ABSTRACT
For decades, Palestinians in the occupied West Bank have lived under chronic political violence, a context that shapes not only their external realities but also their inner, subjective worlds. While research has documented rates of post-traumatic stress, less is understood about the phenomenological experience of continuous traumatic stress (CTS) and the culturally specific ways people find meaning and endure. This study sought to understand the psychological and emotional landscape of Palestinian adults living under ongoing threat, exploring how they experience trauma, process loss, and construct meaning through coping strategies rooted in their culture. We employed a convergent parallel mixed-methods design. During January 2024, we surveyed 402 adults from high-exposure locations in the northern West Bank (Jenin, Askar, Balata, Ein Beit Alma refugee camps, and Nablus Old City) using the Politically Violent Events Scale (PVES), the Continuous Traumatic Stress Response (CTSR) Scale, and a culturally adapted Jalowiec Coping Scale (JCS). In February 2024, we conducted in-depth phenomenological interviews with a purposive subsample of 10 participants. Quantitative data were analyzed using descriptive and inferential statistics; qualitative data were analyzed using inductive thematic analysis, prioritizing the lived experiences of participants. Quantitative findings revealed extensive exposure to political violence, with home searches by soldiers being the most common event (76.6%). Levels of CTSR were elevated, particularly in the domains of fear/helplessness (63.6%) and exhaustion/detachment (62.7%). However, these numbers gain meaning only through the qualitative findings, which revealed six central themes: (1) Military occupation as a source of pervasive terror and humiliation; (2) Political violence as a cause of psychological and physical illness; (3) The profound and ambivalent grief following the loss of loved ones, where pride and pain are inextricably linked; (4) Remembering martyrs as a complex emotional space of both connection and sorrow; (5) Sumud (steadfastness) as a form of active, meaningful resistance that reframes daily survival as a political and personal act; and (6) Diverse coping mechanisms, with spirituality and religious faith serving as an unassailable anchor. For Palestinians living under occupation, trauma is not a discrete event but a continuous, shaping force. Their responses are not merely symptoms but are interwoven with cultural narratives of loss, resistance, and faith. Sumud and religious practice represent profound, culturally grounded forms of resilience. Mental health support must move beyond pathologizing normal responses to abnormal circumstances and instead work to understand, validate, and strengthen these existing, meaning-making resources.