becomes conflict
As New Yorkers try to process their grief in therapy, they are sometimes learning their therapist’s office isn’t always a safe space. There have been numerous accounts of patients feeling distressed after a therapist shared their political opinions on Israel, for example.
“I’ve heard maybe a handful of anecdotes of patients firing therapists over deciding that someone else is a better fit after learning that they differ on that,” DeLuca said.
Dr. Khouri experienced this patient-therapist conflict herself nearly a decade ago. She detailed her experience in a Psychoanalysis, Culture & Society paper through the lens of what’s called ‘‘radioactive identification.” The term was coined by Yolanda Gampel, an Israeli psychoanalyst who studies how social and political violence affects the therapeutic process.
‘There are identifications that become radioactive. Radioactive meaning they seep into the room. What is radioactive material? It’s colorless, it’s odorless, but it’s deadly,” Dr. Khouri said. “And these have to be addressed.”
For Dr. Khouri, her radioactive identification was being a Palestinian whose family fled during the Nakba, when over 750,000 Palestinians were expelled from their homes after Israel declared independence. For her former psychoanalyst, it was being the descendant of Holocaust survivors.
These identifications deeply compromised how both therapist and patient viewed each other. Even though they initially had a good relationship, it became more charged as they unpacked the Israel-Palestine relationship. Her psychoanalyst began regularly falling asleep during their sessions.
“The funny thing is, if we’re talking about the Middle East he doesn’t fall asleep; he’s awake, he’s alert. If it’s front and center, we’re talking about politics – nothing personal – he’s present,” Dr. Khouri said. “As soon as this topic disappears, he starts just dozing off.”
Eventually, the dynamic became too difficult, and they parted ways.
The role of shared experiences in therapy
Many therapy patients – across all races and ethnicities – wonder if their mental health counselor needs to share their identity.
“It’s more likely that that person will understand your experiences, but it’s not a guarantee,” said Dr. Keisha Thompson, a professor of psychology at Kingsborough Community College.
Dr. Thompson thinks a therapist’s training and approach is most important. A culturally competent therapist has a better understanding of how a client’s lived experiences are impacted by their cultural background.
“If someone is just looking at the individual, they might miss what’s happening in the outer society that may be impacting this individual and impacting how that individual is navigating life and also navigating the therapeutic relationship,” Dr. Thompson said.
Many Black therapy patients with white therapists wrestled with these issues during 2020’s political unrest over police brutality.
“Does this therapist even care about what I’m experiencing, what my community is experiencing?” Dr. Thompson said. “It might get tricky if the therapist is, like, ‘look, I care. I make donations, I march, I do all these things,’ because then it’d be, like, ‘why are you telling me this?’”
Navigating mental health and social justice in session
So what should patients request from their therapists in these situations? From our interviews with these three mental health experts, we offer these tips:
Tip 1: Choose a therapist who understands identity and community and embraces the role of both in your life.
Dr. Thompson said patients should expect to have a therapist who will check in with them about how the issues in the wider community affect them.
If racial differences between the therapist and patient feel like “an elephant in the room,” the patient should be able to discuss that on their own terms.
Tip 2: You, as the patient, take the lead.
Patients should always lead these discussions, said Thompson. It’s okay that not every client wants to discuss social justice issues or feels affected by them.
As New Yorkers from all backgrounds follow what’s going on in the Middle East, they should be mindful of their mood and anxiety levels.“What people don’t recognize is that if conflict is happening around you, there’s no way that’s not impacting what’s happening inside of you,” Thompson said.
Tip 3: Rest and self-care are revolutionary.
Practice radical self-care even if there is a crisis in Palestine, says Dr. Khouri.
“Yes, Gaza is in hell. Yes, we’re not homeless, we’re not thirsty, we’re not starving, we’re not orphans, but that doesn’t mean we don’t deserve to live a good life,” Dr. Khouri said. “If you’re tired and you need to switch off social media and not go on a protest, that’s okay.”
DeLuca also suggests testing out somatic therapy exercises – like mindfulness, breathwork, and body movement techniques – to help the body process trauma.
Tip 4: There are many ways to support movements—and each other.
Those who want to engage in solidarity, but feel burned out from organizing, can be creative about how they support the movement.“Not all of it is being in the street or posting on social media.… Do you enjoy time with kids? Can you offer some childcare for people who are showing up to a protest?” DeLuca said.
Tip 5: Find and build a community.
Our experts also offer one common refrain: Dr. Khouri, DeLuca, and Dr. Thompson all recommend finding a community.
“You have local churches, you have local organizations, you have family, you have friends,” Thompson said. “Really tap into and lean into your community to build you up during this time.”
That doesn’t always mean connecting with those going through the exact same situation; it also means cultivating relationships with people who have different but connected stressors.
“I’m a member of Jewish Voice for Peace and they save my life every day,” Dr. Khouri said.
DeLuca says that there is something to gain from “building those bridges and finding solace together.”
If you’re struggling with what you’re seeing in Gaza, here are some resources, some of which don’t require health insurance:
Inclusive Therapists connect patients with therapists, counselors, or coaches who can offer culturally competent care to people with marginalized identities.
Journaling Prompts for Healing is an exercise developed by Palestinian-American Psychologist Hala Alyan in conjunction with The Arab-American Family Support Center.
Somatic therapy exercises may help heal the body from mental and physical trauma, according to some therapists.
The National Suicide Prevention Lifeline offers help if you are having thoughts of suicide. You can call or text the volunteers at 988 or connect with someone online at 988lifeline.org.
This article does not mention the trauma of diaspora jewish people experiencing trauma from this as well