As the trauma and grief of the Mideast war hit his own community , a psychiatrist helps promote healing.
PSYCHIATRIC VIEWS ON THE DAILY NEWS
As I have mentioned recently in previous columns and videos, in my “refirement” state I have found myself much more involved in my community’s mental health, from being a movie discussant to serving on not-for-profit boards. That’s why I am now listed as a pro bono private community psychiatrist and a resident psychiatrist for various organizations.
With the emergence and escalation of the invasion of Israel and its ongoing war, a challenge for this kind of community psychiatry is how to address my Jewish community’s mental health, given the downstream rippling spread of trauma, grief, and anguish occurring in the Mideast and the associated media coverage. At the same time, my concern for our Muslim community needs to be conveyed, as it was in the book I edited on Islamophobia and psychiatry.1
Although the origin and development of the community mental health movement of the 1960s in the United States had a provision for going out into the community for consultation and primary prevention of psychiatric problems, it never developed into large scale psychotherapeutic healing endeavors and died off when the federal funding was turned into block grants to be used by the states for other needs in the 1980s.
However, an example eventually emerged out of Brazil called Integrative Community Therapy (ICT) . With psychiatric leadership using a trauma-informed approach, it brought community citizens together to process their mental health challenges. With researched-based evidence, it was even successful when it went virtual in the midst of the COVID-19 epidemic.2 Here is some of the feedback on it:
“I discovered that I can do more than I thought I was capable of.”
“I took the opportunity to clear my conscience.”
“I was hopeless, and the techniques of ICT gave me the strength to carry on.”
“We were able to discover together that we are living a fruitful experience.”
Such a community approach seems to have historical remnants in the inpatient therapeutic communities set up by Maxwell Jones, MD.3
Given that this Brazilian model has been successfully used in many countries, I wondered if it could be adapted and applied to my local communities as we struggle with our mental health in relationship to the Mideast war. A pop-up opportunity to do so arose last Tuesday for a large Jewish Men’s Club, a session I titled, “Maintaining Mental Health During the Mideast Conflict.”. Because men, especially older males, are not known for emotional sharing, I wasn’t sure how this would come out.
As the session started, I asked for whoever felt comfortable to share how they thought the crisis was affecting their mental health, and what they were doing to maintain it. I thought they could learn from each other without being judgmental. I needn’t have worried. With a full house of 40-50 attendees, voluntary sharing of personal concerns popped up readily, one after the other: expressions of fear, guilt, anger, ambivalence compassion, humiliation, activism, support, and harmful free speech. These along with other reactions were not very different from the ITC feedback gathered during the pandemic. No arguments or outbursts occurred.
There was recognition that some individuals seemingly need to go on as usual because the pain and fear is too much to bear consciously. Speaking up brings the challenge of doing so compassionately, effectively, and safely. Each perspective can provide learning and empathy. Warmhearted humor helps to grease the connection.
After the meeting, feeling drained myself, I went home to recuperate and take a nap. I put on a recording of Candide, the book and play I discussed during the November 1, 2023, video titled “Is This Really the Best of All Possible Worlds?” As I awoke to the beautiful music but distressing words describing so much human cruelty, I sobbed. I recalled a book being developed by the geriatrician Ashish Goel, MD, from India about doctors who cry,4 with a second volume in the works for which I contributed.
Once the tears stopped and dried up, I began to plan other such sessions.
Dr Moffic (he/him/his) is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry, and is now in retirement and "refirement" as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.
1. Moffic HS, et al, editors. Islamophobia and Psychiatry. Springer International; 2019.
2. Barreto AP, et al. Integrative community therapy in the time of the new coronavirus pandemic in Brazil and Latin America. World Social Psychiatry. 2020;2(2):May-Aug.
3. Fees C, Kennard D. Classic Text No. 133: 'Maxwell Jones and the Therapeutic Community', by David Millard (1996). History of Psychiatry. 2023;34(1):78-86.
4. Goel A. Doctors Do Cry. Hyderabad: Paras Medical Publisher; 2005.