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Towards Healing and Growth Rethinking Mental Health in Tunisia5 min read

By Wassim Elhouar August 25, 2023
Written by Wassim Elhouar August 25, 2023
Mental Health in Tunisia

Tunisia finds itself in a precarious position that few other countries can claim.

It was only recently that the COVID-19 pandemic exacerbated and overburdened people’s mental and emotional well-being; in isolation, this event would have been stressful enough, but placed against the backdrop of Tunisia’s continued political and economic woes, there’s little surprise that Tunisia is among the most stressed and depressed of the Middle Eastern and North African (MENA) countries. Yet the pandemic, and Tunisia’s larger problems, alone can’t explain why Tunisians are some of the unhappiest people in the world – the 2022 World Happiness Report ranked Tunisia 120th out of 146 countries.

When we talk about mental health, when we talk about trauma, what comes to mind? We might think of a natural disaster or a terrorist attack; we might think about physical abuse or a terrifying incident that happened when we were younger.

We might resort to stereotypes of what it means to struggle with mental health, or what someone who is experiencing anxiety or depression is supposed to look and act like. Less often, if at all, do we consider the impact of what the physician Gabor Maté calls “small-t trauma”.

Compared to how we generally think of trauma, “small-t” experiences are common, but still hurtful. They aren’t limited to just physical traumas: a professor may make harsh comments about a student’s work in their class, or someone may be subjected to online bullying and abuse.

Small traumas don’t always mean that something bad is happening to a person; they can equally mean that something good isn’t happening, such as emotional needs not being met, or children and adolescents feeling unseen for who they truly are.

These traumas, big and small, eventually accumulate. In a culture like Tunisia’s, where mental health awareness is lacking and still stigmatized, it leads people to bury their feelings, preferring instead to put on a front of strength, happiness and/or indifference. Yet this approach never works, and the emotional debt soon becomes unbearable.

We see this when our friends and family seem more tired and worn out than usual. We see this in public when arguments and fights break out over what seems to be something relatively petty. When one tries to repress their feelings, when one doesn’t know how to manage how they feel, particularly when there are disagreements and conflicts, their feelings manifest in the form of burnout or by attacking others.

In a recent article from the website Raseef22, the psychologist Abdul Baset al-Faqih and sociologist Latifa Tajouri spoke of Tunisia’s issues being societal, noting that Tunisian culture lacks awareness regarding mental health and still stigmatizes those who speak about their struggles. When “normal” means trying to ignore your emotions, when it means not being able to be your full self, is it any wonder Tunisians are so unhappy?

Yet what is “normal” in a culture can change. As Maté explains in his book, The Myth of Normal, what is “normal” isn’t always what’s good for people, but what is expected of them, the attitudes and beliefs that maintain the larger culture, while anything else is seen as “abnormal”. It’s intimidating for a single person to be open or want to change when all of their peers behave similarly and there is no frame of reference for what “different and successful” is.

Shifting how we think and talk about mental health doesn’t require any radical changes, only that we look at what’s in front of us with new eyes. We don’t need to make any big gestures; often, it is the smallest acts that aggregate to something far greater.

The most important act we can start to practice is self-acceptance: we accept ourselves as we currently are and give ourselves permission to be vulnerable and feel our emotions without trying to ignore them. Acceptance is a crucial condition for change to happen and gives us the freedom to begin processing our feelings and traumas instead of repressing them.

As we come to accept ourselves, we extend this acceptance to everyone around us, an invitation to let others know that we will appreciate them unconditionally. Feeling seen, feeling accepted and “known” by one’s family and peers is the first part of emotional healing. It is often daunting and uncomfortable, especially in a culture where mental health awareness and treatment is low, but the discomfort of emotional vulnerability and acceptance still far outweighs the continued costs of ignorance.

Though there is still a lot of work to be done, there are encouraging signs of improvement. During my trip to Tunisia this summer, someone close to me opened up about an underwhelming exam score she recently received, having studied for so many hours in preparation. She first tried to downplay the result and how she felt, laughing it off with a “Whatever”, but then admitted that “she was going to be disappointed for a while”, adding that “sometimes you just need to let yourself feel sad”. Though she may not have realized it, this brief conversation spoke volumes about her mentality: it signaled an acceptance of her feelings of sadness and disappointment, and a willingness to sit with those emotions rather than try to suppress them.

It is this type of thinking that helps one develop and heal emotionally, and there is no doubt in my mind that she will become a mentally healthier and more resilient person after allowing herself to accept the disappointment of her score.

There is no ignoring the harsh realities facing Tunisians; concerns about the government or the cost of living cause justifiable stress and anxiety. But we are doing ourselves no favors when we deny our own, and others’, emotions and experiences. Change is a long, frustrating process, even more so when we want that change to happen on a broader cultural level, but the benefits of addressing our mental health will help us build towards a stronger and happier Tunisia.


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Wassim Elhouar

Wassim Elhouar is a PhD student studying Industrial/Organizational Psychology at Montclair State University. He is of Tunisian and Palestinian heritage. Outside of his studies, he enjoys distance running, reading and music

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