Until recently, it was acceptable to summarize wars according to the number of killed and wounded among the involved parties - mainly adult soldiers who actively participated in the war, whose territory was a battlefield distant from the civilian population. Today, we are witnessing a significant change in how wars are waged, and the result is that many civilians - men, women and children - are getting hurt. Technological advances have transferred wars from the battlefield to the civilian world - to the home and neighborhood. In addition, we are seeing a different discourse on the impact of war, refering not only to physical wounds but also psychological wounds of combattants, civilians and their children.
Other developments during the past few decades are connected to the emphasis and importance given to the psychological welfare of the child. There is no doubt that a child's early experiences have a great influence on the thought and emotional components of its personality. Therefore, exposure to experiences of death, injury and destruction has an impact on the psychological development of a child.
The fact that children are inside the arena of war, either physically or via the media, shows there is a need to study the affect of war on children and to look for ways of mobilizing the maximal psychological assistance to help them. The impact of war on children is connected to "Post Traumatic Stress Disorder" (PTSD), a psychopathological phenomenon originally identified in the context of traumatic experiences in normal life, such as rape, accidents or other life-threatening events. This led to a debate in professional psychiatric literature about the degree to which the PTSD concept could be applied to the reaction of children in violent conflict and war situations.
Jensen and Shaw (1993) point out a number of differences between violent conflict and war as a cause for stress and other life events. In their view, violent conflict and war, unlike regular occurrences, are ongoing and not one-time or temporary situations. In addition, the events of violent conflict and war exist as part of a broader national and ethnic conflict, and many more people are involved than in an individual traumatic experience. They agree with the argument (Rosenblatt, 1983) that it is possible that children born into violent conflict or war and who grow up within its conditions may experience the conflict-ridden situation as normal and part of daily life.
Another debate exists about whether emphasis should be placed on the pathological effect of violent conflict and war on children, or whether it is preferable to study the resilience children reveal in response to violent conflict and war. Scholars such as Dawes, Tredoux and Feinstein (1989) warned against too sharp a movement between the two extremes or an exaggerated emphasis on the suffering caused to children, or the current tendency toward an exaggerated emphasis on the components of power and ability to cope. In any event, we should take into account the many studies that point to the different psychopathological reactions that children reveal during war situations (Arroyo & Eth, 1985; Kinzie et al., 1989), and to the researchers who have explored the Palestinian situation (Punamaki & Sulieman, 1990; Baker, 1990; Abu Hein, Qouta, Thabet & El Sarraj; Maslaha, 1993).
Since the study of the impact of violent conflict and war on children still hasn't resolved many questions, there is much room for research to learn more about the psychological effect of collective violence and wars, about the specific factors which can increase or decrease the damage, about the variables responsible for the differences in children's responses to the same trauma, and about the impact of cultural background on children's responses. We are mainly lacking studies which measure the long-term impact. Many of the war situations that have occurred during the past 50 years were experienced in the developing world where children constitute about half of the population (Zwi & Ugalde, 1989). This limits the possibility of research about children in violent conflict and war because of the lack of resources for such studies in many developing world areas and the limited number of scholars.
That reinforces the importance of the current research, a study that provides an insight into the inner world of Palestinian children through their dreams. This research has two unique aspects: its method (dreams), which is indirect and bypasses the child's "consciousness," and the study of the child's psychological situation through its perceptions and thoughts toward the present and the future.

Methodology

This study uses dream analysis to measure the psychological state of Palestinian children. This method has its strengths, which are expressed in the fact that the children didn't know what the researcher was looking for, thus they projected their inner world in an authentic manner. This observation is important particularly when it comes to the political sphere, which is loaded and where positions are usually clear to all the subjects of such research, including children.
Bilu was among the pioneers of research in this approach to child psychology in a political context (Bilu, 1989). During the first Intifada, a follow-up study was done to examine the unique situation of Palestinian children, who, for the first time, found themselves in the line of fire (Masalha, 1993). The current study is a continuation of this series which enables us to learn about the changes that occur not only in the world of these children, but also in the general situation as reflected in the world of the child.
One hundred and fourteen children, aged nine and ten, half boys and half girls, from the Ramallah and Bethlehem area in the West Bank, participated in the study. The children were asked to write about their dreams in a notebook over a l0 day period. They were also given the opportunity to write imaginary stories, to avoid any confusion between dreams and stories. The analysis was based on the dreams alone.
The 114 children presented a total of 171 dreams, an average of 1.5 dreams per child.

Categories Examined in the Dreams

Content of the Dream: About two-thirds of the dreams were political (a dream who's central subject is political), and one-third were nightmares (dreams which raise fears to the degree of sleep disturbance). A very small percentage of the dreams expressed personal wishes (personal desires that express a wish the dreamer wants for himself, such as economic, academic or other success).
Beginning and End of the Dream: About three-quarters of the dreams had a bad ending, while only one-quarter had a good ending.
Role of Parents in the Dream: Parents appear in only 25 percent of the dreams, and only try to help in one-third. In the remaining two thirds of dreams the parent either tries to help and doesn't succeed, or is himself hurt.
Interaction Between the Images: In 85 percent of the dreams, there is a physical confrontation, while 15 percent of the dreams contain verbal confrontation. In none of the 171 dreams was there friendly contact with Israelis.

Example of a Nightmare:

A girl from a refugee camp in the Bethlehem area wrote: "While I was sleeping, I dreamed an Israeli plane began to shoot at and bomb houses. I was there, I fell on the ground, a missile hit me in the head. I felt that my head was separated from my body. I was very frightened, and I woke up in a panic."

Example of a Dream that Begins Well and Ends Badly:

A girl from the Ramallah area wrote: "We went on a trip from school. We walked in the countryside. It was pretty. Suddenly a jeep arrived with Israeli officers. I managed to get away and climb a hill. I looked down and saw the soldiers make the children stand up and raise their hands and begin to interrogate them."

Example of a Dream which Begins Badly and Ends Well:

A girl from a refugee camp in the Ramallah area wrote: "I dreamed that shooting began at our house. No one was home. I panicked. I hid in one corner of the house, looking for a way to escape. Suddenly I found myself running to a house in the neighborhood where I found my parents. I felt happy."

Discussion

Let me note that, at this stage, there is no reference to other comparison groups that might teach us about the meaning of this data. Comparison groups in this sphere will be those directly involved in a conflict, such as the Jewish and Arab populations in Israel, or the populations in the neighboring Arab states. Comparisons will also be made with other populations in the world.
According to our data, it is clear there are a high percentage of political dreams. This shows us that the children invest a great deal of energy in the political conflict. It is, of course, possible to ask to what degree this investment comes at the expense of other spheres of life, such as education and games that are a central part of children's lives. This is compatible with the findings that there are only a small percentage of dreams that deal with personal wishes. The wish of the Palestinian child is a collective national wish, meaning there is a loss of individual borders and a blending with the collective. It is possible to view this tendency as a defense mechanism against an existential threat, because when there is a threat against the individual, it is much safer to be part of a larger group. Individualism is reinforced by culture but the assumption here is that the cultural values encounter a difficult reality for the individual, reinforcing his readiness to abandon individualism.
Thirteen percent of the children studied see themselves as shahids (martyrs) in their dreams, many actively blowing themselves up in Israel. We can see this phenomenon in the perspective of the giving up of self for the sake of the group. The borders of the "I" expand and encompass the collective.
Interaction with Israelis is characterized by physical confrontation and very little verbal confrontation. There is no positive encounter between the sides in the dreams. This raises serious questions about how the Palestinian child perceives the Israeli. It clearly reflects the reality of violent confrontation that has existed during the past two years, a reality where there are almost no positive experiences between Palestinians and Israelis, particularly when it comes to children.
Concerning the nightmares that constitute one-third of the dreams, one can think about the repercussions of the situation on the psychology of the individual and on the degree of damage to the child's soul. Tamar Lavi, who studied the same population about a year after the outbreak of the second Intifada in 2000 as part of her doctorate at the University of Tel Aviv's School of Social Work, found that more than 70 percent of the Palestinian children answer the criterion for PTSD (Lavi, 2002).
The children's internal feelings and approach to life are expressed in the finding that two-thirds of their dreams end "badly." Is this the expression of a pessimistic outlook, of a lack of optimism, of a discouraging perception of the situation and perhaps to life? Bilu (1989) found that Jewish children's dreams tend to have a good ending. In most instances, a strong, armed adult arrived to extract the child from any situation with an attacking Arab. In contrast to these feelings of security reported by Bilu, the Palestinian child today doesn't have any safe places. Children and their families are hit in the very places which were supposed to be the safest, in the home and at school. The adults are unable to help and parents are hurt in one-third of the dreams. This raises questions about the lack of a basic sense of security and about a perception of parents as impotent.
Another finding worth noting is the high frequency of dreams that have a halt in the flow of an event. When it's connected with a blow, it usually refers to a physical blow, and when it's connected to a psychological blow that expresses itself in post-traumatic symptoms, it is rarely connected to a "restriction" effect. Perhaps the curfews and roadblocks that appear in many of the dreams create an inner sense of deadlock or stoppage in the children. The dream of the girl from Ramallah, where the class trip ended in a halt and the raising of hands, is a good example of flow interruption.
The first findings of the current study raise a number of serious questions at the psychological level of the individual and the family, and also at the level of society and the relations between the Palestinians and the Israelis. Palestinian children are growing up and it's possible to ask to if, within a reality which is saturated with violent conflict and fear, they will trust the world or if social regression and paralysis will be part of their response to traumatic events. Can the relatively high motivation "to explode" that is expressed in their dreams possibly be interpreted as the opposite of the sense of immobilization and impotency? There are still many unaswered questions about the growing phenomenon of suicide bombing among Palestinian youth.
On the plane of Israeli-Palestinian relations, the leaders in the main political streams on both sides recognize there can be no solution based on the physical elimination of the other. In the end, a solution has to be achieved through negotiations which will end the era of war and begin an era of bridge building. In light of the harsh experiences this Palestinian generation is experiencing the question is - to what degree will these emotional experiences leave room for reconciliation and the establishment of relations between the two peoples? Will the continuation of the current situation mean a growing gap between the two sides, what type of experiences will have to be cultivated to bridge this gap, and over what length of time?
Another question raised by the findings concerns the passivity of the children in their dreams. The children usually saw themselves being hurt, which occurred when they didn't initiate an attack or were unable to defend themselves. Abu Hein et al. (1993) pointed to the effect of activism on the children as a positive factor that helped them confront trauma. So what happens to children in the second Intifada when they return to passivity? This study did not examine buffer variables that have been reported in professional literature.
Zahr (1996) reported on the importance of a family atmosphere to help children cope with a war situation, in the Lebanese context. Others have explored the effect of social and community sources of support as a moderating factor on war traumas (Jensen & Shaw, 1993). A careful examination of the social and community situation of the Palestinians reveals factors that serve as buffers and factors that frustrate. The community factor moderating the effect of trauma here is the solidarity among the Palestinians in their perception of the struggle which sees everyone hurt as a hero and every death as an act of martyrdom.
The frustrating factor is the difficult economic situation, the high unemployment rate and the existence of limited community services, particularly in the field of mental health. Though those services underwent significant growth over the past two decades, particularly during the first Intifada at the end of the '80s and the beginning of the '90s. During that period, services were developed that included rehabilitation and mental health centers on both governmental and non-governmental (NGO) levels.

Conclusion

A number of conclusions can be drawn from this study at the level of the mental health of the individual, the family and society, and at the level of relations with the other nation with which an ongoing struggle is being waged. The first findings raise a number of disturbing questions about the mental health of the Palestinian child and its attitude and perception of the Israeli. The multiplicity of nightmares, the fear and the violence are disturbing at the individual level. The lack of any positive interaction and the minimal verbal exchange between the two nations, the Palestinians and the Israelis, are not encouraging indicators to find a way out of the current deadlocked situation.


Abu Hein, F., Qouta, S. Thabet, A., P El Sarraj, E. (1993). Trauma and mental health of children in Gaza. British Medical Journal, 306: pp. 1130-1131.
American Psychiatric Association (1994). Diagnostic and Statistical manual of mental disorders (4th ed), Washington D.C.
Arroyo, W. & Eth, S. (1985). Children traumatized by Central American warfare. In: Post-Traumatic Stress Disorder in children, eds. S. Eth & R. Pynoos. Washington D.C. American Psychiatric Press.
Bilu, Y. (1989). The other as a nightmare: The Israeli-Arab encounter as reflected in children's dreams in Israel and the West Bank. Political Psychology, 10: pp. 365-389.
Dawes, A. Tredoux, C., & Feinstein., A. (1989). Political violence in South Africa: Some effects of the violent destruction of their community. International Journal of Mental Health, 18 (2): pp. 16-43.
Jensen, P.S., Shaw. (1993). Children as victims of war. Current knowledge and future research needs. Journal of the American Academy of Child Psychiatry, 32: pp. 697-708.
Kinzie, J.D., Sack, W. Angello. R., Clarke, G. & Ben, R. (1989). A three-year follow up of Cambodian young people traumatized as children. J. Am. Acad. Child. Adolesc. Psychiatry, 28: pp. 501-504.
Lavi, T. (2002). The Israeli-Palestinian Conflict and its influence on the psychological adjustment of children. A paper presented in the conference "Promises Never Fulfilled." The School of Social Work Tel-Aviv University, May 27, 2002.
Lavi, T. Both sides of the fence: Psychological adjustment of Palestinian and Israeli children exposed to the Intifada. The first bi-national conference on treating traumatized children and adolescents. Schneider Hospital, Petach Tikva. June 2002
Masalha, S. (1993). The effect of pre-war conditions on the psychological reactions of Palestinian children to the Gulf war. In Lewis, A. L., & Fox, A.N. (Eds). The Psychological effects of war and violence on children. New Jersey: Lawrence Erlbaum Associates.
Punamaki, R.L., Sulieman, R. (1990). Predictors and effectiveness of coping with political violence among Palestinians children, British Journal of Social Psychology, 29:s pp. 67-77.
Rosenblatt, R. (1983). Children of War. Garden City, New York: Anchor Press/Doubleday.
Zahr, L,K. (1996). Effects of war on the behavior of Lebanese preschool children: influence of home environment and family functioning. American Journal of Orthopsychiatry, 66: pp. 401-408.
Zwi, A. & Ugalde, A. (1989). Towards an epidemiology of Political Violence in the Third World. Social & Medicine, 28: pp. 633-642.