Vol. II, No. I,  Thirteenth Issue,  January 2002





q       MESSAGE FROM THE SECRETARY GENERAL / DR Mohammed Farouk El Sendiony










q       MESSAGE FROM THE SECRETARY GENERAL / DR Mohammed Farouk El Sendiony

This is it: the end of 2001. It was a bad year for mental health. This was the year when "Panic was rampant everywhere".

The New Year 2002 offers a new clean page for us to write on, a new challenge, a new chance! This year we will get it right. Meanwhile, "Be Merry all, Be Merry all" as we ring out the old and ring in the New Year.

May we find the courage to dream great dreams. Dreams do come true. Happy New Year.



The phenomenon of suicide bombing is a significant topic in the field of mental health. We have devoted this issue for debating the phenomenon.

The term "suicide bomber" is a label which already defines and shapes the discussion. Perhaps we should try to think of a more neutral term. We believe suicide is NOT the primary focus of the action but is rather a consequence. The action is to do damage against the enemy.

Because of the prevalence of suicide bombing around the global village, there is need for a scientific investigation of the phenomenon. What is it?

We need to probe this issue further towards developing new theoretical models to define this phenomenon. Let us see if there is additional material in these manifest behaviors which has not been explained or fully accounted for by other diagnostic criteria.

Are there other models through which to view these actions? For example if we use a    "War Model" how would this behavior be categorized? "Good versus Bad, Right versus Wrong, Positive versus Negative, Healthy versus Pathological.

Looking at the Algerian model there are many actions by soldiers as well as by freedom fighters that would elicit opposite positions on these values. The French would consider it murderous; the Algerian would consider it militarily valid. Fanon would not be quick to criticize the resistance to an occupation for its tactics. The big issue is the occupation, not the means of resistance.



I know it is often argued that suicide bombings are either the result of frustration and desperation, or that they emerge from the pathology of religious extremism.

Some argue that suicide bombing is deeply rooted in the Islamic faith. Nothing can be further from the truth. The opposite is true. Suicide is negatively sanctioned by Islam. Recently the Grand Mufti of Saudi Arabia issued a Fatwa in which he pinpointed that suicide is a deviation from the Islamic Path. According to the Fatwa the suicide bomber is damned to Hell. Trans-cultural psychiatric studies of suicide have demonstrated that Muslim countries have the lowest rates of suicide for as long as comparisons have been made (Okasha, et al).

Contrary to the propagandizing of both some Muslim apologists for these acts of suicide bombings and anti-Muslim demagogues, such behavior can't be fairly ascribed to the Islamic Belief.

Suicide is an act of total alienation and despair. In the case of suicide bombing, it is encouraged and even induced by the propagandizing of a cult-like belief in supernatural compensation. Since the individual who perpetrates such an act feels no real material options are available on earth, he opts to accept what he has been convinced will be rewards after life. There are historical examples of Christians, Jews, Buddhists and Native Americans who have engaged in such behavior with similar rationales being offered for their acts.

But these are cult-like aberrations – not mainstream phenomena – since a fundamental function of all religions is to define a purpose in life and to make survival tolerable and meaningful even in the direst circumstances. Religion is not an invitation or an inducement to suicide or murder: those are negations of religion and the antithesis of its purpose.

The real culprit is frustration and desperation which permeate for example the totality of life of the Palestinians. A generation of Palestinians has grown to adulthood with little opportunity to live normal lives and with no hope that those circumstances can change. Daily life is hellish marked by violence, repression and humiliation, plus racism and despair.

To be demeaned or verbally or physically abused by soldiers or settlers, to lose a child or parent to settler attacks or just to be held arbitrarily for long periods of time in the hot sun at a checkpoint – to have no significant control over any area of one's life, in other words, to be powerless and denied all basic freedoms - can produce hopelessness and the rage that fuels feelings of violence that seek vengeance.

Certainly, Palestinians have been recipients of a consistent dose of such traumatizing and embittering experiences for decades.

In the process, military occupation is taken as an acceptable given and is scarcely mentioned; Palestinian terrorism becomes the cause not the effect, of violence, even though one side possesses a modern military arsenal, while the other is stateless, virtually defenseless, savagely persecuted at will, herded inside 160 little cantons, schools closed, life made impossible.

Worst of all, the daily killing and wounding of Palestinians is accompanied by the growth of Israeli settlements and the 400,000 settlers who dot the Palestinian landscape without respite.

For the Palestinians of all walks of life, Muslims and Christians alike - death seems so random and so close. There probably are times when they feel they want to die. In the words of a teenaged Palestinian, "Why live, why study, why dream or plan when they are going to kill us anyway". In the words of another, "A nightmare. It's a bit like being in an American movie that never ends. You know, it's like one of those horror or police movies, where people are killed in the streets. It feels unreal. But it is real".

Palestinians who were children during the first Intifada: are university students in this one. They never had a childhood, never enjoyed their teenage years. They've lived their whole lives in terror.

There are widows and orphans and homeless people everywhere.

If the reader of these lines has been exposed to what the Palestinians have or are continuing to experience, he would not have been far away from breaking. We know from some psychological "Experiments" that even the most emotionally healthy people (individuals) will break psychologically under enough pressure. The end result of this systematic traumatization might be depression. Suicide bombing is a kind of depression. It is reactive depression. It is a normal reaction to an abnormal situation and as extreme reaction to hopelessness.

The etiological factor lies in living under the Israeli occupation with no foreseeable resolution.

WIAMH invites the World Psychiatric Association to investigate this phenomenon thoroughly. What is it? Is it a post-traumatic stress?  However we are not looking at PTSD here because there is no Post, it is continuous trauma. It is the result of Continuous TS coupled to no one in the World community responding to verbalized cries and pleas for help.

Given the prevalence of this behavior in various troubled areas of the Global Village, WIAMH hopes that the WPA will set an international task force to make a thorough investigation of the phenomenon.

Given the asymmetry of power between Israelis and Palestinians it is incumbent upon members of WPA to demand that Palestinians be protected and their human needs be accorded the same as Israelis and our brothers and sisters.



From:                     "Al-Rashid Hospital" <>


Subject: Dear Dr. EL-Sendiony

Date:                      Sat, 8 Dec 2001 08:44:51 +0200


    Dear Dr. EL-Sendiony


AL-Salam Alikum wa Rahmt Allah wa Barkatoh. I am amazed and shocked to read the article (Suicide Bombing: A Socio-, Cultural Bound Syndrome). In the newsletter VOL.1, No.XII, Twelfth Issue Oct. 2001.


Do the Palestinians have to be sick to defend their land? The syndrome is
named but I don't see the Criteria to diagnose it, do we have to promise our rights of resisting occupations? so that the Zionist world will like us. Is our Islamic association supposed to tell the world, the sick Palestinians are to be blamed for the tragedy in the holly land? I have seen a lot of Palestinian fighters, ex-prisoner, those who are tortured, non of them want to die, but they have to die like any other fighter on this earth, who is fighting for a cause and may lose his life but that is not the target. Do you think of there are other means to liberate Palestine those people would kill them selves?
I hope the world Islamic Association will discuss this matter more and investigate thoroughly before asking the American Association to add a syndrome.



Walid Sarhan
Consultant Psychiatrist



                  Dear Dr. Walid,

I would like to thank you for your interesting contribution to the debate of this highly charged issue, both of intense interest to Israeli and Arab mental health workers.

However, I would like to register my cognitive dissonance for some of the questions which you raised.

Surely the Palestinians don't have to be sick to defend their land. It is very healthy from the mental point of view to fight the occupation. It is also scientifically valid that the fight of the oppressed against the oppressor enhances his mental health. Psychological studies have shown that participation of children and adolescents in the Intifada lifted their self-esteem.

But surely the barbarian and un-humanitarian methods of an apartheid regime have endangered and seriously impaired the mental health of the Palestinians.

And to add injury to insult they are blaming the victim.

Zionists have labeled the Palestinian suicide bombers as "Blood Thirsty Terrorists". Following the Zionists lead, Hollywood has demonized Arab Muslims. Last year the film was "Rules of Engagement" which vilified and demonized whatever, or whoever are Arabs and Muslim.

Our approach is not a "Picking between Mad and Bad". However we start from the fact that the Israeli occupation has seriously impaired the mental health of the Palestinians. And we have to demonstrate as Arab mental health workers, the damage which has occurred to the Palestinian mental health. We don't have to let them get away with it.

The Israeli rule of the occupied territories is the highest rule of immorality. As a testimony to the great damage which happens to the Palestinian psyche, I refer you to the following documentary film entitled "Occupation 101"

The world is not adequately informed of the human circumstances under which the Palestinians live – of how, for instance, the Israeli army has prevented the flow of food and medicine to thousands of wounded civilians. For the last year it has been a daily exercise for Israeli troops to bombard residential areas, gun down demonstrators and assassinate public figures – all in response to protests in which the Palestinians have only stones for weaponry.

The tragedy is deepening. Israel is using helicopter gun ships to kill Palestinian civilians and destroy their homes. Palestinian children and youngsters are being destroyed by Israeli armament for protesting with stones inside Palestinian territory.

How many children face psychological Traumas after Israeli attacks on Palestinian cities, villages and refugee camps, attacks that have been continuing for 35 years? What kind of harvest will be reaped from such trauma? What are the results of wakening children at midnight, so they can watch their fathers and brothers being taken away? What kind of men and women will emerge from such a tortured generation, raised under such a murderous occupation?

The answers to these questions are that these long systematic traumatizations must have serious repercussions on the mental health of the Palestinians. Dr. Walid Sarhan, you are asking for the criteria for the syndrome which I have suggested. The criteria is to live in a socio-political situation like the present Israeli occupation which is "Genocide in Slow Motion; an Apartheid Regime."

Thus pre-disposing factors are chronic psychosocial stressors (the Israeli Occupation), a rejecting and chaotic environment. Another criterion is feelings of hopelessness.

Living under these conditions induces a feeling of "false-hope business" and it also causes a lot of anguish which might trigger a murder syndrome among some people.

Dr. Walid Sarhan, you view depression as a stigma. I don't see it this way. For the last year I felt very depressed as a result of daily exposure to violent TV in which I witnessed the murderous behavior of the Israeli army which is testimony to humanity in short supply. "I am not ashamed of being human".

I would recommend you to read WIAMH newsletter 9, January 2001 entitled "An Apartheid Regime Endangers the Mental Health of Victimized Palestinians."

Dr. Walid, would you kindly circulate this debate among mental health workers in Jordan. We need more understanding of this phenomenon. It is an interdisciplinary complicated issue. It needs further debate.   



Dr. Mohammed Farouk El Sendiony



WIAMH would like to assure its readers of its full support for all genuine efforts to combat terrorism, and to bring those who deliberately harm innocent people for political gain to justice. But what is terrorism?


The State Department’s report, “Patterns of Global Terrorism: 1999” published on May the 1st states "The term "terrorism" means premeditated, politically motivated violence perpetrated against noncombatant targets by subnational groups or clandestine agents, usually intended to influence an audience."

This definition may be overly narrow, since it defines "terrorism" principally on the basis of the identity of its perpetrator rather than by the action and motive of the perpetrator. Hence, if Israel launches a massive attack on Gaza and deliberately drives several hundred people from their homes, openly threatens and targets civilians, and states that all of this is intended to pressure the Palestinian Authority, as Israel is continuing to do until January 2002, it does not fall under the definition of terrorism, solely because the State Department recognizes Israel to be a state.

If, by contrast Palestinian people organize themselves to resist an internationally condemned foreign occupation of their soil, the State Department terms this “Terrorism” even when such people restrict their targets to enemy combatants in occupied territory.

May WIAMH suggest the State Department broaden its definition of terrorism to include state terrorism. While terrorism as defined by the Sate Department is certainly disturbing, compared with the number of victims of state terrorism, it is relatively a minor concern. If you include statistics for state terrorism, observers could then objectively evaluate for example, PKK activities on the one hand against premeditated, politically motivated violence perpetrated against non-combatants carried out by the Turkish government.

This would provide the public with a fuller picture of the problem and analysts and policy makers with better information to make policy recommendations which could end a political conflict, injustices, and occupations which in nearly every case seem to generate the phenomenon known as “Terrorism”.



What will follow is an official recognition by the Israeli army acknowledging of being terrorists. It is entitled "Zionists and terrorism – it is official". It is from the Guardian Weekly, March 19, 1989 Vol. 140 No. 12.


"Zionists and terrorism – it is official"

    Dr. Joseph  Lerner (letters Jan. 22) claimed that Zionist fighters were not terrorist on the basis that their action involved military actions. He cited the infamous Deir Yassin massacre which claimed the lives of approximately 250 Arabs as an example of such military actions. However, a recent examination of sensitive Israeli documents of the early period of Israel does not support Dr. Lerner’s claim and substantially verifies that Zionist fighters were « terrorists ». Memories of those times have been revived by a new and brutally frank history book for the 1948 Palestine war, published by the Israeli Army, which provided the first official confirmation that the infamous Deir Yassin massacre was carried out despite a peace agreement between the Arab village and its Jawish neighbors, « The villagers were keeping to the agreement between us and we could not attack them in such an  ugly way » the author wrote.

     The author of this new book, which has been held up by the government censorship for 15 years in Yitzhak Levi, who served as the Jerusalem commander of the Intelligence Service of the Hagranah the mainstream Zionist militia which formed the basis for  the Israeli Army. His account is the first to be based on official Israeli archives. He goes a long way to debunking other, enduring, myths of the 1948 war « From war to war, Israel is learning to look itself in the eyes », wrote Tom Segev the historian and journalist « What it sees is not very pleasant ».

             I appreciate Dr. Lerner’s letter However, his claims are not only superficial, they are also misleading. They are not supported by official Israeli archives.

Dr. Mohammed Farouk El Sendiony

Riverina-Murray Inst…

Wagga Wagga, NSW