Beyond trauma, beyond humanitarianism, beyond empathy: A commentary
The authors of this Special Section invite us to consider what it means to go beyond the common trope of ‘trauma’ in conceptualizing events in the Middle East. Considering the question in relation to these contributions, I ask: is trauma a concept with sharp edges or a word at hand saturated with context that grows out of the experience of life and its many dissolutions? Together, this collection challenges the reader to think further about a family of concepts that might be honed out of the experience of survivors. It also calls for rethinking the idea of the Middle East itself as a region from which we could get an opening into different ways of showing what it is to be a chronicler of how life is being remade. In my 2015 seminar on violence and non-violence, the four undergraduate students signed up for the class were a little surprised that I began with a discussion on American humor after 9/11. I could think of no better way to stop the automatic rush of thoughts that come with the mention of terms such as ‘9/11’, ‘axis of evil’, or even ‘the Middle East’. In discussing how the media shapes our world and the way we live in it, the anthropologist and cultural critic Thomas de Zengotita (2006, 170) writes in an ironic tone: ‘The vaunted “wisdom of the American people” – even more vaunted than Iraq’s Republican Guard – is the more to be cherished for being theirs by definition, effortlessly acquired, no tedious Beyond trauma, beyond humanitarianism, beyond empathy 106 study, no demanding ethical reflection required, yet another convenience in a convenient world’. While his sarcasm resonates with fleeting thoughts of my own when I read or hear platitudes about the ‘culture of violence’ or the ‘clash of civilizations’ – it also jars against my sensibility of trying to find a voice in which criticism is not so dependent on indignation alone. It is in this spirit that I find a companionship with the authors featured in this Special Section of MAT, who invite us to consider what it means to go beyond the common trope of ‘trauma’ in conceptualizing events in the Middle East, even as we put this trope under question. This is not to criticize indignation, as if those who continue to suffer from the brutality of these wars and occupations have an obligation to be more reasonable than anyone else, but rather to recognize the power of thinking otherwise. As in many other regions in which national boundaries were a result of colonial interventions, the term ‘Middle East’ is not a simple neutral term – it bears traces of its military origins. As Marshall Hodgson (1963), among other scholars (Hourani 1991; Issawi 1980), has argued forcefully, one cannot simply take the present territorial boundaries as the units for narrating the history of the specific spatial configurations in the region. If we then accept that from the start these units were indeterminate categories, more useful for providing a critical analytical framework than marking off spatially distinct social formations (Sinha 2013), then what challenge to thought have the authors of this special issue identified and what critical responses do they offer? First, as the title ‘Beyond Trauma’ signals powerfully, the authors featured here want to loosen the overdetermined connection made between the experiences of war, continuous occupation, displacement and countless other assaults on everyday life, and the proliferation of discursive and nondiscursive forms in which international humanitarian interventions come to focus on trauma as the dominant trope for representing the consequences of these violations. Second, while one might legitimately do a genealogical analysis of the term ‘Middle East’ or show its ‘constructed’ character, it is much more instructive to see the nodes of connection that have emerged in the region precisely in tandem with geopolitical developments, including war, occupation, and the rise and fall of authoritarian and democratic regimes. Recent critiques of international humanitarianism have been quite effective in making available the idea that the centrality of trauma and the recognition accorded to PTSD as a diagnostic category (DSM-III 1981) serve to authorize specific ways in which the suffering of war and occupation can be given expression, while simultaneously putting under suspicion other ways of speaking of violence. This is not a matter of expert versus folk discourses – as if suffering could be neatly partitioned between a modern form and a Medicine Anthropology Theory 107 traditional one – but rather of what Asad (2002) calls ‘strong languages’ that wield power to organize, of what Jacques Rancière (2006) tells us is the arrangement of the seen and the unseen or the organization of the sensible. Yet in many ways, the papers gathered here push what I would call the ‘unthought’ of politics even further. Consider the contribution by Hanna Kienzler and Zeina Amro on mental health system reform in the West Bank. The authors make the astute point that population has emerged as an important object for mental health intervention in global programming and, that when applied to situations of war or genocide, there is an additional assumption that emergency measures to provide therapy must be taken. However, I think that the shift from the individual patient to the population allows another shift to the assumption that everything from severe mental disorders to common mental disorders can be treated with drugs for depression or anxiety in a primary care setting without the need for close clinical supervision. Further, it is taken for granted that we can separate a discrete entity called ‘mental illness’ from the general conditions of severe poverty or from the continuous disruption of ordinary life. And, as Lamia Moghnieh (2014) stated in her presentation at the workshop with great clarity, wars do not always produce trauma of the sort that diagnostic manuals recognize and, even more significantly, ways of suffering become part of the rhetoric of war itself. Moghnieh touches on a much wider problematic that goes beyond the specific case of countries in the Middle East to ask: how do categories such as PTSD become part of political negotiations over what form expressions of suffering have to take to be acknowledged and domesticated, as accounts of suffering move from the private into the public domain? As Allan Young (1997) argues in his brilliant book on PTSD, consolidation of this diagnostic category in the context of the critiques of the Vietnam War allowed the United States to bypass the question of what bearing revelations of war atrocities would have on the treatment of war veterans. Were they heroes to be valorized for their sacrifices for the nation, or war criminals who had violated wartime laws? By recasting the conditions of veterans as cases of mental illness, it became possible to overcome a political impasse. The issue here is not whether PTSD is real or not, but what forms do the relations among politics, law, and psychiatry take in different time-space configurations? In the converse case – when trauma is not found where it is expected to be – its very absence morphs into a form of symbolic capital, as in claims made by Hezbollah about the resilience of the population in Lebanon in the context of multiple wars, or the frequently Beyond trauma, beyond humanitarianism, beyond empathy 108 evoked virtue of sumud, endurance, among Palestinians under occupation.1 Yet, the claims over resilience and tough masculinity notwithstanding, there is spoken and unspoken suffering among those who survive and live in the shadow of these wars, not only resulting from Israeli aggression, but also from the restrictions on citizenship imposed on Palestinian or Iraqi or Syrian refugees by various Arab countries. We might ask: is trauma one thing – a concept with hard boundaries – or is it a malleable category that becomes saturated with context? If we are to train our eyes to look and see what is happening between the crevices of the hard discourses on trauma, it changes shape as we follow the labor performed by various Palestinian therapists, NGOs, or human rights workers in Palestine. These local workers do participate in the humanitarian therapeutic interventions, whether as physicians, mental health specialists, or NGO staff, and pragmatically use what resources become available through international NGOs. One of the important points made by Palestinian scholars such as Sa’ed Atshan who speak from the onthe-ground realities of life in the occupied territories, is that people invest time and labor in these interventions because they find moments of hope in these institutional resources.2 Thus, although people are indeed interpellated by the categories of classification with which they are confronted, they are not entirely remade into the identities imposed by these categories. I do not deny the great contribution of Michel Foucault (2005) as he asks us to consider how we are invited or incited to become a subject, and that of Ian Hacking (1998) who shows that there are ecological niches that allow a particular disease category to emerge at any time, but, as I have argued elsewhere, subjectivity is not determined completely by these modes of subjectivation (see Das 2015).3 These arguments do not take away from the force of criticisms against sentimental humanitarianism but they do try to show the different social life of humanitarian aid. In the hands of bureaucrats reviewing cases for asylum, the presence or absence of trauma as determined by the application of medical diagnostic criteria can be used as a tool for exclusion as immigration officers separate the ‘genuine’ victims from the so-called frauds; it can serve to stage a contest over the masculinity and relative resilience of one set of fighters 1 The category of sumud is frequently politicized as in pressure to control unruly emotions, as shown by Segal (2015) in her work on the wives o