Objective: The mental health consequences of political violence arise within active, dynamic processes of appraisal and coping. Understanding the psychological sequela of war is an urgent task; yet, we have little on the ground exploration of the quotidian events within and the accompanying psychological responses of the totalizing experience of war. Using a transactional-based model of stress and coping, in this study, we use a novel method-retrospective diaries-to explore the shifting, unpredictable, and traumatic nature of life during a major military operation. Method: Our sample consisted of 21 Palestinian women recruited via an intervention for teachers in Gaza. Women's retrospective chronological diaries were analyzed using content analysis. Results: Our analysis drew out the cyclical process of coping within political violence, demonstrating five essential temporal dimensions: warning; bombings, with injuries, death, and destruction; reintegrating within flight and resettlement; ongoing political insecurity within precarious truces and rampant loss and destruction; and persevering: restarting life amid pervasive trauma. Conclusion: Our findings draw attention to vital temporal dimensions and the cyclical nature of stress and coping that underlie the sequela of mental health in a highly charged context. In tracing warfare, its psychosocial consequences, and distinct patterns of emotional and logistical survival, our study contributes to the growing field of psychological epidemiology of war.
Clinical Impact StatementThe transactional model of coping is often used to help understand the complex sequalae resulting from stress and trauma. Here, we demonstrate the importance of using that framework while prioritizing the cyclical and collective nature of coping within the immense and ongoing stress of political violence. Through building on the strengths and strategies women elucidate in our study, we are better able to leverage these protective factors in interventions aimed at ameliorating the psychological effects of war. Furthermore, in demonstrating the complex and lasting mental health issues related to not only acute assaults but also ongoing stressors related to political and economic siege, our study bolsters the movement to engage in efforts to prevent war and occupation.