A Psychological Travelogue: From Casablanca to Morocco

November 12, 2014

Although 2 weeks of protected touring is hardly enough time to get a sense of Morocco, there was a familiar parallel to cross-cultural psychiatry. Let the patient tell you what they are about culturally, respect that particular point of view, relate to them as they wish, and support that with study.


But it’s still the same old storyThe fight for love and gloryA case of do or die . . .

So goes some of the lines from the famous song “As Time Goes By” from the movie Casablanca. It has been playing in my mind on and off recently.

It was October 31st, a day of trick or treat in the US. But we were in Muslim Morocco, and there is virtually no Halloween celebrated here.

I entered a bar that looked like Rick’s Cafe from Casablanca and picked up the International New York Times.1 One of the headline articles was “Israel closes religious site for hours as tensions rise: Action follows killing a Palestinian suspect in an assassination attempt.”

[[{"type":"media","view_mode":"media_crop","fid":"29407","attributes":{"alt":"global psychiatry","class":"media-image","id":"media_crop_5896792623258","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"3041","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","title":" ","typeof":"foaf:Image"}}]]The next day is November 1st, the Day of the Dead in Christian Mexico, but that day is also not celebrated in Morocco. Instead, after boarding our tour bus, a young boy throws a stone toward another boy, but mistakenly, consciously or unconsciously, misses, shattering a small part of our front window. It elicits associations to Palestinian boys throwing stones on the Gaza strip. Two security guards, with rifles and a pink armband shout “Alert” in Arabic. This new security force was established right before we came by the King, as Morocco was targeted by ISIS.

What is cause for celebration is that Morocco is a Muslim country in North Africa. It is 8 or so miles due South across the Mediterranean Sea from Spain, and it is at the far Western edge of what in some connected way could still be considered the Middle East. What a treat it would be if Morocco were to become a model for Mideast and African peace, prosperity, and the prevention of PTSD epidemics!

Cultural competence in psychiatry and society
Fortunately, the Center for Cross Cultural Learning in Morocco organized our tour. Although 2 weeks of protected touring is hardly enough time to get a sense of this country, there was a familiar parallel to my career focus on cross-cultural psychiatry. Let the patient (or person) tell you what they are about culturally, respect that particular point of view, relate to them as they wish, and support that with study. That the US needs to know more about Muslims became obvious once again when in a National Football League game, a player was recently penalized for kneeling for a Muslim prayer after scoring a touchdown, but it was misinterpreted by the officials as a prohibited celebration.

Intriguing to me in my clinical career was the psychological veil worn by traditional Muslim women, revealing little of their inner and family lives and usually only wanting brief medication visits. Shaking hands was not customary, and eye contact averted (to avoid any suggestion of desired intimacy).

Right before leaving for the tour, friends wondered whether we should cancel due to ISIS and Ebola. It didn’t help that the movie Horses of God came out, depicting the suicide bombings across Casablanca in 2003 and targeting Jewish historical sites and sites frequented by foreigners.

I contacted a psychiatrist colleague in Casablanca and he reassured me that because of the unique culture and history of Morocco, we would be safer than in many places in the US. Sure enough, just a few days before we left, 2 students were shot dead and 4 injured in a school shooting outside of Seattle. We came home safe and sound.

Heterogeneity amidst homogeneity
I did not know what I expected to find in my inner journey when I walked alone to the top of a Saharan sand dune to see the sunrise. Three hundred and sixty degree beauty and awe I was sure that I would experience. I was also virtually sure that I would not have any revelations like many religious sages have had in the desert. Instead, the howling winds of nature seemed to sound a paradox. Like the manmade oasis we were staying at in the midst of a barren dessert, Morocco seemed to be a paradox, a country of heterogeneity amidst homogeneity.

The homogeneity is that about 99% of the country is now Muslim, and Sunni Muslim at that, with a Shi’ite Muslim history and influence. ISIS is Sunni, too, but what a difference in fundamentalist versus a moderate expression of such a religious belief system based on the Koran. Perhaps that partially explains the very mild Arab Spring that Morocco experienced.

Besides that, the King made some reforms. The government is a centuries-old constitutional monarchy slowly democratizing. This dynasty is said to stem from the bloodlines of the prophet Mohammed, with the current King being Mohammed the VI. This King identifies the country as the Kingdom of Morocco.

Prayer is called for 5 times a day, and the loudspeaker call to prayer can snap you out of whatever you are doing or thinking at the time. On our last Friday, an extra prayer was added for rain in the midst of a climate caused drought. Sure enough, it rained two days later. Whether that was anticipated due to the weather forecast and/or Allah willing, is open to interpretation, though we all know how wrong weathermen can be in their predictions. What people do in prayer and practice is private.

This practice of Islam, as homogenous as it may be in Morocco, may also be the hub of the many spokes of the country. While the spokes can be blurred when Morocco hums along, here are some of the isolated spokes I saw:

• People
The population is dominated by, and about equally divided into, the native Amazighi (less politically correctly called Berbers) and the later arriving Arabs, with increasing mixtures of the two.

• Protectorate
From 1912 to1956, the country was under French “care,” and while the population of French people is much less now, the French influence is still present in language and culture, especially in the development of the city of Casablanca. Casablanca was a town of 12,000 in 1912, but the French built a port, and now Casablanca is an international city of over 6 million.

• Judaism
As the Protectorate was ending and Israel was developing as a nation, the Sephardic Jews who left Spain with the Muslims during the Christian Inquisition in Spain, left Morocco for Israel in numbers ranging from 500,000 to 1,000,000. However, many do return for holidays, which does not occur in other Middle East countries that Jews left.

• Geography
The geography varies from surf to snow, and from forests to the Sahara desert.

• Exceptions
Almost all Muslim rules have enough exceptions, such as the alcohol prohibition in Islam being skirted in some places, and beaches that allow bikinis in a country where most women are covered in clothing except for the face, hands, and feet. Reportedly, the most popular belly dancer in Morocco is a fully transitioned transgendered woman.

Play it again, Sam-but this time with coffee
We ended the trip in the city of Casablanca. Before we left, we watched the movie Casablanca, which was filmed in the US in 1942, just before the US and its Allies landed in Morocco and successfully drove out the Germans. In 1943, Casablanca was the secret rendezvous for Roosevelt, Churchill, and de Gaulle, who together decided that the war must end in the unconditional surrender of the Axis nations.

Like all great movies, Casablanca revealed more the second time around. For me, one of the new considerations was the relationship of alcohol to violence, a topic I touched on in an earlier blog comparing alcohol and marijuana. Though alcohol, as discussed, is prohibited by Islam, the violence in some Muslim countries has escalated. On the other hand, in the US, alcohol seems to be a significant factor in up to half of violent crimes, but that means it is not in the other half. For that other half, personality vulnerability and cultural values, among other variables, are the more important factors.

This partially significant association between alcohol and violence might suggest that if there were ever a sequel to Casablanca, in today’s coffee culture in the US, maybe the location would be in a Starbucks store. That would even be more respectful of the Muslim culture. However, the coffee should be served without sugar, as some research indicates young people become more aggressive after drinking several soft drinks with caffeine and sugar.

Given that possibility, could the best location for the new Rick’s Cafe in the sequel (and there actually is a new Rick’s Cafe in Casablanca) be a marijuana den? Marijuana and the more potent hashish were celebrated in the writings about Morocco by the American expatriate Paul Bowles, and have remained relatively acceptable substances to use. On the whole, marijuana seems to be associated with less violence.

Whatever the propaganda purposes and the fake description of Casablanca in wartime, it seems to reveal some deep human truths. No wonder the piano player Sam sings “As Time Goes By” over and over. Some lessons are hard to learn and have to be played out over and over to get things right, just as often occurs in psychodynamic psychotherapy.

That’s what the main characters in Casablanca do. They overcome their moral conflicts, past humiliations, and cultural differences for the greater good to trick the local leadership of the homogenous genocidal group dedicated to racial purity and power-not too unlike some of the current goals of ISIS.

Indeed, while the Nazis were escalating their killing of Jews across the lands they conquered, King Mohammed the V (the grandfather of the current King), refused a demand by the pro-Nazi Vichy French regime to turn over a list of Jews living in Morocco. The King reportedly replied, “I don’t have any Jews here, I only have Moroccans.” Many were thereby saved.

If Morocco can overcome its limitations, some of which seem to be paternalism, poverty, and relative lack of international power, we can hope that someday Morocco can contribute something similar to the movie in real life. Go to Morocco and see for yourself if you agree.


1. Kershner I, Rudoren J. Israel closes religious site for hours as tensions rise: Action follows killing a Palestinian suspect in an assassination attempt. International New York Times/Jerusalem. October 31, 2014 (page 1). Also see: http://www.nytimes.com/2014/10/31/world/middleeast/israel-palestinians-jerusalem-temple-mount-al-aksa.html. Accessed November 12, 2014.